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There has been considerable professional debate, in the United States and elsewhere, regarding the precise nature ofthe functions and roles fulfilled by counselors, therapists, psychotherapists, and others who provide mental health services. Professionals using different names, such as counseling psychologist, counselor, and therapist, are viewed quite differently by the lay public. Much of the confusion centers on who provides what services, in what contexts, and to what end or goal.

A common differentiation is that counselors concern themselves more with normative stresses, adjustment difficulties, and life transitions, whereas therapists focus primarily on mental illnesses and psychological disorders. A more comprehensive view recognizes the extensive overlap in the work ofthe professionals using these designations, while, at the same time, acknowledging differences in the relative emphasis they afford to some issues. Increased clarity in this regard can facilitate an enhanced sense of professional identity for mental health practitioners and greater awareness among consumers of mental health services.

Similarities and Differences

A crucial question underlying this issue is whether the type of work performed by the various helping professionals (e.g., counselors, therapists, and clinical social workers) is essentially the same, or whether each “camp” has a unique contribution to offer when assisting clients with their problems. There have been many attempts, at times highly politicized and market driven, to articulate the services provided by the various mental health professions. These attempts have escalated, as the historical progression of these specialties has proceeded and as these groups have sought to professionalize their services. Thus, whereas some impart a distinct meaning to the term counseling or therapy, others use the two terms more or less interchangeably.

The basic roles and functions of helping are by no means new phenomena. The desire to help others with their personal and emotional problems has a long history that can be traced to ancient western and non-western civilizations and that entails the use of very diverse methods. As noted by Colin Feltham, some of counseling's “cousins” include advising and influencing; friendship; co-counseling; teaching and coaching; consciousness-raising; self-analysis and self-help; psychotherapy; the application of basic helping skills by social and welfare workers, probation officers, nurses, and occupational therapists; and other charismatic and fortuitous encounters (e.g., religious conversion) that may lead to healing or change. However, the more formalized or stylized practices of modern counselors and therapists have developed separately and under different sets of influences that initially shaped their functions in somewhat divergent ways.

Perspectives Emphasizing the Distinctiveness of Counselors and Therapists

Use of the term therapist (or psychotherapist) to denote a helping relationship in the form of a “talking therapy” can be traced largely to the work of Sigmund Freud and his pioneering of psychoanalysis around the dawning of the 20th century. Thus, therapists preceded counselors in the establishment of a professional identity and came to enjoy some recognition and status among the medical establishment of psychiatry. Counseling, in contrast, is a more recent label first applied to professional helping activity in the early 1900s by Frank Parsons who used it to characterize his vocational guidance movement. Then, in the 1930s and ‘40s, Carl Rogers popularized the term when he sought to promote his person-centered helping techniques and to circumvent restrictions reserving the term psychotherapist for psychiatrists.

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