What does Counselling involve?

Usually the first thing is to attend an introductory meeting, to explore what the problem seems to be.

After that, it will involve meeting each week or fortnight and talking with the counsellor - usually for about one hour. This may be for a fixed period, to be reviewed at the end - or it may be open-ended.

What are the main types of Counselling available, and what are the features of the different approaches?

• Working with the Past and the Present - Psychoanalytic and Psychodynamic Counselling

These forms of counselling aim to establish a caring, supportive relationship between client and counsellor, and within this to explore your past experiences and current life. The aim is to help you to see how the past is affecting your life now, and to enable you to make changes.

• Exploring Thought Patterns - Cognitive Therapy

This approach emphasises that the way we think influences how we feel. By helping you to recognise negative thought patterns which you may have developed without realising it, the aim is to help you to develop more positive attitudes.

• Behaviour Therapy

The aim of this approach is to change unhelpful ways of behaving that you may have developed, for example avoiding crowds through fear, or abusing alcohol. It works on the basis that the counsellor encourages and rewards behaviour that is helpful to you, and discourages behaviour that you want to stop.

• Other Terms and Other Approaches used in Counselling and Psychotherapy:

There have been many developments in counselling and therapy during the last thirty years. Approaches such as Co-Counselling, Family Therapy, Gestalt, Psychodrama and Psychosynthesis are common today. There is not space to go into detail about these approaches here, but more information can be found in:

"Who Can I Talk To? - The User's Guide to Therapy and Counselling",
by Judy Cooper and Jenny Lewis, Published by Headway at £6.99.

What are the differences between the different services?

Within GP Practices in the Health Service, counselling is likely to be for a limited number of sessions. It is more likely to be "cognitive" or "behavioural".

Private Therapists require payment for the work they do with you. Some offer a "sliding scale", where you pay according to your means.

How do I know if Counselling is Right for me?

Unfortunately many people may have the idea that seeking help in this way is a sign of weakness or inadequacy. The truth is different. To face up to difficulties, with the help of a counsellor, takes courage.

Sometimes, counselling can lead you to make major changes in your life. But it must be remembered that counselling is not a magic wand. It's not a good idea to expect that suddenly your life is going to change.

How can I find a suitable Counsellor? What should I look for?

Access to counselling is very patchy. There are various ways of finding a counsellor:

• Through a GP
• Through an Advice Centre
• Through a Social Worker or Community Psychiatric Nurse - if they are unable to offer counselling themselves
• Through various voluntary agencies
• Through a friend
• The Yellow Pages
• Noticeboards in some public places. >

When you first meet a counsellor, you can ask questions about:

• Experience, Training, Qualifications

• Are they accredited by one of the official bodies - the main ones are the British Association for Counselling (BAC), and the United Kingdom Council for Psychotherapy (UKCP). There has been some concern recently about the training and qualifications of some counsellors who advertise in the classified columns of magazines. So, if you are considering arranging counselling for yourself, it is best that the counsellor is accredited. (This is unless the counsellor works within an organisation where, if you are dissatisfied, you can make a complaint.)

• The approach that the counsellor will take.

• Whether they receive supervision for their work. This should always be the case.

• How long will each session be, how often will you meet, how long will the counselling last?

• Charges, if any, and whether there is a sliding scale.

• Is it a totally confidential service?

• Whether you feel comfortable and safe with this person. Could you trust them with intimate details about yourself?

What information will a counsellor seek from me?

Some counsellors will seek to find out a your history, in a quite structured way.
Others will not normally ask many questions, but will let you take the lead in what is talked about and explored.

What about "Ground Rules"? What is a Counsellor allowed and not allowed to do?

As a client, you can stop anytime you wish to. It is important to remember this. The counsellor may encourage you to look at why you wish to stop - sometimes you might be avoiding something. But the counsellor has no right at all to "force" anyone to continue with counselling.

You have the right to feel comfortable in your relationship with the counsellor. What you talk about together may be painful at times - and the counsellor will, if he or she is skilled, help and support you in exploring these areas.

Over what length of time is counselling given?

It varies a great deal. It may be for a specific number of sessions or open ended, and sometimes it may last for years.

What will happen to me?

What happens to people in counselling varies enormously. Many people say that although the problem that they came with hasn't gone away, through counselling they have become better able to cope with it, and to live more fully.

Sometimes it's difficult to know if things are changing in your life or not, during a period when you are having counselling. One thing which can help is to keep a diary or journal, and then you can look back and get a sense of changes that have happened, of progress you have made.

What about Confidentiality? Is everything I might say to a counsellor kept confidential?

Normally, yes. The exceptions are where a counsellor hears information about child abuse, or about the client putting their own life or the lives of others in danger. Such information will be passed on to other people in the relevant services. Only in very exceptional circumstances would this be done without your knowledge. This is standard practice for all counsellors.

Are any records kept - and if so, who has access to them?

Some counsellors keep records, and others don't.

If records are kept, it is normally only the counsellor who has access to these records. But the counsellor will discuss their work with you with their supervisor. This is to help the counsellor in their work and to ensure they are providing you with useful and ethical help.

As a client, you have a right to ask about who has access to your records.

Does it matter if I'm on Medication?

Not necessarily – if you are taking psychiatric drugs, counselling may well be useful for you.

Research into treatments for depression has shown that a combination of drugs and therapy is more effective than either on its own. Also some counsellors will offer you support in coming off drugs, if that's what you wish to do.

However, there are some counsellors who are reluctant to work with people who are taking mood-altering prescribed drugs. When you first meet a counsellor, you need to make sure that you tell them if you are taking medication of this sort.

Does it matter if I'm seeing a Psychiatrist?

Usually psychiatrists are very happy that a person they're seeing is getting additional help from a counsellor.

Very occasionally, a psychiatrist may recommend that exploring something through counselling would not be a good idea for a person at a certain time. This is normally because, having gained some sense of the state a person's mental health, they consider that it would do more harm than good. This is rare - but, when it does happen, normally an agreement is reached between the three people concerned.

What could go wrong? And what should I do?

Occasionally, things can go wrong. This can include:

• Emotional abuse of the client - the counsellor is unreliable, or encourages the client to become dependant on them in an irresponsible, ill-considered way.

• Financial abuse - the counsellor encourages the client to stay in counselling when they are no longer gaining any benefit.

• Sexual abuse - under no circumstances should counsellors have a sexual relationship with a client - even if, for a time, the client wants one. This also applies after counselling has ended.

• Betrayal of confidentiality.

• Using the client's time to talk about their own problems.

• Imposing their own values on the client.

If any of these abuses is happening to you, you need to stop the counselling and make a complaint. All organisations should have a Complaints Procedure. The British Association for Counselling has a written procedure, and all member organisations of the United Kingdom Council for Psychotherapy are required to have a UKCP approved Complaints Procedure.

Support in making a complaint may be found from a friend, an advocate or a trusted professional, or an Advice-giving organisation and is also available from:

Prevention of Professional Abuse Network (POPAN)
1 Wyvil Court, Wyvil Road, London, SW8 2TG