What is psychotherapy? Is it different to counselling?
There is no one definitive definition of psychotherapy or counselling. The terms are often used interchangeably but there is usually a sense that psychotherapy is more appropriate for issues that are deep seated and may be rooted in someone’s past, whereas counselling may be appropriate for a single issue of a more recent onset. In this sense they can be regarded as opposite ends of a continuum and there can be an overlap and natural progression between them.
Both involve establishing a confidential relationship between therapist/counsellor and client in which the client feels able to talk freely about whatever is troubling them. The idea is that by listening carefully and attentively the therapist can start to gain an understanding of their client’s experiences, what it is like to be them and help them explore not only how they’ve arrived at this point in their life, but what their options might be for the future (if that is important). By talking about what is going on for them, people usually find that at the very least, something opens up, or shifts for them – whether it’s a different way of looking at things or simply how to be. It is important to stress that therapists do not give advice and do not judge.
Different therapists will describe what they do differently. If you want to know more, the Counselling Directory has more information.
Are there different types of therapy? How do I know what type of I need?
First of all you need to pick a therapist who works with the right category of client for your needs i.e. children, adults, couples or families.
Second, you might want to think about the way a therapist works in terms of their ‘modality’, which is basically their theoretical orientation. This will tell you something about how they view the world and how they understand what makes us tick.
This can be tough as most people looking for a therapist don’t really understand what all the different terms mean and even if they do, there is no guarantee that a therapist with a particular label will only work in that way with them. For example, many therapists, like me, call themselves ‘integrative’ which means we blend two or more ways of working in the way we feel appropriate for each client.
Whilst you can find out more about the most common ways of working through the link given below, do remember that research shows that the most important element in psychotherapy or counselling is the quality of the relationship between the therapist/counsellor and client. If this relationship is right, then therapy has a good chance of being successful regardless of the favoured theoretical model of the therapist.
When choosing a therapist therefore the most important thing is to pick someone who feels right for you.
For more information about the different types of therapy (e.g. psychodynamic, person centred, CBT) the Counselling Directory provide a useful summary.
How long will I need to see a therapist for?
If you are seeing a therapist privately then usually you can carry on for as long as it is of benefit to you and this is something you would expect to discuss with your therapist. Some people see a therapist/counsellor for six sessions, some for many years.
What kinds of things should I think about when choosing a therapist?
The most important thing is whether you feel they are right for you – this is a really personal choice and may come out of an instant judgement or a careful consideration of such factors as:
- The therapist’s personal qualities
- The way they work (their theoretical model)
- A word of mouth recommendation / their reputation
- Do they work short or long term
- Location / feel of counselling room
- Their availability to see you when convenient to you
- Ease of access / parking
Most therapists expect a first session to be about establishing whether you feel you can work together. Don’t be scared of seeing more than one therapist/counsellor for a first session in order to make the right choice. This might be more expensive initially but could save you money in the long-term if it means you find the right person first time.
Are there any limits to confidentiality?
Yes. They mainly focus on whether someone is felt to be at severe risk:
- If a therapist feels you may harm yourself or someone else, they may need to talk to someone about that – where possible they would talk this over with you and agree what would happen next. NB There are particular rules that apply to those under 18.
- The organisation the therapist works for or their professional code of ethics may have specific restrictions or requirements around confidentiality, so if this is an issue which concerns you it’s always best to ask.
Many therapists also have professional supervision which means they will discuss their client work with another, usually more experienced therapist. This helps the therapist’s own professional development and helps them to think about how they might best work with each client. Your identity would not be revealed for this purpose.
Where can I turn if I need to speak to someone urgently?
Most therapists are not available to their clients in an emergency situation. If you need to speak to someone urgently about an emotional issue then organisations such as the Samaritans are best placed to offer support and are available 24 hours.
Samaritans UK number is 116 123.
Contacting your GP or emergency services of course always remains an option at any time.