In an article entitled “Master’s therapy not that different” in the Jan/Feb 2018 edition, Larry Powitz, Ed.D., asks what is it that doctoral level mental health practitioners do different than non-doctoral level mental health practitioners, such as master level psychologists, LCSWs, LCPCs, MFTs, and he concludes that the psychotherapy by all provided is quite the same. “I say the M.A. can sing the same tune as the Ph.D.,” concludes Dr. Powitz.
I agree with him. I believe that the intervention being provided by many doctoral level (Ph.D., Psy.D., and M.D.) and non-doctoral level (M.Ed., M.A., M.S., MSW, LPCC, M.Div., EAP) mental health practitioners is quite the same. For me the important questions are “How is that?” “What’s happening?”
Psychotherapy is on the decline, and counseling is growing. The word psychotherapy isn’t even used much anymore. Or the terms psychotherapy and counseling are used interchangeably, as though they are one and the same, but they aren’t.
Psychotherapy and counseling are two different disciplines. Psychotherapy is an in-depth, sometimes long-term, project that addresses inner and often covert core issues. It’s meant to get at and affect the understructure of a person. Carl Jung called psychotherapy treatment of the soul, which for me implies depth. Counseling addresses important but external overt behaviors, usually for brief duration, teaching and improving areas of outward functioning.
Psychotherapy is about personal growth, and the relationship between psychotherapist and patient is critical. Counseling is about life management and adjustment, and the relationship between counselor and client is quite secondary.
For example, there is counseling for career and finances and anger management and sexual issues and grief and psychotropic usage. There is no career or financial or grief etc. psychotherapy, because psychotherapy isn’t directly about such issues; it’s about the person underlying those issues. Psychotherapy is a life changing experience, while counseling is guidance, support and education.
Homework isn’t typical in psychotherapy, other than encouragement to reflect on one’s experience during the session, whereas homework assignments are frequent in counseling, often with time spent in sessions reviewing and discussing lessons, similar to what happens in a classroom. Psychotherapy is heavily feeling and experience oriented, whereas counseling is heavily cognitive and behavioral focused. In traditional language, psychotherapy is a primary process activity and counseling is very much a secondary process activity.
Though psychotherapy and counseling are two distinct disciplines, there has been over the decades a homogenization of the two. For many, the two have become one, in thinking and in practice. Counseling now includes some psychotherapy, and psychotherapy includes more counseling. The homogenization has blended and even equated two different tunes into a new third tune.
I think it’s been a loss for psychotherapy. It’s like blending and equating physical therapy and surgery. Physical therapy is valuable and exactly what some people need, but it’s not surgery. Counseling is valuable and exactly what some people need, but it’s not psychotherapy. Today psychotherapy in its fullest sense is hard to find, and most mental health providers, doctoral level and non-doctoral level, are providing a service that is quite the same. Most are singing the same tune, the homogenized third tune.
David S. Doane, Ph.D., has been a psychologist in private practice for more than 40 years, currently in Perrysburg, Ohio. His special interests are systems, experiential and Gestalt psychotherapy. He may be reached by email at: firstname.lastname@example.org.