Frequently Asked Questions1. What is the difference between counselling and psychotherapy?
There is no one definitive definition of counselling or psychotherapy. 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 appropriate for a single issue of a more recent onset. In this sense they can be regarded as opposite ends of a continuum. As such psychotherapy tends to require a more extensive training including personal therapy for the therapist.
Both involve establishing a confidential relationship between therapist 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 counsellors do not give advice and do not judge.
Different therapists will describe what they do differently (see Q2). If you want to know more, the Counselling Directory has more information.
2. Are there different types of psychotherapy / counselling? How do I know what type I need?
First of all you need to pick a counsellor that 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 counsellor 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 us, 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 therapy is the quality of the relationship between the therapist 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 psychotherapist therefore the most important thing is to pick someone who feels right for you. For more information about the different types of counselling (e.g. psychodynamic, person centred, CBT) the Counselling Directory provide a useful summary.
3. How long will I need to see a psychotherapist for?
If you are seeing a psychotherapist 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 for six sessions, some for many years.
4. What kinds of things should I think about when choosing a psychotherapist?
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)
Their professional qualification and experience
A word of mouth recommendation / their reputation
Do they work short or long term
Location / feel of therapy 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 for a first session in order to make the right choice. This might be more expensive initially but could save loads if it means you find the right person first time.
5. 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.
6. Where can I turn if I need to speak to someone urgently?
Most counsellors 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 08457 90 90 90.
Contacting your GP or attending A&E at your nearest hospital of course always remains options at any time.
7. Is it possible to have psychotherapy at the same time as being on antidepressants?
Yes, usually. As the effects of anti-depressants vary from person to person there isn't a one size fits all answer to this. It is possible that at some point you might decide you are ready to come off your medication in order to get back in touch with underlying feelings. It is important to note that medication should not be abruptly stopped and you should always consult with your prescriber before changing what you take.
8. Can you offer support for withdrawal from antidepressants?
Yes, we are aware that some people might need or prefer support should they choose to come off psychiatric medication (including antidepressants) as this is a difficult process. As withdrawal symptoms vary according to combinations of medication taken, dosages, length of time taken etc. it is important enlist the support of your prescriber in designing an appropriate withdrawal programme for you. We are happy to work with you and your prescriber to support you during this process and can help to identify impacts of the withdrawal, always aiming to ensure it proceeds at a pace that you are comfortable with. We are aware of and happy to work within Dr Peter Breggin's Person Centred Collaborative Approach to psychiatric drug withdrawal.