There are points in life where we know something needs to change but we become stuck and uncertain, or perhaps feel helpless and anxious in the face of a personal crisis or life transition. At such times, our ways of making decisions and of managing and resolving problems may no longer work for us; our familiar outer supports (family, friends, workmates or colleagues) don’t seem to be enough, or indeed may be closely bound up with the difficulties we are encountering. Our physical and mental health can also be adversely affected with anxiety, depression and emotional fragility being common symptoms. This is the point where counselling or psychotherapy could be of help. There is no rigid distinction between the two modes of working but there are differences in emphasis.