INTRODUCING COUNSELLING
Ever had these thoughts? Sometimes it all just gets a bit too much… I don’t know if this is normal… I wish there was someone I could talk to… Nobody ever seems to listen to me… I had this weird dream, I wonder what it means… I really want to give up smoking… If only I could move on… I just don’t know what to do anymore… Whenever I talk to my friends, they just give me advice… My mum thinks she always knows best, even if she doesn’t… One moment I can be on top of the world, the next I can be feeling down… Nobody really understands me… I wonder if I’m drinking too much… I missed her when she was gone… Sometimes I feel like I just want to scream… Everything worries me… I feel empty… I wish I were more confident… Everyone says that I’m doing well, but I feel so inadequate… I couldn’t stop but I wanted to… I wish…
Always remember it’s okay to question what your counsellor says or does in counselling, if you want to.
Q1: Who seeks counselling?
People use counselling for many different reasons. Some clients seek counselling as a treatment for clinical conditions, such as acute depression, addiction, phobias, or psychiatric disorders. Others use counselling to cope with life’s challenges, like bereavement, work stress, separation, or emotional trauma. Yet others seek counselling to improve their lives and gain greater stability and emotional wellbeing. People who seek counselling come from all walks of life and have a wide variety of different work and personal backgrounds.
Q2: What are counselling and psychotherapy all about?
The aim of both counselling and psychotherapy is to provide opportunities for those seeking help to find their own ways towards living more satisfying and resourceful lives. Although the range of issues is very great, what’s common is that people seeking counselling feel distressed, confused, uncertain, unhappy, or in turmoil, in ways that can be alleviated and transformed by confidential, therapeutic methods, including attentive and active listening, the use of art materials and drama, therapeutic play and movement, and other ways of communicating. Respect for the autonomy of the client is a core principle of counselling. This means that counsellors approach their clients as unique individuals with unique needs, bringing their skills to bear in flexible ways.
Underlying counselling responses to distress is a commitment to deepen our understanding of ourselves to enable us to harness our diverse and considerable energies. Counselling is therefore not only ways of healing distress and enabling change but also a democratising process that aims to empower people by fostering self-awareness.
Counselling is delivered through explicit agreements or contracts between practitioners and clients. These agreements typically take the form of regular sessions of a specified length of time, held within clearly defined boundaries of confidentiality.
Q3: What can I expect?
Sessions and the course of counselling overall will always be tailored to the individual client’s needs, and the content of counselling sessions can vary greatly from client to client. You might want to regard the sessions as your own time and space that can be used either to alleviate an immediate crisis or to resolve ongoing underlying issues. Either way, you don’t need to arrive at your sessions with a specific agenda of what you’d like to cover.
Q4: How will counselling make me feel?
Counselling is a very personal process. Sometimes it’s necessary to talk about painful feelings or difficult decisions, so you may go through a period of feeling worse than when you started. However, counselling should enable you to feel better in the long run.If you do experience a period of feeling worse, talk to your counsellor about it to ensure you get the best out of your counselling.
Q5: Will I feel better straight away?
Usually, it will take a number of counselling sessions before counselling starts to make a difference. However, on rare occasions, a single session may be enough.
Q6: Does it work for everybody?
Counselling doesn’t work for everybody. It’s not a universal cure-all. Because you may be talking about very personal and often painful things, it can sometimes be difficult to keep going. Despite this, it’s often worth the effort as you can be helped to work through problems.
Counsellors should:
Offer a safe, confidential place, where you can talk about yourself and your life.
This may be painful or confusing and may make you feel uncomfortable, angry or unhappy.
Offer an opportunity to think and talk about yourself and your concerns in a way that you often can’t do with family and friends.
Offer a place and time which is just for you to talk about those things that bother you.
Listen to the way you feel and how this affects you and others.
Accept the way you are without judging you.
Help you to make the changes you would like to happen.
Work hard to create a good therapeutic relationship with you so that you can work well together.
Work with you towards improving your wellbeing.
May have information and resources to share with you,
Counsellors should not:
Offer to ‘cure’ you.
Judge you.
Make decisions for you.
Take advantage of you in any way.
Spend time talking about their problems.
Inappropriately discuss what you and your counsellor talk about with other people.
Inappropriately discuss what you and your counsellor talk about with other people.
Q7: How long does it take?
Counselling can take just a few sessions and sometimes even one session may be enough. It may continue over several weeks, months or years. This depends on your individual situation. Your chosen counsellor should discuss this with you before and during your course of counselling.
Q8: How long is a session?
Sessions will usually last fifty minutes to one hour. This can be adapted to your needs and should be discussed with your chosen counsellor.
Q9: How often will I see my counsellor?
Many people see their counsellor once a week, but the frequency can vary according to your need and the type of counselling being offered.
Q10: Will my counsellor talk to anybody about what I say in counselling?
Usually, what you talk about in your counselling sessions is confidential; however, there may be some circumstances that may prompt your counsellor to talk to another professional. For example, if there appears to be a serious risk of harm to you or to others. This is usually done with your permission.
Q11: What information will I have to share with my counsellor?
It’s your choice what you tell your counsellor; however, it may be helpful to give them an idea of what has brought you to counselling to enable the process to be effective.
Q12: Will the counsellor tell my doctor?
Usually not, but many counsellors prefer to have your doctor’s contact details in case they feel there is a serious risk of harm to you.
Q13: Can I bring a friend?
This is generally not accepted in individual counselling. However, some cultures would not find this a problem, and if there are communication difficulties, it may be helpful to have an interpreter in the room. If you feel you need someone with you, group counselling may be an option for you.
Q14: How can I end counselling?
You need to discuss this with your counsellor in order to bring things to a satisfactory close. If you feel you cannot do this face to face, you could give notice of wishing to end counselling in writing to your counsellor, however, bear in mind any agreement you made at the beginning of counselling with regards to ending the process.
Q15: I am disabled, will that make a difference?
Disability should not make a difference, although adjustments to usual practice can be made, such as when British Sign Language (BSL) signers or interpreters are involved. A number of counsellors work with issues of disability and offer details of facilities for disabled clients.
Q16: What happens in your first session with your counsellor?
Your first session will be about why you’re looking for counselling; what you want to achieve from the counselling, and agreeing how you and your counsellor are going to work together. Your counsellor will probably ask you a number of questions to help you decide whether you’ll both be comfortable working together and to check that you can be offered the most appropriate support. Perhaps, after discussion with the counsellor, you might decide that you don’t want to continue and if so, then you should be completely free to leave. Also, your counsellor may think that there may be a different and more appropriate counselling available and will, therefore, offer you a referral.
However, if you both feel that the counselling may be beneficial and you wish to continue, it’s likely that you will discuss and agree on how you will work together, for example, how often you will meet, and you will make what your counsellor will call a therapeutic contract, which may be written down. It can be helpful to have a written agreement, because you can refer to this during the period of your counselling to refresh your memory as to what was agreed. This is helpful because new clients may feel nervous at the first session, and find it difficult to take in everything that you and the counsellor talk about. Counsellors work with clients in many different ways and they will probably explain their ways of working to you, but if not, it’s a good idea to ask them about this. You have the right to ask your counsellor anything you want to know about their qualifications and experience and your counselling, and to question anything you don’t understand. Your counsellor should encourage you to do this
Q17: Some things you might want to discuss with your counsellor are:
The number of sessions you’ll have and the duration of counselling can vary widely depending on your individual needs and circumstances. It’s a collaborative process between you and the counsellor. You’ll discuss this together, regularly reviewing progress and setting goals.
You’ll typically discuss this with your counsellor during the initial sessions. They may suggest a rough estimate based on the issues you’re facing, but it’s important to remember that this is a flexible plan. You can adjust it as needed.
If you’re unable to attend a session, it’s crucial to inform your counsellor as soon as possible. This allows them to plan their schedule and make necessary adjustments. Many counsellors have specific policies regarding missed appointments, so it’s best to check with them directly.
If you miss multiple sessions, it might impact the momentum of the therapy process. Your counsellor may suggest rescheduling or discuss the possibility of a temporary break. However, consistent attendance is generally beneficial for progress.
Regarding holidays, you should discuss your availability with your counsellor in advance. They can help you schedule sessions around holidays or suggest alternative arrangements, such as online sessions or rescheduling.
If your counsellor is on holiday, they may offer alternative arrangements, such as a temporary referral or online sessions. They should also inform you in advance and discuss how you can stay connected during their absence.
Confidentiality is a cornerstone of counselling. What you discuss in sessions is private and won’t be shared with anyone without your explicit consent, unless there’s a serious risk of harm to yourself or others.
If you’re in couples counselling, confidentiality is more complex. While the overall process is confidential, it’s important to discuss with your counsellor how you’d like to handle any sensitive information that might arise.
Counsellors often keep records of sessions, including notes and reflections. These records are confidential and are primarily used to help the counsellor understand your progress and tailor their approach. You may have the right to access these records, but this varies depending on local regulations and the specific practices of the counsellor.
Contacting your counsellor outside of sessions can vary depending on the agreed-upon boundaries. Some counsellors may be available for brief check-ins via email or phone, but it’s essential to establish clear guidelines to avoid blurring the boundaries of the therapeutic relationship. Texting is generally not recommended as it may not be the most effective way to communicate complex emotions and thoughts.
The decision to end counselling is typically a joint decision between you and your counsellor. You’ll discuss your progress, goals, and whether you feel ready to conclude therapy. If you feel the counselling is no longer beneficial or you’re ready to move on, you can initiate this conversation with your counsellor.
It’s important to remember that you’re the client and that, for counselling to be helpful, you should feel able to raise anything you wish with your counsellor. If anything confuses you or doesn’t make sense to you during the sessions, it’s important to discuss this with your counsellor.
Counselling is a very personal process and sometimes it’s necessary to talk about painful feelings or difficult decisions, so you may go through a period of feeling worse than when you started. Research shows that this is common and natural. It’s important to discuss this with the counsellor if you’re concerned. It can sometimes be difficult to continue but it’s usually well worth the effort as you’re helped to work through the problems. However, if it really doesn’t seem to be working for you and you’ve discussed this with your counsellor, you should feel free to end the counselling.
How to get the best out of your counsellor
Introduction
Many intending clients do not know what to expect or what is or is not normal in counselling. They are unlikely to know whether any concerns they may have are valid or not.
How to make the most of counselling
You can get the best results by:
Being open
Saying how you are really feeling
Giving your counsellor honest feedback on how you experience the counselling
Good counselling should feel safe and enable you to take risks with the issues you are prepared to work on. This includes saying how you think that you and your counsellor are working together.
Working with your counsellor when things go wrong
You may start out hoping for a good outcome from counselling or you may be ambivalent. Whatever your expectations have been, something may happen that leaves you feeling uncomfortable or unsure. You may feel confused, or feel that what took place wasn’t helpful. It can be really hard to say ‘You are not helping me’ or ‘I felt bothered about x or y after our last session’ and to explain why you feel this way.
The counsellor may come across as a powerful person and you may worry about their reaction to critical comments. The counselling may have been useful until something happened which felt disturbing. You may be reluctant to talk about this for fear of spoiling what had been a good relationship. Uncomfortable feelings are normal and it can be hard to accept that counselling is not always a comfortable process. Counselors strive to deliver a good standard of care but sometimes, as in all human relationships, things can go wrong. The question is how to tell your counsellor about your concerns.
It is important to:
Accept your uncomfortable feelings.
Think about what has caused them.
Discuss them with your counsellor.
Thinking about the problem.
If you feel uncomfortable about any particular aspect of your counselling, it is important to spend time thinking about why. It might be something like:
My counsellor keeps changing the time of my appointment at short notice.
I worry about whether he is good enough.
My counsellor often doesn’t say anything and waits for me to speak. The long silences make me feel uncomfortable.
My counsellor often talks about himself in sessions.
I feel annoyed because sometimes the session is more about him than me.
My counsellor said I could ring him whenever I needed him but now he’s told me to stop and
I don’t understand why.
I feel very uncomfortable because my counsellor takes notes during sessions.
My counsellor wants to tape some of my sessions. I don’t know if this is normal.
I met my counsellor in a social setting and felt disturbed by some of the things he said about
himself. I can’t relate to him now in the same way that I did before.
My counsellor suddenly told me that he can’t carry on working with me because he got a full
time job and next week will be my last session. I feel he’s dumping me and I’m very upset.
My counsellor won’t give me any advice although I keep asking him what I should do. I expected to be given more help in making decisions.
Talking to someone trustworthy or writing down what happened might help to clarify your thoughts and feelings. The aim is to be clear about what your concern is before talking to your counsellor.
Telling the counsellor what the issue is
Once you have thought about the issue, you should talk to the counsellor. This is important if the counselling is to continue to be useful. You could choose to e-mail, telephone or write a letter. It can sometimes be easier to say difficult things about problems in a relationship when there is some distance between the individuals. It is best to tell your counsellor what is wrong as soon as you can. Most people who start counselling do so because they want to feel better. It can be puzzling if you find that you feel worse. This is not unusual because counselling can be stressful and is uncomfortable at times. However, sometimes counsellors can get things wrong. It is important to check out why your counsellor behaved in the way that they did. Even a small thing such as the way the counsellor spoke, the particular words used, the tone of voice or facial expression can be unsettling. A competent counsellor will listen in an open way and work with you to understand what took place, and thereby achieve a better outcome.
Giving feedback
You should give regular feedback during sessions about what aspects of the counselling have been helpful and what have not. A good counsellor will invite you to do this and will allow time for it. This should help issues to be dealt with when they arise.
When the therapeutic relationship is not working
You do not have to stay with a counsellor with whom you cannot relate or feel safe, or whom you cannot trust. You may feel trapped and think you have to continue but this is not the case. You have the right to decide when to stop. You have the right to look for another counsellor.
What can you do if you are dissatisfied?
If you’ve tried to talk to the counsellor and their response has been unhelpful, or you have serious issues about your counsellor’s competence, you need to decide what to do. The first step is to ask yourself what you want. It may be that you want an apology, an acknowledgement of what happened and an undertaking that it won’t happen again. You may simply want an explanation about why something happened. In that case, it can be best to put your concern in writing, explaining the outcome that you would like, and allowing the counsellor time to respond. You may receive an explanation or an apology, either of which may satisfy you and enable counselling to continue.
Other sources of help from BACP
1. The Ethical Framework
If you are dissatisfied or worried about the quality of the service you have received from a BACP member, you can obtain a copy of the Ethical Framework. It gives guidance on the standard to be expected of a BACP member. The Ethical Framework covers a wide range of issues including:
The importance of trust.
What counsellors and clients need to agree before counselling commences, such as length of sessions, meeting times and areas to be covered in counselling (this agreement is often referred to as the contract).
Record keeping.
The need for counsellors to maintain competent standards of practice.
The importance of clear information about the services on offer.
The nature and limitations of client confidentiality.
The responsibility of counsellors to respond promptly and appropriately to complaints.