Psychotherapy And Counselling: FAQs
It’s very normal to have queries and concerns when first thinking about psychotherapy or counselling. So here’s some jargon-free information about how it all works – including answers to some of the really common practical questions.
The terms ‘psychotherapy’ and ‘counselling’ both refer to talking therapies. What happens during sessions in both cases is actually very similar: it’s basically a highly-focused, collaborative conversation about you and whatever may be troubling you. The aim is to clarify where you are (and perhaps how you got there), identify unhelpful patterns, and help you resolve problems and move forwards with your life.
Some people use the word “counselling” to refer to shorter-term work, and “psychotherapy” for longer-term or ‘deeper’ work. But the biggest difference is in the therapist’s qualifications: psychotherapists undertake a lengthier training than counsellors. This enables them to support more complex emotional explorations, and potentially to work with more serious mental health issues, if and when required.
I am a fully-qualified psychotherapist. For more information about my training, see About Sarah.
Psychotherapy and counselling provide a safe and highly focused space for you to talk through whatever it is you’re facing. There is room for you to bring your life experiences, your thoughts and feelings, your hopes and fears, your memories and dreams – all without fear of being hurried or judged.
Each psychotherapist or counsellor works with all this in a different way. I generally start by looking at how things are currently affecting you emotionally, physically, and relationally. We build a picture of your life-patterns, your habits of thought, your coping strategies and resources. And we agree and regularly review what you want from your sessions, so we can ensure the process remains supportive and ‘on track’, till you feel ready to cope on your own again.
You can find out more details about how I work in About Sarah.
Independent research shows that 80% of people who undertake counselling at times of stress feel better than those who don’t. But it’s really important to find a therapist who is the right ‘fit’ to help you achieve change. Psychotherapy or counselling with the wrong person either won’t work at all, or can drag on for far longer than it needs to.
If therapy with a particular therapist is going to work, most people will see clear signs of change within the first 6 weeks, even if it takes much longer than that to completely resolve their difficulties. As you are the expert on how things feel for you, it’s important to trust your own judgement during the first few weeks of counselling.
When we start working together I will regularly check with you how you think things are progressing. That way we can make sure we remain focused on what you want to achieve from therapy. And if you are not seeing positive signs of change then we can talk together about what might be the best way forwards for you – including a referral to a different therapist if needed.
There are more than 400 types of psychotherapy and counselling(!). You may have heard of some of these, such as CBT, Mindfulness, etc. Each type of counselling is essentially a different kind of map for understanding the mind, with its own range of map-reading and path-finding techniques. Like any map, each approach generally comes with a wide range of benefits, and some limitations.
Some of the most important types of psychotherapy and counselling that I draw on include:
- Person-Centred: Provides an empathic, understanding environment where you can feel safe and supported, so that your own natural movement towards healthy growth can flourish.
- Psychodynamic: Examines the influence of early experiences and attachments on how you approach life and relate to others today, to deliver greater understanding and less reactivity.
- Coherence Therapy: Assumes that even our difficulties ‘make sense’ on some level – and aims to uncover that coherence, embed new understandings in the mind, and remove previous barriers to natural change and growth.
- Mindfulness: Develops your capacity to observe and be curious about experience, so you can begin to feel more fully alive, with a solid sense of calm and a growing self-kindness.
- Focusing: Looks at the bodily sensations that arise with emotion, using that information to uncover your own natural insights into problems, and intuitions about how to handle them.
- Somatic Experiencing: Taps into the body’s natural self-regulating systems to integrate and balance different aspects of overwhelming experiences, and safely treat trauma and PTSD.
- CBT (Cognitive Behavioural Therapy): Helps identify thinking patterns that will be supportive to wellbeing, and set practical strategies to adjust problematic behaviours.
For more information about how I work, see About Sarah.
The answer to this question is basically “it depends”. That’s because psychotherapy and counselling are neither fixed treatments like an injection, nor automated processes like a computer programme. They are a fluid, creative conversation with another human being – complete with all the dynamism and riskiness that involves. So, naturally, the ‘feel and flow’ of talking with a particular therapist will have a huge influence on the results.
This explains why large-scale research studies have repeatedly shown that the ‘therapist-doing-the-counselling’ seems to have up to six times more impact on results than the ‘type-of-counselling-delivered’. In fact, the research shows that across any given group of people, no single ‘type’ of therapy delivers better results than any other.
So how do I choose?
What this means is that if you’ve heard about a particular approach or type of psychotherapy or counselling that really seems to resonate with you, then it’s probably worth seeking out a therapist who is familiar with it, as your sessions together are more likely to feel like a good ‘fit’. But if you (like most people) don’t have a preference in advance, then by far the most effective option is simply to look for a therapist you feel comfortable with.
Sessions last for 50 minutes. Sessions are normally scheduled on a weekly basis, at the same time each week. Attending psychotherapy or counselling regularly is really important, in order to build enough momentum for change, and make gradual, steady progress towards your goals (a bit like going to the gym).
Psychotherapy and counselling can last just a handful of sessions, or they can continue for several months, or even years. Sometimes problems that have been around a long time (especially if they began when you were young), or which are quite complex (affecting many different parts of your life), can take longer to resolve. If your problems are more recent, or if you have a wide range of supports and resources available to you, it may be a quicker process. But these are not hard-and-fast rules. Once we look together at what you, personally, are facing, then we can get a clearer picture of how many sessions you might need.
I generally recommend a minimum of six sessions to begin with. On average, the people I work with take around 18-20 sessions to achieve the changes they want to see.
The nature of psychotherapy and counselling means they often involve talking about issues that are difficult or painful. This can sometimes initially make things feel worse, or certainly ‘messier’, than they did when everything was neatly ‘packed away’. Most people find this is part of a helpful process of understanding, cleansing, and moving on. Sometimes, though, you may sense it’s just not the best or safest thing for you to do right now.
If so, it is NOT wise to ignore things and carry on regardless. Much better to say clearly to your therapist that you’re uncomfortable, or struggling. Then together you can try to approach things differently – or go more slowly – or plan an end to your sessions. The important thing is to do what feels right for you. That way you stay in control, and the process remains safe and manageable.
It’s often useful in psychotherapy and counselling to take a look at key events in the past, so you and your therapist can better understand the path that led you to whatever difficulty you’re facing now. That, in turn, can help you figure out a helpful way to move forwards.
However, if there are details you’d rather not talk about, that’s absolutely fine – you never have to say anything you don’t want to. I have trained in specialist approaches which enable me to help you achieve change in the present, even when you don’t feel able to discuss what’s happened in the past.
All psychotherapists and counsellors abide by stringent professional codes of ethics, set by their membership bodies (for example BACP or UKCP). Part of this is a commitment to the utmost confidentiality – therapists understand and completely respect the need for privacy and discretion when looking at sensitive issues. However, if it seems there is a high risk of serious harm to yourself or someone else, then your therapist will most likely want to discuss that further with you, to see if anyone else might need to be informed.
For those under 18, there are additional rules about confidentiality to conform to the safeguards of UK Child Protection laws.
I will talk with you in more detail about confidentiality in our initial session.