Frequently asked questions
How can ‘just talking’ help?
Broadly speaking, talking therapies can lead to new understanding, self-acceptance and ideas for moving forwards. Some people feel immediate relief in voicing thoughts that they've always kept to themselves. Sometimes the power of being really listened to helps us hear and clarify to ourselves what we are really saying - allowing us to take the next step. Encouragement and non-judgmental acceptance can help us genuinely see, face and accept where we are at. Exploring what underpins difficult thoughts and feelings can help us manage or dismantle unhelpful tendencies and replace them with something better. Psycho-education, ideas and tools can aid understanding of what is going on and what we can do about it.
Talking to a counsellor is different to talking to others in our lives, as those close to us typically have their own agenda for us and themselves.
I think I want to see a counsellor/psychotherapist - now what?
Typically, you'd make an appointment by email or phone. At your first appointment you'd outline where you are at, and what you hope to get from therapy - though many people find this difficult to articulate. If the counsellor/therapist feels they can help and you want to go ahead, you'd make an initial plan for meeting. If you both want to continue at that point, it's a good idea to plan just a few sessions (say 3 or so) - by which time it should be clear whether you feel you can work well together - rather than committing to a large number of sessions from the outset. Of course, you remain in control and can terminate whenever you want, although it is usually helpful to raise concerns with your therapist rather than just walking away.
How do I choose a therapist?
Therapy works best when you find a therapist you can build a good working relationship with. Initially, have a chat with a possible therapist to discuss practical matters, and to see if they feel able to help you. This should give you some sense of whether you feel you could trust and work with this person. Your first appointment will help you decide whether they are the right person for you - don't be afraid to ask questions. Although it takes time for a working relationship to develop, if they don't feel 'right enough' at the outset, find someone else. It may take a few gos to find someone you can work well with.
It's a good idea to find someone who is a member of a professional counselling organisation (such as the BACP or UKCP) as this will ensure that they have followed a recognised course of training.
What school of therapy is best?
Research suggests that whether you can form a good working relationship with your therapist is much more important than the school of therapy that they belong to. Having said that, you might find it easier to work with someone who tends to use and explain psychological theory in a way that chimes with your beliefs, so you might find that you usually prefer working with therapists from a particular background.
This short article outlines some of the different approaches. In general, unless you specifically know you want CBT (that focuses on changing negative thought processes) or psychoanalytic psychotherapy (which tends to be very long-term), I'd suggest starting with someone trained in other models or approaches.
How long will it take?
Impossible to say, but perhaps not as long as you’d think. Depending on the issue, many people feel significantly better about life within a few sessions - perhaps even after the first one, in part because they have taken the first steps, or lifted a burden by sharing. Of course, starting to feel differently doesn’t mean that all the work is done, but it is a sign that something is shifting and that there is hope.
Will it get worse before it gets better?
Possibly, but not always (see above). However, in order to move forward you may sometimes benefit from exploring issues that can trigger strong emotions and be stressful. It is NOT the case however that all instances of past trauma must be 'worked through' as is sometimes thought, and a sensitive therapist will ensure you remain in control. Therapy should proceed only at a pace you can handle. Learning how to manage our own difficult feelings is however often a crucial part of good therapy.
Is our work confidential?
In general, everything you tell a therapist should remain confidential, although they may discuss your work anonymously with a supervisor to support good practice. An exception to this would arise if they were very concerned about your safety or that of others very close to you, and ideally they should then consult with you to see what other help could be put in place. Therapists should make clear any limits on the confidentiality offered at the outset.
In general, if you told a therapist about drug use or most crimes, they would not need to tell anyone.
Can counselling help me?
Probably - if you are willing to really try, and if you find a counsellor you can work with.
A therapist can't change you - that's your job, if you want it. A therapist's role is to help you to help yourself, and to help them do that you need to work towards engaging with the work openly which takes courage.
I have a mental health diagnosis - can counselling help?
If you are able to engage in talking therapy, then counselling is often at least as effective as drugs at treating many common mental health conditions such as depression, anxiety, trauma etc., and can be more effective in the long-term. Counselling can also be very effective in managing the wider impact of a health condition on our lives and reducing or managing symptoms (e.g. bipolar disorder, memory issues, some pain conditions). Exploring feelings and thoughts about being given a mental health diagnosis, and its effect on our identify can also be valuable.
Can you (the counsellor) cope with my stuff?
In short - yes. A good counsellor has the personal qualities, experience, supervision and training to cope with whatever issues you might wish to explore. You should not feel worried about shocking, upsetting or overwhelming your counsellor, or that you have to look after them in some way. If, however, it became clear that you might benefit from specific expertise that could not be provided by your current therapist, your therapist should discuss whether an onward referral might be appropriate for you.
Therapist, counsellor, psychotherapist?
I use these terms interchangeably, as does the BACP and many therapists in the UK. Some make a distinction between counselling which is more short-term, and more in-depth longer-term psychotherapy, but acknowledge that the therapies overlap significantly.