How do I choose a Counsellor or Psychotherapist?

Calls to counsellors and therapists are on the increase, as we are subjected not only to stories about the trouble that we are in economically, socially and generally, but also as jobs are lost, debts suddenly become unmanageable and it all gets too much for us. Families and marriages can be put under almost intolerable pressure as financial problems lead to divided opinions on what are basically your living priorities.

However, some of us are put off from asking for help by the fact that it’s almost impossible to choose a complete stranger to whom we know it’s possible we might end up baring our souls.

For those with little or no money, in fact, choosing a counsellor isn’t a problem; there is no choice. The first route to ending up in counselling can be by going to see your doctor and telling them you’re depressed and can’t cope. In many ways, this is the easiest option – you should be referred to an NHS counsellor who will contact you and give you a list of times at which you could come for an initial appointment. No decisions to make over who and what, but a few over when and why and how.

Some might hesitate at this point. The appointment times can be difficult. Many of us under pressure are in this position because we literally have no time. We’re working two or more jobs, we have children, we work compressed hours or whatever, and the hours for appointments can seem a little unforgiving. You can ask for time off work to see a counsellor, but we are in a period where we feel under scrutiny from our employers. It’s easy to feel that we are being watched, and it has to be said that many employers, still make negative and insensitive remarks about depression that make you feel like you would rather run a mile than say you want time off to see a mental health professional.

So, don’t panic. (Even if you suffer from panic attacks.) In fact, although I wouldn’t advocate the use of anti-depressants or tranquilisers alone, seriously, it can be worth chatting to your doctor about your fears, and getting a short-term prescription (if they feel this is appropriate) for anti-depressants or tranquilisers, that will help you to take the deep breath that you might need in order to talk seriously to yourself, not your employer, about your needs.

Look at it this way. You want to earn money. You want to do this the best way you can. Whether or not you like your job, most of the problems you face at work (if you do) will be as a result of the relationships you have with people there. The way in which you relate to people can very much be influenced by factors that you will probably end up discussing with your counsellor. Do whatever it takes to get that first appointment, unless you know that it could seriously threaten your job. Don’t feel bad about phoning in sick, or saying you have a family emergency. Sometimes the end justifies the means. You could be taking the first step that, over time will make you a better and more confident and more productive worker. (Though saying ‘more productive’ kind of sounds a bit Victorian slaver-driver.) Get that appointment, however silly you feel and go, and discuss things.

I will be writing more on what a first session can feel like, but now I’m going to talk about what to do if you haven’t been referred by your doctor.

So you’re in the position of having to actually choose from a selection of counsellors either thrown up by Google or found from the Yellow Pages, or maybe given to you by a friend. I’m going to list a number of things to think about that might help in making that final choice.

In fact research has shown that rather than using check-lists to decide whether or not to choose one option over another, using our intuition can often lead to making a good choice. In the meantime, while you decide whether to trust your intuition (after all, if you’re depressed, you might feel you’ve made some bad choices in the past, and have low self-confidence), here are some factors to take into consideration:

Think about the location of your counsellor: Maybe you don’t have your own transport, or you need to get back in time to get the kids from the childminder, or to pick up from school. Unless you’re very worried about ‘being seen’ choose someone near to you. The less obstacles there are to seeing your counsellor, the more likely you are to go, if you decide they are right for you. Counsellors themselves can be nervous about seeing very local people. (They won’t say this though.) Don’t be surprised if in the future, you bump into your counsellor, outside your session, and they aren’t chatty. They are there for you professionally, and one of the ways they do their job best is by NOT being your friend. Friends have opinions, and are involved in what you do. Counsellors and therapists have a valuable objectivity which means they see you without as much prejudice as your friends do.

Type of counselling:

Ok, I’ll be honest here. I have two degrees, and I still get caught out and ask myself ‘what the hell is that?’ when reading about a type of therapy. It might help to try to understand a little about therapeutic approaches. It’s quite normal to think when your counsellor says ‘I’m a … whatever counsellor’, ‘Well does that work, or not?’ In fact there are a lot of different ways to approach helping people. Yes, they have been tested, but it’s quite difficult to collect data on what helps or not. What is quite evident though is that just seeing and talking to someone who is focussed on you, for an hour of your time, that is yours alone, is helpful in itself. (That’s also why, even if you’re a first-time mum with a baby from whom you don’t want to be separated, it’s still good to get child care just for that hour.) So, if you can, find out a little about different types of therapy, and then at least you know what they’re talking about. Then if you know what you want, check the counsellor’s profile to see if that’s what they offer. Most will offer a mix. Cognitive Behavioural Therapy is very popular (and mostly, effective, at present.)

On the other hand, don’t worry too much if you’re not pre-armed with this information. They are still there to help you, and you alone – when a mechanic fixes your car you don’t really need a degree in engineering so you understand how they’re doing it.

Professional Accreditation:

Would you like to see a counsellor/psychotherapist who is a member of a professional body? If they are, they will make it clear on their profile. BACP is definitely good. There are degrees of affiliation: registration, accreditation and membership. However, there is still the possibility that an unqualified person could help – there are natural and sympathetic listeners out there, and being a member of a professional body doesn’t guarantee success. However, unless you are a risk-taker, (in which case you will need to look at this another way), there is less risk attached to seeing someone who is a member of, or linked to, a reputable organization.

Your Counsellor's Qualifications:

Ask for your counsellor’s qualifications. Ask how long they studied and whether full or part-time, whether from home and with what institution.

Fees:
Fee can be variable. They can depend on the location and the experience of the counsellor. Some are open to negotiation. If you don’t have much money, they might even offer you the very difficult option of paying ‘what you can afford.’ This is enough to send you over the edge in itself. What if you’re seeing them because you overspend? It’s going to be difficult to talk openly about how you spent a grand on a handbag you couldn’t afford, if you also have to tell them you can only pay ten pounds an hour. Anyhow, fees can vary from free to around £90 per 50 minute session. On average, expect to pay about £35 - £45 per 50 minute session.

Finally:
Deciding to go to counselling or psychotherapy is a massively important step for you to have taken.  Now, take your time, and try to get a feel for what you want, before making the decision about who to choose. You don’t have to stick to the person you first end up seeing. You don’t have to tell them everything all in one go. You can use the first session just to gauge their response to you. Remember they won’t respond as a friend does. You might be telling them about something quite traumatic and feel short-changed if they don’t respond as you expect. Remember they are there to help you, not to collude with your mood. They are not there to feel your feelings (although some will), they are there for you to talk to them without fear of judgement. Just think about how good it is to talk into an empty space, and then rather than focussing on whether you like them or not, walk away at the end of the session and take time to reflect on how you feel afterwards. Counselling isn’t just about what happens in the 50 minutes, but on the impact of that shorter hour on the rest of your life. You might feel angry or impotent during the session and then find that the rest of your week goes more smoothly than you expected, or that you find yourself taking steps you didn’t expect you would – like trying to address a debt problem, or deal with a difficult boss, or a marriage problem, in a slightly different way than you have before. Most of all, you should remember you have a space and time that is your own.

More on debt and depression

 

Alone Grieving at Christmas

Christmas is coming up and this is a very difficult time of year for many of us who might be alone, or struggling to bring up children on their own, and also possibly suffering from problems with debts, or with job losses. 

On I'm A Celebrity last night, Esther Rantzen was overwhelmed by a wave of grief as she was reminded of not only all that she had left behind, but also the very sad fact that even when she returns home, her husband won't be there. 

This is a very public reminder to those of us who struggle with feelings of loss, that grieving can be unpredictable, public and overwhelming. It knows no social boundaries. It comes in waves, and can be embarrassing - it can get you in the supermarket, or going for a walk, or waiting for a bus. You might hear a song, or even walk past someone's garden with plants in that your lost loved one used to like (or dislike.) If you are having problems coping with these feelings, there are many bereavement organisations that can help you out - just having someone to chat to about these things can be incredibly helpful. 

It is sometimes hard talking to family members - you might know something about the person who died that no-one else knows, or might be angry that they have left you struggling alone. They might have abused you, or not told you they were dying. They might have got themselves killed by doing something stupid. Or by sacrificing themselves for the greater good - you might selfishly hate them for having joined the Armed Forces, for example, or even for having been a revolutionary, sticking up for a principle. You might think that some of what you feel is inappropriate. Family members might be angry at you, or each other, especially if the person concerned was a suicide. This is why it helps to talk to non-family members, so that you can step back from the agreement that has to be involved in the social family process of 'creating a memory' of a loved one.

Some forms of separation can leave you feeling like you are grieving for someone who has died. If you find out that your partner has been unfaithful and they leave you for a new love, this is like another form of death, as you mourn the loss of the person who you believed in, as well as the loss of your old, trusting self, and the birth of a new, more (it can feel like) distrustful person.

There are some great books on grief; Elizabeth Kubler-Ross wrote and explored the process of grieving in an intelligent way. For children coping with loss, Michael Rosen's 'The Sad Book' is an absolute (and acknowledged) masterpiece, for which he deserves to win just about every prize going. Also, Sharon Creech's 'Walk Two Moons' and for younger children, 'Badger's Parting Gifts' by Susan Varley. 

Although confronting and exploring grief can seem very frightening - it is sometimes a bit like in the fairy tales: turn around on the monster and confront it, and it can become more of a companion. It might be with you for life, but it should eventually shrink and become more manageable. 

Do see your doctor and think seriously about anti-depressants and/or counselling if it all becomes too much. These are very effective forms of therapy (usually most effective together), and should get you through the worst of the process. 

And finally - back to Christmas - if you are feeling bad, think of others. This is one of the best ways to lift you out of yourself for a while. Locally, Gosport Voluntary Action are always looking for help.  It wouldn't do any harm just to go along and say hello to the lovely people who work there. This is not to say, 'snap out of it,' or anything like that, but if you can find others who need a hand, or support someone more vulnerable than yourself, by whatever means you have at your disposal, then this may well help you to restore your sense of self, and your feeling of being a capable, loving person, if this has been in any way diminished.

Mother2Goddess