The terms `counselling’ and `psychotherapy’ are often employed in a loosely interchangeable way, especially in Australia. Where distinctions are made, there has been little agreement on what each term should cover. This article examines several axes on which `counselling’ might potentially be distinguished from `psychotherapy’; the most promising basis for such a distinction seems to be whether or not the mode of work attempts to access the unconscious.
On this basis, several modalities currently termed `therapy’ would in fact be classed as types of `counselling’, including those modalities of family therapy which aim to engage clients at the level of conscious behaviour change and restructuring. Consideration of how new professionals are trained lends support to a continuum, with short-term, problem-focused conscious-oriented approaches at one end, and longer-term, transference-focused, unconscious-oriented approaches at the other, the dividing line coming at the point where trainees learn the skill of `immediacy’.
to feel uncomfortable making. My university offered two programs: a shorter Master of Education award in `Counselling’, and a longer Master of Arts award in Counselling Psychology, aiming to train `psychologists’ for clinical positions in Community Mental Health, where they would often be doing `psychotherapy’. Everyone seemed to know what the difference between `counselling’ and `psychotherapy’ was, although exactly what it consisted in was rarely addressed. An introductory course called `The Roles of Counsellor and Therapist’ set Impact and Change: A Study of Counseling Relationships (Kell and Mueller, 1966).
The `counselling’ in this book seemed to have a lot to do with transference (though that term was not employed) and stressed the counsellor’s `use of the counsellor^client relationship’öthings that had rarely been mentioned in my Australian training in `counselling’. On the other hand, Family Therapy, my chosen specialty and enthusiasm back then, was `therapy’, despite the fact that most family therapists at the time rejected the whole idea of transference (for an exception, see Box, 1998), gave their clients straightforward behavioural homework and checked to see if they did it.
How was this different from the `educational’ approaches in which my friends enrolled in the M.Ed. program were being trained? I did not fully sort out these things during my two years in the US. I returned in 1981 to an Australia still largely committed to `counselling’, only to see it adopt the term `therapy’ with remarkable speed over the next decade (the insistence of family therapists on calling themselves that, rather than `family counsellors’, no doubt being a contributing factor).
Clearly, `psychotherapy’ is now regarded within the profession (and increasingly will be regarded outside it) as the more prestigious term: but what makes it so? A status distinction has arisen without any corresponding thinking-through of the content of that distinction.