Category: FAQ

Frequently Asked Questions on Counselling & Psychotherapy.

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FAQ

Brief Counselling or Open-ended Counselling?

It used to be the case that I offered either brief counselling or open-ended counselling to individuals coming into counselling for the first time.

Experience has taught me that open-ended work can work through some matters in a brief way, and brief work can sometimes need an open-ended approach.  

In other words, it’s the focus of counselling that is the most important, not the length of time spent.

Having written that, I will still  go through an assessment for counselling with new clients.  An assessment is where we discuss what you need from counselling and if I’m the therapist to work with.  We’ll pay attention to the problems that you are bringing to therapy, see how you respond to what I say and ask.

Later in the assessment session, we’ll discuss our approach to the focus for counselling (open-ended / brief) and see what approaches we agree / disagree with.

Brief Counselling.

Brief counselling works on a single (usually) focus and is a set number of sessions (discussed and agreed between you and I).  The therapist and client have to be able to work well together – a kind of instant therapeutic rapport that can be used in the work click to read more.

Open Ended Counselling.

Counselling that is not limited to a set number of sessions.  But we will still work with a clear focus of our work (which might be at working towards an achievement, a change in emotional state, a transformation of life circumstances and so on).

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FAQ

Will my Doctor/GP be told I’m in Counselling?

When we begin our assessment for counselling,  I will talk with you about confidentiality and what it means with respect to your privacy and law. 

I have strict rules that protect your confidentiality: that where the law does not over-ride me, I will not discuss our work with anyone (other than my obligatory clinical supervision).

This means that I will not inform your doctor/GP about your counselling as a matter of course.

 

Let’s highlight a couple of potential exceptions:-

  • If you wish me to write to your doctor/GP, we will discuss this in session before I agree to do so.
  • If your health (physical or mental) appears to warrant intervention from your doctor/GP, in rare circumstances I may request your permission to write to your doctor/GP, but we will discuss this in session before I take any action.

So, when you come to me for counselling I will not automatically inform your doctor that you are receiving therapy from me.

My counselling practice is independent of NHS primary care services.

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FAQ

Do I ask my Doctor/GP to refer me for Private Counselling?

No – you are not required to ask your doctor/GP to refer you to Dean Richardson for private counselling.

As a BACP Accredited counsellor/psychotherapist with his own private practice in Portsmouth (Hampshire) and via video conference through Skype, Dean is fully qualified and experienced to work with individuals, couples and groups.

Dean offers individual the following services:-

… all are in his private practice in Portsmouth & Southsea and online through the Internet via Skype video conference.

You can make your own appointment for counselling to discuss your options for counselling with Dean Richardson – you do not need to seek a referral by your GP (general practitioner / doctor) and your doctor is not automatically informed of any decision you make to enter counselling.

Dean is qualified to make his own judgements & recommendations to you on suitability for counselling through a process called the “counselling assessment”.  This assessment session is a 50 minute appointment for individuals (or individuals wishing to join a therapy group), and 4×50 minute sessions for couples. What you need from counselling will be discussed to help you identify the focus for counselling work before any counselling begins (although many find the assessment process therapeutic too).

If counselling may not be a suitable therapy for you (or your partner when considering couple relationship counselling) other options can be discussed including referrals to therapies and therapists who may be more appropriate for your needs.

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FAQ

Can I ask my Doctor/GP for Counselling?

Counselling can be made available to you on the NHS via your GP.

There is often “stepped” process involved – including a waiting list to begin treatment depending on your presenting issues.

An illustrative example would be:

  • Initially, your doctor may first ask you to come back again in a few weeks time to see if things are better.
  • If things don’t feel better then next you may next be given access to reading material – a form of self-guided self-help therapy.
  • If this doesn’t help you may be offered access to a computerised [tooltip text='Cognitive Behaviour Therapy (CBT) is a form of talking therapy that is focussed on helping a person change the ways they think, how they feel, and their behaviour, in a stepped process. CBT has a reputation for being a manualised treatment (patient is diagnosed and a matching treatment prescribed) which is how computer-based CBT treatments have been created.
    http://en.wikipedia.org/wiki/Cognitive_behavioral_therapy'] CBT [/tooltip] treatment.  This may help you identify and deal with your problems through suggestions the computer may offer based upon your responses to questions.
  • If these “self-guided” therapies remain ineffective, a referral to a low-level  (trained & qualified) therapist may be the next step – involving a waiting list of several weeks or months.
  • If the low-level impact fails to help you, you may be referred to another therapist for further treatment.

Low-level impact treatments are cost effective to the NHS because of their being no need to train highly skilled therapists.

The initially-mild interventions offered to you should be overseen by a therapist who should have an initial qualification, adequate experience & appropriately supervised (i.e. newer (lower-cost) therapists are more commonly used early low-impact intervention stages of a patient’s NHS counselling).

You may later be offered a fixed number of sessions of face-to-face counselling if the previous therapeutic intervention didn’t work for you. You may be offered to meet with a more experienced psychotherapist or psychiatrist if the previous experiences of therapy are ineffective.

Why CBT/Stepped Process?

This NHS stepped process is partially due to costs and partially due to new procedures introduced called IAPT (read more).

CBT is a treatment that GP’s can understand – it principally works on a diagnoses/prescription modality, where several treatments can be normalised (i.e. the CBT therapist follows someone’s recommendations/instructions for treating a particular ailment).  Of course, one would not take a prescription from an unqualified GP, so one would not be prescribed a form of therapeutic treatment from an unqualified CBT therapist – but there are various levels of experience & qualifications.

IAPT originally only offered CBT (cognitive behavioural therapy).  Mild forms of CBT can be offered by minimally trained therapists using a form of manualised therapy (e.g. you may be diagnosed and a therapist may refer to a set of therapeutic interventions that are recommended for your form of diagnosis).

Whilst CBT can be effective for certain issues it is not a fix-everything therapy and not everyone likes to feel like they are responding to a manual-of-therapy.  If you can be helped by the processes then this will be beneficial – albeit that to get to the higher forms of treatment the previous experiences of treatment may have to have failed first.

Private Counselling – Your Choice of Treatment.

Unlike NHS Stepped-Treatment, private counselling with Dean Richardson begins with the FULL service.

There is no tiered/stepped process with Dean. You start immediately with full 50-minute weekly sessions working with Dean face to face.  No computers giving you questionnaires.  No books to read.

You and Dean will begin with an assessment session (meeting to talk about what you need from counselling, and discussing what counselling may and may not be able to help with).

You and Dean will meet weekly (usually the same day, same time, same location – which helps many people manage their commitments elsewhere).

With Dean’s assistance you might decide to discuss choose how many counselling sessions you wish to attend (such as brief/focal counselling) or you may with to work with Dean until the focus of the needs for counselling have been fully addressed.

No waiting lists – no maximum number of sessions.

It’s a very personal counselling service that aims to create a therapy that works for you and your needs.

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FAQ

Do I have to pass (or fail?) an Evaluation to get Counselling?

If you’re thinking of private counselling, then there is no test or evaluation! In private counselling, an assessment for counselling is where you and the counsellor meet to initially discuss what you want from counselling, and what the counsellor can offer you.  This is an ethical approach and informs you about what sort of therapy you are opening yourself up for.

Things can seem somewhat different in NHS counselling.  With newer IAPT services (read more), you may initially be recommended the lowest form of therapeutic intervention to begin with (e.g. go home and come back in a few weeks if things don’t feel better …  or try a computer program that may offer some suggestions on how to cheer up your life).  To the next level of therapy you may feel that you have to be unsuccessful with the previous level of therapy. 

It might be some time before you meet the most basically trained counsellor – and even more time to meet with an experienced therapist.

This can feel like you have to keep failing stages in therapy before you are allowed to go to the next stage.

I’m not suggesting that this occurs all of the time – each individual will be (or should be) treated on an individual needs basis – but it is not uncommon for people seeking counselling on the NHS to frail levels of treatment until one is found that is successful,

With Dean Richardson you are not offered one level of therapy first, followed by other levels if they are unsuccessful. What you receive from Dean is his full service from the beginning (although, of course, we will always take matters at a pace that works best for you).

At the beginning of counselling, you and Dean will go through an assessment for counselling.  This is where BOTH you and the counsellor will discuss your needs for counselling (i.e. not just you being assessed, you are assessing the counsellor and his methods too).  You and Dean will talk about what can (and cannot) be offered to you. 

The assessment is not a test – Dean is not looking for you to score a high mark (or get a low one).  An assessment is an effective way for you and the counsellor to both assess if working with Dean is, or is not, a good idea.  Other options, such as a referral to a more appropriate therapist, are available too.

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FAQ

What is an “Assessment” for counselling?

Counselling contract

An assessment for counselling is where you (plus your partner, if couples counselling) meet with the therapist a session (sometimes more as required) and discuss what you need from counselling and what the therapist can offer.  The therapist will ask you some questions to help understand a little more about your needs for counselling.  This will also helps both the therapist and the client to judge if both are able to work with the therapist’s style of therapy.

The therapist will offer you a number of tentative thoughts about what he learns from you.  He may offer an interpretation or two based on how he may understand how some matters may link together. T his is all part of seeing if a psychodyamic approach to therapy is suitable for you.

This is a mutual assessment – the therapist is not just assessing you for counselling.  You are assessing the therapist and the form of therapy on offer.  Both client and therapist are seeing if they can work together.  If client or therapist have any concerns of each other they can discuss these openly with each other.

At the end of the assessment, the therapist and client should have a clear idea about what the therapy is to offer, and what the client needs from the therapy. Alternatively, discussing a referral to another therapist might be more appropriate.

See also:-

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FAQ

How Often do I need to go for Counselling?

Different counselling services may differ in what they offer with respect to regular counselling sessions.  I believe in the regularity of therapy – consistent times, same location, same room.  It’s an important container for “holding” the client whilst they go through any therapeutic processes.

Counselling.

I offer once-a-week, weekly counselling. Together we will meet once a week on the same day, same time & same location, for our fifty-minutes session. We will meet for either the set number of sessions we’ve agreed upfront (eg brief counselling) or until we both recognise that the work we had agreed to do … has been done enough.

Support Groups.

Support groups run weekly, on the same day, same time and same location each week.  They last for 90 minutes.  Group members meet until either the group member is ready to leave (after which a new group member may be invited to join), or in the case of fixed-term groups, all group members leave at the same time.

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FAQ

How Long is a Counselling Session?

Length of a Counselling Session.

Counselling sessions with Dean Richardson – both individual & couple counselling – face-to-face or Skype sessions – last for 50 minutes and occur weekly.

Couple Counselling sessions have the option to be extended to 90 minutes (prearranged) weekly.

Because each appointment time is reserved exclusively for a particular client, if you arrive late for your appointment our time cannot be extended to make up the the time. Similarly, if you arrive early the session will still begin at your appointment time.

Unlike many GPs, you won’t be kept waiting for your appointment to begin.

Length of a Group Session.

Group therapy sessions with Dean Richardson last for 90 minutes and occur weekly.

Because the group start together, if you are late you may or may not be allowed to join (depending on what the group has previously agreed about late starting).  The group always ends at the agreed ending time – is not extended for any reason.

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FAQ

What can I Talk about in Counselling?

Counselling focuses on you and the problems that you’re bringing into therapy.  So, it may not be such a surprise that you can talk about anything you wish to in counselling.

[iC_leaflet type=”bacp_c1″]You might be worried that your therapist may be shocked or distressed about what you might need to talk about.  This is usually not the case, but many trained counsellors also focus on keeping their feelings and responses contained so that the counsellor does not distress you.

You may even discuss your concerns about your counsellor if you wish; what they might think about certain topics.  Different therapists will respond differently, but they’re all focussed on the benefit of you.  Be assured that your counsellor is ready to hear what you need to talk about.

Counselling and the Law.

You should be aware that there are some subjects that would come under the law.

For example if you wished to talk about your part in terrorism, intended harm to self or others, you talk about a child who is in distress, not being looked after well or is being abused, or any other criminal activity, then your counsellor would be obligated by British law to break confidentiality.

This does not mean to say that your counsellor will immediately run out of the room to dial 999.

Again, different therapists will treat different matters with different approaches.  Most counsellors should inform you about confidentiality before the therapy begins (usually the first session).  Some therapists will give you a document that has everything written down.  Some therapists will remind you, if you begin to stray into legal subjects like these, about the law and confidentiality.

Sometimes, the law requires a counsellor to take action without informing the client – matters such as terrorism or child abuse can fall into this category.  Again, the client should have been informed at the start of therapy about this  – and whilst a counsellor may always wish advise clients beforehand that a subject which has been brought for discussion requires the counsellor to take action, the counsellor may be legally bound not to tell the client of the action before it is taken.

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FAQ

How do I Find & Verify a Therapist?

Searching for a Therapist.

It’s an unfortunate truth with UK law that, presently, anyone can set themselves up and describe themselves as a “therapist” or a “counsellor”. They are not legally required to have to have any formal training, any qualifications, any experience, any insurance, nor do they need to be a member of a professional body that oversees & regulates their therapy practice.

People like these exist – some look quite legitimate – and they can make finding a properly-suitable therapist quite dangerous for the layman.

However, when you know what to look out for, professionally qualified therapists can be easily recognised.

Even if you are still unsure that a therapist/counsellor you’ve found is legitimate or not, the following questions put to the therapist will help you decide.  Do not be afraid to ask your potential therapist to proove their legitimacy!

Vetting Questions to ask a Potential Therapist.

Any of these questions would be appropriate to put to a therapist (private, NHS, charitable, spiritual, religious etc) during the first interview.

  • What are your formal qualifications to practice as a therapist – or are you still in training?
  • Who awarded you your qualification? (Check that the awarding body is also a suitable member of a recognised professional body) -or- who is overseeing your practice whilst in training?
  • If you have no formal qualifications, and are not in training, what is your rationale for offering me therapy?
  • What professional bodies are you a member of … and what is your membership number?
  • If you are not a member of a professional body, what are the circumstances around this?  Was it your decision not to be a member?
  • Does your professional have different levels of membership (e.g. member, accredited member, senior accredited member) – and, if so, what level of membership have you attained?  Are you aware of the next level, and are you working towards it?  If you are not working to the next level, what is your rationale?
  • How do you regularly ensure that are practising to your best (e.g. do you attend regular supervision, or are a member of a group supervision group)?
  • When was your last training course or self-directed learning (continued professional development/CPD)? (Check that the therapist stays up to date with current learning).
  • Do you have indemnity insurance – and who is it with? How does your insurance protect me as a potential client of yours?
  • (If appropriate…) … having learned of my/our needs for therapy, what will be your treatment plan for me/us?
  • Is your treatment suitable for my needs?
  • Have you offered this treatment before?

Trust your Instincts with the Answers.

How do you feel with the therapist’s responses to your questions?  Were the answers given freely?  Some therapists – later on in the therapy – will not immediately answer questions, preferring to investigate the nature of the question first (psychodynamic/psychoanalytic is a legitimate model of therapy, albeit different from other models), so it might be best to bare the therapist’s response with this in mind.

How does the therapist appear to you?  Does the therapist’s website and marketing material give the appearance of professionalism?  For example, does the website look healthily maintained, or is it a bit out-of-date/bedraggled?  Do the marketing materials look professionally produced, or kind of written on craps of paper in crayon?

Services such as VistaPrint can give a professional appearance to anyone in return for some money – but these services also produce rubber-stamp images (i.e. the choices of branding can be used by anyone, over and over again).  Looking professional is a good indicator of the professionalism of the therapist, but on its own it’s not an indication of the therapist’s qualifications, practice or experience.

In addition with the above questions information, if you meet with the therapist consider the following:-

  • Do you have a feeling that the therapist is someone you want to work with?  If not, don’t … and find someone else.
  • Does the therapist at least attempt to answer the questions helpfully, or evasively?
  • Do you know of anyone who has previously seen this therapist for treatment?

Bear in mind that there is no legal requirement for any of the above considerations to be set in place, so you are responsible to protecting your own well-being.

[button type=”small” color=”orange” permalink=”3989″ br=”yes”] Click for a more detailed article on this subject…[/button]

Other sites of interest: Counselling via Skype, Online Zoom Counselling, Havant Counselling & Counselling for LGBT Couples