So what about CBT* then?

(*Cognitive Behavioural Therapy)

Imagine the following conversation:

You come to me and say: “I’m looking for somebody who can help me use my Windows PC, would you be able to do that?”

And I reply: “Sure, I can do that.”

So you continue by asking: “Do you use Excel? I have heard that it’s great. It’s in the news all the time and a lot of magazines seem to be talking about it, and that’s why I would like to use it, too.”

I then say “I don’t really use Excel on its own much, I sometimes use it a little bit in combination with other programs. You see, for the type of work I do, I tend to mainly use Word, PowerPoint and Photoshop. But if you are looking for somebody to just teach you Excel specifically, I can refer you to my friend Janet, she uses it exclusively all the time in her work. Just while I’m looking up her address, would you like to tell me a little bit more about what you are trying to do with your PC?” to which you answer: “I’m hoping to write a book. I’ve been wanting to do this for years now, but somehow I just can seem to do it on my own. The material for it is all up there in my head and it keeps spinning round and round, and it’s really starting to cause me quite a lot of stress. It might sound silly, but it’s actually keeping me awake at night and because I’m not sleeping terribly well I’m exhausted during the day. This means that I’ve had to take time of work and, you know, I’m a little bit embarrassed to admit this, but I’ve even started to have panic attacks over this.”

So I say: “I see; but you know Excel isn’t really suitable for writing a book. I think you really want to use Word. You see, Excel is suitable for producing charts and tables that can do automatic calculations whenever you update them and things like that, but it’s not really going to help you with your book, I’m afraid. I would suggest that we do go ahead and work on this together, but we use Word for the main body of text that you’re going to write. If you want to include pictures in your book as well, then I’d suggest we do those in Photoshop and then embed them into our Word document. And similarly, if there are some tables that you want to include in your book, we can produce those in Excel and then also incorporate them into our Word document. Does that sound like something you’d like to do?” and you say:

“Yes, that sounds like a plan; but basically you’re saying that Excel isn’t suitable for what I’m trying to do?”

I reply: “No, I’m afraid it isn’t.”

Then, finally, you say: “So why does everybody keep going on about Excel, if in reality it’s so utterly useless?” and I’d say: ”Well it’s not useless, in fact it’s really quite good for some things, it just isn’t suitable for everything.”

In those last few lines, substitute Excel with CBT and you get the gist of a conversation that I have with new clients about once every week.

Cognitive Behavioural Therapy (or more commonly known as CBT) is one of several different types of talking therapies available today. The reason it is featured so much in the news is because it is, at the time of writing, the only form of talking therapy that is available on the NHS. The difference between CBT and other talking therapies, such as counselling or psychotherapy, is usually the approach to what can be addressed in sessions and the focus of the therapy itself. CBT tends to be a lot more directive with sessions focusing on very practical issues. A CBT therapist may give you specific exercises and ‘homework’ to do in between sessions, and you won’t generally have as much of an opportunity to explore your feelings and any underlying issues that may have triggered your crisis.

In their introduction to CBT, the NHS website puts it this way: “CBT cannot remove your problems, but can help you to manage them in a more positive way.”[1]

At Cambridge Therapy Centre your therapist will be able to recommend which type of therapy is best suited for your own specific needs and goals, giving you the best possible results. Together we can treat a wide variety of issues, including:

 ·        Abuse

·         Addiction

·         Anger Management

·         Anxiety

·         Bereavement

·         Depression

·         Eating Disorders

·         Family Issues

-         Insomnia

·         Panic Disorders

·         Phobias

·         Post Natal Depression

·         Recurring Nightmares

·         Relationship and Marriage Counselling

·         Stress

·         Traumatic Experiences

 

Why not contact us today, to see how we can help you?

 

How to find a good counsellor or psychotherapist (Part II)

(Please note that, as mentioned in part 1 of this article, I am using the terms counselling, psychotherapy, and therapy interchangeably.)

With so many different theoretical approaches to counselling and psychotherapy, it is difficult to state exactly what makes a good counsellor and what makes a bad one. I am certainly very reluctant to recommend one particular theoretical approach to counselling over another one, as very often clients respond better to one approach then another, making it all very individual and dependent on the actual client and counsellor in question. Nevertheless, it does strike me how many clients come to me stating that they have made a bad experience with a counsellor in the past, or tell me that they have had therapy in the past, but that “it hadn’t worked”. Counselling is a process and for it to work it will take time, effort and patience on both parts, counsellor and client. So, whilst I am aiming to give you an overview of what qualities to look for in a therapist, I’d also suggest that you don’t immediately give up and seek another therapist, just because you felt that your counsellor is no good after an initial session. Keep in mind that it is your counsellor’s job to challenge your views and perceptions, how you currently view the world and how you act, in order to help you to achieve meaningful and lasting change. A therapist who simply agrees that you are right and everybody else is wrong and that all of your problems really are your partner’s, your work colleagues’ or your parents’ fault may be telling you exactly what you want to hear; Whilst this kind of positive reassurance may well provide you with some of the nurturing and comfort you may so desperately need, it will probably not help you to move on and change the way you react to your partner, work colleagues or parents.

So how do you know then if your psychotherapist is providing you with the right kind of support you need in order to achieve your own specific goals? My answer to that would be to trust your instincts. One of the most important aspects for therapy to work is the rapport and relationship you have with your counsellor. Sure, during several months of therapy there may well be occasions where you don’t agree, where you may feel frustration, and maybe at times your counsellor may even genuinely get it wrong and misinterpret something you have said, but overall these occurrences should be easily resolvable. If, on the other hand however you do feel a very strong dislike for your therapist from the very start and do not feel that this is the kind of person you want to work with, then there will be little point in battling on.

If you have never had any form of counselling or psychotherapy before then it may be difficult for you to know what to expect. The following is a list of some of the attributes that I would personally want to see in a counsellor. I would expect a therapist to be warm, empathetic and kind. I would expect them to show genuine interest in what I am trying to achieve through therapy and to make me feel heard. Also, especially where therapy is long term and taking place over a period of six months or more, I would expect a counsellor to carry out regular reviews to keep track of the progress and to evaluate which methods and interventions work best for me. Another big issue is confidentiality and trust; I would want to know exactly what the therapist’s procedures are for keeping my data secure and what level of confidentiality I can expect.

This leads us on to another aspect of counselling: who should not be your therapist? In part one of this article I explained that my reason for writing this guide was the fact that I am often approached by people who I cannot ethically take on as clients for counselling or psychotherapy myself. These include people who are my friends, friends of friends, very close friends or relatives of work colleagues or even anybody frequenting the same social groups as I do. This includes people who I may meet regularly in art or exercise classes or similar. When I explain this, people will often say: “…but I don’t mind you knowing personal stuff about me, as I know that you will keep it confidential.”  That may be true, but keep in mind that therapy is supposed to provide you with a secure environment where you can feel safe to explore your most personal thoughts and feelings. Whilst you may feel right now that you’d be happy for me to know about those thoughts and feelings, imagine sitting in my counselling room, wanting to talk about something quite personal, when all of a sudden there is a slight niggle in your mind that says: “…but I’ll see her at the coffee bar tomorrow….” or “…she’ll be seeing my husband at the squash club later tonight…” Can you see how this might affect and restrict what you might feel able to share with a counsellor? And that is why it is usually not a good idea to choose a therapist whom you or your close friends or family will meet regularly in other settings outside of the therapy room. Having said that, your counsellor does of course have a social life, too, and may well be a member of the same fitness club as you are, and as long as you don’t bump into each other on a daily basis that’s fine. In fact, most counsellors will discuss with you what their procedure for chance meetings is, in case you ever were to meet by coincidence outside of your therapy sessions.

Another important aspect to consider is moving from individual one to one counselling to couples or family therapy. Very often counsellors will conduct some sessions where both partners (or the whole family) are present and some sessions where individual members are seen on their own. This is quite normal, however, family and couples counselling usually does require all of the members to start counselling together. This means that whilst a client may have one or two sessions with a counsellor and together they may then decide that it would be more beneficial to bring in the other partner or the rest of the family, it is not normally appropriate to see a therapist for several months and to then decide to move on to couples or family therapy with that same practitioner.

 Finally here is a list of warning signs that may help you to decide if things are going wrong between you and your therapist. Watch out if your counsellor:

• Interrupts you frequently
• Seems impatient
• Does not seem to listen properly or give you their full and undivided attention
• Takes telephone calls or answers the door/front desk during sessions
• Does not seem to stick to the same session length every week
• Is frequently very late or cancels sessions at short notice
• Will not give you any information about their professional background, training or ways of working, if asked
• Will not give you any information about how data is kept secure and what their procedures for ensuring confidentiality are
• Seems judgemental and/or prejudiced
• Is telling you what to do and regularly uses terms such as “you should”, “you must” or “you can’t”
• Seems to be giving you advice rather than options
• Seems to just agree with everything you say
• Instigates any form of social contact with you outside of sessions
• Is regularly talking more than you in sessions
• Just lets sessions happen from week to week without any from of plan, structure or regular review sessions
• Allows other people (such as the receptionist or other counsellors) to enter the room unexpectedly during sessions

If you are still not sure, try addressing any problems you may be experiencing directly with your therapist. If you do not feel able to do this, then that in itself can be an obvious sign that things aren’t right between you and your therapist. In this case you could contact a different counsellor and ask for a second opinion to see what they say about your concerns.

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What is Online Counselling?

Online counselling provides an opportunity to explore a personal difficulty in a confidential and supportive environment, very much in the way that face to face counselling does. This process may include expressing feelings that are painful, and which many of us experience at certain times in our lives.

When this happens, it can be difficult to stay positive and cope with everyday life, yet at the same time you may not find yourself in a position to go and visit a counsellor in his or her practice. This is where online counselling can give you the opportunity to access counselling support at a time and in a place that is convenient to you. There are basically three different methods of conducting counselling online, email, video conferencing, and instant text messaging. With the first method, email counselling, clients will send an email to their counsellor by a specific date. This could for example be every week, by Wednesday 4pm at the latest. The counsellor will then reply to the client's email by a time previously agreed between counsellor and client, for example by Thursday 6pm at the latest. There are some differences in how counsellors ask their clients to structure their emails, some will suggest clients use a word limit, other will suggest clients spend a specific amount of time writing their email. The latter approach generally mimics the process of real time counselling more closely and tends to give clients a more structured and boundaried approach, just as face to face counselling would. The second method listed above probably comes closest to mimicking face to face counselling: where counsellor and client use video conferencing for their sessions, both will meet online at a previously agreed appointment slot and conduct their session with the use of a web-cam. The third approach, instant text messaging is the one most frequently chosen by clients who would like to stick to writing, but are looking for a counsellor's instant input and interventions that email counselling cannot provide due to the time delay. Where a counsellor and client use instant text messaging, the counselling session is conducted similarly to an online chat session, where counsellor and client meet online for their appointment.

What sort of issues can I contact an online counsellor about?

You can contact Christine with any of the issues that you would bring to a face to face counselling session, as online counselling may be able to help with a wide range of issues. Some clients seek online counselling in order to work through a very specific issue, whilst others are looking for a means to cope with life's challenges, like bereavement, work stress, separation or emotional trauma.  Yet others seek online counselling as a way of improving their lives and gaining greater stability and emotional well being.

You need to remain aware though that not all types of issues can be resolved through online counselling, and your counsellor will advise you if face to face counselling, or some other form of support might be more suitable for you. Where your counsellor considers that online counselling would not be the most suitable means of support, they will make every effort to assist you in a referral to a suitable alternative source of support.

When is online counselling not suitable?

• Online counselling is not suitable for clients who find themselves in an acute crisis situation. In this case you should always contact the appropriate emergency services first; these may include A&E, your GP or the Samaritans.
• Furthermore, online counselling is not suitable for clients who are suffering from psychiatric disorders and/or are experiencing psychotic episodes, including hallucinations, delusions, or feelings of derealisation.
• Online counselling is not suitable if you need intense support, such as ongoing telephone support or hospitalisation.
• Also, online counselling is not suitable if you need a medical diagnosis or a prescription.

You can learn more about online counselling and how it may help you by going to the relevant sections of this website.  

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How to find a good counsellor or psychotherapist

 

Part I: What qualifications should a therapist have?

 (tl; dr? Scroll down to the summary at the end of this article!)

I am often approached for counselling by people who I can't ethically take on as clients. That includes friends, close relatives of friends or people who belong to the same social circle as I do. Sometimes I am able to refer them on to colleagues, but more and more often, all I can do is to give them some help and advice as to how to find a good counsellor. I have started to write some guidance on what to look for, but soon realised that I could end up writing  a whole chapter on the subject. This is why I have now broken it down into different sections about what to look for in a counsellor. The first part is all about what type of qualifications and other professional aspects you should be looking out for when choosing a counsellor. Please note that I have used the terms counsellor, psychotherapist and therapist interchangeably, the article itself explains why. Also, please keep in mind that this article is based on UK standards and that the information contained herein is correct at the time of writing. There may be different rules and regulations applicable in your country.

The probably most important aspect of therapy is the rapport you have with your therapist. That’s why, unless you know a lot about counselling and you are specifically looking for a therapist who works in a certain way, it isn’t really too important for you to know whether your counsellor is a Jungian, Adlerian, Gestaltist or Rogerian counsellor. What is much more important is for you to check that the therapist you are going to see actually has any reputable professional qualifications.

The terms ‘counsellor’ and ‘psychotherapist’ are at the time of writing not protected in the UK. This means that anybody could go and call themselves a counsellor/psychotherapist, and unfortunately, a lot of people who aren’t really qualified therapists do so. I have even seen salespeople for weight loss products advertise themselves as counsellors. This is also one of the reasons why I have used the terms ‘counsellor’, ‘therapist’ and psychotherapist interchangeably in this article.

 I would suggest that you ask three main questions when looking for a counsellor or psychotherapist:

1. What are their professional qualifications?
2. Do they belong to or work in accordance with a governing body?
3. How is their work supervised?

 Let’s look at qualifications first. A person with a long string of acronyms listed behind their name isn’t necessarily better qualified than a person with fewer letters. I personally tend to avoid stating my qualifications with my name in any promotional material, unless I am being asked to do so by an organisation I might work for. The reason for this is that unless you are familiar with a specific field, most of these acronyms won’t really mean anything to you and they can even be used to deliberately mislead. You can see it here: [Christine Schneider _{IMO, IMTU, LOL}]* See how easy it is? If a therapist has genuine qualifications, then you should be able to verify them on the internet without difficulty.

You can try it out with this example: Sometimes I will state my name as [Christine Schneider _MBACP]. See if you can find out what that means, but most importantly, once you have done so, make your own judgement on whether you think that this makes me an adequately qualified counsellor or not**.

If looking up your prospective therapist’s qualifications hasn’t helped you to decide whether they are trustworthy or not, you might want to find out a little bit more about what kind of training course they actually attended. There are many very good and thorough courses available that will provide therapists with excellent theoretical foundations as well as expert practical knowledge and experience. Some of these courses are taught at degree level, others are taught at further education colleges or polytechnics. The kind of institution where your therapist has gained their qualification isn’t as important as the type of course they attended. The biggest problem is that there are many places that offer short term courses, some as short as six weeks or even distance learning diplomas in counselling and psychotherapy. This, as you can imagine will not do, but it will still allow a therapist to display a genuine and probably very impressive looking certificate. A professional therapist should have spent at least three years on a training course (some psychotherapy courses are five years long) and a proportion of that time should have been spent in a placement, working as a trainee counsellor. During their training your therapist should also have spent a considerable amount of time in therapy themselves.

So when you are looking for a counsellor, don’t be shy, ask them about their qualifications and what kind of training course they attended. If they are genuine, they won’t mind answering your questions. (But do be prepared for a truly person-centred counsellor to respond with: “I wonder what makes it so important for you to ask me this question?”)

Once you have established that your counsellor or psychotherapist is professionally qualified, you might want to ask whether they belong to any professional body or whether they at least work in accordance with such a body. The reason I have phrased this so carefully is that just as I said that there isn’t just one specific qualification that makes a good counsellor, I don’t want to state that a therapist has to belong to one specific professional body in order to work ethically. There are several reputable professional bodies for counselling and psychotherapy and each of them charge an annual membership fee. If a therapist were to belong to all of them (and some therapists do belong to more than one) the costs would quickly add up. There is another reason why I would not want to state that a therapist has to have professional membership of their own. For years I have worked both in private practice as well as for counselling organisations where I have been covered under their organisational membership without the need to pay my own fees. It has only in recent years become necessary for me to take out my own membership since I have moved the main focus of my work more and more onto private practice. However, even when I did not pay individual membership fees and was covered through organisations that I worked for, my private work has always had the following disclaimer: “I am bound by the British Association for Counselling and Psychotherapy’s (BACP’s) Ethical Framework for Good Practice in Counselling and Psychotherapy.” This is what you will need to know about your prospective therapist: do they work in accordance with a governing body and if so which? This is to make sure that they are governed by some sort of ethical framework and aren’t just making up their own rules as they go along. The following is a list of some governing bodies in the UK. I do not want to present this list as complete or compare any of the individual organisations; you can make your own judgement by looking them up online. When you ask your therapist which organisation’s ethical framework and good practice guidance they adhere to, they might mention one of the following: BACP (British Association for Counselling and Psychotherapy), UKCP (United Kingdom Council for Psychotherapy), COSCA (Counselling and Psychotherapy in Scotland), ACC (Association of Christian Counsellors), BPS (British Psychological Society).

Finally, I mentioned supervision. Every professional counsellor or psychotherapist should have regular sessions with a qualified supervisor. This is to ensure that your therapist is providing you with the best possible course of therapy and has somebody to double check their work. This doesn’t mean that your therapist’s supervisor will know who you are though as any work presented to a supervisor should always be anonymised. A supervisor is a bit like a therapist for a therapist. They have additional qualifications and are registered, just in the same way professional counsellors are. The amount of supervision that a therapist has depends on their workload and on how experienced they are; the minimum amount of supervision required by the BACP is 1.5 hours per month.

 In Summary:

• The titles counsellor and psychotherapist are at the time of writing not protected in the UK. This means that people can use them in a variety of confusing or misleading ways.
• Where therapists list acronyms after their names you should look up what they mean and verify their relevance yourself.
• It doesn’t matter so much where your therapist gained their qualification, what their theoretical background is and whether they gained their professional status at a university, polytechnic or a further education college. What is important is that they spent at least 3 years in training, have had therapy themselves during their training and have had to complete a placement as a trainee counsellor as part of their training.
• Your counsellor should either be a member of a recognised professional body, or at least adhere to the ethical framework and best practice guidance of a professional body. Remember that some counsellors might be covered by organisational membership and simply not see the need to pay membership fees for themselves. Again, look up that professional body to verify its reputability and relevance for yourself.
• Finally, ask you therapist how their work is supervised. Every professional counsellor or psychotherapist should have regular sessions with a qualified supervisor to ensure their work is of a professional standard.

 End of part 1, you can carry on reading part II of this article here.