CBT/PSYCHOTHERAPY/COUNSELLOR??

One of the questions I get asked most frequently is how do I know what to look for in a counsellor/therapist and where do I look? They’re good questions. It really is a minefield out there. In this post, I’m going to try and sift through the jargon and try and signpost according to what you feel you might need:

WHAT SORT OF HELP DO I NEED?

First step here is to think about what it is you’re dealing with. If you have been recently bereaved and feel like you would like some help dealing with your grief, you could try reaching out to some local bereavement counselling charities. A quick search of google will tell you what’s on offer in your area. Cruse is a pretty well known organisation which will likely have well trained counsellors who have lots of experience in grief counselling. Kingston Bereavement Service is a local charity in Kingston Upon Thames that also offers a great service. The major advantage here is that they are affordable. Disadvantages may be that they have a long waiting list and sessions may be time limited.

If you are feeling generally quite low with no obvious sense of what is wrong then you would probably benefit from some one to one counselling to help you figure out what’s going on. I’ll detail below how you go about finding the best counsellor for you.

If you are feeling anxious, again one to one counselling will probably be helpful.

It may be that you have experienced or are experiencing something in your life that you are having trouble dealing with. This could be a relationship, a job, your family, friendships. The list really is endless. The point isn’t so much what it is, it’s how it’s making you feel and if you are having trouble tolerating those feelings or life just isn’t how you want it to be then again, counselling is probably the best route.

It might be worth noting that often people seek counselling not because they are feeling particularly low or depressed or anxious but because they are seeking to self actualise, to take time to learn and grow within themselves and again, counselling is a great way of exploring your inner self.

Counsellors do not diagnose mental illness. If you or someone you know is suffering from what you believe to be a personality disorder, bipolar, narcissistic personality disorder and so on then the best approach is likely to be your GP who can refer you to a psychiatrist. A psychiatrist is a doctor who is qualified to diagnose and medicate. That’s not to say that if you have been diagnosed with something like generalised anxiety disorder that you can’t see a counsellor. In fact, a counsellor would likely offer a comprehensive appraoch that helps you understand your anxiety along with some tools to help manage it.

I NEED A COUNSELLOR SO WHAT SORT OF COUNSELLOR DO I LOOK FOR?

This really is where the minefield begins. As mentioned above, there are lots of reasons why someone might seek counselling but knowing the type of couseller is a different matter. What I would say is that ultimately, the most important aspect of counselling is the relationship. If you don’t feel comfortable with the counsellor you’ve chosen then it won’t be as effective. Don’t be afraid to meet with a couple of counsellors to ensure you get the right fit. (Initial sessions are often at a reduced price or sometimes even free).

Most people have heard of CBT. It’s a popular approach used widely within the NHS. CBT focuses on cognitions - the thoughts that dominate our minds and consequently influence how we feel. These thoughts are often destructive, unhelpful, catastrophising and judgemental both of ourselves and others. Put simply, a CBT therapist will aim to help you unravel these thoughts and offer ways to reconstruct them. The advantages of this approach is that it is solution focused and fairly efficient. The disadvantages are that it can be a short term fix. CBT is the plaster over the wound. If the wound isn’t looked at, it is unlikely to heal. It also doesn’t focus on the relationship between counsellor and therapist. Some people don’t respond well to the ‘homework’ that is sometimes set in CBT. This can involve filling in forms between sessions to log your thoughts etc or setting short term goals. There may be a feeling of failure if the client doesn’t do it or the pressure to do it might put the client off attending the next session. On the other hand, having something constructive to do in your own time might be very appealing. It’s a very personal choice about how you feel you might work best.

I am an integrative therapist which means I draw from a number of theories and approaches to influence my work. What that means in real terms is that I am a relational counsellor who tracks the client with wherever they may be and with whatever they bring. In other words having a prescriptive pre determined approach wouldn’t work as it is vital that I stay with my client and what is important and unique to them. For me, counselling is as much about figuring out what it means to be you, what your values and purpose and inner truths are as it is about finding ways to tolerate and manage difficult feelings and thoughts. It’s about delving deeper and looking at the wound carefully and gently alongside some psycho education and tools to help relieve difficult sensations and thoughts.

There are lots of different titles for counsellors out there and some will adopt very specific approaches. I’ve elaborated on CBT and Integrative as they’re perhaps the most prevalent. Broadly speaking, you want to establish a couple of things from a counsellor’s profile: What do I want to acheive from counselling and is this person likely to be able to help me achieve it? Is the counsellor/client relationship important to them? What are their fees (and are they in line with other local counsellor’s fees)? Is their location convenient? What is their professional qualification? What feeling do I get from reading their profile? We often feel drawn to someone either through their photo or their words and this is worth paying attention to as feeling comfortable before you start will definately help.

HOW DO I FIND A CREDIBLE COUNSELLOR?

Google searching counsellors in your area might bring up a few websites. Have a read through them and cross reference against some of the points I’ve listed above. The counselling directory provides a database of qualified counsellors as does the BACP. (www.counselling-directory.org.uk or www.bacp.co.uk).

If you have any questions or would like to discuss this further, please do not hesitate to contact me.