Techniques and therapeutic modalities that can be used in specialized counselling for chronic pain may include pain psychoeducation, relaxation techniques, developing coping strategies, setting realistic goals, improving sleep hygiene, managing medication use, engaging in pleasant and meaningful activities despite the presence of pain, or developing solid emotional regulation. Other techniques may delve deeper into the root causes of mental health struggles such as trauma or PTSD and may include trauma processing.   

Various counselling techniques will focus on mood, like depressed mood and anxiety, and other modalities will help address underlying trauma.  

• Somatic Experiencing (SE) is a trauma therapy that focuses on body’s natural ability to heal from trauma and traumatic stress related symptoms. The main idea behind SE is that when body’s natural response to stress was interrupted and not fully completed, it can lead to physical and emotional lingering effects. In SE therapists help client tune into their body’s sensations and feelings, allowing the trauma and the stored stress energy to be released from the body for the body to restore sense of balance and safety.
• Dialectical Behaviour Therapy (DBT) is a therapeutic approach which helps individuals develop mindfulness skills, improves flexible thinking, increases distress tolerance, improves emotional regulation, and interpersonal effectiveness. 
• Cognitive Behaviour Therapy (CBT) can help with challenging negative thoughts, while using Behavioral Activation (BA) to engage in activities to counteract low mood, or low motivation, and to overcome avoidance or withdrawal behaviours. 

Any one of these modalities or a combination of them can be used during therapy sessions, depending on client’s unique presentation, history, and need.

Many individuals only need a few sessions, while others may benefit from longer term care. Typically, 12-20 sessions can be sufficient for most, others may need less or more care. This is dependent on client’s history, presenting issues, goals, and preference.

During the initial session, the patient will be asked to inform the counsellor about their current struggles, relevant mental health history, and what they would like to address first. Together the counsellor and client co-create a plan while prioritizing and identifying achievable and attainable goals.

While counselling and psychotherapy share similarities there are some differences between the two:

Scope and Focus:

• Counselling typically focuses on specific issues or concerns, such as relationship problems, career challenges, or life transitions. It often addresses more immediate and practical problems, providing guidance and support to help individuals navigate through difficult situations, deal with grief and loss, or specific family dynamics.
• Psychotherapy, on the other hand, has a broader scope and aims to explore deep-rooted issues, psychological patterns, and the overall mental and emotional well-being of an individual. It delves into the underlying causes of distress and seeks to promote long-term personal growth and self-awareness.

Depth of Exploration:

• Counselling tends to be problem-oriented and solution-focused. It focuses on helping individuals identify strategies and develop coping skills to manage specific issues.
• Psychotherapy involves a more in-depth self-exploration of emotions, thoughts, patterns of behaviours and relationships. If facilitates gaining insight into underlying psychological dynamics, unconscious processes, traumas, while addressing root causes of presenting issues

Time Frame and Therapeutic Approach:

• Counselling is typically shorter in duration and can be brief, ranging from a few sessions to a few months, depending on the specific goals, but the aim is to provide immediate support and guidance.
• Psychotherapy is typically longer in nature, although there is a short-term brief psychodynamic psychotherapy as well. Psychotherapy typically requires a deep therapeutic relationship, and it may last between a few months to a several years, depending on the complexity of individual’s concerns as well as the desired outcome

Both Counselling and Psychotherapy can employ various therapeutic approaches, such as mindfulness based cognitive therapy (MBCT), cognitive behaviour therapy (CBT), Psychodynamic Psychotherapy, Interpersonal Psychotherapy, Eye Movement Desensitization Reprocessing (EMDR), or Somatic Experiencing (SE). It is important to know that some modalities are better suited for some individuals, depending on individual’s history, presentations, severity and complexity of presenting issues, as well as the unique response of each person. Essentially, Counselling and Psychotherapy can overlap, and terms used are sometimes used interchangeably, however, specific distinction may vary depending on cultural, regional, and professional context, as well as regional regulating body in different districts.