What does a typical therapy session look like?
The arrangement is simple and informal: A session involves an individual or a couple and the therapist sitting across from one another. There are no disruptions. Phones are switched off excepting in cases of urgency. We mutually agree a seating arrangement and this can change. For instance, I have a couch if a client wishes to lie on it - if only to get a sense of what that might be like to 'free associate'! We can swap armchairs - there is no 'therapist's chair' as such.
Does it get emotionally intense in every session?
The atmosphere in therapy is conducive to having a relaxed, unhurried and deep, reflective conversation that can bring up all kinds of feelings. Despite what many people think, therapy sessions are not usually a hot-house of intense emotions - although it sometimes can be, which is, of course, fine. All of our feelings, if allowed to surface naturally in the safety of a therapeutic setting, are trustworthy. There is an instinctual self-regulation built into our emotions. Often the work in therapy is creating an atmosphere of trust in which these emotions can be allowed a safe expression. All of our emotions can be useful guides that bring us invaluable self-understanding that can vitalize our existence. It is worth remembering that therapy is a space for all kinds of emotions - 'dark' and 'light'. I have experienced some of the most profound stillness, laughter, connection, wisdom and joyfulness with my clients alongside some of their more difficult feelings.
What is 'therapeutic' about therapy?
Current research world-wide supports that positive experiences in counselling result from an atmosphere in which a client feels safe enough to be able to talk freely to a therapist. For this, the genuinely responsive, non-defensive, and non-judgemental presence of the therapist is a vital factor. In a calm and reflective space a therapeutic dialogue can develop in which any difficulties in life can be recognised, acknowledged, understood, and eventually resolved. For this, I think it is important that a therapist remains attentive to the unique moment-to-moment interactions with their client. The confidential nature of therapy enables you to find your own words for describing your situation in a way that is close to your experience of it, and it is this expression from which a way towards a more satisfying way of living can be realised.
How do I decide whom to select as a counsellor or therapist?
Choosing your therapist is a responsible decision. And it can be confusing too. There are many forms of therapy, many training organisations, and several professional bodies. Fact is: no amount of professional or academic credentials can guarantee that a therapist will always be right for you. Professional requirements can only ensure that the therapist has adequate training and has committed to the ethical framework of the membership organisations. It is particularly important that you understand that for therapy to succeed the therapist needs to be able to relate to the client in a way that maximises the potential and resources of the client. Therapy, in essence, involves a strong working alliance resting upon a genuine relationship that is held securely within clear professional boundaries. Check with a prospective therapist if they offer a free initial consultation. At least ask to speak to them on the phone about your situation and get a clear sense of how it feels to talk to them. I think it is very important that a therapist is personally free from any 'unconscious' stigma attached to 'being in therapy' and is able to draw from therapeutic support in their own life. In addition, it is also essential that therapists receive clinical supervision throughout the period of their practice in accordance with their regulating professional body. So before deciding, you could ask them about their own therapy and supervision.
What is the significance of therapist accreditation and registration?
Both terms mean pretty much the same thing. They indicate that the therapist has undergone a certain level of professional training and gained practical experience. These also provide accountability to a professional membership body in terms of 'good practice' and ethical working. These bodies have a complaints procedure that members adhere to, and you can take out a complaint against the therapist with the organisation that the therapist is accredited or registered with.
The UKCP is the main registration body in the UK for psychotherapy and requires that each therapist has undergone their own own training as well as personal therapy. BACP is a professional organisation in Britain which gives accreditation status to counsellors and psychotherapists. I am registered with both these organisations, and subscribe to their ethical frameworks.
How will I know if my therapy is going well?
When counselling sessions are 'working' most clients know by how they feel and think about their situation. Even when things are difficult, there is a certain sense that being in a session with their therapist is a positive and worthwhile experience. More commonly, one begins to take the insights and learning experiences from therapy into their relationships and circumstances in the 'outside' world.
In my view, at the very least, you can expect from your therapist the following:
- a clear sense that they are able to listen to you with genuine patience and interest
- you are not forced to think, feel or act in ways you are not ready to or are against your values
- what they say makes sense to you, and if not, they are prepared to clarify
- you experience a genuine sense of their non-judgemental stance
- you experience a genuine sense of their empathic understanding of your difficulties
- you feel at the centre of your therapy and are encouraged to take the lead in sessions
- you experience them as actively engaged and confident whilst they are listening to you
- you sense a dynamic structure in a session even when being intuitive and spontaneous
- they do not act as 'experts' on your legal, philosophical, moral, health - or indeed any issues
- they can hold professional boundaries for a working relationship based on genuine respect
- a non-defensive in response to what you might say about your experience with them
- a clear sense of respect for you as a person, for your autonomy, and any difference of opinion
- you are supported in ending therapy when you feel ready to move on
Can I expect to receive advice from you about my problem?
Occasionally people expect advice from their therapists - which is understandable given that the word 'counselling' has another meaning, which is 'advice giving'. It is generally accepted that giving directions for making decisions to a client is not a good idea. To begin with, the thrust in the counselling process is to foster client's autonomy. There are other reasons why counsellors do not give advice, such as each person has their own set of values, goals, needs, and aspirations in life. Having said this, my presence in this work is not neutral, I actively engage with clients, but remain mindful of my limits both, as a person and as a practitioner.
How long does it take?
The length of counselling usually depends on the issue(s) that you face, and also on the depth at which you wish to address them. Often a specific issue can take just a few sessions. If you are facing a number of issues affecting your life at personal, interpersonal, social and existential levels, this will probably take longer. Longer term therapy can provide an opportunity for recovering the self you have lost as well as discovering the person you have yet to become. You should bear in mind that therapy is not a medical procedure, nor is it anything like an engineering project where there are fixed deadlines and milestones. Of course, this does not mean that therapy has to go on long-term, although sometimes it just does. What you would like to focus on, and for how long, can be discussed in the initial session and also reviewed periodically.
Why is confidentiality so important in therapy?
Confidentiality ensures trust and security in therapy. Since your therapist will commit to not divulging any of your thoughts and feelings, you are free to express whatever concerns you have as you experience them, without any need to censor yourself. Speaking in social situations usually has consequences. In therapy, you can allow yourself to say things with a view to expressing yourself, or to try out a new way of describing an experience, or to 'tell it like it is' in the 'here and now'. Such a broad commitment to confidentiality has necessary limits. The exceptions to confidentiality will be explained in the early session(s). In principle, however, what you explore and express in therapy will remain secure within the boundaries of the therapeutic relationship.
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