“Everything depends on inner change; when this has taken place, then, and only then does the world change.”
This Guide is essential reading for patients starting therapy with me and gives an overview of the structure of the work, which outlines some basic steps in the psychotherapy process offered by my practice:
- Basic Reading that will help you make an informed choice of therapy and therapist before you start
- Introductory Meeting: meet your therapist for the first time
- Assessing your needs, history and lifestyle in detail
- Planning and starting psychotherapy or personal development work
- Reviewing and summarising our work together before discharge
You can exit at any stage and are never under any obligation to continue, but following and completing each of the five steps will give you the most benefit from any work you do.
Step 1: Basic Reading
If you are new to therapeutic or personal development work the following articles may be a useful resource for helping you make an informed choice about psychotherapy or counselling:
STEP 2: 60 minute Introductory Meeting
The first meeting is a reduced-cost, no obligation way for us to discuss what you are looking for, get a sense of one another as people, and allows you to ask any questions, talk about your concerns or aims, and to get the gist of what might be involved in any work you might want to do. If another service or approach may be more appropriate to what your needs appear to be, then this is a place where we might identify that. If you wish to continue to assessment I will give you a copy of my Agreement and Boundaries after the Introductory Meeting and my standard assessment form to complete and return at least 24 hours before the first assessment session.
- Book your Introductory Meeting HERE
- You can also do individual, couples or group psychotherapy online via SKYPE HERE
STEP 3: 60 minute Assessment Session
Before we meet for Assessment:
- Fill out and return my Assessment form
- Read and sign my Agreement
A good psychotherapy assessment allows you, in the space of a couple of sessions, to get to a place of clear understanding of how your difficulties are created, how they work and the kinds of tasks that might allow you to address them in psychotherapy. Many psychotherapies forego this formal assessment stage and you can spend ten or twenty sessions trying to get answers that my formal assessment may be able to provide in two sessions (on average). A thorough assessment helps you save precious time, energy and money in the long run and helps you with direction and focus in therapy. It can also tell you whether or not psychotherapy or counselling are appropriate ways to help you address your particular needs, and what other options might be more helpful.
“You do not have to be on the couch for years, decades or centuries to achieve healing.”
I have over 20 years experience in assessing patient needs and I undertake a comprehensive psychosocial assessment prior to any therapeutic or personal development work. My assessment forms help us gather information that will highlight your needs, lifestyle, habits, existing support, history and general circumstances and allows us to establish your aims and a focus for the work you want to do. A detailed assessment can usually be done in one or two sessions, or span multiple sessions, depending on your needs, your particular circumstances, and the amount of information we need to understand.
- Full assessments can be done in one day, if preferred, or over a few days or once per week until completed, and usually take between one and four sessions, with two being the average.
At the end of the assessment process I am normally able to provide you with:
- Our joint understanding of your circumstances and difficulties.
- A brief summary analysis that explains how I think your problems work (Occasionally this is not possible when, for example, your difficulties are not clearly defined or amenable to neat or concise conceptualisation. In such cases, further exploration in psychotherapy sessions may be appropriate)
- Where possible, I can also provide you with a breakdown of the therapeutic tasks or kinds of work I believe you could undertake in order to address your difficulties, and
- The structure of the work and support provision we could organise to provide you with the most effective help
You are free to stop at this assessment stage.
- I also offer a detailed written assessment summary, problem formulation and recommendations for an additional fee if you require this (see fees list).
- Detailed Support Planning is also available (see below)
- If you are looking for the type of assessment that gives you a psychiatric diagnosis your best starting point is the NHS via your GP. This may or may not give you access to NHS psychotherapy. NB You do not need a clinical diagnosis to do psychotherapy work.
STEP 4: 60 or 90 minute Sessions
Once the assessment is complete each psychotherapy, counselling or personal development session usually takes place each week, in-person or via Skype if you prefer. My appointment times run from 12:00 to 19:30 Monday to Saturday, with Out-of-Hours appointments available 7 days a week from 09:00 to 23:30 (ending) for a supplementary fee. I can also offer 90 minute sessions for a reduced supplementary fee. But the important factor is attending sessions regularly rather than randomly or with large time gaps in between, both of which reduce the effectiveness of any work we might do. Regular weekly sessions help you concentrate on your goals at a steady pace, maintain momentum, develop new habits, and apply what you gain from each session during the week. Attending once a week or more may also come with reduced feesº, otherwise a standard fee is applied for less frequent attendance.
- Full access to articles in my Resources section and other supportive materials is available to patients who attend weekly once assessed.
- Provision can be made for supplementary and Out-of-Hours support by telephone, email or Skype support between sessions where this could be helpful. Home Visits are also possible. I would also normally suggest regular reviews of our work along the way so that we can both monitor progress and assess the effectiveness of the therapeutic relationship.
º I offer commitment-related fee reductions via my Therapy Cards, which reduce costs for patients with the greatest need and motivation to engage with the help I offer. See the Fees Page.
Essential Reading List
Once you have completed assessment and started your first therapy session, begin working your way through my Essential Reading List (see Agreement for current password), which provides you with valuable information on how to get the most out of your investment of time, energy and money in therapy. Articles are information-dense, so it is wise to take your time with the reading in order to absorb the information gradually, rather than cramming or skim reading.
Week 1 Reading:
Week 2 Reading:
Week 3 Reading:
You can find many other articles on various subjects in the Resources Section that can significantly enhance what you gain from therapy. Most articles and resources require a password, and full access is available once assessment or review is completed and you start your first weekly session (Or with any Therapy Card, or by Flexible Attendance plus a one-off Supplementary Support fee).
You start each session by talking about what concerns you. It’s often helpful to ask yourself at the start what you need from each session. Your therapist then works with whatever you bring.
During sessions you are responsible for:
- what you choose to discuss or raise in the sessions
- your mindset, feelings and level of motivation and openness
- your degree of engagement with therapy exercises and methods
- any changes that you make (or choose not to make)
- how you use the session time
- continuing therapy between sessions by doing agreed tasks
- asking for what you need, and speaking openly about what may be missing in sessions in order to help your therapist better support you
Your therapist is there to:
- listen intently and carefully
- help you develop greater awareness of yourself (of your mind, body, thoughts, feelings, beliefs, needs etc)
- build a shared understanding of your way of experiencing the world
- respond empathically
- encourage you to be authentic
- offer suggestions and new ways to explore your experiences in depth
- guide you if asked to do so
- suggest therapeutic tasks that could help you
- help you better support and empower yourself and meet your own needs
- challenge any assumptions, beliefs and habits that do not serve you
- offer yoga, meditation, writing and art therapies where appropriate or when you request them
- continue an analytical and intuitive understanding of you during and between sessions
- regularly monitor and review with you whether you are getting what you need from the work
This last point, in practical terms, means that, as your therapist, my work with you doesn’t end at the end of each session. Instead, my thinking process continues in the service of better understanding you; empathising with you, your history and current life; and developing better ways of supporting you. This is a process that often occurs unconsciously, with solutions emerging into conscious awareness as time passes. It is a process that happens within motivated patients too and makes therapy more than just what we do in a meeting once a week. With less frequent sessions this process obviously begins to be a less prominent feature of therapy.
- Supplementary Support and Out of Hours support is also available (see below)
STEP 5: Review Session
Review sessions can be requested at any time throughout our work, but are mandatory after a 3 week gap or more. They allow for a review of motivation, commitment and progress, re-establishing aims and focus after a break in sessions where therapeutic momentum is usually lost to one degree or another.
Ending therapy by reviewing our work together and looking at gains and saying our goodbyes is a healthy, constructive way to bring the relationship to an end. It may also be an opportunity to address misunderstandings or discuss options like follow-up sessions, doing deeper or more challenging work, or tapering sessions off if this is helpful to you. Open discussion in a review session leaves the door open for you to return comfortably if you need to at some future point. Usually I would draw up a discharge summary in advance of our final review session when you give me sufficient notice of your intentions to finish.
Attending after a break?:
- Read and sign my Agreement to remain up to date with any changes
- Read the Essential Reading List to get you back in the right frame of mind for therapeutic work
Additional Services and Types of Work
- 60 minute support planning session. This is an optional step in the assessment process for patients who want to proceed with psychotherapy or counselling work. It offers you the opportunity to have a full written therapeutic self-support plan as a guide for the work you want to do including a 60 minute session. Written support plans are particularly useful for time-limited work or where you are particularly vulnerable or at risk of self-harm, or if you experience variable states of emotional stability, or where you feel that you might have difficulty focussing on particular topics or outcomes.
- 60 minute Personal Development, Life Coaching and Psycho-education Session. Personal Development work is so varied in scope that it is best to let me know your needs and enquire for details of what might be involved for the direction you would like to take. It would normally follow similar steps to the therapy route i.e. informal meeting, assessment and agreed sessions. The assessment for personal development work and Life Coaching differs somewhat from my psychotherapy assessment but is still in-depth.
- Out-of-hours appointments. As a supplement to your usual sessions, provision can be made to provide you with out-of-hours support during particularly difficult times (see the Fees page for hours and tariff). Short-notice face-to-face or SKYPE appointments can be made, or support can be put in place in advance to provide help if needed outside of normal business hours, either by Skype, telephone or in some circumstances face-to-face and by home visit. Please let me know your specific needs and see the Fees Page for more details.
- Supplementary Support: Email, Skype, Telephone and Chat support in between sessions. Supplementary support is available prepaid if you feel that you might need some supportive contact in between sessions. Provision can be made for daily contact or Out-of-Hours support each week, depending on what you feel you need. Pre-paid support minutes can be purchased and used for this purpose. See Fees Page for details.
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