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Types of Talking Therapy Explained: CBT, Counselling & Psychotherapy

  • Writer: Martin Middleton
    Martin Middleton
  • Jan 20
  • 6 min read

Updated: Apr 2


You’ve made the decision to seek help and sit down, open Google, and search for a "therapist in Hinkley" or "help with anxiety near me'. Suddenly, you are hit with a wall of acronyms: CBT, DBT, EMDR, ACT and a list of job titles that seem to mean slightly different things depending on who you ask.


One of the most common sources of confusion is the job titles themselves. What is the difference between a Counsellor and a Psychotherapist?


A helpful way to think about it is the old rule of logic:



All Counsellors are technically Psychotherapists, but not all Psychotherapists are Counsellors. Psychotherapy is the umbrella term for the activity of treating mental health through talking. Therefore, anyone practising talking therapy is doing psychotherapy.


The terms Counsellor and Psychotherapist are not protected terms in the UK and can often be used interchangeably. There has been a push by some to clearly define a difference, but there has been as much resistance as there has been support, and a lot of disagreement. People are very protective of their labels and job titles.


The first use of the term psychotherapy was by Daniel Hack Tuke (1872) in his work, “Illustrations of the Influence of the Mind upon the Body in Health and Disease,” and was used in reference to hypnosis.


Over time, the term then expanded, evolved and was adopted by other talking therapies as they have emerged in the last 150 years. Under the umbrella of Psychotherapy, there is now a vast array of different approaches, modalities and 3-letter acronyms. See this guide provided by the NCIP for some of them. 


The labels in this case are more likely to be more important to the therapist than you as the client. Once you are in the room, these titles often matter less than the way the therapist works and, most importantly, how you get along with them.



Two Approaches: Structured or Exploratory?


If you strip away the confusing acronyms—CBT, DBT, PCT, EMDR—most talking therapies fall on a simple spectrum based on one question: who's holding the structure of the session?


Think of it as the difference between a Guide and a Mirror.


A Guide brings frameworks and tools — they've read the map before, they know where the paths are. A Mirror creates the conditions for you to see yourself clearly — they're not pointing anywhere; they're reflecting.


They suit different people in different situations. Understanding where your preference might be will help you pick the right fit.


Structured Collaboration: The "Guide" Approach (CBT & Hypnotherapy)


In structured therapies like CBT and Hypnotherapy, you bring expertise about your own life — your history, your patterns, what you want to change. The therapist brings frameworks for understanding how those patterns work and techniques for shifting them.


It is not giving you advice or telling you what to do but getting you to a place when you feel able to “be you” in the face of distress, stress or anxiety. If you present a problem to the therapist, they might give you a structured set of questions to answer to explore all the possible solutions, the positives and negatives, so you can pick the best option for you. This then might lead to discussing the implications of that decision and strategies to cope while "in" the situation - for instance, a guided relaxation or imagery exercise to reduce the intensity of your fight or flight response.


Exploratory Listening: The "Mirror" Approach (Person-Centred Counselling)


At the other end of the spectrum are the exploratory, non-directive therapies. These are built on a different belief: that you already have the capacity for insight and change — what you need is the right conditions to access it. They're there to create a space — genuinely non-judgmental, unhurried — where you can say things out loud, possibly for the first time, which can help you become deeply self-aware about who and how you are and the ways you might want to change (or not - it could just be acceptance of yourself).



The Middle Ground: Integrative Therapy 


It is worth noting that many modern therapists identify as "Integrative." and work across both approaches, moving along the spectrum depending on what you bring to a session. Listening without an agenda while you work through something difficult; shifting to structured problem-solving when you want concrete tools for a specific situation.


Therapy as a Relationship Between People


Research into therapy outcomes has consistently shown the same result for decades. The specific technique a therapist uses is often secondary. The single biggest predictor of whether therapy will work for you is the quality of the relationship between you and your therapist.


This is known as the Therapeutic Alliance.



You can have the most highly qualified professor of psychology in the world, armed with the most cutting-edge techniques. But if they make you feel judged, unsafe, or simply that you "don't click," the therapy is unlikely to be effective.


Conversely, a therapist using a very simple technique who makes you feel deeply heard, safe, and validated can help you achieve positive life changes.


It also means that if therapy isn't working for you, the first question worth asking might be "Is this the right person?"


What to Look For


Most therapists will offer you a free 25-30 consultation. When you make contact pay attention to your gut feeling rather than just their certificates. Ask yourself:


  • Do I feel safe? Can I be vulnerable here without fear of judgment?

  • Do I feel heard? Is this person really listening to me, or are they just waiting to speak?

  • Do I respect them? Do I trust them to hold the weight of what I need to share?


If the answer is "no," it is okay to walk away.


Finding Your Fit


When you're looking for a therapist, two things are worth working out alongside each other:


What kind of support do I want? A Guide — structured, skills-focused, working toward a defined goal? Or a Mirror — exploratory, open-ended, space to think and feel without pressure? Or something that moves between both?


And if the answer to any of these questions is "I'm not sure?" this is worth trying: the Cooper-Norcross Inventory of Preferences (C-NIP) is a short, research-backed questionnaire to help you identify what they actually want from therapy — how much structure, how much emotional depth, whether they want to focus on the past or the present. It takes about 15 minutes and produces a summary for you to use at the end.


Does this person make me feel like I can actually do this? The certificates they hold will tell you they're qualified and experienced - their online presence, recommendations from family and friends, and initial consultation will tell you whether you can work together.


Some practical checks before committing:


  1. Professional Membership: Is the therapist a member of a professional body that has verified their experience and qualifications? They will be listed on a register of members on the body's website, such as this: My Own Listing

  2. Hyperbole: Be wary of anyone making exaggerated claims or guarantees about results. A majority of people do see some improvements with talking therapy, but no therapist can guarantee this for any specific person. See this useful breakdown of an NHS study into outcomes for more information: NHS


If you're looking for a therapist in Leicester, Hinckley or online across the UK, I offer a free 20-minute call to talk through what you're dealing with and whether my approach is likely to be the right fit for you.


You're welcome to ask me directly in that call: "How do you work — structured or exploratory?" My answer, and how I give it, will tell you something useful.


Interested in finding out more about my approach?


I offer CBT, Hypnotherapy and Mindfulness sessions online throughout the UK, and in-person around Leicester, Nuneaton and Hinckley. Early, late and weekend appointments available.


You might also find these useful:Dyslexia and Anxiety or Phobias





Sources & Further Reading

For transparency and further research, the following sources were used to compile this guide:

  • British Association for Counselling and Psychotherapy (BACP): Definitions of terms and the interchangeability of "counselling" and "psychotherapy" in modern practice.

  • Wampold, B. E. (2015): The Great Psychotherapy Debate: The Evidence for What Makes Psychotherapy Work. (Key source for the "Common Factors" theory and the importance of the alliance).

  • Rogers, C. R. (1951): Client-Centered Therapy. (for Non-Directive/Person-Centered approaches).

  • Beck, J. S. (2011): Cognitive Behavior Therapy: Basics and Beyond. (for Directive/CBT approaches).

  • Lambert, M. J. (1992): Psychotherapy Outcome Research. (

    factors contributing to therapy success).

About Martin Middleton


Martin Middleton is a Cognitive Behavioural Hypnotherapist based near Leicester and Hinckley, specialising in anxiety, shame, and confidence building. He combines Cognitive Behavioural Therapy (CBT) and Hypnotherapy, drawing on Donald Meichenbaum's resilience framework, supporting clients in moving from surviving to thriving. Martin offers judgment-free sessions online across the UK and in person.

 
 
 

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