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It's important to first understand the difference between counselling and clinical psychotherapy.

The word 'counselling' is often used synonymously with 'supportive counselling', which means offering to listen, empathize and validate someone's problems. Sometimes that's all there is to it, but counsellors will also often offer practical advice to alleviate particular difficulties.

In contrast, clinical psychotherapy, as practiced by clinical psychologists, refers to treatment of serious mental illness, such as major depression or an anxiety disorder. In this context, it is important to have a set of diagnostic criteria that allows the therapist to choose the best strategy for treatment. Diagnostic criteria and definition of symptoms also allows mental health professionals to communicate in mutually understood terminology.

Therefore, the DSM is very important in clinical psychotherapy, and less so for counselling (though there would be some instances in counselling where it might be useful, but relatively less so than in clinical psychotherapy where it is used all the time).

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