It is not easy to define “clinical counselling”, as there is no consensus on what it means and how it is different from counselling in general. When searching for definitions, references to the setting of the services are found, but there are no clear descriptions on the nature of the services. I will do an attempt to describe both.

The setting is either an office within an agency or in private practice where counselling therapists work directly with clients. Many counsellors have added remote modalities to their practice and use videoconferencing, phone, or email as flexible options in addition to in-person (in-office) counselling.  

The nature of clinical counselling, also referred to as clinical therapy or psychotherapy, is a professional and therapeutic process consisting of assessment, evaluation, and treatment of individuals seeking assistance from trained mental health professionals to address emotional, psychological, and behavioural concerns.

The foundation of counselling is based on a strong counsellor-client relationship based on trust and includes listening, asking open questions, showing empathy and acknowledgment and validation of clients’ feelings and experiences.

The adjective therapeutic refers to the treatment, which can be formal, including psychotherapeutic approaches or a description of the subjective experience of those receiving the service.

Although all mental health services offered by counsellors, clinical counsellors, and psychotherapists are built on the foundation of a solid respectful therapeutic relationship, clinical counsellors include assessment, treatment planning, and monitoring of client progress into their practice. Clinical counsellors are familiar with the current version of the Diagnostic and Statistical Manual of Mental Disorders (DSM) and are capable in offering services to clients who meet one or more DSM diagnoses. Further, clinical counsellors are responsible for the use of therapeutic approaches that are research based (evidence-based practice) and that have been found helpful to many clients.

Most counselling therapists have received education in the theory and practice of the major approaches to psychotherapy: Humanistic/Person-Centered, Psychodynamic/Process Orientated, Behavioural, Cognitive and Cognitive Behavioural, Systemic, Expressive, and Integrative/Eclectic approaches, but differ in the approaches they implement in their practice.

Counselling and psychotherapy are often used interchangeably and there are many similarities, although those who state that they practice psychotherapy share all characteristics with clinical counsellors but are often more loyal to one or more of the theoretical approaches listed above and have a deepened level of knowledge of the diverse theories on the origins of mental health symptoms.

Elisabeth Scheepers, Ph.D.