What is Counselling and Is It For Me?

I hope you have all had a good summer and got a break from your usual routine. To get myself back into the routine of writing I have decided to take an overview of what Counselling and Psychotherapy is, as this might help any of you who are considering seeking help. While my weekly Agony Aunt column and radio slot gives me a chance to offer some general thoughts on various topics, my real ability to help people lies in the therapy work I do with people in person.

What is Counselling & Psychotherapy?
Counselling & Psychotherapy is based on talking, and the respectful and trusting relationship that builds up over time between therapist and client. Clients overcome personal difficulties and are helped to facilitate change and growth through this relationship. As a result of years of training and experience the counsellor knows how and when to ask the right questions to help the client gain insight and make effective changes.

• The counsellor gives time, attention and respect, their role is to help the understanding and change take place, not by giving advice or taking over direction from the client, but by assisting the client in their own understanding and ability to take control.
  
• The client has an opportunity to explore and understand their situation, and then discover and activate ways of living more effectively and with a greater sense of well-being. As a client you get to know yourself and understand your feelings and behavior better, which in turn helps you to feel more in control of your life.

Is there a difference between Counselling and Psychotherapy?
Counselling often focuses on a specific problem while Psychotherapy might deal with more deep seated issues and encourages you to look more closely at the past and patterns that may be repeating in your life. In practice there is a great deal of overlap between the two and while you might feel you have a preference for a particular type of therapy, in reality it is often the skill of your therapist, your motivation to change, and the quality of the relationship you develop with your therapist that will be the most powerful factors in your growth.

You talk about Psychotherapy, how is that different from the other ‘Psychs’?
Anything to do with ‘Psych’ is to do with the mind, as in the Greek word for Psyche which means a mixture of mind, feelings and spirit. Psychotherapy and Counselling refers to talk therapy which helps a person with current personal problems or a need for deeper self-exploration. This differs from Psychology which is a science exploring how the mind works and patterns of behavior in humans and animals, or Psychiatry, which is a branch of medicine where psychiatrists must first train as medical doctors, and then go on to specialize in a study of the mind and mental health. They tend to treat patients with drug therapies and have the authority to diagnose and prescribe. Sometimes clients find a mixture of drug and talk therapies to be very beneficial, so the different disciplines are not mutually exclusive.

Who goes for Counselling & Psychotherapy?
We all go through phases where we feel we can’t cope, or we feel stuck. This is quite normal and when we look back on these phases we can see that they are just part of life, but at the time we can feel overwhelmed, sad, anxious or depressed. We don’t always like to burden others with our problems; friends can be great at listening but they often have their own problems. In addition, they can find it difficult to remain objective, or we might find our problems are too personal to share with them. A therapist is trained to listen attentively and objectively, their job is to offer the concentrated time and impartial perspective that friends cannot.

Sometimes people also come to therapy when they are not in crisis, but because they are looking for a way to get to know themselves better, to improve their relationships and get more out of life.

Countless people seek help from a counsellor or psychotherapist at some point in their lives. Men, women, children, couples, individuals, families … people from all walks of life go to therapy, and needing help certainly doesn’t mean you are self-obsessed or going mad, so don’t be embarrassed to reach out and ask. The therapist won’t ‘do’ anything to you, they can’t read your mind, and they don’t rake up the past or force you to talk about something that you would prefer they didn’t.

In reality, we all know that emotional problems don’t go away if we just push through them or ignore them. Trying to do so can lead to headaches, low energy, sleep problems, stress, irritation with loved ones, depressed feelings and angry outbursts – our mental health is clearly linked to our physical health, so it makes sense to take care of both.

It is worth knowing that most therapists have been through therapy themselves, in order to deepen their understanding of themselves, to resolve their own issues, and to help their appreciation of the therapy process.

What kind of problems are typically dealt with in Therapy?
Some counsellors specialize in specific problems such as working with addiction or sexual issues, but most will cover a wide range of general problems. If you aren’t sure, then ask prospective therapists about the concerns you are having. Often people seek one to one help with a therapist and this can allow you to concentrate on yourself and your own needs. Sometimes it is also helpful to seek Couples Therapy, where you sort out your emotional problems together, or Family Therapy, which is a highly effective way of helping everyone get along rather than letting one person (often a child who is acting out) take the blame for problems in the way the family or couple is functioning. 

What happens in a Counselling Session?
Typically, a session lasts for one hour and takes place once a week or regularly over a period of weeks or months, depending on the arrangement that works best for the client and therapist. Usually there is a goal that you form with the counsellor, or something you are working towards together, and your counsellor helps you to stay on track in working towards that. You spend the hour talking together, and sometimes your therapist will suggest things they would like you to do in-between sessions, kind of like homework, to keep the momentum going.

Most people initially go for short term help to tackle a specific issue and to see if therapy works for them. As things develop you might find you want to extend the therapy, or you might want to take a break and go back for more help later.

Therapy might be offered for free through your health service or through your school or employer. Otherwise, you might want to seek a private therapist. Fees vary widely and should be openly advertised by the counsellor; there may also be some concession available if you have a low income, so it is worth asking. Counsellors often offer a free or low cost initial meeting where you can decide if you want to work together. When you first meet the counsellor, take the opportunity to ask questions and decide if this is the person you want to work with. Ask yourself if you feel comfortable being open with this person? The more open you can be, the more you will get out of the therapy process. Don’t be afraid to ask them about their training, their experience, their supervision and anything else about their counselling qualifications that seems important.

Where can I find a good counsellor or psychotherapist?
If you are in the U.K., start with your GP to see what is available on the NHS, or see if there is a service available through your school or workplace. You can also try looking on the British Association for Counselling & Psychotherapy website at http://www.itsgoodtotalk.org.uk/therapists/. If you are outside the U.K. and in Europe you can also try your local health service, or look at this site for France and Spain, and know that many therapists in Europe now offer services via Skype so that distance doesn’t have to be a problem: http://counsellinginfrance.com/

It is also worth asking around your friends and local community for recommendations to a good therapist. You might be surprised to find out how many people you know have already seen a therapist!

I am of course available to consult if you are considering entering into therapy, and I wish you the best of luck on your journey!
Dr Jules (Julie Askew, PhD).