In recent years, there has been a notable trend in Australia in merging psychotherapy and counselling and using these terms interchangeably, a development that has triggered considerable discourse within the field. Valid concerns exist about practitioners, especially those in positions of power (such as in psychotherapy and counselling associations and counselling and psychotherapy educational roles), lacking proper training in psychotherapy, advocating for its conflation and, on occasion, its elimination. In the article “The Australian Counselling Profession in 2030: An Educator’s Perspective”, Nathan Beel (2024) suggested that being a psychotherapist should be a secondary identity to counselling. Furthermore, he recommended that the term psychotherapy be removed altogether from the title of the Psychotherapy and Counselling Federation of Australia (PACFA) and that the federation be rebranded as the Counselling Federation of Australia. In essence, he has thrown psychotherapy under the bus! Envisioning the future, Beel stated,

Titles such as Psychotherapist no longer form primary alternative identities to counsellors but are recognised as specialist identities, like clinical psychologists who are specialist psychologists. Additional specialist identities also include Counselling Supervisor, Counselling Educator, Indigenous Healing Practitioner, and Mental Health Practitioner. However, all these specialist identities are secondary to the primary identity, that being a Registered Counsellor. This decision was made to simplify recognition of one profession, one identity, while allowing for select specialisations within the identity. Additionally, this reduced the previous infighting and territory marking between the (previously) two distinct identities of counsellors and psychotherapists. It follows that PACFA is now the Counselling Federation of Australia, or CFA. (para. 10)

As a PACFA-Registered Clinical Psychotherapist® and a member of the PACFA College of Psychotherapy Leadership Group, I find this proposition deeply concerning and believe its adoption would be a grave mistake and pose severe implications for the health and wellbeing of Australians. It is understandable that practitioners lacking training in psychotherapy might fail to grasp the proposition’s significance, thereby leading to misconceptions and misguided proposals. This issue is compounded by the presence of influential figures within the psychotherapy and counselling industry who lack proper training in psychotherapy and consequently struggle to differentiate between the two disciplines.

The training landscape for psychotherapy and counselling has also undergone shifts; to entice prospective students into their courses, some programs may adopt a “bums on seats” approach, emphasising quick online courses devoid of placement experience. Alternatively, some academic counselling and psychotherapy courses are moving towards a medical model approach, often lack experiential training, add psychotherapy in name only, and fail to prioritise personal counselling or psychotherapy. Furthermore, some registered training organisations employ social workers or psychologists to teach counselling and psychotherapy, despite those practitioners lacking specific training in more than a module or two in these specific disciplines during their own education.

The conflation of psychotherapy and counselling in Australia is exacerbated by the absence of a national standard for these professions, leading to a situation in which individuals aspiring to become counsellors or psychotherapists may pursue degrees in social work or psychology instead to access Medicare for their potential clients. As a result, psychotherapy and counselling roles within health care settings are often filled by social workers or psychologists, which further dilutes the distinctiveness of psychotherapy and counselling.

While psychotherapy and counselling associations rightfully focus on establishing a national standard for counsellors and psychotherapists to stand alongside social workers and psychologists, small, private psychotherapy institutes are now few and far between in Australia. Consequently, membership numbers for psychotherapists remain disproportionately low compared with those for counsellors, and the emphasis is primarily placed on satisfying the needs of counselling members.

In a recent discussion with Martha Calhoun (personal communication, March 25, 2024), a member of the PACFA College of Psychotherapy Leadership Group, Calhoun shared with the Group that PACFA originally aimed to provide an “umbrella” to shelter, nourish, and recognise smaller, “excellent” psychotherapy training opportunities in Australia. The concept of an umbrella is symbolised in the logo by the letter “f”, stylised to represent an arching umbrella over psychotherapy and counselling. The intention is to bolster these training opportunities, granting them strength and credibility.

Moving forward, it is crucial to maintain a clear distinction between psychotherapy and counselling to cultivate the growth of psychotherapy in Australia as a thriving discipline, as it once was. While psychotherapy and counselling share similarities, they differ significantly in their approaches and objectives. Psychotherapy should not be viewed as a mere addition to counselling. One challenge faced by psychotherapy is articulating what sets it apart from counselling. In this article, I aim to shed light on this distinction.

In psychosynthesis, the model of psychotherapy in which I am trained, psychotherapists conceptualise the psyche as a multistorey house (Gale, 2010). Using this metaphor, psychotherapists work with the lower unconscious energies in the basement, utilising theories and techniques from self-psychology, psychoanalytic, and object relations psychotherapists such as Sigmund Freud (1900), Melanie Klein (1932), Donald Winnicott (1987), Margaret Mahler (1975), Ronald Fairbairn (1952), John Bowlby (1969), and Heinz Kohut (1978). On the ground floor, which represents the middle unconscious, their work is primarily focused on the “here and now”, incorporating somatic, humanistic, and existential theories and techniques pioneered by influential figures such as Wilhelm Reich (as cited in Conger, 2011), Carl Rogers (1951), Viktor Frankl (1959), Fritz Perls (1992), and Abraham Maslow (2010). In the loft, representing the higher unconscious, they explore spiritual and transpersonal theories and methods pioneered by Roberto Assagioli (1965), Carl Jung (1933), Stanislav Grof (1989), Ken Wilber (2000), and Michael Washburn (1995). Throughout a session, they dip in and out of these different levels of the psyche, exploring the client’s history (past), the here and now (present), and the potential for healing (future).

Counselling primarily remains on the ground floor of the house, occasionally dipping into the basement and the loft. In contrast, psychotherapists embark on the task of “restructuring” the foundations of the house, metaphorically speaking, by delving into the basement and recovering the deeply buried and split off parts of the psyche caused by attachment injuries, and interpersonal and developmental trauma. It is worth noting here that the use of subpersonality work to recover parts split off into the lower and higher unconscious is just one part of an 8-year depth psychotherapy training course; training in parts, whether it be ego-states, subpersonalities, or internal family systems, is a tool psychotherapists and some counsellors use, not a psychotherapy training approach in its own right.

Psychotherapists also work to integrate significant existential, transpersonal, and psychospiritual crises, dilemmas, and emergencies. These crises and traumas might manifest as addiction, attention deficit hyperactivity disorder, anxiety, borderline and narcissistic presentations, depression, disordered eating, severe and repetitive relationship problems, or suicidality. Often, when presenting to a general practitioner, clients are medicated or prescribed interventions such as cognitive behavioural therapy or solution-focused therapies. However, from a psychotherapeutic perspective, this may sometimes constitute a case of “right intention, wrong intervention”.

The training of psychotherapists, typically spanning 4 to 8 years, prepares them to work with complex concerns and severe psychopathology. A significant component of this training is that it is highly experiential and involves significantly engaging in Martin Buber’s (1970) “right relations”–style group therapy and, at least weekly, individual depth psychotherapy for the duration of the training. This intensive personal psychotherapy experience is crucial because it enables psychotherapists to explore their own feelings, needs, and vulnerabilities (Gale, 2014). Moreover, it enables them to restructure their psyches if necessary and gain the experience needed to accompany their clients into the basement and loft, and “be with” them as an external unifying centre in the heights and depths of their joy and despair. The Circle of Security International (2016) described “being with” as follows:

Being-With is, in many ways, at the heartbeat of our Circle of Security approach. It’s such a simple concept: the need every child has for caregivers (parents, teachers, etc.) to recognise and honour feelings by staying with core feelings rather than denying their importance. At the centre of this Being With approach is decades of research that make it clear that we learn to manage feelings (for example, anger, sadness, fear, joy, shame, and curiosity) by experiencing the sponsorship of an adult who is with us in the feeling rather than staying outside the feeling and focusing only on our behaviour. (paras. 1–2)

Once therapists become transfixed on changing the client’s behaviours, or focused on eradicating their presenting symptoms, they are no longer being with the client. It is the psychotherapist’s use of self, in relationship with the client, that facilitates the psychotherapy process: a long and arduous journey of the soul, as Assagioli (1965) often noted throughout his career as a neurologist, psychoanalyst, and psychospiritual practitioner.

Relationship lies at the heart of psychotherapy, and it is also central to counselling, albeit in a different manner. Counsellors typically prioritise the therapeutic relationship, often adopting a humanistic approach popularised by Carl Rogers (1951, 1961), the father of humanistic psychology and author of Client-Centered Therapy and On Becoming a Person. Rogers emphasised the significance of the therapeutic relationship in fostering personal growth and psychological healing. He believed that the therapeutic relationship should embody three core conditions, often referred to as the “necessary and sufficient conditions” for therapeutic change: unconditional positive regard, empathy, and congruence. This relationship serves as a supportive and facilitating environment in which clients can explore themselves, gain insight into their experiences, and work towards self-actualisation.

Psychotherapists also start from this premise; however, they employ the therapeutic relationship in a different manner. While counsellors may notice transference and countertransference, psychotherapists actively engage with these phenomena within the therapeutic relationship—this is increasingly known within the psychotherapy field as the psychotherapeutic relationship. It is crucial for the psychotherapist to discern what belongs to them and what belongs to the client. Transference refers to the phenomenon whereby clients unconsciously transfer feelings, attitudes, and expectations from significant figures in their past (such as parents or authority figures) onto the therapist. Transference can manifest as positive, negative, or ambivalent feelings towards the therapist, reflecting unresolved attachment injuries, conflicts, and dynamics from the client’s past interpersonal relationships. Psychotherapists do not shy away from becoming the primary attachment figure for the client nor from the transference this may evoke; they utilise it as a valuable tool for gaining insight into the client’s inner world, facilitating the psychotherapeutic process (including the development of an internal unifying centre, otherwise known as the self; Firman & Gila, 2010), and promoting reparation and repair of the ruptures from the client’s earlier relational world. This process takes time—lots of time—which is why psychotherapy is inherently a long-term process.

Rigorously trained psychotherapists are passionate about ensuring that clients seeking psychotherapy receive precisely that. While all professions mentioned in this discourse hold value, it is crucial to recognise their differences and honour them accordingly. My intent is not to disparage any profession but rather to underscore the importance of clarity and precision in terminology. Each discipline serves unique needs and should be respected as such. Not everyone requires psychotherapy, but those who do should have access to it, provided by rigorously trained psychotherapists.

PACFA now recognises psychotherapy as “Advanced Specialist Training”, which it is. However, during a conversation with Lindy Spanger (personal communication, March 25, 2024), soul-centred psychotherapist and member of the PACFA College of Psychotherapy Leadership Group, she rightly stated that “psychotherapy is a profession in its own right, just like social work, psychology, and counselling”.

The PACFA College of Psychotherapy has the highest standards and guidelines for entry in Australia. The PACFA Psychotherapy Training Standards (2020) align with the entry expectations of psychotherapists who are members of the New Zealand Association of Psychotherapists (, where psychotherapy is now regulated by the Psychotherapists Board of Aotearoa New Zealand (, and those psychotherapists who are members of the United Kingdom Council for Psychotherapy (UKCP). It is worth noting that the UKCP is partner to the Scope of Practice and Education (SCoPEd) framework for the psychotherapy and counselling professions. SCoPEd is “a partnership that has developed a competence framework that maps the core competencies and practice standards for counsellors and psychotherapists working with adults” (UKCP, 2023, para. 1).

Considering that psychotherapists work with some of the most traumatised and vulnerable people in society, they should have the highest standards. If a training course has the title “Psychotherapy” in it, it should meet the PACFA College of Psychotherapy’s standards and guidelines so that students are not dumbfounded when they complete their training yet are unable to meet the College’s entry requirements.

In navigating the complexities of the current mental health crisis, intensified by global existential challenges such as the pandemic, there is an unprecedented urgency for depth psychotherapy now more than ever before. Individuals who require this level of support should receive it from practitioners rigorously trained specifically in psychotherapy to address their unique psychotherapeutic needs.

To revitalise psychotherapy in Australia as a thriving discipline, it is imperative to recognise that while some crossover exists between professions, maintaining differentiation ensures the integrity of psychotherapy as a distinct profession and guarantees that those wanting or needing psychotherapy have access to it. This access must be provided by professionals who offer psychotherapy not only in name but also in practice.