What is Counselling therapy?

Counselling is a process which aims to help us deal with issues through exploration and discussion. It is a series of confidential meetings of up to one hour duration, usually once a week at the same place and at the same time. Psychotherapy is similar but the sessions may be more frequent, longer-term and explore the issues in greater depth.

Counselling offers a safe and confidential place to talk about yourself and your concerns and to help you move forward in a positive way. It does not offer advice. The therapist does not make decisions for you. Decisions are often difficult and we may avoid making them for fear of mistakes or looking foolish. What the therapy will do is help to clarify the issues, look at a range of options and empower you to make a decision based on your values and your choices.

Why don’t I just talk to a friend or family?

While knowing people who love and care for us can be very helpful and supportive, sometimes talking to them very openly is not easy. It may be that your difficult feelings are actually about someone close to you. The opportunity to be listened to and heard by someone outside your normal life provides a safe, confidential, objective, non-judgemental space in which to identify, explore and work through the issues which are preventing you from leading a psychologically healthy life.

What can counselling help with?

People seek therapy for many different reasons and there is no right or wrong, good or bad reason. Often people feel confused about what their problem is and experience anxiety around making decisions which may include the decision about seeing a therapist in the first place. The following are just some of the more common issues but it is far from comprehensive: self-esteem, family and other relationships, work issues, stress, anxiety, depression, anger, loss and trauma, addictions, issues around control, change, sense of meaninglessness, sexuality, identity, shame, guilt.

Feelings though are often too complex to fit under just one heading. Indeed, the initial problem may be confusion about just how in fact you are feeling. What you know for sure is that you do not feel comfortable.

What will it be like?

Everyone’s experience of therapy is different. It is a very personal process but at its heart there should be a special relationship between therapist and client. It is your decision what you tell your therapist, but the more open and honest you can be the better. The therapist will really listen to you but will not judge you. In trusting them with your very difficult and painful feelings you will feel supported. However, in opening up these these emotions you may initially feel worse. Your therapist is there to help you through this.

In this safe and confidential environment you will have the opportunity to talk, explore your situation, clarify what is going on and identify what is not working for you. You will be helped to understand what you find difficult, identify what choices you have in order to make some positive changes to your life and thus to feel better. This will assist you in developing skills/resources to cope with problems in the future. Throughout this process you will be supported by your therapist to gain self-insight, improved self-worth, better relationships and a more positive outlook.

How long will therapy last?

Although sometimes only one or two sessions can be enough to make the difference, generally the length of therapy depends on the problems to be addressed, for how long they have been an issue and how deeply the client wishes to explore. Solution-focused work and CBT is often 6 – 12 sessions. Other approaches may be open-ended. The length of counselling is a joint decision between therapist and client and can be regularly reviewed.

Will it work for me?

It is not a magic bullet and it is not suited to everybody. If you are not motivated to work through often difficult and painful problems it is less likely to be helpful. You need to come to therapy because you want to and not because other people have told you to.

Are there different types of therapy?

There are different methods and approaches. When you are looking for a therapist and meeting them for the first time you should get a clear idea of how they work. However, some research studies have shown that the most important element in achieving a successful outcome is the quality of the relationship between client and therapist. This is why you should listen to your instincts at the first meeting with a counsellor and if you do not feel comfortable with them it may be better to look elsewhere.

How do I start?

It is normal to feel apprehensive and nervous about seeking help regarding some very private feelings. However, we all face emotional difficulties at some point in our lives which makes us feel more vulnerable and therefore it may become even harder to talk to people. We may feel increasingly lonely, misunderstood and isolated and so it is even more important to get appropriate help.

You are already taking the first step in helping yourself by seeking a therapist. Once you have identified a potential counsellor, you can arrange an initial appointment with no obligation beyond that.

What happens at the first appointment and what should I ask the therapist ?

The first appointment is a general assessment in which the client should outline the main concerns which they want to address and the outcome for which they are hoping. The therapist in turn will explain how they work, their overall therapeutic approach and what they feel can realistically be achieved for the client. The ‘counselling contract’ will be outlined and this should include an explanation of the confidential nature of the arrangement, the time, place and duration of the sessions and cost. The terms regarding holidays and cancellations and how many sessions are anticipated in the first instance should be laid out. Each party should decide if they feel that they could form a good working relationship. If a therapist does not think they can help a person they should disclose this and if a client does not have confidence in a therapist or feels uncomfortable and inhibited it is better to look for another one. If this continues to happen it may indicate that you are not ready for counselling.

You may want to ask about the counsellor’s qualifications and experience. You should feel able to ask any questions about all of this and indeed it is best to voice any other concerns or reservations you may have.

What is the The Counselling Contract?

This is usually a verbal agreement between therapist and client to establish clearly the basis of the work they will do together. The main points will be:

• Time (preferably to suit the client)

• Place

• Length of session (usually 50 minutes to an hour)

• Frequency (usually once a week but this can be varied according to your needs and the type of therapy agreed on)

• Number of sessions – a few initial sessions e.g. 4-6 may be agreed followed by a review to decide what is most appropriate going forward.

• Cost per session, method and frequency of payment. Some therapists work on a flexible basis determined by someone’s ability to pay/income

• Cancellation – how much notice is needed in order not to incur a fee

• Confidentiality- what you say will not be disclosed to anyone else but there could be a situation in which the therapist feels they would like to talk to your doctor, for example, if you are either at risk to yourself or to others. The therapist should try to let you know if this is something they intend to do. You may therefore be asked for contact details of your doctor. You may want to ask if the therapist keeps notes and whether or not they use your name or a pseudonym. You should be aware that counsellors use the services of other counsellors who are trained as ‘supervisors’ with whom they review their work with clients. However, there are standard safeguards regarding confidentiality within this process.

• Procedure if several sessions are missed or cancelled without notice

• Whether therapist will be available for online or telephone sessions when face-to-face sessions cannot be attended.