What’s the difference between counselling and psychotherapy? Now there’s an interesting subject for debate! We could argue that psychotherapy is historically associated with medicine, whereas counselling in Britain has its roots in education and the church. Or that psychotherapy involves a deeper meeting between two people, whereas counselling is more of a problem-solving activity. For years we have been failing to exactly pinpoint a distinction between the two activities that was universally accepted, but it didn’t terribly matter, until now. With HPC regulation looming, suddenly it matters a lot. A small number of separate standards of proficiency are being proposed for counsellors and psychotherapists (see page 47) which are likely to be regulated as separate titles.

There is much concern in the profession that counselling will be hugely damaged by the course that regulation is taking and become a kind of junior version of psychotherapy, affecting both employment opportunities and public perceptions of counselling. John McLeod, however, sees this is an historic opportunity to redefine counselling as an activity distinct from psychotherapy and to claim a separate space for counselling.

In this issue he teases out what sets counselling apart from psychotherapy and proposes a radical vision of what counselling might become: a frontline form of help that is readily available within communities with an emphasis on collaboration between the counsellor and the person, flexibility in terms of what might be the most effective means of help, and context, whether that be social, cultural or organisational. Counselling would be goal and task orientated and, unlike psychotherapy, would not operate on an individualised concept of the person – moving away from the notion of expert and client with psychological problems as defined by DSMIV towards a more egalitarian approach where counselling would become a form of social action. Some readers will no doubt disagree with McLeod’s proposal, particularly the aligning of psychotherapy with the medical model.

As always, we welcome your views.