The quick answer is that therapy looks deep and counseling is focused on problem-solving today. You think about counseling or therapy and wonder if you need it, or if it might be beneficial to you. Many people don't know the difference between counseling and therapy. That difference seems small, but it is not. Therapy dives deep into your heart to see who you are and what makes you the way you are. Counseling, on the other hand, takes what is in front of you and looks to help you correct it as you move forward.

Ironically, I'm not sure the licensing terms matter much when you differentiate between counseling and therapy. I know many people with counseling licenses who are adept at diving deep into who you are. I also know therapists who tend to focus more on the here and now and what immediate changes need to be made. The question then becomes something like, "What is true about counseling and therapy?" "What information can you take to the bank about both?"

There are many misconceptions about therapy and counseling. One that you might think of is that asking for help is a sign of weakness or that you are mentally ill. Nothing could be further from the truth. I've written some facts about therapy and counseling that will help you move closer to deciding whether getting help is right for you.

1. Why does everyone need wise counsel?

We all need an objective ear that helps us navigate the difficulties in life. The Bible tells us that we need wise counsel. The book of Proverbs is full of references to that need. Counseling and therapy can be a source of wise counsel.

Proverbs 12:15 (ESV) tells us that a fool is right in his own eyes, but a wise man listens to advice. Proverbs 11:14 (ESV) says that people fail without guidance, but safety is found in an abundance of counselors. My favorite, though, is Proverbs 19:20-21 (ESV): "Listen to advice and accept instruction, that you may gain wisdom in the future. Many are the plans in the mind of a man, but it is the purpose of the Lord that will stand."

I think about my friends who follow Jesus and how important they are to me. They pray with me and for me. I believe that the right counselor or therapist should also be praying for you and with you. People who do not consider themselves Bible believers still need help considering their problems from an objective perspective. Therapists and counselors can do that.

2. Why can't I just talk to my family and friends?

When you talk with family and friends about your conflicts, both internal and external, they are not objective.

There was a time when I was discussing a particularly difficult problem with a friend, and her response was simply, "You know I choose you, right?" She didn't want to tell me that I was being a jerk. Those of us from the south and especially the mountains know who will "help you hide the [proverbial] body."

Your therapist or counselor should hold you accountable for your part in the decisions that you make and the things you do. Otherwise, you never reach that place where you experience true growth and inner peace. You don't like the thought of looking inward and seeing the mess inside, but just as a skilled surgeon uses pain to promote healing, a skilled therapist or counselor can do the same for you.

3. Should I see a therapist or a counselor?

You don't have to discriminate against particular types of providers. You do want to make sure the person from whom you seek therapy or counseling is well-qualified. Frequently, providers are fully booked, and getting an appointment anytime soon can be difficult. Understanding who you should see can help. When you are looking for individual help, you can and should consider almost any licensed psychotherapy provider, whether they are LMFT, LPC, or LCSW. If those letters mean nothing to you, I sorted them out in What Do Those Letters Mean?. Some people may even choose someone who is not fully licensed.

Couples need special consideration, as do children. You want to talk with the provider and make sure they have experience and are comfortable addressing your problem. Sometimes churches will offer couples and individual counseling from a Certified Biblical Counselor, for example, The Biblical Counseling Center at Foothills Church in Maryville, TN https://counselingfc.com.

They specialize in couples counseling and are more experienced than most. They also see people ages thirteen and up. However, if you are looking for a provider for a child, you want to carefully consider experience and training. This is especially true for young children, as they require unique services that necessitate training beyond the school setting. I don't have much experience with children and will refer you to someone with that specialty.

I specialize in individuals who struggle with telling others "no" to such an extreme that they hurt themselves and the people they love. I also specialize in treating trauma or the ongoing pain of a life filled with series after series of unfortunate events. There is wisdom in choosing a well-qualified counselor, therapist, or Certified Biblical Counselor.

4. How do I know if my therapist gives good counsel?

The relationship you have with your provider is an extremely important factor that correlates with success for you as a client (Flückiger et al., 2018).

There are hundreds of documented theories of counseling and therapy. However, no two therapists apply those in the same way or use them in the same way. There are new treatment models developed out of those theories or combinations of those theories emerging all the time. You do need to consider this when making your decision. These theories and treatment models are not always the best predictors that you are getting wise counsel. You need to be very careful to make sure you are comfortable with your provider.

Therapists and counselors are taught that we are one being with our body, our mind, and our social relationships. I believe we also have a spiritual relationship. Providers should address all three of these areas of your life based on licensure expectations. I try to address all four, and I do it with respect for your beliefs. When you look for a counselor or therapist, you want to consider your needs and your beliefs. The sessions can enhance all four if managed properly.

Earlier, I quoted the Bible as encouraging you to seek WISE counsel. You need to consider what you believe to be a good source of wisdom for you. I look at the Bible first for my source of counseling and therapy. Other theories, such as Family Systems Theories, Cognitive Behavioral Therapy, and Accelerated Resolution Therapy, are some of my favorite secular theories. Used correctly, these theories align with the Bible. You are the only one who can decide what approach is best for you.

5. Why does talking about it help?

Sometimes getting things off your chest makes you feel better. Confessing in a non-judgmental, forgiving environment that allows for repentance is commanded in the Bible. James 5:16 (ESV) says, "Therefore, confess your sins to one another and pray for one another, that you may be healed."

You want to hide in shame when you have done wrong and when someone has wronged you. Talking about those things in a safe and private environment is healing and gives you hope.

There is a great truth to willingly asking yourself the hard questions, finding answers, and seeking forgiveness. Confession of wrongdoing leads to repentance, which leads to healing. Sharing your pain with one who offers comfort leads to peace, which also leads to healing.

I love watching years of tension fall from my clients' faces as they acknowledge their mistakes and release the guilt they have been holding for years. Sometimes, when I use ART, I literally watch lines melt from faces, and it is beautiful.

6. Is what I say in therapy really private?

Yes, I am legally bound to protect your privacy. I will even ignore you if I see you in public. There are some exceptions to privacy and ways to protect yourself and decrease chances of an exception.

You may unwittingly obligate me to release information to your insurance company if you use insurance to pay for your therapy. Without insurance, generally, the only ones who know that you are attending therapy or counseling are you, the provider, and those you tell. There are exceptions. I will discuss some of them below.

Every provider has a legal obligation to report child and vulnerable adult abuse, neglect or exploitation as well as life-threatening behavior such as suicidal or homicidal intent.

A judge can issue a court order for records about you and can order your therapist to disclose information about you. They can only do this if they know you are seeing someone.

You can refer to my notice of privacy practices and treatment consent documents for more information about confidentiality.

I believe that the best way to maintain your privacy is to pay out of pocket so insurance is not billed. Then, the only ones who know about your work are you, the provider, and who you tell. I will only tell if there is a safety or legal issue that I am forced to disclose.

7. What kind of therapy will I get?

The truth is that most providers use the theory that fits the circumstances of the person in front of them. You read earlier that there are hundreds of documented theories for counseling and therapy. There is no time or space to list them here.

You might experience bits of Cognitive Behavioral Theory, Psychodynamic Theory, Client-Centered Theory, and Family Systems Theory all in one session, depending on what I believe you need at that moment

You likely want to decrease your pain and increase your happiness; that's probably why you are thinking about seeing someone. I recognize that these theories exist and will also draw up bits and pieces of them. Seeing you as a unique individual is important, and our relationship helps make therapy successful.

Consider this: You are made up of mind, social needs, and body. Your mind contains your personality, your emotions, and your thoughts. Healing your mind brings about healing for your emotions, and releasing stress helps your body heal as well.

You may notice that it feels as if there is no end to the writing of theories about the human psyche.

8. Is therapy the same for everyone?

The process is unique for every person. Psychotherapy for an individual is about you and what you need. Your needs and wants are the priority of the session. While you are the center of attention and focus, that does not necessarily mean that psychotherapy is easy.

Psychotherapy is meant to help you examine yourself to determine the changes you need to make to live a better life. That is not always easy, and sometimes it means your therapist will confront your weaknesses. The difference is that this confrontation will be done with great humility, love, respect, and forgiveness. Remember, confrontation is not judgement.

Sometimes a follower of Jesus will tell me with tears in her eyes about the abortion she had forty years ago. We settle for a while on her imaginings of the lost child. We consider if the child would have been a boy or girl. Sometimes a mom just knows. We grieve together, and both our hearts break. That acceptance allows healing to begin.

9. Do I have to be sick to see a therapist?

While insurance requires a mental health diagnosis and documentation of what they call "medical necessity," you don't need those to see a therapist or a counselor. Therapy and counseling are about your own growth as a person. Justifying weekly counseling or therapy to an insurance company requires you to have symptoms of a mental illness severe enough to warrant a diagnosis.

Most of us have some symptoms, especially if we are trying to manage the bad stuff that happens in life. There is another option as well. You can see me on a self-pay basis simply because you want to be better tomorrow than you are today. I wrote more about this in Do I Need Therapy? You Don't Need a Diagnosis to Need Help.

Not everyone needs a label or diagnosis. You may recognize that you are struggling with managing day-to-day life and that there should be a better way. You are a good candidate for counseling and therapy.

You may just want to understand yourself better and make better decisions. You are a good candidate for counseling and therapy. Maybe you have a decision to make and are not sure what choice to make. Both a counselor and a therapist can help you step out of your emotions and consider the decision from several perspectives.

Who doesn't want to be better tomorrow than they were yesterday? I certainly do. I keep writing and rewriting these blogs simply because I want to do a better job giving you what you need. I am a better writer today than I used to be. I may not rewrite these blogs again, but I will write more and hopefully each one will be better than the last.

You can do the same thing with your emotions and stress management. You can get objective help to be healthier tomorrow than you are today.

10. Does my therapist's worldview matter?

Everyone, including me, has a core belief about our sources for understanding what is right and what is wrong. Your therapist or counselor is no different. Just as political opinions are greatly divided in the United States, so are therapeutic opinions.

You should use caution as you consider your choice of therapist. You want to consider your therapist's source for his or her core beliefs. You will find many ignore this issue and will tell you it doesn't matter. I disagree.

When you are considering your therapist, you may want to ignore the spiritual aspects of therapy, and ethics tell us to give you that freedom.

Some of you may be looking for a therapist who relies heavily upon what is often called spirituality in the United States. You want to be careful about this term. Sometimes these therapists will tell you that you can call on whatever spirit you want, even Jesus. They will have you use exercises where you empty your mind of the junk. You are the only one who can decide if this approach is what you are looking for. I don't use these techniques.

That does not mean spirituality is not addressed. I wrote about what that looks like in Does Jesus Belong in Therapy?. I use the Bible as the sole source for spirituality and will encourage you to allow yourself to be filled with God's spirit by entering into a closer relationship with Jesus Christ. Regardless of your decision about this level of spirituality, you will be treated with kindness and respect, with a goal to decrease your pain and increase your joy.

Closing

One of the most important factors for successful therapy is the relationship between you and your therapist or counselor. When you think about your needs and what you want from therapy, please interview your therapist. I put the questions I would ask in How Do You Choose the Right Therapist? Ask the hard questions about these truths and think about your needs.

I want to be kind, compassionate, and gentle. I am also direct and firm. I will laugh with you and cry with you as you struggle to navigate the difficulties of life. I use sarcasm, sometimes a little too much. I rely on faith and want the best for you, understanding that the decision about what is best for you belongs only to you.

I am Vickie, a Licensed Marriage and Family Therapist in Maryville, TN, and I help people from Knoxville and the surrounding communities heal from their trauma and the bad stuff that happens. I can help you. Click the link at the top of the page so we can talk.

Crisis Resources

If you or someone you know is in crisis, call or text 988 (Suicide & Crisis Lifeline) or go to your nearest emergency room. If you are in immediate danger, call 911.

About the Author

All clinical content on this website is written or reviewed by Vickie Starkey, LMFT, a Licensed Marriage and Family Therapist in Tennessee since 2005 (License #579). Vickie holds a Bachelor of Arts in Psychology and Sociology from Carson-Newman College (1989) and a Master of Divinity in Psychology and Counseling from New Orleans Baptist Theological Seminary (1995), and is a Certified Master ART Practitioner since 2023. This content is for educational purposes only and is not a substitute for professional diagnosis or treatment. Verify my license here: https://internet.health.tn.gov/Licensure/

References

English Standard Version Bible. (2001). Crossway Bibles.

Flückiger, C., Del Re, A. C., Wampold, B. E., & Horvath, A. O. (2018). The alliance in adult psychotherapy: A meta-analytic synthesis. Psychotherapy, 55(4), 316-340. https://doi.org/10.1037/pst0000172

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