What are Counselling and Psychotherapy?
Counselling and psychotherapy are complementary therapies that use talking to help you work through things that you might be struggling with. This might be to do with illness, grief and loss. It could be focused on relationships. It may be related to the mental health difficulites that we can all experience during our lives, such as depression and anxiety, or because of traumatic events we have lived through. Talking to a counsellor or psychotherapist gives you space to reflect on what is happening in your life. This can help you cope with change or make changes at your own pace with support, if that is what you decide is the best option for you.
There are several different types of counselling and psychotherapy. I use an integrative, relational approach. This means that I will draw on a range of different theories to help fit my approach to you. We might look at patterns of thinking, how an early experience is impacting on your present life or help you focus on a particular issue or problem. If you want to find out more about the different types of counselling/psychotherapy that are available in the UK, please look at the BACP's online guide.
Can counselling and psychotherapy help me?
Research shows that counselling and psychotherapy can help you with a range of different issues (Cooper, 2008). To find out more about the kinds of things counselling/psychotherapy can help with have a look at the BACP's online resource: What Therapy Can Help With.
How does therapy work?
Different approaches have different ideas about how therapeutic change takes place. A neuroscientific explanation might focus on the fact that our brains are plastic and that talking with a therapist can help us change at a neural level. A psychodynamic practitioner might suggest that therapy works because you gain insight. A narrative therapist may well say that this type of therapy achieves change through creation of a new narrative. A CBT practitioner could suggest that change occurs through alterations to thinking patterns. Integrative practitioners may suggest a combination of all of these will effect change.
What are the alternatives?
Talking to a GP can help you find out more about medical treatments that could help you. For example, your GP might prescribe anti-depressants, if you are feeling depressed. There are a number of self-help books published that can help you understand more about your difficulties. Research has shown that self-help books can be effective (Bohart and Tallman, 2010). There are also a range of complimentary medicines that can provide additional support. For example, acupuncture can help with chronic headaches, migraines and pain management (NHS, 2016). You can also choose to take no action.
What are the benefits of counselling and psychotherapy?
Counselling and psychotherapy are non-medical approaches to health and well-being, which means you can access help and support without consulting a doctor. However, your therapist may suggest you see a doctor, as there are sometimes biological explanations for problems.
What are the disadvantages of counselling and psychotherapy?
There are several disadvantages to counselling and psychotherapy that focus on commitment and finance. Meeting weekly, at the same time each week for the length of time agreed with your counsellor or psychotherapist can be difficult to fit in to busy schedules. In addition, there can be a significant financial outlay working with a private counsellor or psychotherapist on a weekly basis for long periods of time.
Are there any risks involved in working with a counsellor and psychotherapist?
Some people find that working with a counsellor or psychotherapist makes them more aware of uncomfortable emotions. Others find that their relationships with others change when working with a counsellor or psychotherapist. A few experience strong feelings towards their therapist. A very small number of people report negative effects after counselling or psychotherapy, but it is believed that this can be minimized if you are given information about therapy before you start (Crawford et al., 2016). You need balanced information about therapy to help you decide if it is the right course of action for you, at this point in your life.
Are counselling and psychotherapy sessions confidential?
Yes, but there are limits to that confidentiality that focus on prevention of harm to yourself and others, as well as prevention of terrorism. In addition, counselling and psychotherapy work needs to be discussed with a supervisor to make sure it meets the ethical guidelines that counsellors and psychotherapists work within, such as the BACP’s Ethical Framework for the Counselling Professions.
Are you able to commit to meeting at the same time, on the same day, each week?
Are you able to pay for counselling and psychotherapy?
What will happen in my therapy sessions?
Your therapy sessions usually start with an informal, pre-therapy appointment. This enables you to tell your therapist more about you and the reason you have sought counselling or psychotherapy. At this point, your therapist is likely to ask you questions about your personal history. It is a chance for both of you to decide if you want to work together. If you feel uncomfortable, it is important to look for someone who you do feel comfortable with. In your first session, you will be asked to agree to a counselling contract, which sets out the rules that you will both work to, including limits to confidentiality, session fees and what notes will be kept. You will be asked to sign a written contract before your counselling or psychotherapy begins. The BACP’s guide What Happens in Therapy is a helpful resource if you have not had counselling or psychotherapy before.
What will I be expected to do when I am working with a counsellor or psychotherapist?
There are three key things that you will be expected to do. These include coming to booked sessions regularly and on time, letting your therapist know in advance if you can't make a session and to be willing to examine your thoughts, feelings, reactions and motives. This is not always an easy thing to do.
How many counselling or psychotherapy sessions will I need?
This is a hard question to answer because we are all different. There is some research that has estimated the following: 30% of people experience change in 1-2 sessions; 60%-65% of people experience change in 1-7 sessions; 70-75% of people experience change after 6 months and 85% of people experience change at one year (Howard et al., 1986 cited by Bohart and Tallman, 2010, p.91).
How can my counsellor or psychotherapist measure change?
There are several different forms that therapists can use to help measure therapeutic change. Some require you to answer questions about the way you have been feeling over the past week or two and take a few minutes to complete. There are also forms that can be used to help you rate your therapy session, or feedback what you have found helpful about it. Regular reviews of your work with your therapist can help you tell your therapist what has worked well for you, as well as what has not.