Frequently Asked Questions

The service is confidential except under specific circumstances:

• If there is a risk the client may harm themselves or another person then I am legally obliged to inform an appropriate authority. I may not necessarily inform the client of my action.
• If therapy is funded by a medical insurer, or other organisation, reports are usually required. To proceed, you must agree to me complying with funder report requests.
• I am a Data Controller and listed with the ICO. Privacy must comply with GDPR. Please see the privacy notice.

Yes, there is a free 15 minute initial chat, not an assessment, to answer the question ‘Can I help you?’

This is usually termed an ‘assessment appointment’. After introductions and clarifying any practical details, the therapy contract will be signed and then you will be able to ask questions and talk about your issues. The therapist will ask a number of questions and ask you to complete one or more questionnaires. This is to help the therapist obtain a better idea of the nature, and severity, of your problems. The assessment appointment is often helpful for a client to get a sense of whether the therapist will suit them.

Fees
These apply to self-funding clients. For clients with private medical insurance there may be an excess which is payable direct to me. The insurer will advise as required.

The fee, per hour for online therapy is £70.00 (€75.00)

The fees are the same for individuals and couples.

Payment is to be made by BACS following the issue of my invoice.

Locations
Appointments are available during weekdays and the evening. To make an appointment simply phone, text or email and a convenient time can be agreed.

Currently, I am only offering online appointments.

Should further difficulties occur – sometimes life is like that, throwing something else up – you will be well equipped with the knowledge gained from therapy to better understand and resolve or manage the situation. Of course, further therapy can be arranged.

For couples and individuals it is important therapy goes at the ‘right’ speed – not too slow as this can undermine motivation, nor too fast as this can lead to the changes made not being strong enough to stay in place: remember, practice is important to change old habits.

I consider it important to have a periodic review of how therapy is progressing for the client. This helps ensure therapy work meets client needs. However, as therapy develops, it is common for more issues to show themselves, so it becomes a matter of deciding which to work on. Clients often find a review helpful as they can see what changes have been made during therapy.

This usually depends on the level of distress: the more distressed the person then more frequent appointments are likely to be helpful. If the distress is very high, then involvement by a GP or mental health team is likely to be necessary.

This depends on the individual and the nature of the difficulty. Often much progress can be made in six to ten appointments. However, for those with long term, deep rooted problems, it can be much longer.

• Self-funding clients can have an unlimited number of appointments. However, I am always careful to ensure the therapy is helpful for the client.
• Clients funded by medical insurance and others are likely to be allowed a specified number of appointments. This must be clear at the commencement of therapy. In these circumstances I am keen on helping a client to see where they could obtain further help (I am not necessarily allowed to see a client after they have completed their allocated appointments).

Workshops
Recent topics have included:

• Using mindfulness in clinical practice
• Bereavement and loss
• Psychosocial change and illness
• Psychosexual therapy
• Couple therapy
• Self-preservation for therapists
• Thinking about forgiveness
• Affairs and internet infidelity (couple therapy)
• Anger its meaning and management (couple therapy)
• Is the relationship repairable? (couple therapy)
• Body image and presentation in a psychosexual clinic
• Dissociation

This is the agreement that governs how therapy will be provided. It covers payment arrangements, cancellation and non-attendance policy, confidentiality and records.

Behaviour therapy

The behavioural approach started as a number of investigations to observe how animals behaved in a variety of experimental conditions . These observations were generalised to human behaviour; no consideration was given to feelings or thoughts. It was an observation of behaviour. As a therapy it was not always effective because it did not consider the effects of emotions, thoughts and experiences. However, the insights gained were developed to be included within CBT.

CBT (Cognitive Behaviour Therapy)

This is a combination of behavioural and cognitive therapies: observations as to how people behave and consideration of how thinking and emotions affect behaviour. Three elements in a person’s thinking are considered in CBT:

1. Negative automatic thoughts: these are unhelpful thoughts that occur spontaneously in specific situations. They are characterised by being biased (you are in some way wrong), make you feel bad about yourself, they stop positive behaviour and thinking, they arrive uninvited, and, perhaps worst of all, they are believable. They will affect behaviour. An example may be:
2. Dysfunctional Assumptions: general beliefs a person has about themselves in the world. They are thought to develop form childhood experiences and may only be activated in specific situations. A dysfunctional assumption may trigger a flood of negative automatic thoughts. Use of the word “should” and “must” can indicate these unhelpful assumptions are present.
3. Core beliefs: these are the deep rooted, often unconscious, beliefs a person has about themselves. If they are negative they affect behaviour and thinking; consequently they potentially affect all aspects of a person’s life.

CBT can help a person develop realistic, constructive ways of thinking. It is an approach that can help a person to change.

Cognitive Schema

This model was developed by Dr Jeffrey Young, an American psychologist. It is a combination of CBT techniques together with problem solving, object relations and psychodynamic therapies used to help those with long term mental health difficulties. His book “Reinventing Your Life” is one I use with clients.

Couple therapy

The theory and practice of couple therapy differs from that of individual therapy as it is concerned mainly with working on relationship issues. Assessment – which can take longer than for an individual – seeks to understand the patterns of communication and behaviour in the relationship and then consider possible approaches to improve the life of the individuals in the relationship. Couple therapy is not about saving a relationship at all costs. Sometimes it can be a forum where a couple decide to end the relationship. Other couples attend because they want to work through the effects of an affair; this can be helpful in the couple gaining a deeper understanding of themselves and improving the relationship.

EMDR (Eye Movement Desensitization and Reprocessing)

This is a technique developed in the US by Francine Shapiro for the treatment of distressing memories caused by trauma. The trauma can be major, or an event, not as traumatic, that has led to behavioural change. A traumatic or distressing experience can overwhelm a person’s usual coping strategies. This can lead to unpleasant post-trauma after effects. PTSD (Post Traumatic Stress Disorder) is one of many mental health consequences. EMDR aims to reduce, or eliminate, the effects of distressing memories. It is called “Eye Movement” because the therapy uses bilateral stimulation (moving the eyes from side to side, receiving hand taps, or stereo sound effect) whilst recalling the traumatic incident. As with any therapy that treats trauma, it can be a difficult experience, but it can create lasting change rapidly. Good assessment and preparation are essential before this can be used.

Existential therapy

This is a filled of therapy developed from ideas in existential psychology and philosophy. These discuss the realities of the human condition.

• The fact we die and the fears associated with this (existential anxiety)
• What does it mean to be free?
• Isolation and loneliness
• The search for meaning

For a number of clients, thinking about these has proved valuable, and enabled them to find the strength to engage constructively with life.

Integrative therapy

This approach links different therapy models that can enable an effective, but flexible methodology that helps clients. An example would be that of linking mindfulness with CBT. The practice of mindfulness helps to calm the mind. With a calmer mind it is easier to absorb and practise CBT or other therapy.

Mindfulness

Mindfulness is an approach that has been used for a few thousand years. Originally from Zen Buddhism, it is now in widespread use in healthcare settings; in particular, pain and stress clinics. Originally, it was part of an ethical approach to encourage “wise action, social harmony and compassion”. There is much research into the topic (over 9000 papers on Medline in December 2016) which supports the effectiveness of the practice of mindfulness. It is not a quick fix option – it does need practice. It is an approach that is non-judgemental – staying with the present moment and observing the process.

Psychodynamic

This therapy seeks to uncover the unconscious influences of a person’s mind and in so doing, relieve psychological discomfort. It relies heavily on the client-therapist relationship. This is where a person’s unconscious may play out; once it becomes evident, there is the likelihood of it being understood and changed.

Psychiatrist

A psychiatrist is a medical doctor who has had additional training in mental health. In the UK psychiatrists and medical doctors are the only health professionals who can make a diagnosis and prescribe medication.

Psychologist

There are different professions within the field of psychology and is related to their training:

• Clinical psychologist
• Counselling psychologist
• Educational psychologist
• Child psychologist
• Research psychologist

Psychologists undergo training approved by the British Psychological Society. They are regulated by the Health Professions Council (HPC).

Psychotherapist

A psychotherapist has training approved by the United Kingdom Council for Psychotherapy (UKCP) who also act as regulators. Psychotherapists are registered with the Professional Standards Authority (PSA).

Counsellor

A counsellor will usually undergo training approved by the British Association for Counselling and Psychotherapy (BACP). There are counsellors who specialise in particular areas of therapy such as drug addiction, alcohol abuse, and bereavement.

All psychological therapists, private or NHS, must be registered with an appropriate professional body, receive regular clinical supervision, have professional indemnity insurance to the amount specified by their professional body (Therapists employed in the NHS or other organisation will be covered by that organisation). Registration with the Information Commissioners Office (ICO) is often compulsory to comply with data protection legislation. DBS clearance is also often required.