Counseling vs Therapy: What's the Difference?

If you’ve never sought or received mental health services before, it can be difficult discerning the differences between the different types (therapy, counseling, or psychiatric help) and deciding which is the right fit for your needs. Here's a quick primer to better understand the differences between different types of mental healthcare services so that you can choose the treatment that will best support you.

First: What Do the Letters After a Mental Health Professional’s Name Mean?

Different types of mental health services depend on the level of education and type of training that practitioners have. The letters that come after their name are an indicator of the license(s) they have earned and the services they are authorized to provide:

• Counselors typically earn master’s level degrees as Licensed Mental Health Counselors, LMHC, and Licensed Professional Counselors, LPC.

• Licensed therapists earn master’s level degrees as Licensed Clinical Social Workers, LCSW, and Licensed Marriage and Family Therapists, LMFT.

• Psychologists & Psychiatrists earn doctorate-level degrees. While both specialize in the field of mental health, they differ in their focus and practices.

  • Psychologists are trained to diagnose and treat mental health disorders, and often work in collaboration with psychiatrists and other healthcare professionals to provide holistic treatment to their patients, but they cannot prescribe medication or perform medical procedures.

  • Psychiatrists are medical doctors for psychological conditions and have authorization to treat patients with medications or medical procedures.

While qualifications are helpful indicators for the type of service practitioners provide, they’re not an indication of quality or effectiveness of treatment.

What’s the Difference Between Therapy and Counseling?

Therapy/counseling or therapist/counselor are terms that are often used interchangeably to refer to mental health treatment. While their education and training may differ, many therapists and counselors generally use similar approaches to talk therapy. In the past, counselors often specialized in behavioral approaches to address short-term goals in specific areas such as addictions, relationships, or grief, while therapists have specialized in longer term and holistic approaches. Counselors also typically have had more training in community mental health practices. However, these delineations between therapy and counseling have softened over time and there are many similarities between client experiences.

What makes a difference in the effectiveness of a client’s mental health treatment is not so much the licensure or extent of a practitioner’s education, or even the therapeutic method a practitioner uses, but the bond that the practitioner and the client build, as well the client’s commitment to healing and changing their life. (Read more about this in our post “What Matters More: The Therapy Method or the Therapist?”) When seeking mental health treatment, it’s important to pay attention to whether you feel comfortable being vulnerable with your therapist or counselor, and whether their insights and support are helpful for addressing your needs. If not, it’s okay to continue your search until you find the right fit.

When to Seek Therapy/Counseling vs a Psychiatrist or Psychologist

According to the American Psychological Association, a general rule of thumb for knowing it’s time to pursue mental health support is when something in your life is causing distress that interferes with your life. It could be depression or anxiety, an addiction or disorder, a relationship conflict, a major life transition (jobs, new parenthood, divorce), a loss or death, or another traumatic experience. Choosing which type of mental health service depends on the type of presenting issue you're experiencing and how acute you feel it is, but it is very common for mental health professionals to refer clients to other mental health professionals that can offer additional services to address the issue, if needed. For example, if you seek therapy for depression and anxiety, you and your therapist may decide that medication is needed to further improve your condition. At that point, your therapist will refer you to a psychiatrist, and you will likely see both professionals on a regular basis. Similarly, it is common for clients to seek psychiatric help for acute depression and anxiety, and in addition to prescribing medication, the psychiatrist might refer you to a psychologist or therapist if you don’t already see one. The goal is that you should experience holistic care, and sometimes that takes more than one type of mental health service.

Mental Health Services in Chicago

You may not find the right fit with a therapist on the first try, but the good news is that there is a vast network of licensed practitioners ready to help you find the support you need, even if that means referring you to another professional for additional support. All you need to do is take that first step to reach out and ask for help.

At ECC Chicago, we offer a multidisciplinary approach to mental health care, with a diverse team of licensed therapists and counselors who specialize in a number of different research-backed therapeutic approaches, including Emotionally-Focused Therapy, Attachment-Based Therapy, Diagnostic Behavior Therapy, Internal Family Systems, Narrative Therapy, EMDR, and more. We provide referrals to psychologists and psychiatrists, as needed. We’re committed to helping you find the right therapy method and practitioner to address your unique needs. If you’re ready to take that first step to seek support, we’ll help you find the right fit.

About ECC

Empowered Connections Counseling is a practice of licensed therapists providing quality, multidisciplinary counseling for adults, children & teens, relationships, and families in Chicago and across Illinois. Whether by in-person session or via telehealth, we can work with you to find the therapist and treatment methods that best suit your needs. Connect meaningfully with your life by booking an appointment today.

Dialectical Behavior Therapy: Accepting Reality & Embracing Change

*Content Note: This post will mention sensitive topics such as suicidal ideation, self-harm, and invasive thoughts.

Do you ever feel like managing emotional dysregulation is a full-time job? Like your emotions are running the show, and it’s hard to function or focus on anything else? When tricky situations happen and the emotions feel overwhelming, do you resort to behaviors you know are harmful, such as cutting, binge-eating, or drinking? If you’ve suffered a serious loss or trauma, or you’re experiencing acute depression or anxiety, Dialectical Behavior Therapy is a method that might help you tolerate stress with healthy habits and access emotional equilibrium.

What is Dialectical Behavior Therapy?

Dialectical Behavior Therapy (DBT) is a type of talk therapy based on Cognitive Behavioral Therapy (CBT) that has been adapted for those who need help managing and regulating intense emotions. Unlike CBT which focuses on changing an individual’s thought patterns, DBT is focused on giving clients skills to manage their emotional dysregulation. DBT is especially effective for people of all ages who suffer from mood disorders such as depression and anxiety, severe PTSD, suicidal ideation, self-harm, substance abuse, disordered eating, or other issues.

Maladaptive coping skills like substance abuse and self-harm are forged from traumatic experiences when healthy coping skills (like talking to a safe adult) aren’t accessible. These maladaptive strategies may offer immediate relief by easing or numbing the emotional pain, but they also pose risks to a person’s emotional, mental, and physical health that further increase dysregulation. Oftentimes, clients want to end these maladaptive behaviors but need help replacing them with healthier coping mechanisms. Dialectical Behavioral Therapy is all about redirecting behavior to better manage emotional dysregulation through:

• Acceptance of reality

• Awareness of emotions

• Healthier coping mechanisms, like mindfulness techniques

Two Things Can Be True

“Dialectical” refers to the act of accepting contradictory ideas. For example, someone who has a severe mood disorder can accept that their brain chemistry makes it difficult for them to feel safe and happy, while at the same time choosing to stop engaging in self-harm behaviors with help from a DBT therapist.

DBT is about “walking the middle path” between two things, i.e., building awareness of the emotions without acting on the impulses. Clients in DBT are coached on how to tolerate intense emotions and accept painful realities without engaging in maladaptive behaviors such as cutting or disordered eating.

Managing Dysregulation with Mindfulness

Of course, ending maladaptive behaviors isn’t as simple as stopping. We have to replace the maladaptive impulse with healthier skills that decrease emotional dysregulation. In Dialectical Behavior Therapy, therapists work with clients on mindfulness activities to help them ride the wave of discomfort without action or judgment. Many of these activities employ acronyms that are easy to recall in the middle of dysregulation, such as the STOP and RAIN methods.

The STOP mindfulness technique stands for:

• Stop

• Take a breath

• Observe your thoughts and feelings

• Proceed, i.e., return to what you were doing before you stopped, but with more awareness

The RAIN mindfulness technique stands for:

• Recognize what’s happening in the moment

• Allow the experience to exist just as it is

• Investigate with interest and care

• Nurture with self-compassion

The Benefits of DBT

Dialectical Behavior Therapy offers many benefits, whether its for individuals, couples, or families:

• Greater self-awareness: individuals learn how to notice their emotions and identify cycles of self-harm.

• Emotional resilience: clients can also learn to tolerate stress through mindfulness techniques, so that when difficult situations or emotions occur, they can stay present and emotionally regulate themselves.

• Interpersonal effectiveness: in couples or group therapy settings, DBT gives clients the chance to practice communicating their emotions, slow down the conversation, and identify what’s important to say and how to say it, so that their needs are met.

Is DBT Right for Me?

As mentioned above, Dialectical Behavior Therapy can be applied in a variety of contexts, from individuals (including children) to couples and families. Here are a few signs that DBT might be right for you:

• You find it hard to stay present when difficult emotions arise

• You struggle with impulsive or compulsive behaviors when feeling overwhelmed

• You have severe anxiety and depression

• You have an eating disorder

• You’re struggling with substance abuse

• You’re struggling with suicidal ideation or intrusive thoughts

DBT Therapy in Chicago:

Suffering happens when we get stuck in a cycle trying to change something we can’t, but acceptance is a skill we can learn. Some things about our lives may always be painful or difficult, but through practicing acceptance and mindfulness, we can end cycles of self-harm and find emotional equilibrium. DBT can be a profound and transformative therapeutic experience that sets people on a path toward peace. If you’re curious about whether DBT is right for you, your child, or your family, reach out today. We’ll connect you with the therapist and therapeutic approach to help you thrive.

For more information about Dialectical Behavior Therapy, watch this video of ECC Founder Danielle Zawadski discussing it on PHTV4’s Living Well segment!

About ECC:

Empowered Connections Counseling is a practice of licensed therapists providing quality, multidisciplinary counseling for adults, children & teens, relationships, and families in Chicago and across Illinois. Whether by in-person session or via telehealth, we work with clients to find the therapist and treatment methods that best suit their needs. Connect meaningfully with your life by booking an appointment today.

New Year, Same You: A Guide for Healthy Resolutions

The new year is a clean slate, a chance to set intentions and try new ways of caring for yourself, your body, your aspirations, your relationships, your career… And yet, we’re all familiar with those feelings of shame and disappointment when we fall short of our resolutions. Self-compassion often takes a backseat to the goal we’re trying to achieve, and before we know it, we’ve failed to keep up with the rigorous diet and exercise routine, or trying to stay sober, and we’re deep in shame about it.

Now that we’re several days into 2024, it’s a good time to check in and make sure the goals we’re setting feel attainable. If you’re looking for guidance on how to meet this new year with hope for improving our lives in meaningful and lasting ways, here are a few therapy-based tips.

Why We Fail at New Year’s Resolutions

The thing about new years and resolutions is that we are still our same human selves, facing the same familiar stressors as last year (which was just days or weeks ago). What we know from decades of psychology studies on human behavior is that the more rigid and unrealistic our expectations for ourselves, the harder time we will have meeting those expectations – and caring for ourselves when we fall short.

This can create a vicious cycle of failure and shame:

• We set a resolution that we have a hard time living up to,

• Then we fail and feel angry and ashamed of ourselves,

• Then we double-down on our efforts, but still fall short

• Then we feel incapable and struggle with self-esteem, so we stop trying to achieve the resolution—or any resolution at all. (Meta-emotional cycles can exacerbate this.)

When we’re caught in this cycle, tapping into self-compassion and care becomes extremely difficult. The more ashamed we feel, the less likely we are to reach out to anyone for support, and loneliness becomes another factor that can worsen these feelings of shame and inadequacy.

How to Get Out of the Shame Cycle of Failed New Year’s Resolutions

Okay, so you set a goal that you couldn’t live up to, for one reason or another. Now what? You could scrap the whole idea of doing anything differently this year and just accept that you’re not capable of change, or… you could tap into self-compassion. One way to move forward with self-compassion and find hope with your new year resolutions is to honor your motivations while adjusting your goals. You’re self-aware enough to know that the way you’ve been doing things isn’t how you want to keep doing them. Honor your desire for change. But how that change can look is fluid and you have the agency to adjust your goals and strategies in a way that feels more comfortable and attainable.

The moment when we fail to follow our resolution or achieve the goal is a moment to check in with ourselves and reflect on our actions and feelings without judgment. What is our intuition telling us?

For example, let’s say your new year’s goal is to lose a certain amount of weight by following a strict nutrition plan you found online and go to the gym every weekday morning at 6AM. When you fail to either achieve the number on the scale or follow through with the routine, you could double-down by trying harder and being more strict with your habits, or you could take a moment to check in with your body’s needs and reflect on the motivation behind your resolution. Are you full or hungry? Do you need to rest, or do you have the urge to move? Do you want to change your diet and exercise habits because you want to be healthier, or because you’re self-conscious about the number on the scale? What would it look like to honor your desire for change, while also honoring your body’s needs?

Approach the New Year with Mindfulness

We’re all going to encounter moments this year where we’re disappointed with ourselves, ashamed of the ways we’re falling short, worried that we’re not capable of all that we hoped. Mindfulness is a really effective therapeutic tool that you can access in those tricky emotional moments to stop shame in its tracks, access self-compassion, and find a way forward. There are many different mindfulness strategies that can help regulate your emotions, but all of them involve some form of pausing when we feel emotionally dysregulated (anxious, frustrated, depressed), engaging the five senses to reconnect with our bodies, taking a moment to notice our emotions and investigate what triggered them, and moving forward with self-compassion.

Getting Support to Create Meaningful Change

Making meaningful, lasting change in your life is hard work! You don’t have to do it alone. If you’re struggling to form goals and find strategies for change that feel healthy and effective, therapy can help. You can talk with a therapist about what your hopes are, what your obstacles are, and find a path forward that feels right for you. At ECC, our diverse, multidisciplinary team of therapists can help you create a life that makes you feel happy and whole. Change is possible.

About ECC:

Empowered Connections Counseling is a practice of licensed therapists providing quality, multidisciplinary counseling for adults, children & teens, relationships, and families in Chicago and across Illinois. Whether by in-person session or via telehealth, we work with clients to find the therapist and treatment methods that best suit their needs. Connect meaningfully with your life by booking an appointment today.

Managing Loneliness During the Holidays: Four Tips from a Therapist

It’s the most wonderful time of the year, right? The holidays are meant to be a time of connection and joy, but sometimes they can be a time of disconnection, grief, and isolation, especially if you have recently suffered a loss such as death of a loved one, divorce or estrangement, job loss, or a move away from your community. Perhaps the holidays are a reminder of past trauma. Even when everything in your life seems normal, the social expectations around holiday celebrations can be overwhelming. It’s all too easy to get caught up in comparing yourself to others who seem to have it all together, especially through social media. All of these things can not only increase loneliness, but anxiety and depression as well.

If any of this feels familiar, know that you aren’t alone. In the last year, over half of Americans have reported feeling sadness and loneliness during the holidays. Loneliness at the holidays is incredibly common, despite the sparkly veneer of lights and gifts and sweet treats.

Mental Health Struggles During the Holidays

An increased sense of loneliness can lead to maladaptive coping mechanisms, especially ones we may have turned to in the past: substance abuse, disordered eating, and other addictive behaviors like mindless shopping. It’s also common to experience increased relationship conflict with family members and partners, given the social pressure to conform to old traditions that may not be comforting anymore.

Another mental health struggle that many experience during the holidays is meta-emotional cycles: in other words, having feelings about your feelings that exacerbate your despair. For example, you might feel loneliness, and then sadness or self-doubt in response to the loneliness: Why am I so isolated? Is there something wrong with me? Another example might be jealousy that others have partners and big families to celebrate with, followed by shame for being jealous: Why can’t I just be happy for others and content with my life? These meta-emotions often lead to greater distress and dysregulation. All the while the original, primary emotion is unattended to, making matters worse.

Therapy Tips For Managing Your Loneliness During the Holidays

The good news is that there are ways you can reorient yourself during the holiday season to protect and improve your mental health. These strategies may not fix your loss or erase past trauma, but rather, can serve as a touchstone for reminding yourself that you are not alone in the world, and joy is still possible.

1. Mindfulness practices – Take time to slow down and connect with your thoughts and feelings. A simple practice of journaling, writing down things you’re struggling with and things that you’re thankful for, can have the effect of reducing how overwhelmed you feel and stopping those meta-emotional cycles from spiraling out of control. Or you might try going outside for a winter walk and focusing on your senses to get out of your head and back into your body: enjoy the crunch of snow beneath your boots, the fog in the air, the wind on your cheeks, or a favorite song in your earbuds (even if it’s a sad one).

2. Make new traditions – Whether it’s because the old traditions don’t feel comforting anymore, or because doing them simply isn’t possible this year due to financial issues or travel constraints, it is okay to try new ways of celebrating. This is possible whether you have people to celebrate with or not. If the thought of trying to celebrate holidays alone makes you feel even more sad or self-conscious, consider an activity that will connect you with others in need, like helping out at a center for unhoused people or underprivileged groups.

3. Adjust expectations and boundaries – We all go into the holiday season with hopeful expectations that we will be surrounded by loved ones and everyone will have a merry time together, full of joy and delicious food and fun gifts. But some years, that’s just not how it works out, for a variety of disappointing reasons. In these times, adjusting our expectations – and communicating clearly with others to help them adjust their own expectations – can make room for other opportunities to find joy. So maybe this year, gathering together with loved ones just isn’t possible; talking about it early on and making other plans to connect over FaceTime or in-person at a later date can help ease the disappointment and reassure each other that you care. (Read this post for more tips on setting boundaries and expectations with loved ones during the holidays.)

4. Support through therapy – No matter how lonely you feel this holiday, remember that you don’t have to cope alone. Therapy can help you process your feelings, prepare for the hard moments, and find joy and comfort.

Get Extra Support This Holiday Season

There’s no better time to seek support from a therapist than during the holiday season. You don’t have to wait until the new year to get the support you need. At ECC, our diverse group of licensed therapists can help you process the loneliness of the season and offer new strategies for coping and connecting with others. Book an appointment with us today to get started.

About ECC:

Empowered Connections Counseling is a practice of licensed therapists providing quality, multidisciplinary counseling for adults, children & teens, relationships, and families in Chicago and across Illinois. Whether by in-person session or via telehealth, we work with clients to find the therapist and treatment methods that best suit their needs. Connect meaningfully with your life by booking an appointment today.

Attachment Styles: What They Mean and How They Can Help in Your Relationships

Have you ever wondered what your life right now would be like if your childhood relationships with your parents or caregivers had been different? Have you ever reflected on a conflict with a partner or friend, and felt intuitively that if your bond with your parent or caregiver had been healthier when you were a kid, perhaps it would be easier for you to communicate as an adult? Maybe you’re not used to stating your needs clearly because your needs as a child were a burden. Maybe it’s hard for you to get through an uncomfortable conversation with your partner without arguing, because arguing was the predominant way your family communicated. Or maybe you often feel anxious in your relationships, and that anxiety has been with you since childhood?

If any of these experiences resonate, attachment-based therapy might help you.

What are Attachment Styles?

Attachment Theory, founded by John Bowlby, is based on the idea that the relationship young children develop with their primary caregiver or guardian impacts their long-term social and emotional development. These bonds are based on children’s survival needs for safety, food, and protection. Our earliest experiences with attachment are formed through our primary caregivers, from birth through early childhood, setting our expectations of how we can relate to others and how they will respond to us.

“Attachment” is a framework for how you relate to others. “Style” is shorthand for how you are connected or disconnected from others. There are two main types of attachment:

• Secure attachment: A secure attachment between a small child and a caregiver forms when the caregiver consistently responds to the child's needs, providing comfort, reassurance, and emotional support. This “secure base” allows the child to explore the world confidently, knowing they have a reliable source of comfort and safety to return to. This early experience fosters a sense of trust, self-worth, and an understanding that relationships can be dependable and supportive. As the child grows, this secure attachment becomes a template for future relationships, influencing their ability to form healthy connections, manage emotions, and navigate conflicts with confidence and resilience.

• Insecure attachment: In an insecure attachment dynamic with a caregiver, the child's needs might be inconsistently met or disregarded, leading to uncertainty about receiving comfort or support. This inconsistency can create anxiety or avoidance in seeking closeness or reassurance. As the child grows, this insecure attachment style might manifest as difficulty in trusting others, struggles with intimacy, and challenges in managing emotions within relationships. It can lead to patterns of either excessive dependence or reluctance to seek support, impacting the ability to form healthy, secure connections in adulthood, often resulting in difficulties with intimacy, communication, and trust within relationships. Within “insecure attachment” there are a few variants:

  • Anxious Attachment, also called anxious-ambivalent attachment, is when a person feels anxious and insecure in their relationships. They might act clingy in relationships, in constant need of reassurance that their loved one isn’t mad or about to leave them. Anxious attachment is often formed when a child’s caregivers are themselves anxious, hovering over the child and then pushing them away, or making the child feel responsible for the caregiver’s feelings.

  • Avoidant Attachment, also called anxious-avoidant attachment, is when a person acts ambivalent or dismissive in their relationships. They struggle to build intimacy or voice their needs in relationships. Avoidant attachment is often formed when a child’s caregivers were strict and emotionally distant, expected the child to be independent, left the child to fend for themselves, or neglected a child’s basic needs.

  • Disorganized Attachment, are people who crave connection with others but are viscerally terrified of it at the same time, leading to erratic and contradictory behavior. Disorganized attachment is often formed in extreme circumstances, like trauma, abuse, or neglect.

How Do I Know What My “Attachment Style” Is?

While there are formal tests that trained psychologists use to determine a client’s attachment style, such as the Adult Attachment Interview or the Adult Attachment Projective, oftentimes you can identify your attachment style through talking with a therapist, reflecting on your current relationships and behaviors, and reflecting back on your childhood. A therapist who specializes in attachment-based therapy and similar modalities like Emotionally Focused Therapy can ask guiding questions to help you identify your attachment style and how it's impacting your relationships.

What is Attachment-Based Therapy?

Attachment-based therapy is a trauma-informed and process-oriented therapeutic method that helps clients identify attachment wounds and repair relationships. It can be effective for individuals of all ages, couples, and families. In attachment-based therapy, a therapist will talk with you to help you understand the four attachment styles, and then lead exercises to help you identify your attachment style, identify deeper attachment wounds, and repair bonds with a partner or other loved ones. Attachment-based therapy can be applied to treat a multitude of presenting issues: individuals (including children and teens) who have experienced abuse, trauma, couples who have experienced infidelity, and families who have experienced a loss.

Attachment-based therapy (also known as attachment-focused therapy) is distinctly different from the similarly named “attachment therapy,” which is a series of behavioral interventions for children with attachment disorders. Though the names are very similar, attachment therapy is not based on the theory by John Bowlby and is not considered compatible with attachment-based therapy. Attachment therapy interventions like rage reduction or rebirthing have been shown to cause adverse effects in children and are not used in attachment-based therapy.

What Makes Attachment-Based Therapy Different From Other Methods?

Attachment-based therapy is different from other talk therapy methods like Cognitive Behavioral Therapy and Dialectical Behavioral Therapy in its focus on early childhood experiences and repairing relationships. While Emotionally Focused Therapy (EFT) is also based on Bowlby’s Attachment Theory, the goal of EFT is to understand the emotions that arise from our attachments and how they influence our behavior.

How it Works: What to Expect in an Attachment-Based Therapy Session

In attachment-based therapy, there’s a lot of time given to reflecting on the client’s childhood experiences and relationships to understand present-day conflict. A therapist might also use structured activities to help the client practice new ways of communicating to change the way they connect with others and repair relationships. Whatever strategies a therapist uses, the goal is to establish a secure relationship between therapist and client, so that the client feels safe to explore their past and try new ways of coping and communicating.

Is Attachment-Based Therapy Right For Me?

There are many different effective therapeutic methods, and attachment-based therapy is just one that may be helpful. You may benefit from attachment-based therapy if:

• You experienced trauma, neglect, abuse, or separation from a caregiver as a child

• You sense that childhood experiences are negatively impacting your adult life and relationships

• You want to better understand how your past is affecting your present

• You struggle with trust and security in your relationships

• You want to improve communication in your relationships

• You want to repair broken or difficult relationships

How to Find Attachment-Based Therapy Near You

When we take time to understand our pasts and families of origin, we can begin the work of forming healthier attachments in our present-day lives. Attachment-based therapy is one therapeutic method of many that may be effective for you. At Empowered Connections Counseling, our diverse group of therapists offer a multidisciplinary approach – we will work with you to find the right therapist and the right therapeutic method to suit your needs, including attachment-based therapy for individuals (adults, teens, and children) couples, and families in Chicago and across Illinois.

About ECC:

Empowered Connections Counseling is a practice of licensed therapists providing quality, multidisciplinary counseling for adults, children & teens, relationships, and families in Chicago and across Illinois. Whether by in-person session or via telehealth, we work with clients to find the therapist and treatment methods that best suit their needs. Connect meaningfully with your life by Connect meaningfully with your life by booking an appointment today.