The differences between therapy and counselling (and why ACT can work in both settings)

From a client perspective, the terms “therapist” and “counsellor” are often used interchangeably, which can sometimes lead to confusion. While both roles involve supporting individuals in improving their mental health and emotional wellbeing, there are distinctions in their focus, training, and scope of practice. Understanding and explaining these differences can help ensure that our clients receive the most appropriate support for their needs.

Counsellors: providing guidance and emotional support

A counsellor typically works with clients to address specific issues or life challenges, such as relationship difficulties, grief, stress, or low mood. Counselling tends to focus on the present and is often solution-focused, aiming to help clients develop coping strategies and make practical changes in their lives.

Counsellors are often employed in schools, workplaces, charities, and private practice. For example, a school counsellor might help students manage exam stress, while a workplace counsellor might support employees dealing with burnout.

Therapists: deeper exploration and treatment

The term “therapist” is broader and can encompass various professionals, including psychotherapists, clinical psychologists, and other mental health practitioners. Therapy often involves a deeper exploration of an individual’s past, patterns of behaviour, and underlying mental health concerns. Therapy is often longer-term, addressing not just immediate concerns but also underlying issues that contribute to emotional distress or unhelpful patterns of behaviour. Therapists often have advanced training in specific therapeutic modalities, such as acceptance and commitment therapy (ACT), cognitive-behavioural therapy (CBT), or psychodynamic therapy. This training equips them to work with a wider range of complex mental health conditions, such as trauma, personality disorders, or chronic depression.

The primary distinction between counselling and therapy generally lies in their scope and depth. Counselling often focuses on immediate challenges and practical strategies. It uses ACT as a tool to guide clients towards specific goals within a relatively short time frame. Therapy, on the other hand, allows for a more comprehensive exploration of the client’s inner world, past experiences, and long-term patterns.

Here we’ve used a few examples to illustrate the differences in the approaches and also how ACT can be utilised in both counselling and therapeutic roles.

Example 1: A client suffering from career dissatisfaction and low self-esteem

In counselling, the focus would be more on immediate clarity and practical movement:

• Clarifying current values and goals: Help the client name what matters most right now in their work life (e.g., creativity, contribution, growth).
• Using simple defusion strategies: Introduce quick tools such as saying “I’m having the thought that…” or brief mindfulness to reduce the power of self-critical thoughts.
• Identifying workable next steps: Support the client to brainstorm and commit to concrete, short-term actions that reflect their values (e.g., signing up for a class, updating a CV, seeking mentoring).
• Building small wins: Focus on achievable actions to create momentum and confidence, rather than trying to resolve long-standing self-esteem issues.
• Present-focused support: Keep the work centred on what is happening now and how the client can respond, without deep exploration of historical causes.
• Shorter-term, solution-focused structure: Sessions may be time-limited and goal-oriented, helping the client make immediate progress while feeling supported and understood.

In therapy, the treatment would likely involve a deeper exploration of the issue. The therapist might use ACT not only to address the client’s present struggles but also to examine underlying patterns and historical influences contributing to their feelings of inadequacy. For example:

• Exploring the origins of self-critical thoughts: The therapist might explore the client’s past experiences, such as critical feedback from authority figures or early life experiences that shaped their self-view. Understanding these patterns can provide the client with greater insight into why these thoughts persist.
• Self-as-context work: Therapy may involve more time spent on exploring the self-as-context process, helping the client develop a more stable sense of self that is separate from their thoughts and feelings. This could include exercises that encourage a sense of self as an observer, allowing the client to see their self-critical narratives as fleeting mental events rather than core truths.
• Long-term values exploration: While counselling might focus on immediate, actionable steps (e.g., enrolling in a class), therapy could involve a more in-depth exploration of the client’s long-term career goals and life aspirations. The therapist might guide the client in considering how their life choices align with their values and help them navigate potential barriers to pursuing a more fulfilling career.

In therapy, the focus extends beyond practical solutions to include a more profound shift in how the client relates to their self-esteem and career dissatisfaction, enabling them to break free from deeply ingrained patterns over time.

Example 2: A client dealing with grief and loss

Grief counselling tends to be shorter term and more focused on helping the client cope day to day and begin moving forward, without going as deeply into long-standing patterns or existential themes. For example, a counsellor might:

• Create space for the immediate pain: Offer compassionate listening and validation of the client’s sadness, shock, and confusion, helping them feel supported and less alone in the early stages of loss.
• Support emotional expression in manageable ways: Encourage talking about memories, journaling, or sharing stories about the person who died, while keeping the focus on coping in the present.
• Normalise grief reactions: Help the client understand that emotions such as sadness, numbness, or even moments of relief are common and not signs of “grieving wrong.”
• Use ACT acceptance strategies for daily distress: Teach simple tools to stay with painful feelings (e.g., mindful breathing, noticing waves of emotion) without pushing them away or getting stuck.
• Clarify near-term values and actions: Explore what matters most now — for instance, connection with friends or maintaining routines — and support the client in taking small, meaningful steps forward.
• Reinforce practical coping: Address sleep, self-care, and daily structure, helping the client maintain stability while grieving.

This approach provides compassionate support and actionable coping strategies to help the person adjust and keep functioning, while leaving more in-depth exploration of identity, long-term meaning, and deep self-compassion work to therapy.

Grief therapy may take a more expansive and exploratory approach, addressing not only the immediate sorrow but also the broader emotional, relational, and existential challenges that accompany loss. For instance:

• Processing the grief experience: A therapist might spend more time helping the client explore the full depth of their emotions, including anger, guilt, or unresolved feelings towards the loved one. ACT’s acceptance component would still play a central role, but therapy would allow for a more comprehensive unpacking of these emotions.
• Exploring identity shifts: Loss often leads to significant changes in how individuals see themselves. Therapy might focus on helping the client navigate these identity shifts, such as adapting to life without their loved one or redefining their role in family or social contexts. For example, a widow may struggle with no longer identifying as part of a couple.
• Self-compassion work: While counselling might focus on taking values-based steps forward, therapy might include additional work on building self-compassion, particularly if the client is experiencing guilt or self-blame related to the loss. Exercises such as writing self-compassionate letters or practising kindness towards oneself could be integrated into the work.
• Values exploration beyond the immediate loss: Therapy might involve a broader examination of how the loss impacts the client’s overall sense of meaning and purpose. For instance, the therapist could help the client reflect on how their values might evolve in light of the loss and consider how they wish to move forward in broader areas of their life.

Therapy provides the time and space for a more nuanced and in-depth exploration of the grieving process, allowing the client to work through complex emotions and existential questions while still being guided by ACT’s core principles.

In both contexts, ACT’s processes (acceptance, cognitive defusion, mindfulness, values, and committed action) remain central. However, therapy may involve greater emphasis on self-as-context work, deeper values exploration, and resolving historical influences on present struggles.

Ultimately, whether a client benefit more from counselling or therapy depends on the nature and complexity of their concerns. Both approaches, when grounded in ACT, can provide a powerful framework for acceptance, psychological flexibility, and meaningful change. In the end, whether a client chooses a counsellor or a therapist, the most important factor is the quality of the therapeutic relationship. Feeling understood, supported, and safe is key to making progress, regardless of the professional’s title.

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