Answering Questions About Therapy Sessions
When you choose to start therapy our first session will be an opportunity for you to talk about what is bringing you to therapy. I will ask you to tell me about the history of the problem and explore potential triggers and situations which may have impacted on your mental health. It is helpful for me to gather a wider picture of your life as many different aspects of this can impact on your mental health, often without knowing. As such, I will ask you about areas including your current relationships, work, friendships, social and family life. I may also ask you to give me a brief life history, especially if you feel your problems have been around for a long time. At the end of this session we will spend some time discussing your goals for therapy. We can then review these regularly within sessions.
You do not need to have seen a Doctor and received a diagnosis to come to therapy. It is a very personal experience and many people who attend therapy do not require a formal diagnosis.
Often, people attend therapy and have been prescribed some medication, for example anti-depressants or anti-anxiety treatment. Medication and therapy are often recommended as a dual approach to managing mental health conditions. I believe that medication can aid the therapeutic process by reducing some of the difficult and distressing symptoms that may otherwise get in the way.
If you have a family member who you think would benefit from therapy, I would always encourage you to speak with them firstly to see whether it is something they would like to pursue. I am happy to take queries from family members however ask that the initial telephone discussion occurs with the individual who is seeking therapy. I will leave it at their discretion whether they would like you to be present for this. From this point forward any information shared by your family member is confidential and I would not be able to share it with you or other family members. The only time this would be possible is if there was a signed agreement with your loved one. For example, sometimes an individual requests a joint session to share any plans they have created or to discuss how family can support them out of the session.
Please email or text me to let me know. I ask for 24 hours’ notice for cancellations. If you have to cancel within 24 hours of the session, I ask for full payment, although I will take into account extenuating circumstances.
My clinic takes place at a small therapy office on St Mary’s Road, Market Harborough. There are three rooms, in a quiet first floor location. These rooms are only used for talking therapies and are set up in a bright and comfortable way.
Please see my online therapy page for more details of this.
You may not remember everything that was said in a session, but it is likely that you will remember and think about certain parts that are important to you. I encourage people to write down any personal reflections about a session, both to explore together but also for your own benefit. I often use worksheets and draw information to aid understanding in sessions. In these circumstances I will type up the relevant information and let you have a copy of this via email.
I am able to offer therapy for individuals 16 years old and above.
I offer a twenty-minute telephone consultation free of charge before arranging a full session. This gives us an opportunity to discuss your current concerns and for you to ask me any questions you may have about therapy.
Some people come to therapy having recommendations for specific types of therapy. For example, you may have been recommended CBT for anxiety or depression by your GP or insurance company. Individuals who have the diagnosis of Borderline Personality Disorder are often recommended DBT. Individuals who suffer from PTSD may wish to engage in EMDR. Other people come to therapy with no prior knowledge of the types of therapy I can offer. This is perfectly normal, and part of my role is to assess and guide you to make a decision about this. I may give you a number of options to think about and choose the one that feels best for you. At other times, I take an integrative approach where no specific therapy approach is agreed on. Any approach that is offered will be agreed collaboratively. I will give you detailed information about what the therapy will involve.
DBT and Schema therapy are types of Cognitive Behavioural Therapy. They are what is known as ‘Third Wave’ CBT. This is because they include therapeutic approaches that look at other psychological processes as well as cognition and behaviour. DBT includes mindfulness and Schema Therapy includes an emphasis on experiential and emotional needs. In brief: Cognitive Behavioural Therapy has a strong evidence base for concerns including anxiety, depression and stress. It is usually offered for between 10 – 20 sessions. Schema Therapy has a developing evidence base for people with Personality Disorder and pervasive mental health problems that CBT alone does not treat. It is best used to explore connections between current behaviour and past experiences, and can be helpful for those with childhood trauma. DBT was developed specifically for Borderline Personality Disorder. It has a greater focus on behavioural strategies to help reduce life threatening crisis behaviours. It is suited for individuals who need a therapy that focuses on present behaviours.
There are occasions where an individual may wish to access private therapy but are also with an NHS mental health team. From my experience, this has mainly occurred for individuals who are seeking therapy for Personality Disorder or a specialised service but there is a long waiting list. In this circumstance I would require consent to speak to the Mental Health Team you are working with. This is so that I can liaise about their ongoing treatment for you, and make sure that therapy fits with their care plan. It also means that I would be able to share any relevant information with them to support your ongoing care. I would only do this if you have given informed consent for specific information to be shared. There are occasions where gaining private therapy may lead you to lose your place on a waiting list for NHS treatment. This is something that you should be aware of, and speak to your team about, before accessing private therapy.
I am unfortunately not able to offer out of session support. I will ask individuals to identify their support network in an early session, and I would encourage you to speak to them in the first instance. Otherwise, there are a number of support phonelines that you can access. These can be found on my support page.
I am unable to offer therapy to individuals who are actively acting upon suicidal or self-harm urges. This is because I cannot offer support outside of your hour session, and it is important that in these cases an individual has the support of a full Multi-Disciplinary Team that will include psychiatrists, CPN’s, psychologists or social workers. If you are currently experiencing suicidal or self-harm thoughts or are in an emotional crisis you should contact your local Crisis team or the Samaritans. You can also ask for an emergency appointment with your GP, or ring 111 out of hours for further advice.
At the start of therapy, we will agree on some therapy goals, which will be directed by what you want to talk about. Therapy is a collaborative process, and I would not ask you to speak about anything you did not feel able or comfortable to do. Sometimes people come to therapy because of a traumatic event but do not feel able to discuss this straight away. In such situations, I would suggest starting with developing coping skills for any current symptoms. This may include anxiety or depression. When you feel able to we will then speak about the traumatic situation in a collaborative way. A normal process of therapy for many people is that there may be some experiences they do not feel confident to talk about. As they become more comfortable and trust is built in the therapy, they may choose to bring these to the session for exploration.