There are overlaps between each form of therapy. It can be difficult to distinguish between Counselling, Psychotherapy and Psychoanalysis and the many trainings and levels of qualification allowing safe and good practise. There is no statutory protection of these professional titles and it may therefore be necessary to ensure that practitioners do have relevant serious qualifications for the therapies offered.
Counselling is usually one a week for short term interventions. It provides a space for thinking about emotional difficulties and there is more focus on the present and difficulties on everyday life. Psychodynamic counselling is helpful for difficulties that are not deep seated and can be resolved with shorter term sessions. There are a wide range of psychodynamic counselling trainings, some requiring specific thorough training and personal experience.
CBT is a form of counselling which works with clients to develop alternative ways of managing emotions and behaviours through a focus on strategies of coping, rather than a relational or exploratory approach and is helpful for specific issues or behavioural, rather than relationship difficulties. The meaning of symptoms or internal work is not usually considered as helpful; with an anxiety state for instance managed by distraction or exercise. CBT therapists usually not have engaged in any personal counselling or therapy. Fully trained CBT therapists may have had extensive training, while current NHS psychological services increasingly offer telephone or brief counselling with therapist or well being workers with very limited training who may call themselves CBT trained, or 'CBT'. CBT therapists are not trained in understanding and working with long term therapeutic relationships and practitioners who find themselves offering longer term interventions have often moved away from CBT practise but are not fully trained in a further level of understanding.
Psychologists have worked to a doctoral level in human behaviour, often having initial training in a range of behavioural and integrative therapies, but will require specific further training in psychotherapy to offer psychoanalytic or in-depth work. Their role is often of assessment in diagnostic medical terms, with short term eclectic treatment. Many psychologists, medical doctors, and social workers have gone on to undertake full psychoanalytic training.
Psychotherapy is twice to three times a week sessions and usually open ended. This is helpful for long term and more complex difficulties that can be explored with the therapist through the emerge of difficulties in a live way within the therapeutic relationship. It requires a longer term training than counselling and CBT including personal therapy of at least three times a week and there is more focus on linking past and present experiences, with deeper exploration of unconscious factors behind emotional difficulties. The main training for psychoanalytic psychotherapy in the North is the North of England Association of Psychoanalytic Psychotherapy training (NEAPP). Registered and accredited psychotherapists will be registered with the British Psychoanalytic Council
Psychoanalysis is four to five times a week open ended sessions. It provides the most intensive form of treatment helpful for complex difficulties and a full unfolding and development of an analysand's understanding of their self. It can enable depth of understanding and the possibility of more far reaching change, with the intensity of the sessions allowing a very secure basis which allows deeper issues and difficulties to emerge and be understood within the relationship with the psychoanalyst. The intensity of the training and work as a psychoanalyst is held within a secure setting which allows detailed attention to inner life and unconscious representation, allowing deepening self understanding and consequent change. Becoming a psychoanalyst requires further intensive training and personal psychoanalysis usually over many years, and psychoanalysts will usually be engaged in a full creative life of study and learning as well as forms of teaching through their careers. The main training for psychoanalysts in the UK through the Institute of Psychoanalysis, which leads to qualification and membership of the British Psychoanalytical Society.
The title psychoanalyst is not protected,
and counsellors can describe their work as psychoanalysis, although this will be a very different experience from seeing a
psychoanalyst. A register of psychoanalysts can be found on the website of the Institute of Psychoanalysis
Consultation and Supervision:
In addition to full psychoanalytic
treatment, consultation includes:
- Supervision to psychotherapists and mental health professionals.
- Initial consultation including a discussion of appropriate treament
- Referral advice or recommendation where psychoanalysis or psychoanalytic psychotherapy is not appropriate