FAQ

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If you are feeling in need of emergency support, and/ or feel you cannot wait for your regular appointment, there is help out there. You can:

-contact your GP for an emergency appointment
-ring the NHS 111 advice line
-go to your local A& E

The mental health charitable organisation MIND suggest the following telephone and online services might be useful;

Samaritans. Samaritans are open 24 hours a day, 365 days a year, to listen to anything that is upsetting you, including intrusive thoughts and difficult thoughts of suicide and self-harm. Their national freephone number is 116 123, or you can email jo@samaritans.org.
SANEline. SANEline offers emotional support and information from 6pm–11pm, 365 days a year. Their national number is 0300 304 7000.
CALM. If you’re a man experiencing distressing thoughts and feelings, the Campaign Against Living Miserably (CALM) is there to support you. They’re open from 5pm–midnight, 365 days a year. Their national number is 0800 58 58 58, and they also have a webchat service if you’re not comfortable talking on the phone.
Nightline. If you are a student, you can look at the Nightline website to see if your university or college offers a night-time listening service. Nightline phone operators are all students too.
Switchboard, the LGBT+ helpline. If you identify as gay, lesbian, bisexual or transgender, Switchboard is available from 10am–11pm, 365 days a year, to listen to any problems you’re having. Phone operators all identify as LGBT+. Their national number is 0300 330 0630, or you can email chris@switchboard.lgbt.
MIND are a useful source of information if you are struggling with mental health issues.

Assessment is a very important part of therapy and designed to ensure safety for both client and therapist. As a counselling psychologist I would probably use a technique called formulation,  which involves an all round look at what seems to be happening in order for us to decide how to move forward. One of the decisions that has to be made is whether I am the right person to work with you at this time as it is important I work within my training and experience. If not, I belong to a local network of private practitioners and would look to refer you to someone more appropriate.

Often, the assessment process itself can be therapeutic but it can also feel a little impersonal answering questions. My advice would be to bear with it and don’t be worried about asking questions along the way. We will hopefully be building a trusting, therapeutic relationship, working out what you would like from therapy and how to get there.

How long therapy might last will be an individual consideration which might change along the way. What would usually happen is we would agree a number of sessions then review this as we are going along. I have worked with short-term therapies and longer term treatments, so am happy to work with both.

Compassion focused therapy (CFT) was developed by Professor of Clinical Psychology Paul Gilbert who observed that it was often difficult to reach those struggling with issue of shame and self-criticism using Cognitive Behavioural Therapy (CBT) techniques. He noticed that these people could engage with the CBT model but not feel any better and being something I’d encountered I started investigating what might be helpful as a therapist,  ultimately training in CFT.

The approach draws on ideas in evolution, social psychology, developmental psychology and buddhism, as well as the latest research in neuroscience – utilising a mix of psycho-education (to understand the model) as well as practices to try and help develop the compassionate mind. The hope is that by understanding how our brains have evolved into having three systems (threat/ drive / soothing) we can move to help better develop the self-soothing system to create a better balance for ourselves. There are many ways and techniques that can be offered to help develop a compassionate mind which include breathing techniques, imagery and letter writing, for example – these can be matched to an individuals needs. What I particularly like about the approach is its humanity in appreciating how we all have the same struggle with our ‘tricky’ brains.

As a therapist I have seen this approach help people feeling stuck in very self-critical and shameful places to move on with their lives and sustain their own recovery. I have also received help myself after a traumatic event and cannot underestimate the strength developing a compassionate mind can bring to your life.

Of course this is my take and my experience of compassion focused therapy and in this short ‘clipped notes’ space may not have done it justice. But there is a growing body of research supporting the development of compassion for good mental health and information out there to read if you are intrigued by this therapy. Very good help books in the compassionate mind range have been written on subjects such as; anger, anxiety, overeating, trauma and post-natal depression but if I were to recommend one accessible book to everyone it would be –

The Compassionate Mind – Professor Paul Gilbert

I have included a link to the Compassionate Mind Foundation who are a charitable organisation looking to spread the word on how effective this type of help can be, and who I have found to be very generous in nature. They have lists of books and research which may be of interest.

 

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This is a very legitimate question and in the interests of being open and honest I would like to answer it.

I like to think I am offering value for money as I can assure you that I have a very high level of training and experience. When I am working with you it will be to the highest possible ethical and professional standards. I will be devoting the time we are together towards helping improve your mental health and make sure I am as rested and prepared as possible prior to our meetings.

In our agreement it will state clearly how much money is being asked for and when payment is due. This may be prior to the therapy in order to make sure taking payment doesn’t interfere with therapy.

Whilst I hope we manage regular appointments there are of course occasions when life gets in the way, and I completely understand that. What I would ask is that 48 hours notice is given in order that I can schedule something else in the gap and not travel to the therapy venue in vain. Missing an appointment without notice means I will need to charge (as per our agreement) to cover costs,  and it also means I cannot schedule in another work engagement. Like any other self-employed  private practitioner I have overheads to pay for like; room rental, telephone costs, paying professional bodies, travel costs, recouping the cost of my training, keeping up to date with additional training and tax to name a few. I hope you can appreciate why I have made these decisions.

Confidentiality & Safety

Therapy could not happen without a high degree of confidentiality as it relies on being able to trust a therapist with your deepest feelings. In this respect being open and honest about the boundaries of that confidentiality is key to developing a good working relationship and prevalent in both the British Association for Counselling and Psychotherapy (BACP) and British Psychological Society (BPS) ethical guidelines.

So, what does it all mean? There are several things to consider when talking about confidentiality: the law, professional guidelines and a therapists personal beliefs on confidentiality. Of course life is a bit risky and it would be foolish to say confidentiality is always a 100% assured, but by following the guidelines and being vigilant we aim to act as ethically as possible.

The law – The law around confidentiality is complex and not necessarily very clear but in certain circumstances a therapist is required to lawfully pass on information. The BACP currently suggest the following;

Information about an act of terrorism (Terrorism Act 2000, section 38B).
Information that the client was a driver involved in a road traffic collision – if approached by the police (Road Traffic Act 1991, section 21).
Information about the whereabouts of a missing child who is in care, under police protection or subject to an emergency protection order – could be obliged by the family court to pass on that information (Children’s Act 1989, section 50).
Courts can also order disclosure of information for other purposes.
Professional guidance – Whilst I would look to abide by the policies of all of the professional bodies I belong to summarised here are the BPS Counselling Psychology guidelines on confidentiality and record keeping;

A therapist needs to be open and honest about the limits of confidentiality.
Explain in advance the possible requirement to break confidentiality if the therapist considers there is a risk of harm to self (the client) or to another person.
Make sure a client is able to make informed consent decisions on all aspects of their therapy.

Therapists face many dilemmas in their work and have a back up network to help make a decision. In the first instance they can seek advice from their supervisor and can also approach their professional body to help. The sensible acid test is that the therapist needs to be prepared to explain and justify any decision.

The purpose of Record Keeping should be –
-to improve continuity.
-to facilitate assessment, planning and evaluation of therapy.
-for statistics to measure outcomes.
-to make sure records are clear, complete and up to date.

Personal confidentiality policy – Here are some realistic ways I work on maintaining ethical confidentiality.

-I do not talk about clients outside of the therapy room except in very specific circumstances.

-I keep client personal information separate from any notes made about the therapy.
-Any paper notes made will be looked after carefully and stored at a secure location in a secure cabinet.
-I use a first name or pseudonym when talking to my supervisor about a client.
-If I bump into a client outside of the therapy room I do not acknowledge them to ensure their anonymity. If a client chooses to speak to me i would encourage saying hello but discourage any further conversation which can safely wait for the therapy room.
-If I were in a position to consider breaking confidentiality through worrying a client might harm themselves I would always seek to discuss it with them first if possible. I would be working in the clients best interests and look to contact their GP or other health professional in order to support them.
-If in a position to consider breaking confidentiality through worrying a client might be a risk to others I will follow professional guidelines and seek advice from my supervisor and/or professional body.

Talking about suicide
My experience has shown me that often people show their distress in talking about feeling suicidal and I feel it is important to have an outlet to talk about suicide and suicidal feelings in this way. However, I have a duty of care to my clients and if I consider that there is a real plan and the means to commit suicide I would look to seek support for the individual. This may mean breaking confidentiality but be assured this would be done for the best intentions, and if possible I would discuss this with the person prior to doing so.

Using a computer

Like most people I use a computer but when it comes to confidentiality there are further considerations in safeguarding information. Because I am keeping sensitive information on a computer I have registered as a data controller with the government and these are the ways I aim to protect it.
-Any client notes or information written on a computer will be stored on an external hard drive, not connected to the internet.
-All business computers used will be password protected.
-Any information that might be considered sensitive and/or identifiable sent via email will be password protected.
-For extra security I have use various online communication providers that have encryption.

Story behind my logo

One day I was feeling a bit under pressure from life so,  as I often do,  walked out into my garden to grab a bit of fresh air. It was a dewy spring morning and as I looked around I was stopped in my tracks by the following sight.

There, in the middle of a lupin leaf, was what looked like a diamond! Of course it was a big dewdrop but it was such a striking sight I took a picture and vowed that if ever i were to have a logo this is what it would be based on.

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The power of this image stands to remind me of the strength a person can find in having compassion for ourselves and others, and the courage it can take to reach and maintain a compassionate position.

The fantastic logo was designed by Godjira websites.

There are several different types of psychologist trainings – Neurological,  Sport & Exercise, Forensic, Health, Counselling, Educational, Clinical and Occupational. There is probably most overlap between Counselling and Clinical psychology trainings – the biggest difference being that Counselling psychology trainings include the requirement to provide a minimum of 450 hours of therapy with clients. Counselling psychologists are encouraged to understand and work with the context of what is being presented.

This is what the British Psychological Society say about Counselling psychologists in the careers section of their website –

Counselling psychologists deal with a wide range of mental health problems concerning life issues including bereavement, domestic violence, sexual abuse, traumas and relationship issues. They understand diagnosis and the medical context to mental health problems and work with the individual’s unique subjective psychological experience to empower their recovery and alleviate distress.

Counselling psychologists are a relatively new breed of professional applied psychologists concerned with the integration of psychological theory and research with therapeutic practice. The practice of counselling psychology requires a high level of self-awareness and competence in relating the skills and knowledge of personal and interpersonal dynamics to the therapeutic context.

Counselling psychologists work in hospitals (acute admissions, psychiatric intensive care, rehabilitation), health centres, Improving Access to Psychological Therapy Services, Community Mental Health Teams and Child and Adolescent Mental Health Services. They also work within private hospitals, private practice, forensic settings, industry, education, research and corporate institutions.

Counselling psychologists focus on working with a tailored psychological formulation to improve psychological functioning and well-being, working collaboratively with people across a diverse range of disciplines.

Professors John McLeod and Mick Cooper are contemporary advocates of pluralistic therapy who write books and articles on the subject. Here is a brief synopsis of the therapy.

In recent years pluralism has emerged as way of thinking about therapy and is based on the assumption that no one therapeutic approach has the monopoly on understanding the causes of distress or being the most helpful response – in other words there is no one size fits all treatment. It suggests therapists should respect understandings and practices from across the therapeutic spectrum,  and use their skills to help tailor therapy to the individual client. The approach advocates that different clients are likely to want (and benefit from) different things in therapy and emphasises shared decision making as well as metatherapeutic communication: which pertains to also talking to clients about the process of therapy, what they would like from it and how they would like to get there.

In this respect it is a flexible, collaborative therapy with the client at its heart and appeals to me as a Counselling Psychologist who is trained in different forms of therapy.

I have also been lucky enough to be involved in a pilot study ‘Pluralistic therapy for depression’ run by professor Mick Cooper, with supervision by professor John McLeod. The results were positive and gave me a great opportunity to test out the program they developed. I was also involved in a symposium at the 2014 Counselling Psychology conference to showcase the possible benefits.

Here is a link to an article in the British Association for Counselling and Psychotherapy online journal Therapy Today , which has more information and references to follow if you are interested.

Supervision is a safety net for therapy as it supports therapists performing their work. A supervisor should understand the type of therapy utilised in order to lend guidance,  and improve the ability of the therapist to provide value to their client. Therapists are human beings and it is important to have this safe feedback system to make sure they are practicing appropriately. Even supervisors have supervisors so in effect it’s like a mirror in a mirror, in the hope that you as the client are looked after.

Supervisors are usually experienced in the type of therapy being offered and are also bound by ethical and practice guidelines, according to the professional body they affiliate with.

I have two supervisors; one for my online work and one for my face-to-face practice.

NICE (National Institute for Health and Care Excellence) produces guidance for the NHS on how to treat certain health conditions and often advocates talking therapies for common mental health issues (e.g. depression and anxiety disorders).

Talking therapies are a range of psychological therapies that each have their own evidence base. Some therapists have one approach,  but quite often you will be treated with a mixture of approaches to meet your needs.

The charitable organisation Mental health uk  have a well written article about different types of therapies and what you can expect from trying them – please follow the link if you would like to read more;

Talking therapies

HOW talking therapies often work is in helping people work through the problems that are causing them distress and move forwards in their lives. But people come for all sorts of reasons so there is no one size fits all solution. In my experience the beauty of a talking therapy is that it gives you the freedom to talk through whatever is troubling you in  a safe place,  with a safe person. Lots of people who come to a talking therapy do have people in their lives that care about about them; but it can feel very difficult to talk to a loved one about a deep emotional issue for fear of upsetting them. Sometimes the idea of talking through a problem is compounded by feelings of deep shame or highly self critical thinking  and a therapist skilled in working with these issues can often help.