Just to muddy the waters further, CBT is only one *type* of psychological counseling - not necessarily the best. It is, however (prepare to die of shock) favored by insurance companies because it is much quicker than other forms of therapy. "Psychodynamic" therapy is the approach that many therapists use - which is the basic thing people usually think of when they think about "therapy" - you talk about your feelings, your life experiences, your family etc. and the therapist is supposed to be your neutral ally - not telling you what you should and should not think, but helping you sort things out. It can take quite a while, but it's not like, say, classical Freudian analysis that can basically go on for years or indefinitely.
CBT, on the other hand, is designed to correct "wrong thinking" in a minimum number of sessions. There is evidently a philosophical divide between this approach and more interpersonal forms of therapy, as well as a lot of potential for abuse in what might be considered "wrong thinking." That potential for abuse certainly isn't limited to our patient group. CBT is also considered more "evidence-based" as it has been studied a lot more, thereby reinforcing the ability of insurance companies to claim it is not only a legitimate therapy, but the therapy with the best evidence of success. So if I'm an insurer and I'm *obliged* to offer mental health coverage, I will typically limit sessions of talk therapy to, say, 10 sessions a year of CBT, if that, and rationalize the limitation by pointing to the "better research base" of CBT. (At my insurer you also have to be really significantly distressed to qualify for the 10 sessions.) I can see the dilemma in not wanting to hand out weekly 1-hour sessions to anyone who is having minor problems, or just wants to unlock their creativity, or something, but something about using the "success" of CBT as a framework for rationing care smells fishy to me.
Part of the problem is that the psychodynamic/interpersonal crowd has often been opposed to doing formal studies of their work, believing that what they are doing cannot be understood by data alone. (I'm paraphrasing here, there's a lot more to it which I don't remember clearly.) And frankly, I think they're at least somewhat right. I've never *had* CBT, but from what I've heard and understand about it, many people claim it's just a band-aid over your deeper problems - or, worse, an exercise in training the patient to tell the therapist what they want to hear. Studies typically don't follow patients for years and years after therapy is concluded; the claim often made about CBT is that, by failing to address deeply underlying issues, it just temporarily suppresses those issues, where they can easily bubble back up again in the future.
This is all based on secondhand information and stuff I've read, so take me with a grain of salt. Just a reminder that "CBT" does not = "therapy." CBT is merely one form of therapy, that's designed to be quick, not dig too deeply, and starts from the premise that the patient has "wrong thoughts" and "wrong feelings."
