Where to get support?

Following on from my post last week for those who are not in a position to look for a private counsellor, these are some thoughts and suggestions. Please note these are all England based.

  • For the NHS, try searching for your local area and “IAPT”. This usually brings you to a way to refer yourself directly to your NHS trusts mental health services.
  • Search for charities in your area that offer mental health support.
  • Look up counselling schools and organisations near you as they may offer support working with a counsellor in training for a nominal fee.
  • https://www.mentalhealth.org.uk/explore-mental-health/get-help has a list of some options, especially for those in crisis that need immediate help.

Please be aware that most counsellors/therapists working privately are not able to take on clients and charge back to the NHS. The system isn’t designed that way. When seeing someone through the NHS or a charity, you usually have to work with the counsellor you are assigned unless there is a significant reason not to.

What clients experience when having therapy

You may question why people go to therapy? What is different about talking to a counsellor than talking to your friends and family?

Quite often our loved ones are great to talk too but they may find it difficult to sit with you when you are emotional. They may want to ‘fix’ you and make you feel better or get defence and not hear you properly.

For example, if someone you care about is upset and crying, what do you do? Offer comfort, hug them, pat their hand or arm, tell them it will be ok? These are all normal responses – but they won’t really happen in therapy. We let the client carry on crying and work through it. It may seem harsh, but it’s about giving the upset space. Otherwise we can end up suppressing it to make other people feel better.

One of my clients feedback years ago taught me how powerful this was “you let me cry, you didn’t try to stop me”.

What is it really like to have counselling?

What’s it really like to have counselling?

This is the question that so many people have before they start.

We see so many portrayals of it in the media, some positive, some not.

It doesn’t have to include a couch! My old office for my face to face work did have one but every client just sat on it.

In our initial assessment I will have some things that we need to cover. The first is around my contract and boundaries of confidential. This is to ensure you know what you are working and ensures you feel safe with those. It wouldn’t be ethical for me to let you tell me loads of things that I then have to disclose as you didn’t know I would have to do that.

The second thing I like to get a feel for is why you want to come to counselling. Not everyone says all the things that are bothering them as this point but it does give me an opportunity to assess if I have the skills and experience to work with you. Again this is about keeping you safe and not offering you something I can’t work with. For example I am not trained to deliver exposure therapy so I am not the person to help you overcome a fear of flying or spiders.

The first sessions usually go one of two ways. The client comes and has loads they want to say and have someone hear so I don’t say much at all.

Alternatively the client isn’t sure where to start and I might invite them to talk about themselves by asking them general questions about themselves and their life.

Each client is unique so it can take time for us to get to know each other better. 

Counselling is all about the relationship between us; I don’t mean that the client is going to hear all about who I am as well. I mean that the client can see if they feel able to share their problems with me. If they can’t do that then the therapy can only go so far.

This relationship can take time which is why I ask clients to give it a few sessions unless they absolutely hate it or they already have got what they want out of it.

The more we build our relationship the more the client is able to explore what is going on for them and find some healing.

Why does this experience of therapy brings about change though, that’s another big question. It doesn’t always, let’s be honest about that. Sometimes it the relationship not working as effectively as it could; sometimes it’s just not the right point in the clients life. Too much may be going on to give the therapy the space it needs or they don’t have the best support network around them.

Yet when all these things do come together clients can make amazing changes.

The process is enhanced by have someone who is there for you completely for a fixed period of time every week. It becomes all about you which is quite a unique experience for most of us yet once we become used to it then the work really begins.

Am I the right counsellor for you?

I believe that everyone can benefit from having counselling once they find the counsellor that suits them.

How do you know if I am the right one for you? It may help to know a bit more about me. I come from a London Irish working class background and I was raised in Southwark.

I am down to earth and open in the counselling space and my role is to help facilitate your exploration of the issues that have brought you there. I do this by listening to what you are saying but also what you may not be saying. By exploring this with you it can lead to greater understanding of what you are experiencing.

I don’t just listen, I work to understand what it would be like to experience what you are telling me in a non judgemental way and I will check my understanding with you to ensure I am getting it right. This stops me making assumptions about you and your life.

I think its important to use regular language and vocabulary in our work together, I’m not there to impress you with my use of theory and academic abilities. When I speak it is only to help you in your processing of what you are bringing.

I believe that as many people as possible should have access to counselling so I also work online as it gives people more options, clients can schedule around work and family commitments without having to take extra time to travel to appointments.

Visit the contact page to find ways to get in touch. You may also notice that my home page gives details of my current availability. I know it can be incredibly frustrating reaching out to a counsellor only to find they don’t have space that is suitable for you so I try to keep this as up to date as possible.

Frequency

I talked a bit about how long counselling should be in a previous post but I didn’t mention frequency.

The most common is to have a weekly session. This is so that the client has time to process what may have come up for them and review where they are before the next week while still keeping things fresh in memory at the next session.

However, this a huge commitment for some people both in time and money so every two weeks has become something that a lot of people choose. I work online this way but not face to face for personal practical reasons. I only have office hours on Fridays so I would have to find two clients that would use the same slot on alternating weeks which wouldn’t necessary be easy, otherwise I would be wasting a time slot every two weeks.

However working online I do offer every two weeks as I can be a lot more flexible with my working hours that way.

I really wouldn’t recommend planning to work on a longer frequency than every two weeks. I believe it would make it very difficult to build a therapeutic relationship and then see change occur. It may be that after a period of regular therapy then the client would like some check in sessions after a longer period to see what progress has been made and if it is being sustained. This could be useful towards the end of an alliance once an relationship has been formed and worked on. However again for practical reasons I could only offer this online.

How long is long enough?

How long is long enough?

It’s one of the hardest questions to answer from a client. How many sessions do you think I will need?

It’s just like the question how long is a piece of string?

I have worked with people who got what they wanted from one session, others needed years.

I recommend giving the start of therapy six sessions. This six session model has become a bit of a standard. It gives the client and counsellor some time to get to know each other which I believe is the most part of the therapeutic process. There is time to address a specific issue the client wants to focus on and maybe see some results.

I say maybe because it really does depend on the issue. For example, if the client wants to use the space to offload about some work related stuff that is going on, then this can happen.

Some clients have an initial group of sessions and then come back later. E.g. they may want a few techniques for improving their behaviour when they are angry. They can get these and then take some time to put these into practice. They may choose to continue therapy during this process or take and break and come back to explore the results.

There are some issues that clients bring that may have built up over years and may need longer term work. Low self esteem, anxiety, bereavement and depression can take time to work on and it’s impossible to guarantee the outcomes or how long it will take. But there are always exceptions to this and sometimes the six sessions are enough.

It may be that the six sessions are enough for right now and the client may find what they are really looking for is coping mechanisms for the present time so that in the future when they are in a better place they can address more of the underlying issues.

So the answer to the question is no real help I suspect for people. All I can say is that when people commit to the process I have seen real change occur and I believe it is possible for anyone. Give yourself time to heal from the wounds of the past.

What are the benefits of online counselling

Are you thinking about having therapy online but are not sure about if its right for you and don’t understand how it works?

Below are some of the benefits which may apply to you but firstly:

how does it work?

You will need to make some choices on how you want to engage with your therapist. It can be a video call where you see each other or an audio call. Alternatively you can go text-based like having a conversation on a chat application which will still be in real time.

The benefits

Making this choice is one of the first benefits, you can choose what makes you more comfortable. Some people are distracted by video calls and very self-conscious so prefer an audio call. Others have slower connection speed which means they prefer audio or messages. Others prefer message based because they find it very hard to talk about their issues and this makes it easier for them. I have clients who have chosen different ones for these reasons.

You may be one of the many people ok with meeting their counsellor face to face in their office, but you may also be one of those who finds it very hard and it may be stopping you accessing counselling in the first place. Working online means you are able to choose where you are, usually at home, so it can be a lot more comfortable. Being in a more comfortable place can make it easier for you to talk about what is worrying you.

You may be one of the clients who need one of the biggest benefits, convenience. Not having to travel to and from the counsellor’s office can save a lot of time. You may not live or work very close to a counsellor or be in a small community where seeing a local counsellor wouldn’t feel comfortable.

As well as the travel convenience, scheduling a regular weekly slot can be hard for some people due to other commitments. Therefore, for people working shifts, evenings and different patterns each week or have to be in different location this might be the only way you can get to see a counsellor.

Next steps

As a way of working, it’s still relatively new to a lot of people but try it. You might find it is the best way for you. Get in touch and we can schedule a trial session.