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What a Therapist Can (And Can't) Do

4/4/2018

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A therapist and client talking together in a counselling session
Client and therapist talking in a counselling session. Copyright: Garneteyed

If you’ve never had counselling before it can be hard to know what to expect. But, almost certainly, everyone who comes for therapy walks into the counselling room with a degree of expectation. It might be an expectation that the therapist is going to “fix” the problems you’re experiencing, or maybe that they’re going to be shocked by what you tell them. To help keep your expectations of therapy realistic, here’s a guide to what a therapist can and can’t do.
 
What a therapist can do
 
Give non-judgemental support – no matter what you tell us, your therapist is not going to judge you. We’re there to provide support in a space that’s free of judgement or criticism, so you feel safe to disclose your innermost thoughts and feelings.
 
Offer confidentiality – we don’t discuss clients with anyone else, unless it’s in supervision (where you’re kept anonymous) or in exceptional circumstances where something you tell us means we have to break confidence. Your therapist will always outline what these exceptional circumstances are when they contract with you in your first appointment.
 
Help you identify and change patterns – your therapist will reflect back what they hear you say and make observations in order to help you make links between the events in your life and identify behaviour patterns. We will then support you in making changes to break negative patterns.
 
Support you in achieving goals – we work with you to help you achieve your goals. In some cases, this may mean referring you to another therapist who is more experienced in a particular specialism so you can get the best support and therapy experience.
 
Increase your self-awareness – the therapy process is one of learning, and your therapist is there to offer observations and challenges to increase your self-awareness, which you can continue to use to inform your life decisions after therapy has ended.
 
Be human! – we’re not robots, and one effect of having empathy for your experiences is that we feel your emotions as we sit with you. It’s what helps us to understand the world from your point of view and offer non-judgemental support.
 
What a therapist can’t do
 
“Cure” you – while therapy can help you find ways to manage the problems/symptoms you’re experiencing and find new coping strategies, it can’t change the underlying stressors. For example, if you have anxiety life events may continue to cause you anxiety or stress. Therapy can’t eradicate this but it can help you to manage your anxiety more effectively.
 
“Fix” the problem(s) – therapists aren’t there to give advice but to support you, offer encouragement, and to challenge you along the way as you find your own solutions and way forward. We can’t offer fixes, tell you how to resolve a problem or guarantee there is a “solution”. Rather, we work with you to help you achieve goals and find a positive way to move forward.
 
Change other people – if you come to therapy hoping to change your partner or someone around you, you’re going to be disappointed. Therapy is about looking at your thoughts and behaviours, and how you relate to others. And while changing your behaviours may naturally have an effect on those around you, it may not necessarily be in the way you're hoping.
 
Give a diagnosis – therapists aren’t medically trained and we won’t give you a diagnosis of a mental health condition. Instead, we’ll signpost you to the relevant source of medical support while you continue with therapy.
 
Give guarantees – it can be difficult to know how long the therapy process will take, what might be uncovered or how the process will make you feel. Often, people believe they’re coming to therapy for one issue but the real issue is actually something different. New, unforeseen difficulties may also arise during counselling that extend the therapy process.
 
Be your friend – while your therapist is there to provide support, we’re not there to be your friend. This doesn’t mean we don’t care about you, just that this care is restricted to being in a professional capacity. Your therapist should outline the professional boundaries of their relationship with you in your first meeting (often called an initial consultation).
 
Be on call – your therapist isn’t there to provide a personal support line between sessions. But that doesn’t mean you’re alone. If you’re finding things difficult, we'll chat to you about who to contact between sessions when we’re not available so you always know where to go for support.
 
Be shocked by what you say – it’s unlikely that you’ll tell us something we haven’t heard before. And even if you do, we’re there to understand the world from your point of view.
 
All the work - there’s no getting away from it, therapy can be hard work. And it’s work that your therapist can’t do for you. We'll be there to provide support and guidance, but it’s down to you to make changes. This means putting in work both during and between sessions.
 
Now you know more about what to expect from counselling, why not find out what to expect from your first therapy session. Or simply get in touch for a chat and to make an appointment.
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What are the Benefits of Counselling?

23/4/2017

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A man holding his head sitting opposite a therapist in a counselling session
Client and therapist talking in a counselling session. Copyright: Evellean

When people are thinking about coming for therapy, a common question they have is: What will I get out of it? The answer is there are numerous benefits you can get from counselling. Here are just some of them:
 
1. Reduced anxiety
 
2. Better relationships
 
3. Reduced panic attacks
 
4. Reduced stress
 
5. Increased self-confidence and improved self-esteem
 
6. Improved communication ability
 
7. Greater emotional openness
 
8. Improved emotional resilience
 
9. Increased assertiveness
 
10. Increased motivation
 
11. Improved decision-making
 
12. Reduction in negative emotions and behaviours
 
13. Development of positive coping strategies
 
14. Clearer insight into the impact of past events
 
15. Resolution of trauma
 
16. Increased self-awareness
 
17. Increased self-care
 
18. Achievement of personal goals
 
19. Greater sense of control and empowerment
 
20. Self-growth
 
It’s quite some list! Of course, the benefits you get from counselling are different for each person and depend on the issues you want to explore and the goals you want to achieve. But people will typically gain a multitude of benefits from therapy, even if the therapy is only short-term.
 
If reading through this has made you think that counselling could benefit you and you’d like to find out a bit more about it, take a look at the what to expect from counselling page on my website. Or simply get in touch to make an appointment.

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Building a Connection: The Therapeutic Relationship

25/2/2017

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Counsellor and worried client talking together in a counselling session
Client and therapist talking in a counselling session. Copyright: Iconic Bestiary

In counselling, the relationship between the therapist and client is usually referred to as ‘the therapeutic relationship’. Developing this bond is essential for therapy to be successful. But just why does it matter so much?
 
Why is the therapeutic relationship important?
 
People enter into therapy to explore a wide range of issues but all are looking to get support and, typically, to make a change. To do this they need to feel listened to and to trust they can share intimate thoughts and feelings with the therapist. For this to happen, there needs to be a strong, trusting and secure bond between the client and counsellor.
 
For some people coming to therapy, this may be the first time they have experienced a warm, non-judgemental relationship with another person – a relationship in which they are valued and listened to. Such a bond can foster openness by providing a sense of safety that allows the exploration of thoughts and feelings that can be difficult, painful or even traumatic to experience and share.
 
How is the therapeutic relationship built?
 
To create a successful therapeutic relationship, the therapist will typically provide three key components: empathy, genuineness and warmth[i].
 
By providing empathy (not sympathy), the therapist understands a person’s situation and the thoughts and feelings they are experiencing. In other words, they step into their client’s world and see things through their eyes. This provides a sense of being listened to and understood, developing a connection between the therapist and client.
 
The therapist will also display genuineness. This allows the therapeutic relationship to be built on the basis of openness and honesty, without fear of judgement. And there needs to be warmth and respect. The sense of safety this gives helps people to overcome any fear or trepidation they may feel about coming to therapy or about raising certain issues.
 
How to recognise an unhealthy therapeutic relationship
 
Occasionally, a therapeutic relationship may be unhealthy. Unhealthy therapeutic relationships occur when professional boundaries and ethics are violated. Sometimes the client can form a reliance on the therapist (or vice versa) and therapy isn’t ended at the appropriate time. Or one or both people in the relationship might overstep professional boundaries, either physically or verbally. This can include the therapist enforcing their personal or religious beliefs on the client, or making decisions on their behalf.
 
If a person experiences any doubt or negativity within their therapeutic relationship, they should try to raise it with their therapist. The therapist ought to be open to exploring the reasons for this and to working together to help overcome it. Or they may choose to end their relationship with the therapist and look for someone they feel more comfortable working with.
 
Ultimately, without a healthy connection between the counsellor and client, therapy isn’t going to be successful. The therapeutic relationship is at the heart of every counselling session, developing and strengthening over time to provide a secure foundation from which the client can explore their thoughts, feelings and actions, and achieve their goals.


[i] The key components (or ‘core conditions’) of a therapeutic relationship were defined by psychologist Carl Rogers, who developed the person-centred approach to therapy. This model proposes a client can achieve their goals if they are provided with empathy, congruence (genuineness) and unconditional positive regard (warmth) by their therapist.
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How to Choose The Right Therapist For You

24/8/2016

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Therapy client looking at lots of doors trying to choose one
Man trying to choose a therapy room. Copyright: alphaspirit

The stigma that once existed around having therapy has greatly diminished but contacting a counsellor can still feel like a daunting prospect. Finding the right one for you can be confusing, with counselling directories providing pages of therapists all listing an array of qualifications and theoretical approaches. With so many counsellors and therapists to select from, how do you know who to choose?
 
One good starting point is to look at whether they’re a member of a professional body, such as the British Association for Counselling & Psychotherapy, or National Counselling Society. Registering with a professional organisation means the therapist has agreed to abide by their ethical framework and should practice ethically.
 
Also, check out their qualifications and training. Have they completed a specialist counselling qualification such as a postgraduate diploma or a degree? If the answer is no, then look elsewhere.
 
Think about their theoretical approach. This one can be tricky because it’s sometimes hard to know what type of therapy you want before you start. But it may be helpful to read about the different types of therapy that are available to see if a particular approach seems more appealing than the others.
 
Have a look at whether the counsellor is a specialist in the issue you’re going to therapy for. Many therapists work with a wide range of issues but may have specialist training in a certain area, while others only work with very specific issues. Selecting someone with the right expertise is an important factor in your choice of therapist.
 
You should also consider your needs and preferences. Would you prefer to work with a man or a woman? Is their cultural background, sexuality or age important? Do they need to be able to speak a certain language? Do you want to have face-to-face therapy or maybe email or telephone sessions? How much can you afford to spend? Do you need an appointment immediately or are you happy to go on a waiting list? Once you’ve decided what you need, you can narrow down your search accordingly.
 
Check out their website. A therapist’s website should give you information about their prices and where they work, and tell you about their qualifications and training. It can also give you an indication of how professional they are. For example, do they include a photo of themselves that’s cropped from a night out or a holiday, or is it a proper headshot? You could have a look at their social media accounts too, such as Facebook and Twitter.
 
You may also want to speak to friends and family and ask for recommendations. Hearing glowing, or not so glowing, reviews of a particular therapist may make up your mind.
 
Finally, talk to the therapist you’re thinking of working with. Picking up the phone can feel difficult to do, especially if you’re suffering from anxiety. But speaking to a counsellor can help you get a sense of what they’re like.
 
The result of this careful search should be a trusting, supportive relationship with the therapist that’s right for you.
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