Whilst there are some similarities between counselling and psychotherapy, they are in fact very different disciplines, with very different aims and significant differences in the extent of training and experience required to practice.
Broadly speaking, “counselling” describes a way of listening and talking to a person in distress, with the aim of helping them feel relieved of their difficulty by sharing it with an empathetic and attentive person. People come to counselling training from a variety of backgrounds, and training can take anywhere between a few weeks to a number of years, depending on the training institution. Counselling is most suited to relatively minor difficulties, where a person is clear about the difficulty which they would like to address, for example a bereavement, or low mood.
Psychotherapy is a clinical treatment for mental illness, and psychotherapists will usually have a background in psychology, medicine or another related discipline before embarking on further specialisation in psychotherapy. Child psychotherapists, as recognised by the ACP¹, have completed extensive training in developmental psychology (the study of the development of a child’s mind), before embarking on a four year, doctoral level training, funded by the NHS. Child psychotherapists treat patients form 0-25, and over the course of their training will have integrated findings from attachment research, developmental neuroscience and other related disciplines into their clinical practice.
A child psychotherapy approach is particularly useful when difficulties are complex and/or chronic, or where a family or young person feel a more in depth approach is needed.
 The Association of Child Psychotherapists, a national accrediting body and member organisation of the Professional Standards Authority
For many parents it can be very difficult to differentiate between the normal ups and downs of a child’s development, and the early signs of an emerging mental health difficulty. Many of the parents we see are seeking clarity on exactly this point, and have reached the conclusion that a professional perspective is needed.
A parent may have noticed a change in their child’s mood or behaviour, or feel that their child is not developing in line with their peers. Their child may seem to be trying to develop too quickly, or the opposite – may seem to be thinking and behaving in ways more typical of their earlier childhood. Many of these changes and ways of being can be accounted for within the normal ups and downs of development, however for some children these issues may be indicative of an underlying emotional difficulty.
At The Anchor Practice we can help you to think about what might be helpful for your child’s development, and whether or not therapeutic input might be useful.
We offer various evidence-based treatments for a wide variety of difficulties, and treatment length can vary significantly. Many families feel sufficiently helped by a brief episode of work, lasting approximately six sessions. Typically, therapy for a younger child presenting with moderate difficulties would consist of around 20 sessions, though this could be longer depending on complexity.
For adolescents and young adults, treatment tends to be longer, depending on circumstances.
Many of our patients seek open ended therapy, which is reviewed at regular intervals, to allow for the freedom to get to grips with problems which may have persisted for some time. Furthermore, many of our patients continue in therapy after their symptoms have reduced, as they feel that the supportive space offered by therapy becomes helpful and worthwhile in its own right.
Length of treatment will always be discussed and agreed at the outset of therapy, and our clinicians will aim to provide a treatment that is practically sustainable, thorough, and in accordance with the current evidence base.
In child psychotherapy, at the start of treatment a child will be given a box containing toys, art materials and other items, which will be theirs to use in each subsequent session. The box will remain in the treatment room, but will not be used by any other children – it is theirs for the duration of their therapy.
During sessions children are invited to play, draw, and paint. The games that the child plays, and the themes that their drawings and paintings express offer the trained therapist an insight into the child’s preoccupations. It is the task of the therapist to help the child understand these preoccupations, and by acting out, and ultimately verbalising these difficulties, a child can feel less under the sway of more volatile feelings.
For adolescents/young adults
Sessions will be held at the same time, every week. You will be invited to speak about whatever is on your mind, and the task of the therapist will be to help you make sense of confusing or distressing thoughts or behaviours. Over the course of therapy, you may find strong feelings emerge, and these can be discussed in the room, with regard to the way that they link to the problem under examination. Often during therapy, people become aware of thoughts and feelings linked to a problem like depression or anxiety, but are unclear as to the nature of this link. It is the task of the therapist to help a patient understand the way in which these feelings, which may be outside of conscious awareness, impact them in their day to day lives.
Many different approaches are available for the treatment of mental distress in children, adolescents and adults, and psychoanalytic psychotherapy is one of these modalities. Some therapies, like CBT focus on a symptom (like anxiety), and aim to resolve this by modifying behaviour, such that one's thinking changes accordingly, and felt anxiety is diminished. Sessions are clearly structured, and patients will often be asked to complete homework about their mental states, or keep diaries of their thought patterns. This can be very helpful, particularly with discrete anxieties, phobias and other difficulties which are relatively localised.
Psychoanalytic psychotherapy utilises a broader understanding of the mind. A psychoanalytic psychotherapist will understand a symptom like anxiety or depression to be a feature of a person’s inner, mental life that expresses an unresolved conflict. People often suggest when coming to therapy that they have always felt something was not quite right, and that they require help in understanding what this might be. For this reason psychoanalytic psychotherapy can often be helpful when other approaches have been tried but a difficulty remains, or when someone is more interested in an exploratory approach, that is not directed, but allows a person to begin to understand themselves in a more authentic way.