A while ago I saw a trailer for a film called The Counsellor. Apparently the counsellor in question is a hotshot lawyer, smart, ambitious and morally flexible, working for a drug-trafficking cartel. Not much like anyone I know. As we already learned from American TV shows, “counsellor” is an honorary title used in some countries for a courtroom lawyer, meaning, like the Godfather’s “consigliere”, someone who gives advice, or counsel. This meaning persists in other uses of the word: a counsellor can be an officer in the diplomatic service or someone who advises on debt and other problems. The Queen has about 600 Privy Counsellors to advise her, mostly senior politicians. People who sit on other types of council are councillors; known for debate and opinion, as well as advice.
As a psychodynamic counsellor, I worry sometimes that if I don’t fully identify with my job title, neither will the people who come to me for help. However clearly counsellors like me explain that we do not give advice, or offer judgement or opinion, these ideas linger implicitly in the semantics.
Our professional body echoes this confusion. The British Association for Counselling and Psychotherapy (BACP) acknowledges a large overlap between the terms “counsellor” and “psychotherapist” and, in practice, treats the titles as interchangeable. Couldn’t we all be one, or the other? If “counsellor” can be ambiguous, “psychotherapist” is liable to be confused with similar sounding professions. Part of the difficulty may stem from outdated generalizations that counsellors work for shorter periods and at less depth than psychotherapists, or have less training. Currently, the Health & Care Professions Council regulates many other health-related roles like dietician and physiotherapist but anyone can style himself as a counsellor or a psychotherapist, whether trained or not. The BACP is working to assure quality and public confidence through its registration and accreditation schemes but has never sorted out this terminology.
For me, one of the greatest difficulties is that whereas “counselling” derives from a Latin root meaning advice, the origins of “psychotherapy” are in Greek words for healing and the soul. The latter concept is much closer to what I and my colleagues aim for.
So, with all this confusion, what should we call ourselves and does it matter? Anything that sets up uncertainty, or skews expectations, can be a barrier to trust in the all-important relationship we endeavour to establish with our clients. Things being as they are, the safest approach is to be clear about what we do, and what we don’t do.
What we do is to offer a particular form of psychotherapy, which needs to be explained.
What we don’t do is to offer counsel or make life easy for gangsters.