What Is Psychotherapy? Approaches, Training and How It Differs from Counselling
Psychotherapy is a sustained, confidential working relationship in which a trained psychotherapist helps you understand and change patterns of thinking, feeling and relating that have been causing you difficulty. Where counselling often focuses on a current problem, psychotherapy tends to go further back and deeper, asking not only what is happening but why it keeps happening.
How psychotherapy differs from counselling
In Ireland the titles are not yet protected in law, and many practitioners hold both. In practice, psychotherapy training is usually longer, includes substantial personal therapy for the trainee, and prepares the practitioner for longer-term and more complex work. The ICPHAA Accredited Counsellor standard, for example, requires a qualification at QQI Level 7 or higher of at least two years part-time, at least 50 hours of personal therapy and 450 hours of supervised client work after training. Psychotherapy programmes often exceed this. The label matters less than the practitioner's training, experience and accreditation, all of which you can ask about.
The main approaches
Person-centred and humanistic. Built on the work of Carl Rogers, this approach trusts the client's own capacity for growth and emphasises empathy, acceptance and genuineness in the relationship. Gestalt and existential therapies belong to the same broad family.
Psychodynamic and psychoanalytic. Rooted in Freud and developed by many since, these approaches work with the unconscious: the ways early relationships, repressed feelings and repeated patterns shape present life, often outside awareness. The relationship with the therapist itself (transference) becomes a place to notice and rework those patterns. Lacanian psychoanalysis adds a particular attention to language and desire.
Cognitive behavioural therapy (CBT). A structured, present-focused approach that examines the links between thoughts, feelings and behaviour and builds practical ways of responding differently. Often time-limited, with between-session tasks.
Integrative. Many Irish practitioners train integratively, drawing on several models and adapting the work to the person rather than fitting the person to a model.
Systemic and family therapy. Works with couples and families as systems, looking at patterns of communication and roles rather than locating the problem in one person.
Trauma-focused approaches. Including stabilisation and grounding work, EMDR and body-oriented methods, used by practitioners with specific training for people living with the effects of trauma.
What a course of psychotherapy looks like
Sessions are usually weekly and last around 50 minutes. The first few meetings establish what you want to work on, how the therapist works and whether the fit is right. Long-term work may continue for a year or more; some approaches, such as CBT, are deliberately shorter. Reviews are built in, and you remain free to pause or end. A good therapist will talk openly with you about endings rather than letting the work drift.
Psychotherapist, psychologist or psychiatrist?
A psychiatrist is a medical doctor who can diagnose mental illness and prescribe medication. A psychologist holds a degree in psychology and may work in assessment, research or therapy, depending on their training. A psychotherapist is trained specifically in talking therapy and does not prescribe. The three often work alongside each other; for example, someone may see a psychiatrist for medication and a psychotherapist for weekly therapy.
Choosing a psychotherapist
Check accreditation with a professional body and verify it. ICPHAA members can be checked on the verification page.
Ask about their training, approach and experience with the difficulty you bring.
Notice how you feel in the first sessions. Respected, understood and a little challenged is a good sign; dismissed or rushed is not.
Agree the practical frame: fee, frequency, cancellation terms, how breaks and endings are handled.
Frequently asked questions
Is psychotherapy only for serious problems?
No. People come for many reasons, from a specific crisis to a wish to understand recurring patterns in work or relationships. The depth of the work is decided with you, not imposed.
How do I know which approach suits me?
Most people choose a therapist rather than an approach, and that is reasonable: the relationship predicts outcome more than the model does. If you have a clear preference, for example for a structured approach such as CBT, say so when you enquire.
Are psychotherapists regulated in Ireland?
Not yet by statute. CORU's registers for counsellors and psychotherapists have not opened at the time of writing. Accreditation by a professional body is currently the main assurance of standards; see our CORU update.
Finding an accredited practitioner
ICPHAA members who have published their directory listings can be browsed by county and by area of focus on the find a counsellor pages, including CBT therapists and trauma counselling. Every listing links to the member's full profile and to the verification page, where you can confirm that their membership is current before you make contact.
This article is general information from ICPHAA, the Irish Counselling, Psychotherapy & Allied Healthcare Professionals Association. It is not a substitute for individual professional advice. If you are in crisis or at immediate risk, contact emergency services on 112 or 999. The Samaritans are available free, day and night, on 116 123, and you can text HELLO to 50808 for a free 24-hour text service.
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