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Every session is different because every client is different, as are their problems. Your psychotherapist will encourage you to talk and explore, in a structured way, about your feelings and experiences.
Depending on their training and modality, your therapist may also suggest particular techniques as part of that exploration - for example, using art, imaging, dream or movement work.
Whatever the technique or clinical approach, psychotherapy is not a magical cure, it is a process to help you find the capacity for improvement within yourself.
The difference between the two is a hotly debated issue. The British Psychological Society defines counselling as a system intended to 'help people improve their sense of wellbeing, alleviate their distress, resolve their crises and increase their ability to solve problems and make decisions for themselves'. This suggests it works best with people who already have a sense of wellbeing and are able to solve problems and make decisions but need a helping hand during a crisis.
Psychotherapy might be more helpful for psychological problems that have built up over years than at a time of crisis or distress. Given the variety of opinions on this subject, there's bound to be someone who reads this and disagrees, and they'll probably have a view worth listening to. The therapist will use both counselling and psychotherapy skills while working with a client depending on the issue presented and the treatment plan decided.
Ultimately, the only way to decide for yourself is to get involved in the debate by reading. A good place to start is A Complete Guide to Therapy: From Psychoanalysis to Behaviour Modification, by Joel Kovel (ISBN 0394733363).
Psychotherapy aims to help clients gain insight into their difficulties or distress, establish a greater understanding of what keeps these unhelpful ‘patterns’ in place, and enable them to find more appropriate ways of coping and bring about changes in their thinking and behaviour.
Psychotherapy involves exploring feelings, beliefs, thoughts and relevant life events, sometimes from childhood and personal history, in a structured way with someone trained to help you do it safely.
Depending on the nature of your problem, therapy can be short or long term. Sessions can be provided for adults, adolescents and children on a one-to-one basis, or for couples, families and within groups whose members share similar problems.