What is Psychotherapy/Counselling?
According to the British Association for Counselling and Psychotherapy it is the provision by qualified practitioners of a formal and professional relationship within which patients/clients can profitably explore difficult, and often painful, emotions and experiences. These may include feelings of anxiety, depression, trauma, or perhaps the loss of meaning of ones life. It is a process which seeks to help the person gain an increased capacity for choice, through which the individual becomes more autonomous and self determined. Psychotherapy may be provided for individuals or children, couples, families and groups.
How is Counselling different from just talking to a friend?
You may feel you want to talk things through with friends or family instead of going for counselling. This can be helpful, but they often have their own vested interest in how things 'should' turn out; or you may feel awkward telling them some of the things that you feel, in case they are critical. Maybe they will want to turn the conversation around to their own troubles; or give you advice before you have even finished telling them how you feel; and so on. A professional counselling session on the other hand will give you a chance to work things out for yourself. A trained counsellor will really listen, in an unbiased and uncritical way, and reflect back to you the way that you are feeling and thinking, so you get a chance for a new perspective, and the space to look within and find your own answers. That may be enough in itself for you to see things more clearly.
It may also be helpful to explore parts of your past during a counselling session, especially your childhood, so as to better understand how things came to be the way they are, and why you take some things for granted, while rejecting other ideas instinctively.
Counsellors will never tell you what to do - they believe that you have the answers to your own problems hidden within you, although you may need some help to find them. Counselling is not just having a good moan (although it may be helpful to do that as well), nor is it simply going over and over the problems. In successful counselling, you will work together with your counsellor to get a sense of understanding, of power, and of purpose, which will help you to move towards a more relaxed, authentic and positive way of living. The ultimate aim is for you to make your own choices and put them into action.
Who benefits from Counselling?
Anyone who wants to make fuller contact with their 'real self', and feels that talking could help, will benefit from counselling. It is often some kind of life-trauma which nudges us towards seeking help to change, but you don't have to wait for a crisis. Many people use therapy as a way of getting to know themselves better, and improving the quality of their lives and their relationships with others.
Counselling, Psychotherapy, Psychoanalysis, Psychology - what's the difference?
Such differences as there are tend to be more in theory than in practice. Counselling tends to be shorter-term, and the therapist may concentrate on helping you to clarify your feelings by reflecting things back to you for a better perspective. In Psychotherapy there may be more exploration of your childhood, or other ways of working such as visualisation or dream-work. Psychoanalysis is less common, takes the most time, and involves in-depth work with the unconscious. Psychology is the study of human behaviour, thinking and feeling, Most therapists (whether they are called Counsellors or Psychotherapists) tend to use a mixture of counselling and psychotherapeutic techniques - the first session is a good time to ask about their training and theoretical orientation.
What can I expect in the first counselling session?
You will be asked to outline why you have come, and what you are hoping for. Your counsellor will ask you some questions about your background, and you will have a chance to ask any questions of your own. This is an opportunity to discuss fees if you haven't already. You could also discuss how many sessions may be appropriate. You should ask about the counsellor's qualifications, and even more importantly, whether they belong to a recognised professional association, and whether they continue to receive ongoing counselling training and supervision (see the section 'How can I tell if my Counsellor is going to be any good?')
The most important thing is that you should get a sense of whether the two of you will work well together. You need to feel comfortable, at ease, and above all, safe. If not, remember that you are under no obligation to continue; your Counsellor will respect your decision to 'shop around'.
How much will counselling cost?
Outside London, you can generally expect to pay between £15-£50 per hour for professional counselling, around £30-£40 on average, some operate a sliding scale of fees according to financial circumstances. You may be able to obtain counselling via the NHS - ask your GP in the first instance.
How long will counselling last?
You will normally see your therapist once a week, sessions last about 50 minutes. There are no rules about how many sessions will be appropriate. Some people get all they want in a single session, some work with their therapist for years. It is a good idea to agree to a review of progress at a fairly early stage - this will give you a chance to assess whether the counselling process is meeting your needs.
What if I want to stop?
You are always in charge of the process, and you can stop at any stage. However, do be aware that uncomfortable feelings are a sign that things are moving in your unconscious - you may feel worse before you feel better. Discuss this with your therapist, rather than simply deciding not to go to your next session. It will be more helpful to understand what is happening than to evade it. Most therapists ask for a week's notice so as to discourage clients from trying to cope with their bad feelings alone.
How can I be sure that what I talk about will remain private?
A professional counsellor will subscribe to a Code of Ethics which ensures absolute confidentiality for clients, except in a few very rare circumstances. Ask your therapist to explain this at your first meeting.
How can I tell if my Counsellor is going to be any good?
Word-of mouth or personal recommendation is probably the best way to start. But there are other things that you should check:
Ask about their counselling training and qualifications: They should have at least a Diploma. They should have undergone a training course of at least 2 years, which should have included skills practice and required personal therapy. Shorter courses or correspondence courses do not offer the necessary level of training.
Ask about their theoretical orientation: There is no one 'best' kind of therapy, but ask your counsellor to explain how they work, and find out whether you will be getting what you want.
Ask about their supervision: Good therapeutic practice dictates that no matter how well-qualified or experienced a therapist is, regular supervision of cases should be undertaken.
Ask about their ongoing training: A dedicated counsellor will continue to attend training courses so as to keep up-to-date and 'fresh'.
Ask about their experience: How long have they been practicing?
Ask about which professional body they belong to: A professional therapist will belong to one or more of the following organisations. This means that they will subscribe to the Code of Ethics, and thus be subject to the Complaints Procedure, of that organisation.
British Association for Counselling and Psychotherapy (BACP), 1 Regent Place, Rugby, CV21 2PJ
British Psychological Society (BPS), St Andrew's House, 48 Princess Street, Leicester LE1 7DR
United Kingdom Council for Psychotherapy (UKCP), 167-169 Great Portland Street, London W1N 5FB
National Association for Psychotherapists (NAP), PO Box 774, Windsor, Berks, SL4 4FS
You can contact any of these organisations to check.
Do not be afraid to discuss any perceived problems with your counsellor - remember that you are working together to make the changes that you want. But only you can take the final decision about how well counselling is working for you. A good working relationship between therapist and client is worth more than any number of qualifications.
