Therapy vs. Counseling: What are the Key Differences?

The umbrella of mental health services encompasses a wide range of methods and specializations, as well as both short-term and long-term care. Many people use the terms "therapy" and "counseling" interchangeably, but they are separate areas. It can be confusing to parse the finer details that differentiate one expert from another.

Both therapy and counseling are popular options for support, with a 2022 Gallup poll showing nearly a quarter of Americans had visited a mental health professional in the last 12 months.¹ This rate has been increasing steadily over the last 50 years, creating a significant demand for highly trained therapists and counselors.²

This article will explore the key differences between therapy and counseling.

Defining Therapy and Counseling

Therapy, sometimes referred to as talk therapy or psychotherapy, addresses ongoing issues, such as mental health disorders, trauma or deep emotional work. Common goals include improving a patient’s quality of life or providing relief from symptoms of mental illnesses.³

Counseling, on the other hand, offers guidance and problem-solving support in specific situations, including life transitions, bereavement and marriage or family troubles.³

There is some overlap in these roles, and "therapy" and "counseling" are colloquially and interchangeably used for many mental health services.

Historical Context

Our modern conception of therapy is deeply rooted in psychology and psychiatry, fields that date back to the 1800s. Many early practitioners of what we now call psychiatry—such as Sigmund Freud and Carl Jung—paved the way for different modern modalities, including psychotherapy and cognitive-behavioral therapy.⁴

Counseling is historically intertwined with social work and community guidance; counselors originally served as mediators and peacemakers.⁵ Social workers and counselors differ from psychologists in their holistic approach to their clients’ lives.

Both fields have evolved to overlap in some spaces, with many specialists collaborating.

Scope of Practice

Therapists may call upon a range of practices:⁶

• Dialectical Behavior Therapy (DBT): A type of therapy designed for patients who are struggling with extreme emotions, which helps them recognize, accept and process those feelings⁷
• Cognitive Behavioral Therapy (CBT): A form of talk therapy focused on recognizing and changing thinking patterns that have harmful effects⁸
• Eye Movement Desensitization and Reprocessing (EMDR) therapy: A practice of guiding specific eye movements while focusing on individual memories in order to process traumatic events⁹

Counselors often specialize in one area such as substance abuse, marriage or grief. While they may use psychotherapy, their focus tends to be on solution-based support. This can entail creating a goal or vision for what the patient's life will be like after solving this problem, and then working through their life experience to identify the traits or qualities they will call upon.¹⁰

Training and Qualifications

In the US, therapists first pursue a bachelor’s degree, which may or may not be in a health-related field, followed by a master’s degree in psychology. Some also seek a PhD or a PsyD before they participate in clinical training in their chosen specialization. A PhD program focuses on research and academics, whereas a PsyD program has a stronger emphasis on clinical practice. Therapists must also complete licensure and accreditation, which will vary based on the type and location of their practice. Two major accrediting agencies are the Council for Accreditation of Counseling and Related Educational Programs and the American Psychological Association Commission on Accreditation, but there are also additional organizations with narrower focuses.

Counselors must also have at least a bachelor’s degree to practice, but they may have more options if they pursue a master’s degree, such as a master’s in psychology, a master’s in social work (MSW) or a master’s in counseling. After completing their degree program, they complete supervised training to gain experience. Then, depending on their state, they will take either the National Counseling Examination or the National Clinical Mental Health Counseling Examination.¹¹

When considering therapy or counseling, determine which specializations are most appealing to you. From behavioral disorders and substance abuse to school counseling and even providing counseling for therapists, there is a wide array of options.

Settings and Delivery

Therapists typically work in formal healthcare settings such as hospitals, mental health clinics or private practice. They may receive patients through referrals from other healthcare providers. Until recently, most therapy sessions were undertaken in person, but more providers have begun to offer online options for those who either can’t or prefer not to come to a physical location.¹²

Counselors may work in a wider variety of places in the community, such as schools, community centers or employee assistance programs. Often, their outreach is part of more holistic offerings alongside other providers. Again, for those who do not wish to attend sessions in public, online meetings are readily available.

Key Differences and Similarities

The key differences between therapy and counseling center around the duration and depth of the issues they address, with therapists providing focused long-term care and counselors offering short-term problem-solving strategies for full-being wellness.

Both counseling and therapy require emotionally intelligent practitioners who specialize in client-centered care. Therapists and counselors share the core goal of well-being for their clients and their communities, which they achieve through the use of therapeutic techniques.

As previously noted, the terms "counselor" and "therapist" are often used interchangeably to mean a mental health professional, and in most cases, this is fine. However, if you’re working toward pursuing one of these professions, the distinction is an important one.

Foster Healing and Help Improve Lives

Counselors and therapists are critically important to their communities, and individuals in need should never hesitate to reach out for professional help. If you or someone you know is in need of support, search the Psychologist Locator on the American Psychological Association’s website,¹³ or the provider directory at the American Counseling Association.¹⁴

Counseling is a deeply rewarding career field, offering tangible opportunities to improve lives and reduce harm. The Yeshiva University online MSW program is fully accredited by the Council on Social Work Education, and its comprehensive curriculum provides specialized training through small class sizes and dedicated faculty.

Explore our career center to learn more about the graduates of Wurzweiler School of Social Work graduates. If you are ready to explore the possibilities of a career in social work, review the admissions requirements, and then schedule an appointment with an admissions outreach advisor.