The beginning of counselling involves us meeting, getting a sense of each other, and for you to feel at ease telling your story and what brings you to counselling. Upon getting a sense of what the issues are we will create some mutually agreed goals and areas of focus for the work.

Collaboratively we will then discuss what sort of contract or commitment you would like to make to counselling. Contracts may be short, 6 sessions, or longer as some goals may take longer to actualize than others. As circumstances change and different areas of focus arise contracts are reviewed to assess progress and direction of the work.

I understand my therapeutic role as a collaborative one whereby I will explore the work with you, and support you, to get in touch with what is most important to you and what choices and directions in life feel the most growthful and healthiest to follow. I utilize my expertise to help you access your own resources, strengths, clarity about what you desire, ability to engage in life with greater satisfaction and to discover your own life-solutions.

My aim is to provide an accepting, validating, non-judgmental therapeutic space and relationship. This becomes a place where you may feel accepted and where you may learn to accept yourself and those parts of you you struggle with. Being ok with who you are is an important step to recognizing who you may become.

I will support you in discussing anything you feel important, including issues you may not have shared with others in the past due to fear or lack of support. I will help you to learn to manage strong emotions and to engage with past hurts until they cease to have such a strong impact in your life. I encourage you to bring all of who you are to this work.

Sometimes our focus will be on your thoughts, sometimes on your feelings, sometimes on your behaviours, sometimes on your life-context/situation and how all these are connected to how you are in the world and in relationship to other people. This work enables you to understand how you organize your experience, to understand yourself better and to begin to access new, healthier and more satisfying ways of being.

Therapeutic work on improving, changing or accepting stuck patterns of being or painful areas in our lives isn’t always smooth, predictable and painless. It will require patience and commitment on your part, as well as skill and expertise on my part. With the challenges of therapy, though, come the joys of discovering areas of your life you may have lost touch with, or may have never known, and the new or deeper sense of self that arises as part of the work.

When to end therapy is up to you. Our contract may come to an end and you may feel satisfied or you may extend the contract or shorten it. Some people come for a block of work and have a break before returning again. I like to discuss endings and spend some time integrating the work as we finish up.

Counselling or psychotherapy is many things to many people. It can be:

• support during times of stress and distress,
• a place of self-learning and the undertaking of a journey in self-exploration.
• a space to focus on changing particular unsatisfying habits.
• a confidential space to explore areas of your life you cant elsewhere.
• a way of accessing vitality/resilience and confidence.
• a space of deep-healing of past hurts and a moving on to horizons not yet foreseen.
• a place to learn self-acceptance and let go of old shame and guilt.
• ongoing support for a chronic mental health condition.
• a place for the learning of practical life-strategies.
• an exploration of how you relate to other people by engaging in a therapeutic relationship with a therapist.
• a place of creativity, joy and connection.
• or all of the above…and more.

I encourage you to be open to what therapy can be for you.

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What follows is a simplistic and very general outline of how I understand the difference between psychiatrists, psychologists, counsellors and psychotherapists. There are, of course, exceptions to the rule. What I identify are general patterns exhibited in the field.

Psychiatrist

A psychiatrist is a qualified medical doctor who has specialized in a medical understanding of mental health. As a result, Psychiatrists primarily focus on the biological/neurological facets of psychological distress which involve the use of  various ‘chemical imbalance’ theories of mental illness. Psychiatric treatments, therefore, primarily involve prescribing medication. Psychiatrists are able to diagnose and are often used to conduct formal mental health assessments. Mostly psychiatrists do not provide counselling.

Psychologist

Psychologist

A psychologist is someone who has completed a Psychology degree and the requisite qualifications/supervision to belong to a psychology registration board.  Psychologists are primarily trained in a medical model of managing psychological distress which focuses on symptom reduction. The most common psychological approach utilized by psychologists is CBT, (Cognitive Behavioural Therapy) which focuses on changing behaviour and thinking styles and developing improved strategies for dealing with problematic situations.  Many psychologists, though, have trained in other, non-CBT, ways of working. Psychologists work mostly short term with clients.

Counsellor

Counsellors train in the traditions of what is known as the “talking therapies”.  The counselling profession is broader, compared to the psychological profession, in its  approach to emotional distress and psychological growth. A great variety of counselling approaches, with long traditions of practice and efficacy, can be found practiced by counsellors. Whereas psychiatrists focus on medication and the biological/neurological facets of psychological distress, and psychologists primarily focus on teaching cognitive and behavioural strategies of change, counsellors often work integratively: utilizing various counselling approaches according to client need. Counsellors work mostly short term with clients.

Psychotherapist

The word psychotherapist is often used to imply 3 things (i) practitioner who has undertaken extensive training in working with clients from an emotional and perspective, (ii) this training involving the practitioner undergoing their own therapy as a requisite to working with clients deeply, (iii) and that the focus of the work is longer term. Psychotherapists often focus on working on developmental deficits of clients, including enduring personality characteristics, that are not amenable to change through short term counselling/psychological strategies. An important area of focus of psychotherapeutic work is on the therapeutic relationship between client and therapist; this being an important space for creating change.

From: Feltham, C. & Dryden, W. (2006). Brief Counselling: A Practical Integrative Approach. Open University Press. London,.

Counselling is a confidential and ethically protected relationship with a trained and qualified practitioner who will take your personal concerns seriously.

There are different counselling styles or approaches. Some are more non-directive and the counsellor will mainly listen or strive to understand your deepest feelings; others are more active and perhaps directive and the counsellor may make suggestions or ask you to try certain activities.

Knowing which direction to take (for example, exactly what to talk about in the session) depends largely on you, on your intuition about what is most important, current or vital, but your counsellor may also prompt you or make suggestions. Don’t just wait for the counsellor to initiate things; and don’t treat your sessions as ‘just a chat’.

Counselling is mainly based on listening, understanding and responding; in other words, it is psychological therapy. Depending on training, each counsellor may emphasize thoughts, feelings or actions. Many counselors will address all these diminesions.

Counselling aims to help you understand yourself better and improve the parts of your life that have become stuck or painful. But it isn’t always smooth, predictable and painless; it will require patience and commitment on your part, as well as skill and knowledge on the part of the counsellor.

Counselling is a disciplined, ethical and professional activity but it is quite different from medicine, law, accountancy, and so on. This is because it focuses on each individual and their unique cluster of concerns, it includes emotions, and it sometimes works via feelings that are stirred up between you and your counsellor.

Counselling is a fallible activity. Counsellors are closely supervised. They should be ready to hear your views about the process of counselling and you have avenues for making complaints if not satisfied.

I work from an integrative approach to counselling and psychotherapy. This means I integrate various counselling/psychotherapy approaches according to client need.

In my work there are certain modes of working and domains of exploration which are important. The following expresses some of these:

Faith in the client’s expertise, ability to self-regulate and to change: I approach therapeutic work as a facilitator of change whereby I help to create a certain environment, a certain relationship and utilize my skills in a way which empowers the client to create the changes they want in their life. I understand the client as having untapped resources of wisdom and clarity about what they would like out of life and how to regulate themselves in attaining this. My role is not to impose what I feel the client needs but to cultivate a certain space where the client accesses their own needs, power, self-regulation and ability to change and for them to create this change in their own way and at their own pace.

The client/therapist relationship: Many of the problems we experience in life are linked to relations to people and our challenges in having satisfying relationships. Often this is related to the dynamics of our relationships to our early attachment figures. Working through and healing many of our concerns often involves doing so in relationship. I attempt to provide an empathic, non-judgmental and authentic relationship with the client which allows for a safe exploration of the client-therapist relationship as a way to explore early attachment deficits. This way of practicing is based on the notion that the client-therapist relationship mirrors how the client relates to others. This exploration can be the key to therapeutic growth.

Emotion focus: I believe that therapeutic growth is helped through counselling that is grounded in an awareness of the emotions underlying our thoughts, (cognitions), and our behaviours. Accessing and working with emotions, rather than solely trying to change thoughts, allows a greater spectrum of the client’s life to be engaged in the change process. The psychotherapist Leslie Greenberg states that ‘you cant move on until you have arrived’. Often we carry wounds which have not been processed and are still having an impact on our lives. In order for us to move on we need to arrive at these wounds, feel them, process and make meaning out of them before we can let them go. My work as a therapist involves creating a safe and holding environment within the therapeutic relationship where whatever needs to arise and move on does so.

Mindfulness: Mindfulness is a word that arises out of the meditation traditions of the east. The theory behind mindfulness is that it is our attachment to emotions/ thoughts that create un-necessary suffering in our lives. Becoming mindful and less attached is a key to increasing freedom and peace in our lives. Mindfulness is used in western counselling/psychotherapy in two, general, ways: (i) as a strategy for clients to learn and practice outside of therapy, (ii) as a climate to be cultivated within the therapeutic encounter. In my work a key to letting go of old unsatisfactory ways of being involves ‘sitting with’ one’s experience, including one’s wounds, without reacting or becoming self-judgmental, and learning to accept oneself and one’s experience as it is. This mindful acceptance, paradoxically, allows for the creation of therapeutic movement and is often the basis for growth and the changing unproductive habits.

Body awareness and somatic orientation: The current psychotherapeutic world, especially the field of trauma studies, is strongly influenced by neuro-biological and brain-cognitive studies which are problematizing the idea that the mind and the body are separate. What is arising out of these studies is that we, humans, ‘are/have’ an ‘embodied mind’ or a ‘mindful body’ and that thoughts and emotions inhere in our bodies in various ways. These studies, and the schools of body-oriented psychotherapy, such as Somatic Trauma Therapy, claim that attention to body processes and increasing awareness of our experience of our body is vital in accessing not only our wounds but our potential. In my work mindful exploration of body-awareness can be an important and powerful way to free constrictions and stuck areas in one’s life. As there is a relationship between the mind and the body working through the body allows emotional and cognitive change to arise thus creating space for novel change in one’s actions in the world

Cultivating self-support: More often than not we are divorced from our own needs. Cultivating self-support involves being in touch with one’s needs and finding ways to support oneself in having these needs met. This may be through learning how to relax wherever you are in order to better manage day to day stress, creating the support for yourself that allows you to ask your partner/family/friends for what you need without feeling ashamed, learning to walk away from a situation when you know it is nurturing to you, learning to support yourself through healthy habits and not through destructive addictions and so on. Counselling and psychotherapy involves the internalization of the ability to self-support and a safe space where this self-support can be practiced. I find that engaging the client in a on-going conversation around what they feel they need in life and how they can have this need met is powerful and healing work.

Socially aware cognitive re-structuring: All counselling and psychotherapy involves cognitive re-structuring; changing how we see the world is correlated with psychological change. In this process I attempt to be aware of the ethical, social, ecological and political dimensions of the types of thoughts and linguistic structures client’s may be internalizing. Language has power and how we articulate the world has ethical, social, ecological and political consequences: the worldview we internalize becomes the world we live in. In my work with clients I find it important to raise awareness around such issues while engaging in conversations around socially aware and compassion based narratives.

Homework and experimentation: Much growth occurs in counselling ‘simply’ through the therapeutic relationship, talking and working things out during the session. Yet, experimenting with new ways of feeling, thinking and acting during the therapy session and outside it can only increase awareness around one’s patterns of being, possible novels ways of experience and help one to internalize one’s growth. I find it useful to negotiate with clients experiments during sessions in order to raise awareness around patterns of being and also to negotiate various forms of homework; creative tasks and experiments to be engaged in as a way to empower the client in their own self-exploration and growth.

Systemic/field focus: As much as we try to become independent we are, on many levels, inter-dependent with others. We exist and live within systems and fields of relationships such as families, peer-groups, work environments, organizations and political systems. Often clients come to counselling thinking/feeling that they are the carriers of all their problems and it is all their fault. Frequently it is the systems and relationships we find ourselves in which have problematic dynamics which create suffering in our lives. In my work I find it important to assess the systems in which people find themselves in and often the work involves raising awareness about and creating change within the systems people exist in. Often this involves empowering clients with a political orientation to their life-world.

Exploring, affirming and celebrating strengths, successes, connections, joys: Lastly, it is important to deconstruct counselling and psychotherapy as being solely about pain and suffering. Therapy can be and is so many things. Processes of change involve facing ‘unfinished business’, (old pain), facing truths about how one is that are difficult to digest, learning to act in the world in a way which is new, learning to let go old and dear habits which are no longer useful and so on. These processes can be challenging. Yet, a big part of this process is accessing vital, healthy and empowering resources that lie within one. Finding oneself thinking, feeling and relating to others in healthier ways is a joyful experience. At the heart of my work is a strong focus on therapy not as bunch of techniques to fix broken people but as a growth process which, in most cases, is a fundamentally positive experience.

The difference between brief counseling and longer term psychotherapy is hard to define as there are common factors that apply to both ways of working. There are many and varied definitions of what counseling and psychotherapy are and the differences between them. What follows is a common definition, one that I find useful and one that broadly applies to how I work.

BRIEF COUNSELING:

Brief counseling can range from anywhere from 3 sessions to 20 sessions, although some schools of therapy may claim 20 is actually long term whereas other schools of therapy may claim 20-40 sessions is a relatively short amount of counselling! It depends on what schools of counseling are defining these terms.

In general brief counseling is often problem and solution focused. A client may have some symptoms, various particular problems they would like solved and the counseling stays focused on achieving the goals negotiated between client and counselor. Brief counseling is, what is often called, ‘directive’ counseling in that the counselor is mostly task oriented and works in a direct and active way in motivating the client to achieve their goals.

The focus of brief counseling is less an understanding of one’s personality dynamics but more on achieving quick changes in one’s life. This involves working more on cognitions and actions and less on emotions. There are limitations to brief counseling as often we have psychological patterns which are enduring enough as to require deeper and longer work to change. Yet, much therapeutic work of value can be engaged in brief counseling.

LONGER TERM PSYCHOTHERAPY:

Psychotherapy, or longer-term counseling, can be anything from 20-40 sessions to over 25 years of weekly sessions. (Irvin Yalom, the famous existentialist psychotherapist, saw a client for this long!). This form of work is more oriented towards a deeper exploration of personality dynamics. Rather than focusing on problem solving particular issues current in one’s life, although this can be part of the work, psychotherapy involves an exploration of enduring themes in one’s life. Although the focus is still on how these enduring themes are played out in the client’s life now, the therapeutic work often involves an awareness of past developmental issues and how they effect the present.

Psychotherapy often focuses on personality and relationship issues, especially how these manifest in the relationship between the client and the psychotherapist. The key to psychotherapy can often involve a close exploration of the relationship between the client and the therapist and how the client’s enduring themes of relating to others manifest in their relationship with the therapist. In this work the relationship between the client and the therapist is seen to mirror the client’s relationships to others outside of the therapy space. Gradual working through of what arises within the therapeutic relationship provides the opportunity for gradual change in this relationship and in the client’s other relationships.

In contra-distinction to the brief and more active/directive counselor the psychotherapist is less active, in being directed to helping the client achieve goals, but more focused on creating a ‘holding environment’ where the client feels safe and trusting enough to allow old wounds to arise and to be healed through the therapeutic relationship. The focus on this work is thus not on cognitions and behaviour, as in brief counseling, but more on the emotions underlying the latter.