What is this thing we call 'counselling'?

I've just rediscovered this 'information sheet' I wrote earlier this year, & thought I'd share it on here. It gives a very brief overview of counselling & some of the different approaches available ...

Counselling

When might counselling help?

If anything is troubling you in your life, counselling can provide a safe, accepting, confidential place in which you can talk about your concerns. People talk about a wide range of things in counselling, including; drug use, eating problems, bereavement, family issues, relationship problems, sexual assault or childhood sexual abuse, other forms of childhood abuse, work related concerns, sexuality and much more.

What is counselling and how does it work?

Counselling allows you the opportunity to sit down with a trained professional and explore your thoughts, feelings and emotions about the situation you find yourself in. The counsellor will offer a safe and accepting place in which you can talk about yourself and any concerns you may have. The counsellor will not judge you, or anything you say, but will instead allow you to explore the thoughts and feelings you may be having which you maybe don’t want to share with friends or family.

By talking about yourself and your experiences in a safe place and having what you say heard and listened to carefully you may find that the influence of those experiences on your life begins to lessen. The process of sharing your thoughts and feelings can be very helpful in enabling you to make sense of yourself and your life. Sharing things with a counsellor who you can trust not to judge you and who isn’t part of your usual circle of friends can be a healing experience in itself.

We don’t often get the opportunity to sit down and talk about ourselves in such a focussed way. Having your experiences and yourself listened to in such an accepting way by someone else can help you begin to feel better about yourself. And this in turn can help you begin to like and accept yourself more, which leads to improved self-esteem and self-confidence.

Counsellors tend not to give advice or tell you what to do, and will instead enable you to make your own decisions about what you need to do. In this way, you learn to trust yourself more and learn how to empower yourself to live your life more effectively.

Counsellors will reflect back to you some of the things they hear you say; hearing your words reflected back by someone else can sometimes help you hear them in a different way which can change the way you understand them or think and feel about yourself. Sometimes too, just hearing yourself tell your story out-loud and the process of having to think about it clearly in order to tell it to someone else can help you make clearer sense of it for yourself.

Counsellors may also ask you questions or offer you exercises and activities to help you explore your thoughts and feelings in a different way. Sometimes we can get stuck in unhelpful ways of thinking which leave us feeling unhappy or unfulfilled. The counsellor’s questions can help you challenge these ways of thinking and find more effective ways of viewing yourself and your situation which will enable you to make changes in your life.

Working together with you like this, the counsellor is aiming to help you develop a clearer understanding of yourself and your life and to help you decide upon any changes you wish to make to help you live more happily.

The counselling process

Counselling sessions tend to last between 50 minutes and one hour, depending on how the counsellor works. They usually happen on a weekly or fortnightly basis because counselling is a process which you need to engage in regularly in order to get best results. Once you’ve talked about something in a session, it’s helpful if you think about the things you’ve talked about in the time between sessions. In this way, you are beginning to make changes to yourself and your life which you can discuss with your counsellor at your next appointment.

At the first session, the counsellor will discuss the “counselling contract” or “counselling agreement” with you. This will set out what you can expect from your counselling and will include things like the counsellor’s confidentiality policy, how often you will be seen, how many sessions you are entitled to, what happens if you miss sessions, etc. In the first session, the counsellor will give you the opportunity to tell your story and talk about your hopes or what you wish to achieve from counselling. They may also carry out a formal assessment, looking at things including your history, your support systems, your current life situation and any risk factors (things like excessive alcohol use, drug use, self-harm or suicidal intent). This first session gives both you and the counsellor the opportunity to decide if counselling is the most appropriate service for you.

The first session also gives you the opportunity to find out if you feel comfortable with the counsellor. The relationship which you develop with them is an important part of the process and you need to feel comfortable with the person you are choosing to work with; after all, you're going to talking to them about personal, precious, private, and sometimes painful things.

Accessing counselling

Counselling is offered by a number of organisations, depending upon which services you are accessing. This counselling is very often free, although some organisations may charge a fee. You can also be referred to counselling within your GP surgery, which is free. Private counsellors also offer counselling, although you will need to pay for this.


Different styles of counselling

There a number of different approaches to counselling and different counsellors work in different ways. Below are details of four of the most common approaches used. Some counsellors work purely from one particular model, whilst others may integrate skills and techniques from a number of approaches, and call themselves ‘Integrative’ or ‘Eclectic.’ It can be useful to talk to your counsellor about how they work so that you can understand a little bit about their approach and how you will be working together.

Person Centred

Person Centred counsellors work from the belief that clients are the experts in their own life and have all of their own answers inside. The approach is non-directive which means that the counsellor will not give you advice or tell you what to do in any way. They will follow your lead, believing that you, as the client will bring to counselling those things which are most pressing for you to explore. This also encourages you to learn to take responsibility for yourself, by teaching you to decide what is most important to you. The counsellor will help you explore the issues you take to counselling to help you find more effective ways of understanding your situation or living your life.

CBT (Cognitive Behavioural Therapy)

The underlying belief of CBT is that the thoughts we have influence our behaviour and how we act. By helping you to take more notice of the thoughts you are having, the therapist will help you find ways of challenging and changing your unhelpful thoughts to more helpful ones. With these more effective ways of thinking in place, you can then choose to change your behaviours to help you live more effectively.

Psychodynamic

Psychodynamic counsellors will help you explore the impact your unconscious and your past experience is having on your current life situation. As children, we learn beliefs, values and behaviours from the adults around us and how they treat us and other people. Sometimes when we grow up the things we learned in childhood prevent us from being happy or living our lives effectively. By exploring where our beliefs originate from, we can then find ways to challenge and change them to more effective beliefs which fit more easily with the adult we have become. Psychodynamic therapists also believe that we often respond to people and situations in our current lives in ways which remind us of past experiences and relationships. This may occur in the counselling relationship and the therapist will observe how you interact with them, with the aim of assisting you to find more effective ways of relating to people in the present.

Gestalt

Gestalt therapists focus on the whole of the client’s experience. They will encourage you to gain self awareness and understanding of your behaviours by encouraging you to talk about yourself. They will focus on your body language (the unconscious movements you make as you talk), which can often give clues as to how you are thinking or feeling. The Gestalt therapist may encourage you to act out scenarios or explore your dreams in order to enable you to become more aware of your unconscious thought processes. Bringing your unconscious gestures and thoughts to awareness allows you to make more effective choices about your beliefs, behaviours and ways of living.

The Evolution of a (My) Counselling Philosophy

I'm currently reflecting on my therapeutic practice and my counselling philosophy. I describe myself first and foremost as a 'Person-Centred Counsellor' and much as my philosophy is very much based in Carl Rogers' original Client-Centred Therapy, I'm very aware that I'm not a purist Rogerian therapist.

As my confidence and experience has developed, I've integrated ideas, theories and practices from other schools of therapeutic thought including Gestalt, Cognitive-Behavioural Therapy, Psychodynamic, and more. My research over the last couple of years has also begun to lead me down paths of Body Psychotherapy and I’m increasingly aware of the role of the body and its communications within the therapy room. I’ve always been intrigued by body language, by client’s gestures and movements. And, as our bodies are how we present our Selves in the world, I believe their potential for communication and understanding is very often underestimated, or even ignored.

In my experience, which concurs with a recent conversation I had with a very experienced therapist, when we set out on our paths as counsellors / therapists we quite often tend to stick rigidly to the ideas and practices of our preferred school of therapy. However, as experience (and clients!) teach us, we learn how to integrate other practices and we each develop our own unique therapeutic philosophy and practice which works for us. What’s important for me is that as my understanding of human beings deepens, I am able to refine my understanding of how ‘problems,’ ‘symptoms’ and problematic coping mechanisms develop and are used, and from that I can develop an integrated therapeutic philosophy that is congruent with my personal belief system.

When I begin a counselling relationship, I very much approach the work from a Person-Centred perspective; following the client rather than directing them in any direction. I aim to understand the client's unique experience and I listen carefully to the words they use, reflecting them back, or challenging them. Quite often I find, when I question client's usage of particular words or ask them what they mean by a specific word, the client themselves isn't sure, or hasn't really stopped to think about the words they're using. I love words and language and my work with clients has taught me to never assume that I understand what my clients mean … I always question their interpretations of what I say to them and I always ask them what they mean by specific words they use. For example, in my work in GP surgeries, so many clients tell me they feel ‘depressed’, or the GP has diagnosed them with ‘depression’. I never I assume I know what they mean by that word or diagnosis … I always ask them what their experience and / or understanding of depression is. I see every client as a unique individual and I’m interested in hearing and understanding (as closely as I can) their unique, individual experience.

As our counselling relationship develops, I continue to follow, or walk alongside my client. I aim to remain empathic with them to understand their experience and I remain mostly non-directive. However, I’m also always mindful that as clients talk, their words often trigger theories, exercises and practices from different therapeutic schools, and it’s at this point, as the client’s words have suggested these things to me, that I bring other therapeutic practices into my work.

I've recently become intrigued by Neuro-Linguistic Programming (NLP) and Hypnosis; and especially the language patterns used in each. In the past I've been very sceptical about NLP, but over the last few months, I've began reading more and more about the approach, its philosophy and structure, and I’ve been surprised to realise how much of its philosophy I’ve been able to integrate into my idea of person-centredness. Indeed, how much of it seems to overlap with the philosophy of Person-Centred Therapy.

I’m embarking on a training course tomorrow in NLP and am greatly looking forward to learning more. At this stage, I have no idea how, or even if I’ll be able to, integrate any of its practices into my current work, but I’m looking forward to finding out. My current feeling, from the reading I’ve recently been doing, is that NLP will deepen, or give another perspective to some of my current ideas and therapeutic beliefs. I’m open to them all being challenged and questioned….

At this stage in my therapy career and my own personal development journey, I’m very much looking forward to the coming year and seeing how, and where, my practice (and my Self) develops….