What is counselling and how can it help you.
When you are not feeling well it is sometimes difficult to take everything in, so please make time to be in a quiet and calm place to read through this guide and direct any questions you may have to your therapist.
Counselling is umbrella terms that cover a range of talking therapies. They are delivered by trained practitioners who work with people over a short or long term to help them bring about effective change or improve their wellbeing. Counselling allows people to talk about their problems and feelings in a safe, confidential environment. The meaning of the term can differ individual to individual but generally, it is a process individuals seek when they want to change something in their lives or simply explore their thoughts and feelings in more depth.
Why people choose to have therapy? what benefit can be expected ?
People normally decide to have therapy as a result of experiencing difficulties and distress in their lives. At times people can be isolated but at other times, even individual with most supportive family and friends can find it difficult or even impossible to explain why, for example, people may be feeling anxious and or depressed. Or it may be easier to talk about personal, family, or relationship issues with a person who is independent of friends and family.
Other life issues and events which can be very difficult to deal with include bereavement, divorce, redundancy, health issues, bullying and so on. However, you do not have to be in crisis or on the verge of one, before choosing to have therapy. You may be experiencing underlying feelings of dissatisfaction with life in general, or be seeking balance in your life and spirituality. All of these reasons and more will bring individuals to therapy.
What is therapy?
What Conditions Can it Help?
Therapy is time set aside by you and the therapist to look at what has brought you to therapy. This may include talking about life events (past and present), feelings, emotions, relationships, and ways of thinking and patterns of behaviour.
The therapist will do their best to help you to look at your issues and identify the right course of action for you, either to help you resolve your difficulties or help you find ways of coping.
Talking about these things may take time, and will not necessarily all be included in one session. The number of sessions offered may be limited, so it is best to ask about this in advance. For example, brief therapy or short term therapy might provide a maximum of 6, 8, 12 or 16 sessions. Other types of therapy, for example psychodynamic, can be longer according to the issues you bring.
Types of therapeutic models in brief
A therapy session is a time set aside on an agreed date at an agreed place, providing a safe space, which is private, undisturbed, and cannot be overheard or interrupted. The counsellor will reach an agreement with you about confidentiality. Therapy is available for individuals, and self-help groups. There are different ways of working with people, usually referred to as approaches, techniques or modalities.
Psychological therapies used depend on the training of the counsellors but generally fall into the following categories:
Humanistic Therapies, which focus on self-development in the 'here and now'.
Behavioural Therapies, which focus on cognitions and behaviours.
Psychoanalytical and Psychodynamic Therapies, which focus on the unconscious relationship patterns that evolved from childhood.
Arts Therapies, which use creative arts within the therapeutic process.
This is a generalisation as counselling or psychotherapy usually overlaps some of these techniques. Some counsellors or psychotherapists practice a form of integrative therapy, which means they draw on and blend specific types of techniques.
Other practitioners work in an eclectic way, which means they take elements of several different models and combine them when working with clients. There are also a number of specific other therapies that can be used.
Below is a breakdown of some of the different psychological therapies available.
Humanistic therapies focus on self-development, growth and responsibilities. They seek to help individuals recognise their strengths, creativity and choice in the 'here and now'.
Existential therapy focuses on exploring the meaning of certain issues through a philosophical perspective, instead of a technique-based approach.
Gestalt therapy can be roughly translated to 'whole' and focuses on the whole of an individual's experience, including their thoughts, feelings and actions. Gaining self-awareness in the 'here and now' is a key aspect of gestalt therapy.
Human Givens Psychotherapy
Human Givens psychotherapy is a relatively new approach that has been described by its founders as a 'bio-psycho-social' approach to psychotherapy. The therapy's basic assumption is that humans have innate needs (called givens) that need to be met for mental well-being.
Person-Centred Therapy (also known as client-centered counselling)
Person-centred therapy focuses on an individual's self- worth and values. Being valued as a person, without being judged, can help an individual to accept who they are, and reconnect with themselves.
Psychosynthesis aims to discover a higher, spiritual level of consciousness.
Reality therapy is an approach to therapy that focuses on the here and now rather than issues from the past. Developed by William Glasser in the 1960s, the theory behind the therapy is that an individual in mental distress is not suffering from a mental illness; instead, they are suffering from a socially universal human condition as they have not had their basic psychological needs met.
Solution-Focused Brief Therapy
Also known as solution-focused therapy or brief therapy, this approach predominantly looks at what the individual wants to achieve rather than historical problems. Questions are asked by the therapist to help the individual uncover their own strengths and resources. Solution-focused therapy can be especially helpful to those who are goal-orientated and have a desire to change.
Transactional analysis is based on the theory that we each have three ego states: Parent, adult, and child. By recognising ego-states, transactional analysis attempts to identify how individuals communicate, and how this can be changed.
Transpersonal psychology means ‘beyond the personal’ and seeks to discover the person who transcends an individual's body, age, appearance, culture etc.
Therapists usually work for a mutually agreed set period of time for each session. The length of sessions may vary depending on the therapist’s training, how the therapy is delivered and also whether it is a specialist treatment.
Therapists and clients need to keep sessions to a reasonable length of time to ensure that they both can maintain their energy and focus and get the most out of the session. In one-to-one therapy, a session may be time-limited – usually 50 minutes to an hour per session. However, a specialist therapy, for example, trauma treatment, may involve longer sessions. In the initial meeting with your therapist, you may find it useful to discuss the way they work, i.e. their approach or preferred modality.
Cognitive Behaviour Therapies
Behavioural therapies are based on the way you think (cognitive) and/or the way you behave. These therapies recognise that it is possible to change or recondition our thoughts or behaviour to overcome specific problems.
This can involve Acceptance and Commitment Therapy (ACT), Behavioural Therapy, Cognitive Analytic Therapy (CAT), Cognitive Behavioural Therapy (CBT), and Cognitive Therapy.
Psychoanalytical and Psychodynamic Therapies
Psychoanalytical and psychodynamic therapies are based on an individual's unconscious thoughts and perceptions that have developed throughout their childhood, and how these affect their current behaviour and thoughts.
Jungian psychotherapy is a specific branch of psychodynamic therapy that works from the theories of Carl Jung, considered to be one of the forefathers of psychology.
Psychoanalysis was developed by Sigmund Freud and focuses on an individual's unconscious, deep-rooted thoughts that often stem from childhood. Through free associations, dreams or fantasies, clients can learn how to interpret deeply buried memories or experiences that may be causing them distress.
Based on psychoanalysis, psychoanalytic therapy also focuses on how an individual's unconscious thoughts are influencing them. However, psychoanalytic therapy is usually less intensive than psychoanalysis.
Psychodynamic therapy evolved from psychoanalytic therapy and seeks to discover how unconscious thoughts affect current behaviour. Psychodynamic therapy usually focuses on more immediate problems and attempts to provide a quicker solution. This can involve Jungian therapy, psychoanalysis, psychoanalytical therapy and psychodynamic therapy.
Confidentiality is a must in a therapy relationship as part of building trust. (BACP Ethical Framework for Good Practice in Counselling and Psychotherapy [2010). However, confidentiality is not absolute, and there are exceptions.
Sometimes, in the public interest, counsellors may need to make a referral to an agency or organisation (for example GP, police or social services) when there is a serious risk of imminent harm to their clients or to others, for example where a client is seriously mentally ill and needs hospitalisation, or in cases of child or elder abuse.
These referrals are usually (but not always) made with the client’s knowledge and consent. This decision will depend on the particular circumstances of each client. There may be times when a therapist is required by law to break confidentiality, for example, about terrorist activities. It may also be a criminal offense to ‘tip-off’ a client when such a disclosure has to be made.
Disclosures may sometimes be made at the client’s request, for example, in the case of a victim of abuse where a client asks for help or for an assessment or report to help with a court case involving a claim for damages by the client. In initial session and you and your therapist should talk together and reach agreement about the limits of confidentiality for your work together.
Therapists do not make telephone calls or engage in discussions about you to your GP, employer, partner, family members, friends or to other agencies to find out, clarify, or add to your personal information without your knowledge. This would be an absolute breach of confidentiality and trust.
However, there may be some circumstances when your therapist may be obliged to disclose information but your therapist should discuss this with you when agreeing your contract. You may wish to ask your counsellor to contact your GP and/or other agency, in which case you would agree and confirm the issues to be discussed between the counsellor and other named parties, and this would not be a breach of confidentiality.
After discussion with your therapist, you should be clear about what information may need to be shared and with whom it may be shared.Contracts and boundaries
Therapists should establish clear boundaries. This is a framework where you and the therapist have agreed on a contract covering the following:
Dates and times of therapy sessions
How and when the therapist and client can be contacted
Agreement about the limits of confidentiality
Clarification of the nature of the relationship, i.e. that it is a professional one where the therapist will not be a personal friend
A written contract will be provided for you to take away, usually in your first meeting, stating the agreement you have made to work together.
What therapy is not
Therapy is not about giving advice or influence orientated to the therapist's viewpoint, although therapists may offer information, and some therapeutic approaches may ask you to do homework as part of your therapy.
Nor is it just a friendly chat discussing the week's events as you would with a friend. Talking with a therapist is not the same as talking with a friend, a parent or sibling, who would probably have an opinion about the issues discussed.
The therapist is an impartial professional, who is able to listen to you non-judgmentally and to work with your emotions and not get emotional themselves. The therapist helps you to develop an understanding of yourself and others and to find your own solutions, making no demands upon you except for the terms agreed in your therapeutic contract.
Therapy sessions are normally regular and not held at random, for example, two sessions this week, one next week and then ‘see how we go'. Some therapy models allow some flexibility in the spacing of sessions. Sessions are held in counselling rooms where there is no possibility of being overheard.
Therapists aim to be impartial and be able to express warmth and empathy to assist you to talk openly about your feelings and emotions. They should also be non-judgmental (this means not judging what a person discloses about themselves, their attitudes or behaviours); fair; open and trustworthy to enable a respectful working relationship to develop between them and the individual.
Therapy is a very personal experience, for you and the therapist, and to a certain extent, feelings about the relationship will help determine whether you both can work effectively together. The therapist should also provide a good standard of care for you, which includes being aware of their own training, experience, and limitations and be referring you on when appropriate if the therapist feels unable to assist you.
The therapist should be either undergoing professional training or be professionally trained and qualified and have knowledge about the issues that you want to discuss. They should be aware of their own issues and support needs and also be receiving regular supervision. Supervision is a formal arrangement for therapists to discuss their work regularly with someone external in order to maintain adequate standards of therapy. (Ideally, the supervisor should not know the identity of the client).
Therapist qualities continued
The therapist and their supervisor should be members of a recognised professional body such as the BACP, or ACC, and preferably accredited by them. In the BACP Ethical Framework therapists are encouraged to develop their personal qualities in terms of their empathy, sincerity, integrity, resilience, respect, humility, competence, fairness, wisdom, and courage.
For further information and explanation see www.bacp.co.uk; the BACP Ethical Framework for Good Practice in Counselling and Psychotherapy (2010) (the Ethical Framework).
Communication and Accountability
It is important that you notify the counsellor if you are unable to make a booked appointment. If you fail to attend three counselling sessions without sufficient reason then you will be advised that counselling will finish and that you may, if you wish, go back on the waiting list.
COMMUNITY ADVICE AND LISTENING LINE (CALL)
If you need urgent support before or during your counselling appointments you can contact the Community Advice & Listening Line, a 24 hour mental health telephone helpline on
Freephone: 0800 132 737 or text ‘help’ to 81066
What Benefits can be Expected?