(c) Wen-Yan King, Flickr

If you are a in a relationship – regardless of either of your sexualities – and you are having relationship problems after an HIV test gave a positive result then contact me, Dean Richardson, today to arranging a no-obligation initial session to see if couples counselling could be suitable for both of you. My contact details are here, or you can click here to send me a secure email .

Counselling following an HIV Diagnosis.

It has not been unusual for a couple – gay, lesbian or straight – to come to see Dean Richardson for couples counselling after one (or both) have been diagnosed as HIV positive.

• Sometimes the couple therapy is about the shock of receiving a positive diagnosis.
• Sometimes the counselling is about trust issues raised by one partner being diagnosed.
• Sometimes the diagnosis is cathartic in releasing other matters that have been put off – but now need someone to help the couple discuss.

Whatever the core reasons of seeking couples counselling, Dean is a qualified and experienced couples counsellor who works with couples that have received a positive HIV diagnosis (amongst many other couple relationship reasons for counselling).  His couples counselling service can help a couple negotiate their way through difficult problems resulting from HIV diagnoses.

The GU clinic may give you and your partner support after an HIV positive diagnosis, but longer term therapy is available privately through meeting with Dean.

What to do next.

You don’t need to be referred to Dean via your local GUM clinic, nor your doctor.  Initiating private counselling is totally up to you and can be arranged as soon as you make contact with Dean.  It is a confidential service that can compliment the medical treatment that you will continue to receive through your GUM clinic and/or your doctor.

Click to contact me for more information or to make an appointment.

(c) danielbrezina.com, Flickr

Introduction.

A current problem (2010) is that counselling and psychotherapy is not yet governed by UK law.  Anyone can advertise themselves as a counsellor or therapist without actually having any professional training, appropriate qualifications or any actual experience. Unfortunately, this might suggest that the client seeking therapeutic treatment could be at risk of working with an unqualified therapist.

However, finding a qualified and experienced counsellor can be a straightforward process if you know of some helpful things to look for.

This post describes how to find a suitable therapist – and offers some topics to check out with your potential therapist.  At your first meeting, most – if not all – therapists should not be phased by you asking about the topics (in later sessions, however, some therapists may not answer your questions about them directly, but be interested with you in the purpose of your question – keeping the focus upon you.  This is a legitimate form of therapy (eg psychodynamic / psychoanalytical) – but I include it here just so that you are aware).

Advice for Clients.
Read: “How to get the best out of your therapist”
(c) BACP – 2010

Search a Professional Body

An easy way to find a suitable therapist is to use a professional therapists’ body that offers a “find a therapist” type of service. The therapists listed may have had to pay for an entry, but would also have had their qualifications checked before being allowed to pay for an entry in the list.  It’s a good place to begin searching for a therapist.

• British Association for Counselling and Psychotherapy
  http://www.bacp.co.uk/seeking_therapist
• British Association for Psychotherapy
  http://www.bap-psychotherapy.org/
• The British Psychological Society
  http://www.bps.org.uk/

… however, if you wish to find your own therapist – or you would like some advice on what to check out about your potential therapist – then read on.

Finding your Own Therapist.

Finding your own therapist can be easier when you want to find a counsellor with specific criteria.  Sometimes professional bodies do not include such criteria.  Use search engines such as Google, Yahoo and Bing to begin your search – and then refer to the information below about what you might want to check about each potential therapist.

Qualifications.

Does the counsellor has a recognised qualification in counselling.

Diplomas and Degrees – check that the qualification included actual supervised practice (eg 100 hours counselling practice to achieve the qualification).  Having a qualification in the theory of counselling without any actual practice may be insufficient for your needs.

Certificates in counselling may not include any actual practice to gain the award if they are just certificates of attendance.

Membership of Professional Body.

Is the counsellor a registered member of a professional body?  Do they subscribe to a recognised code of ethics or an ethical framework for their therapeutic work?  Is there anyone to whom you could report your complaint if you needed to?

Special interest/experience.

Does the counsellor have any special interests or special experience in working in particular therapeutic areas?

Theoretical approach.

There are different forms of counselling and psychotherapy – and whilst it’s the relationship between therapist and client that is shown to matter, some approaches might suit you better than others.

See Wikipedia – http://en.wikipedia.org/wiki/List_of_psychotherapies for information on therapy models.

Who does the counsellor work with?

Does the counsellor state what types of person they can work with (eg adults, couples, young people, children, elderly etc).

“This is how I work”.

Does the counsellor give you an idea of how they work therapeutically?

Fees.

Do you understand what the therapy will cost?

Supervision.

Counselling supervision is a formal meeting in which the counsellor meets with a qualified supervisor (or another counsellor) to review their clinical work.  Sometimes their professional development and their personal development is reviewed too – depending on the counsellor’s needs. A supervisor is not a managerial role, but more of a professional service designed to support the counsellor.

Is the counsellor taking regular supervision?  Some therapists’ professional bodies require the therapist a minimum amount of supervision every month (eg 90 minutes).

Continual Professional Development.

Does the therapist make you aware that they attend CPD (a form of contining their training and experience throughout their practice).  Some professional bodies, such as the British Association for Counselling & Psychotherapy, require that the counsellor obtain a specific number of CPD hours per year.

Therapy Today - October 2009, Vol. 20 Issue 8

If you are troubled by your sexuality and you think that counselling might help you, make an appointment with Dean Richardson to discuss counselling and what you might need from therapy.

The gay cure?

by
John Daniel

http://www.therapytoday.net/article/show/1168/

Except:

The counselling and psychotherapy profession was subject to unflattering media scrutiny earlier this year [2009] following the publication of research which found that a significant minority of mental health professionals in Britain are attempting to help lesbian, gay and bisexual (LGB) clients become heterosexual.

Under the headline ‘British therapists still offer treatments to “cure” homosexuality’, the Guardian¹ reported that a survey (of 1,328 counsellors, psychotherapists, psychoanalysts and psychiatrists throughout the country) found that 222 practitioners had attempted to change at least one patient/client’s sexual orientation, while 55 said they were still offering the therapy. The fact that some of those practitioners are members of BACP prompted the following response from Phillip Hodson, BACP Fellow and Media Consultant, in the letters page of the Guardian the next day: ‘[BACP] is dedicated to social diversity, equality and inclusivity of treatment without sexual discrimination or judgmentalism of any kind, and it would be absurd to attempt to alter such fundamental aspects of personal identity as sexual orientation by counselling.’²

Click http://www.therapytoday.net/article/show/1168/ to read the article in full.

(c) Daquella manera - Flickr

Couples Counselling can help a couple to separate -  if this is what they wish to do – whether this is decided at the start of therapy or if such a decision is made during couple counselling.

It can be a common misunderstanding when couple counselling is considered simply as “a therapy to prevent a couple separating“.  This single point of view is not entirely true, of course, because some of the aims of couple therapy are much more complicated than a simple situation of staying-together-or-not.  Outcomes of couples therapy are at the (informed) decision of the couple themselves and not the therapist nor the intention of couples therapy in general.

Couple counselling is a therapy targeted toward the couple’s relationship, rather than therapy for two individuals in a relationship.  The focus of a couple’s therapy will be what the couple want to change about the relationship, their behaviour within the relationship and as a qualified couples counsellor and BACP accredited therapist, I have training, experience and supervision in working with couples whose chosen outcome for therapy is not staying together.

Therefore, in the assessment, a couple and I will discuss what the couple wants from counselling … and separation is a legitimate option for couples counselling.  Sometimes this decision is made at the beginning of counselling, sometimes it’s made during counselling.  Either is a legitimate option for couples therapy.

Separating / Staying together / Unsure?

I have worked with couples who wish to work to stay together, and with couples of wish to separate.  I have also worked with couples who, at the time of the assessment … and for several months after, did not know what they wanted to do with their relationship – and so part of the counselling was to discover what our focus for the therapy should be.

Also, the focus we agree upon in the assessment is not set in stone.  Sometimes, during the course of counselling, one (or both) partner(s) may change their mind … or find their voice … and begin talking about wishing to separate.  Vice versa, a couple wishing to separate can change their minds during the therapy.  All of these situations are legitimate and as a couples counsellor I can help facilitate a couple in discovering what they want to do with their relationship. And when mixed-agendas appear (partner “A” wishes to stay together, partner “B” wishes to separate) I can assist the couple in working with those differing agendas too.  When a couple change their mind and wish to change their focus of their work (ie separating instead of staying together, and vice versa) I can help a couple work with that change too.

Couple Counselling & Divorce.

Couples who have engaged in marriage or a civil-partnership may decide that they wish to formally separate.  Of course, solicitors will be involved for the legal matters but the couple can still meet weekly with me to discuss matters about their separation.

It is often the case that an individual wishes to leave a relationship by “saving face” … and there can be pressure to denigrate their partner (because doing so helps the individual to appear or feel better than the partner).  Couples counselling can assist with the separation processes so that both partners leave the relationship in a neutral (perhaps even friendly – though not essential) position.

Advice on Separating.

Couple counselling can be helpful when a couple decide to end their relationship and need help in separating out the emotions and building blocks that originally joined them together. My qualification is in systemic and psychodynamic couples counselling (similar to the training that Relate (ex “Marriage Guidance Council”) counsellors receive.

Therefore, I do not give directive advice on how to separate, but instead I help facilitate the couple in finding their own solutions to how they wish to separate. I do this by remaining neutral in the relationship and being curious about many things. This can help the couple in discovering new information about their relationship, how they operate, and how things go wrong.  With such discoveries, the couple can put into place difference behaviours that can be helpful in relieving some of the distresses of separating.

Are you thinking about Couples Counselling?

See my Contact Me page or click here to send me a secure message to make an initial no-obligation appointment for an assessment for counselling.

(c) Flickr / Wallyg

If you are a gay or lesbian couple in a relationship, you are having relationship problems, and you wish to work with a counsellor who identifies himself as similarly sexually orientated, then contact me, Dean Richardson, today to arranging a no-obligation initial session to see if gay couples counselling could be suitable for both of you. My contact details are here, or you can click here to send me a secure email .

Why a Gay Couples Counselling Service?

When I began setting up my private practice in Portsmouth/Southsea (and later expanding to include Chichester, West Sussex), I was aware that the last thing the areas I practised within really needed … was just another generic counsellor offering just another generic counselling service.

Notwithstanding that my qualifications and experience in individuals- and couples work allow me to work generically with all sorts of people and presenting problems, as a gay man, and beyond my general counselling service for gay and non-gay individuals, I have chosen to offer a counselling service specialising in working with gay couples whose relationship is in difficulty and who wish to work with a gay counsellor who is trained, qualified and experienced in helping couples resolve their relationship problems.

Why consider Couples Counselling?

Do any of these phrases sound familiar to you?

Gay Couple Relationships.

It is true that gay couple relationships have as many problems and issues to negotiate as any other couple relationship, regardless of sexual orientation.  So a systemic & psychodynamic approach to the couple therapy is useful no matter what the sexual orientation of the couple.  However, gay couples have a number of issues that other couples tend not to have:-

• Their relationship roles are not defined purely by their gender or their gender-stereotyping.
• Their relationship may require extra negotiation skills – requiring more openness in their communication skills.
• Family may not be able to help with gay relationship problems.
• Gay couples cannot marry – and some gay couples do not find the Civil Partnership to be a satisfactory equivalent.  Without formal commitment, gay couples can experience an extra burden when struggling to commit to one another.
• There can still be prejudice toward gay people – and gay couples – and living together as a couple may attract unpleasant attention.
• A gay couple may find entering therapy with a heterosexual therapist to feel problematic (whether real or not) & may prefer to work with someone of their own community.

Therapeutic interventions for LGBT relationships.

As part of my qualifications, I practice couples counselling using a combination of systemic and psychodynamic methodologies (plus some useful techniques borrowed from other therapies such as CBT and Gestalt counselling).  This allows me threefold:-

1. To therapeutically facilitate a couple in discovering behaviours and possible root causes of their chosen focus for therapy,
2. To assist the couple in hypothesising for themselves what could be done to creatively perturb the problems sufficiently to create a change,
3. To help the couple find lasting changes to the originally presenting relationship problems.

Working with one gay relationship – not two gay partners?

Therapeutically, when I work with a couple I work mostly with the one relationship as my client.  Thus, my contract is, in a way, with the couple’s relationship itself and less with each individual within that relationship.  I meet with the couple together (weekly) but when there is a difficulty in the couple meeting together we can discuss an alternative approach suitable and agreeable to everyone (for example meeting with the available partner and bringing the other partner up to date when they return).  Meeting with one partner, though, is not individual counselling and the therapy is still in the context of the relationship, not the individual’s personal problems in isolation.

Sometimes a couple come to therapy identifying that one partner “has the problem.”  Nevertheless, I will work with the both of you at the problem within your relationship – if you both agree – rather than to see the one partner in isolation in an attempt to “cure” them to the satisfaction of the other partner.

Problems in the relationship are within the relationship and needs the relationship available to therapeutically work the problems through to a resolution.

Domestic Violence.

If domestic violence is revealed in the assessment – or in the counselling work – then we will talk about stopping the violence immediately.

We will discuss the “Safety Plan”.  In summary: during a situation between the couple that may be leading to violence, one partner will take responsibility for leaving the room/leaving the situation.  The other partner will take responsibility for not following the leaving partner (the partners don’t need to decide beforehand which role they are going to take).  The partners will stay separated until such a time when both partners feel that it is safe to come back together.  Then can then have a conversation about what lead up to the safety plan being executed.  They will also discuss with the counsellor what happened when they next meet with the counsellor.  Whilst this sounds like a simple plan – and in essence it is simple – it can be very difficult for a couple to execute the plan.  In counselling we will discuss the plan in detail and discuss things every time the plan is put into action.

Relationship counselling can helpful but it can initially make things worse because we are perturbing with a relationship system in order to help re-build it more safely and successfully.  Disturbing a disturbed relationship can be very difficult for both partners.  Both of you must convince me that it is safe for you both to work with me in counselling – and discussing the safety plan is the main way we will achieve this.

The counsellor’s sexuality – does it matter?

Many therapists will agree that the counsellor does not have to have very much (if anything) in common with  a client in order to work successfully in therapy.  Although some clients may ask “have you been through this yourself” or “have you worked with other people with this problem” they are seeking assurances that their problem can be worked through – that is the important part.  For the most part I would agree that the counsellor does not have to identify with the client for helpful therapy to take place.  However, LGBT-identifying clients have also told me that when they have attempted to work with a non-LGBT counsellor they have found themselves reserved .. and sometimes unable to speak about matters that are strongly related to a LGBT lifestyle. I find that this concerns me for the clients.

Indeed, this particular issue may, or may not, be about the therapist themselves … but the fact is that the gay client needs to feel as though they can talk with the therapist.  Gay couples working with a gay couples therapist is part of the unique selling point of my practice.

Could your choice of counsellor, for example, appreciate the struggles and practicalities of an open-relationship?  Or discuss openly gay or lesbian sexual practices?  S&M?  Threesomes?  Keeping your relationship secret because one or both of you are not “Out”.  Or just the struggles of a plain vanilla relationship between a couple who happen to be homosexual?

See also “LGBT Counselling – Does the Counsellor’s Sexuality Matter?”

Arriving together and leaving … together … or separately?

Sometimes couples come to therapy in order to learn how to stay together.  Sometimes they come to learn how to separate.  This is no different with gay and lesbian couples.  If part of the initial therapy is to help you two decide what you wish to do (stay together or separate) then this is perfectly fine with me.

Should the two of you decide that you wish to stay together then I will help you work on how this can be achieved.

Similarly, if the two of you decide that you wish to separate then I can help you work towards separation.

Perhaps the two of you disagree on if you shuld stay together or separate.  I can help you work towards making this decision too.

How to begin gay couples counselling?

Initially we would meet together for an assessment.

The assessment allows us time to discuss the relationship problems, discuss finding a focus for our couples work, and then setting a contract to work together.

Together – or individually.

If, during the assessment, it was felt by all parties that couples therapy could not proceed at this time … perhaps because one or both of the individuals wanted to seek individual therapy, or domestic violence could not be worked with sufficiently to proceed with counselling  … then I would suggest making a referral to one of my other experienced colleagues.  Ethically, it would not be appropriate for me to work with the one individual in the relationship, only to later invite the other partner to return later to begin couples therapy.

If individual therapy was appropriate before couples therapy began, then after one or both of you had completed individual therapy, we can arrange for you both to return to couples therapy with me later.  This is a perfectly legitimate situation, if not unusual, because working through individual problems within the couple-relationship is also a perfectly legitimate therapy too.

It is also perfectly OK for a couple to be in couples therapy at the same time as one or both are in individual therapy.  This is because I will be working with your relationship, not you as individuals.  Individual therapy works with you as an individual.

Appointments.

I offer a weekly counselling appointments (rather than several times a week, or ad-hoc ‘drop-in’ sessions) – and both partners are required to attend each session.  On the occasion where it’s not possible for one partner to attend, the other partner may attend on the understanding that (a) the session will continue to be about the relationship (not the individual, or the other partner) and (b) that the attending-partner and I will inform the other partner about what we discussed.

(c) -Marlith-, Flickr

Does the sexuality of the counsellor make a difference to lesbian, gay, bisexual and transgendered clients? In this post I will discuss briefly my experiences as a gay counsellor in meeting LGBT-identifying clients for an assessment-for-counselling.   This is in my private practice in Portsmouth & Chichester.

Client/Counsellor Differences.

It would be my experience of therapists that many would state that differences between a counsellor and a client do not have to be so different that they are detrimental to the therapeutic relationship.  In other words, I do not have to be female to empathise with a female client.  So, therefore, I would generally agree that differences can be – and are – worked with successfully and often.

Recently, however, in my private practice I have assessed gay and lesbian clients for counselling and have noted that a majority of these clients (who have worked with straight counsellors) have expressed varying degrees of dissatisfaction toward the counsellor when they needed to discuss matters that were particular to their sexual identify.

For example:-

(Male client – identifying as gay) “When I told him [the counsellor] that my sex life with my partner was diminished, he shifted in his chair noticeably uncomfortable.  I couldn’t take it back to discuss with him about his reaction.”

(Female client – identifying as lesbian) “I don’t understand how a little old grey-haired lady can really understand what is happening in my sex life – even though she claims to understand.”

Counselling “Sexuality Workshop” training.

From my experience of my counselling training in the 90s, the subject of “homosexuality” was – interestingly – firstly avoided, and then actively vetoed during our two workshops on sexuality. It was put to us by the trainer that although the trainer understood that some of us were interested in homosexuality and working with gay clients, this topic was not going to be included in the scope of the training.

A number of my colleagues – along with myself – noticed with interest the role playing exercise later in the day regarding bestiality (sex with animals). Bestiality OK? Homosexuality Not OK? We wondered what that message was meant to convey,  and could such a trainer also (unconsciously?) communicate something about this interesting imbalance toward the clients that they took in therapy.

It leaves me wondering what sort of message therapists with – possible – unresolved issues relating to their sexuality or sexual identification are giving to some of their clients.

Perhaps by the nature of society and the homosexual child, LGBT counsellors may be trained from an early age to reflect upon their sexuality, its nature, and how it fits in (or doesn’t) with people around them.  I believe this predisposes an LGBT counsellor toward LGBT client’s issues in a more empathic manner than, say, some heterosexual therapists who have rarely been required to review their own sexuality or their place in a sexual-minority in much depth.

Empathy versus Experience.

I would very much agree with the majority of therapists that we do not have to be experienced in all matters in order to be able to work as a therapist with a majority of clients. We do have to be experienced in working empathically, of course.  But is that the point for our LGBT clients here? Our LGBT clients appear to be looking for therapists whom they believe will understand them … not just empathise with them … actually know what they are talking about.

LGBT counselling for LGBT clients.

I am a qualified, accredited and experienced therapist who work with wide example of client issues, both genders, different relationship setups, and many different life issues.  I also choose to advertise myself as a gay counsellor for gay clients – which I have found is an unusual position in the areas of Hampshire, West Sussex and Surrey.  Advertising like this has brought in a significant number of LGBT clients who seek to work not just with an LGBT-understanding counsellor, but whom wish to work with someone whom they feel lives, as well as works, within their LGBT community.

This form of identification, I believe, can be very valuable in the initial stages of the developing therapeutic relationship between gay client and gay counsellor, but tends to become – quite rightly – somewhat less significant as the therapeutic relationship is built sufficiently for the therapeutic work to be done. In other words… initially identifying with a counsellor who is “similar” to the client is a good thing initially for the client, whilst later on it can become to matter less.

Essential Boundaries.

It’s important to reflect on the nature of boundaries in therapeutic work.  Boundaries contain and protect both counsellor, client and the therapeutic relationship. A counsellor should reflect the purpose, say, of them agreeing to meet a client outside of ongoing-therapy for, say, lunch or an evening beer (a practice which I would consider to be highly unethical).

The nature of therapy requires safety, boundary keeping and ethical reflexivity to protect both client and counsellor.

The fact that my sexuality may lend me to be sympathetic toward LGBT issues in counselling should not be confused or misunderstood as my willingness to forego therapeutic boundaries.  Just as, for example, a female counsellor might help a male client work through an eroticised transference whilst maintaining boundaries and ethics, a gay male counsellor should in no way deviate from similar practice when working with lesbian or gay clients in similar transference issues, whilst also maintaining ethicals and boundaries.

In conclusion – so far!

In identifying as a gay man, and therefore a gay counsellor & psychotherapist, I am experiencing that I had unintentionally been offering LGBT clients a way into therapy that may not be quite so available from heterosexual counsellors.  Once comfortably into the work, others differences between client and counsellor can be allowed in and worked with just as most other therapists would work with differences.

There may be something important here in the psychological make up of LGBT clients (and counsellors, for that matter!) from an interesting  need to find similar individuals to identify with each other … and to feel support in bringing in differences later on. After all, I had never heard the term “Lesbian Bed Death” … and needed to ask my lesbian client to explain it to me.

(c) a_kep (Flickr)

This section discusses common questions asked about counselling.

To ask a question that is not answered here, either use the comments section (below) or contact me directly.

How do I know that counselling will benefit me?

By using a survey called CORE-OM, counselling can be demonstrated to benefit a majority of people. My own CORE-OM statistics show that every client who has chosen to take the CORE-OM survey has benefited from counselling.

This data suggests that counselling could benefit you too, although meeting with your counsellor for a proper assessment session is always a wise & necessary procedure to make sure that counselling is a suitable treatment for you.

However, we cannot know if counselling will benefit you, and so an ethical counsellor will be paying attention to the counselling work, and discussing in his/her supervision, if the counsellor has concerns that the therapy work seems not to be helping you … and discussing this with you if it is felt it would be helpful to do so.  It’s not in the counsellor’s client’s interest to keep a client attending therapy that is not being beneficial.  Plus, as the client, you too can discuss with your counsellor any concerns that you’re having at any time.

Read more about my CORE-OM Statistics…

How do I find and evaluate a counsellor?

See my separate post on this topic.

Download this free pamphlet on “How to get the Best out of your Therapist.”

(c) BACP – 2010

How do I start counselling?

1. Make contact with me to arrange an appointment for an assessment.
2. Following the assessment, we will both be in a position to discuss if counselling could be beneficial for you.
3. If we proceed into counselling we will arrange a weekly appointment (usually same day, same time, same location each week).
4. If we decide not to proceed into counselling I can either make a referral for you to a colleague, or you are free to find your own counselling.
5. If we proceed into counselling, we will continue to meet together either until a fixed number of sessions is up, or until the issues you came into counselling for are worked through sufficiently for you to feel that counselling can come to an end.

See individual assessments &/or couple assessments.

What Counselling Services are Available?

I offer counselling for the following main services in both my Portsmouth & Southsea (Hampshire) and Chichester (West Sussex) practices:-

• Counselling for Individuals (read more).
• Counselling for Couples (read more).

LGBT Counselling Specialities.

I also practice counselling for on lesbian, gay, bisexual and transgender clients’ specific needs in the areas of Portsmouth & Southsea (Hampshire) and Chichester (West Sussex).

• Counselling for Gay, Lesbian, transgender & Bisexual Individuals (read more).
• Counselling for Gay, Lesbian, transgender & Bisexual Couples (read more).

Is Couples Counselling different from Individuals Counselling?

Counselling for couples is similar to individuals, but with some obvious (and not so obvious) differences.

Primarily, in couple counselling my “client” is the couple’s relationship - I am not working with two individual peoples’ seperate problems. I assist the couple in finding their own solutions to their relationship issue. I work systemically and psychodynamically, meaning that I help the couple to peturb their relationship system sufficiently to gain new information that helps the couple take different approaches to their relationship problems, and I use some of their history to help them understand what each person may be bringing to the table that is helping and hindering the couple’s relationship.

Individual counselling my client is the individual him/herself.  I work psychodynamically with individuals, helping them gain insight into their problem and assisting them in working through the issues to a more satisfactory state.

Which counselling to choose?

An individual coming to counselling for her/her own issues is suitable for an assessment for individual counselling.

A couple coming to counselling for issues with their relationship are suitable for an assessment for couples counselling.

An individual coming to counselling to try and change relationship problems is likely better coming to counselling with her/her partner to work in couples counselling together.

A couple coming to counselling in the hope that one individual is going to be changed sufficiently to suit the other partner is possible unsuitable for couples counselling.

See also Couple Counselling & Individual Counselling.

What can I talk about in counselling?

Advice for Clients.
Read: “How to get the best out of your therapist”
(c) BACP – 2010

You can talk about anything that you think you need assistance with. I have written a separate page for this topic – click here to read.

There are some matters that would come under the law – for example if you wished to talk about your part in terrorism, intended harm to self or others, or criminal activity, then I would be obligated to break confidentiality in serious matters such as these. I will always advise you beforehand about confidentiality, and advise you before I take these matters elsewhere.

How long does a session last?

Counselling sessions with Dean last for 50 minutes. The time is there for you to do with what you need. Because every client’s time is reserved exclusively for them, if you arrive late the time cannot be made up later (eg adding an extra 10 minutes onto the end of the session). Similarly, if you arrive early the session will still begin at your appointment time.

How often do I need to come for counselling?

You will come once a week (on the same day, same time & same location) and attend one fifty minute session.

We will meet as many times as either we have initially agreed up front (eg brief counselling) or until we feel that the work has been done.

What is an assessment?

This is where you and I meet for a session (sometimes more, as required) and discuss what you need from counselling. I may also offer you a CORE survey (which is a questionnaire that helps us identify how things have been for you during the past week). I will offer you a number of tentative thoughts about what I hear from you, and maybe offer an interpretation or two based on how I might understand how matters link together. This is all part of seeing if we can work together.

This is a mutual assessment – you are seeing if you can work we me too.

If I have any concerns then I will discuss these openly with you – and you are welcome to discuss any concerns with me too.

Read more about:-

individual assessments &

couple assessments.

Do I have to pass (or fail?) a test to be allowed counselling?

No.

Unlike some newer IPT services in the NHS, where you only get to the next level of therapy by first being unsuccessful with the previous level of therapy, with me I don’t offer one level of therapy first, followed by other levels later. What you receive from me is my full service from the beginning (although, of course, I will always take matters at a pace that works for you).

Do I need to get my doctor to refer me to you?

No – I am a fully qualified and experienced counsellor/psychotherapist supervised according to BACP recommended standards. I am able to make my own judgements on suitability for counselling, can discuss matters with you directly, and you can make an appointment with me independently of your doctor.

Will you inform my doctor?

I will not inform your doctor that you are receiving therapy from me (unless, of course, you wish me to do so) as my service is confidential and independent of primary care services.

How do I decide between brief or open ended counselling?

When we have our assessment together, I will be paying attention to the problems that you are bringing, seeing how you respond to what I say, and considering if brief of open ended counselling would suit you best. Later in the session I will discuss with you what I think and ask you for your opinion. If we disagree with each other we can talk about this too.

Brief counselling: a set number of sessions, negotiated, usually six or twelve.

Open ended counselling: unlimited number of sessions, but working towards an agreed goal or improved emotional state.

Sometimes, we can also begin counselling in a form of a trial: which is open-ended counselling but starting with four or five sessions. Then we can discuss if we both think counselling is benefiting you after these sessions. If not, we can agree how and when we would like to end the trail.

What happens in a session?

After counselling has been going on for several sessions to establish itself, I usually greet you in reception, accompany you to the counselling room and then wait quietly whilst you consider what it is you want to talk about (you will lead the session).

Read more…

Do you have a particular style of counselling?

I am qualified in psychodynamic counselling for individual work, and am a qualified systemic & psychodynamic counsellor for couples. With careful consideration, I may also incorporate other therapeutic techniques that I believe may be useful to you, provided that I have had previous training and experience in these matters. I do not practice therapy models for which I have received no training nor experience.

Read more about psychodynamic and systemic models…

Are you a Christian Counsellor?

Christian counsellors (http://www.acc-uk.org/) are a form of support that follows religious beliefs at their core.  The following description is quoted from http://www.walking-wounded.net/html/christian_counselling.html :-

[the] approach is a Christian one, that is that Christian beliefs about human suffering and its causes – for example the role of sin in causing suffering, and the need for the presence of forgiveness in people in order for them to be spiritually (and also emotionally) free, is taken fully into account.

My form of therapy respects all form of religious and secular beliefs but is not based upon them.

How does counselling come to an end?

If we have agreed on brief counselling, then both you and I know when the sessions will end.

Open ended counselling is a little different, and more flexible. Usually, you or I or sometimes both of us will begin to notice that the reasons you came to counselling are no longer so prevalent. It is around that time that we can begin talking about if counselling has done its job, and if we are ready to begin an ending process. When we both agree that counselling can end, we will agree how we would like to end. For example: we might agree to end counselling in six sessions time, using those sessions to review where we’ve been, what it’s been like in counselling, and what it will be like to no longer come to counselling in the future. Then we end after the last session is complete.

What if I don’t like my counsellor?

Some clients find it very difficult to tell their counsellor what they do not like. Whether it something about the person themselves, their style, something they said in a previous session and so on.

All counsellors intend to be as open as they can to their clients, and thus we would very much like to hear when you are not very happy about something. Afterall, although this “something” might be happening between you and the counsellor, it might also be an example of something that, if we were able to work through together, might benefit you in your every day life.

And sometimes clashes cannot be resolved – no matter what good intentions both client and counsellor would like to have.

Sometimes a client simply stops coming to counselling, leaving no word why this is. Sometimes a client is able to find the courage to bring up what is bothering them with the counsellor themselves. Sometimes, moving to another counsellor is an option.

As your counsellor, I try to be attune to your needs, and as a human being sometimes I might be mistaken or I might miss something that is important to you. If I spot that something seems amiss, I will try and bring both our attentions to the matter (delicately, of course, because I might be mistaken in what I thought I spotted). Discussing with me what is bothering you about me can be helpful to us both.

Will what I say be told to anyone else?

Confidentiality.

I practice confidentiality. This means that you can speak with me knowing that your friends, your family, your work colleagues and so on will not get to learn what you have said in a counselling session.

I abide by and adhere to the British Association of Counsellors and Psychotherapy’s Ethical Framework.

As a BACP accredited therapist I am supervised to a minimum of 90 minutes per month. This is where I meet with a qualified counselling supervisor to discuss my practice and my case load. I will, from time to time and with your permission, discuss your case with my supervisor – but I will have first made sure that my supervisor does not know you, or is likely to come in contact with you (say, for example, though the workplace) and I will refer to you only by your first name (or another name if you prefer). If I cannot assure your confidentiality in this manner – for example if my supervisor knows you in the work place or socially – then I will seek supervision from another supervisor for your particular case.

Confidentiality will be broken if you disclose intent of harming yourself or others (including children) or if you disclose intent of committing a serious criminal offence. I intend to inform you of my intent to break confidentiality with you before I do so.

See also Ethical Framework.

What if I miss a session?

Missed sessions happen from time to time. Please try and let me know as soon as know that you are not going to be able to attend a future session. If you miss a session without notice, I will still be available for you at the same time and same day the following week (excluding any vacation or planned absences that either you or I have discussed).

The session fee is still payable if you cancel the session within two business-days ahead of the appointment time, if you do not attend your session without having given any prior notice of your absence.

What if I want to change our arrangements?

From time to time changes may come up. Please discuss these with me.

For example, the appointment time may become difficult or you may have heard of a treatment that you would like to try. All of these matters are worth having a conversation about because sometimes what seems to be an obvious resolution (eg changing the appointment time) can look quite different having discussed what’s going on around the potential change.

I need some paperwork completing by you.

Confidentiality is vital to this work – even when, sometimes, it’s not recognised that discussing the contents of the session outside of therapeutic containment would break this confidentiality. Therefore, I operate with some boundaries in this matter:

• Solicitors letter – I will make a charge for this. I will state you are in counselling but I will not reveal the contents of our work. I may also seek advice before agreeing to write a letter.
• Attendance forms (e.g. student placement) – I will co-sign a form that you have completed showing that you have attended counselling, but I will not reveal the contents of our work.
• Attendance forms that I am required to complete on your behalf – I will make a charge for this also.
• Most other letters that you ask of me will require a discussion, as I will not break confidentiality by discussing your counselling.

How much does private counselling cost?

See my Fees page for a description about my standard fees and sliding scale.

Could I see an example of a counselling session?

Counselling, of course, is confidential and therefore I will not demonstrate a real session with a real client.

However, as part of a university project with Pete Allen-Worth I took part in a recording of a role-played counselling session – click to see the video.

If I wished to raise a complaint.

Firstly, please try to discuss your complaint with me first. We will try to address your concerns and put things right.

However, if we cannot attend to your complaint together you are welcome to take your complaint to my professional body – the British Association for Counselling & Psychotherapy.  This will be make your complaint formal and the BACP have procedures in place to handle formal complaints.

See also BACP’s Making a Complaint page.

British Association for Counselling & Psychotherapy,
BACP House,
15 St John’s Business Park,
Lutterworth,
LE17 4HB.

Tel: 01455 883300,
Fax: 01455 550243,
Minicom: 01455 550307,
Text: 01455 560606

http://www.bacp.co.uk/

I have another question?

Please use the comments section, below, to ask your question – or contact me directly.

A Brief Overview.

Couple Counselling

“Is couples counselling with this counsellor suitable for us?”  “Are we both suitable to work with this counsellor’s therapeutic practices? ”   These two questions would be how I would very briefly describe the purpose of an assessment with couples.

As a BACP Accredited counsellor in private practice, I perform my own assessments with my private clients.

A Summary of the Assessment Process.

Counselling begins with an assessment process which in the case of couples is a four-session procedure involving the partners meeting together, and separately, with the counsellor.  The intent is to allow everyone to gain a full-as-possible picture of the relationship problems and to see if we can agree upon what the focus of the counselling work should be.  This is an ethical process to ensure that counselling is an appropriate treatment for the couple, and that the couple are fully aware of what therapy they are embarking upon.  Sometimes the assessment process is sufficiently therapeutic to free up a couple to be able to talk things through on their own and further counselling is not needed. All these possibilities are discussable in session.

In summary, I have found this process works well:-

• Week one: counsellor meets with the couple together for 1 x 50 minute session.
• Week two/three: counsellor meets with one of the partners separately … and the other partner the subsequent week. This allows each partner to tell their side of the story separately from their partner, and allows me to also gain some history about the individual.
• Week four: counsellor meets with the couple together again (50 minutes) to discuss previous sessions (respecting any personal confidentiality that may have come up in weeks 2 & 3), to consider if we all agree that we can work together, if counselling seems a suitable therapy, to agree what the focus of the couples counselling work should be and where we go from here.

Whilst I refer to this as an “assessment” process, it is can also be a therapeutic helpful process for the couple too.  Both partners begin to look into the relationship problems more deeply and, with the help of the therapist’s processes, from perhaps newer angles.  Some couples do not need to proceed further after the fourth week as the process has been sufficient to perturb seemingly-immovable conflicts sufficiently for them to work on their issues subsequently by themselves.  Others choose to proceed into further counselling to receive help in supporting them address the relationship issues further.

It may become clear at any of these stages whether or not couples counselling feels right for the both of you, and to me, and if it does not we would (ideally) talk this through to a conclusion.

We will, no doubt, all have questions of each other – I need to know about you and your relationship and you will need to know about me.  This is everyone’s mutual assessment of everyone.

I have a form to complete.  On the form I have such questions as:-

• Your occupation, relationship status, children, medical health.
• Have you had counselling before? Together / separately?
• Reason(s) for seeking couple counselling.
• What is expected/hoped for?
• How has your sexual relationship been effected?
• Is there Domestic Violence/Abuse in this relationship?
• History of the relationship (how did you meet, how did you get together etc).
• Individual personal histories.
• Family, life, circumstances etc.

Informing you.

I will discuss with you about my counselling models, qualifications and ethics, about confidentiality and how it effects you, about where the law requires I disclose information (such as serious criminal activity, intended harm to yourself and/or others, or the Children’s Act) and that I will discuss with you before I make such disclosures, also about my supervision arrangements.

By the end of the assessment.

At the end of the assessment we should both have a better understanding of if we think we can work together, if couples counselling might be a helpful process (for you both) to go through together with me, and what will be the focus of our counselling work.  We will discuss fees, appointment times and vacation/absences, and what we can expect from each other (we call this “contracting”).

I offer a weekly counselling appointments (rather than several times a week, or ad-hoc ‘drop-in’ sessions) – and both partners are required to attend each session.  On the occasion where it’s not possible for one partner to attend, the other partner may attend on the understanding that (a) the session will continue to be about the relationship (not the individual, or the other partner) and (b) that the attending-partner and I will inform the other partner about what we discussed.

Domestic Violence.

If domestic violence is revealed in the assessment – or in the counselling work – then we will talk about stopping the violence immediately.

We will discuss the “Safety Plan”.  In summary: during a situation between the couple that may be leading to violence, one partner will take responsibility for leaving the room/leaving the situation.  The other partner will take responsibility for not following the leaving partner (the partners don’t need to decide beforehand which role they are going to take).  The partners will stay separated until such a time when both partners feel that it is safe to come back together.  Then can then have a conversation about what lead up to the safety plan being executed.  They will also discuss with the counsellor what happened when they next meet with the counsellor.  Whilst this sounds like a simple plan – and in essence it is simple – it can be very difficult for a couple to execute the plan.  In counselling we will discuss the plan in detail and discuss things every time the plan is put into action.

Relationship counselling can helpful but it can initially make things worse because we are perturbing with a relationship system in order to help re-build it more safely and successfully.  Disturbing a disturbed relationship can be very difficult for both partners.  Both of you must convince me that it is safe for you both to work with me in counselling – and discussing the safety plan is the main way we will achieve this.

Note taking.

I do not take written notes during a counselling session, but I do write notes during an assessment.

This article discusses the assessment sessions in couples counselling.

A question I am sometimes asked in counselling is “how long will counselling take?”

As a counsellor (see article: “How I work as a Counsellor”) I offer two main types of contract when I meet a client for an assessment.  These are Open Ended counselling and Short-term “focussed” counselling.  This article summarises both methods of working.

Short-term “focussed” Counselling.

In short-term focussed counselling, the client and I agree a set number of sessions (anything between four or twelve) and we agree a specific focus for the work (i.e. one specific element in the client’s life). The focus must be reasonable to work with within the time constraints.  We then meet weekly focussing in on the agreed topic until the number of sessions is complete.

It is not usual for the number of sessions to be altered once we have begun – although there are always exceptions which we can talk about during the therapy.

One benefit of short-term counselling is that the number of sessions and the focus is agreed upon at the very beginning … even though it can be tough work focussing upon a problem and even six sessions can fly by very quickly.

One disadvantage of short-term counselling is that it doesn’t afford any time to work upon matters that are related (or very close to) the focus in any depth.

Short-term counselling is not suitable for every situation and, ethically, if I think that such work is not suitable for a client I will discuss it with the client before offering such a counselling contract.

See also my post on Short-term, brief counselling.

Open Ended Counselling.

In open ended counselling, the client and I meet weekly for enough sessions to address the focus sufficiently -  allowing the therapy to develop in its own time.  Both client and I keep an eye on what we discussed in the first session (the assessment) and at some point during the therapy either the client, or I, or both of us will begin to talk about if the counselling work has been completed sufficiently to warrant setting an end date (or a set number of sessions in which to complete and say goodbye).

Ethically, I would not let open ended counselling continue unlimited, forever.  And having an unspecified number of sessions can be a valuable container for the client as he/she addresses his/her concerns and makes changes to his/her life before we both agree that the focus of the counselling work has been addressed and worked through – and now the work should come to an end.

In Summary.

Sometimes a client may ask “how long will this take” and estimating a set number of counselling sessions to address fully a problem is more of an art than a science … if not impossible (and unethical) in some cases.

Brief therapy offers a set number of sessions, but the focus is not suitable for everyone’s tastes.  Open ended counselling offers an unlimited number of sessions, which allows for the focus of the therapy to be addressed in its own time, until both client and counsellor agree that the focus has been sufficiently worked through.

Some personal matters cannot be adequately addressed by brief/focussed therapy because the client is not in a safe enough place to work in such a focussed manner (for example – past trauma such as an attack, rape or other forms of abuse).

As a BACP accredited counsellor working with the BACP Ethical Framework – my clients and I discuss various forms of therapy before beginning the work – finding the right counselling treatment for the client’s presenting issues.

Over a 5-year period (1974 to 1979), the authors interviewed in depth 156 gay male couples [in the California, San Diego County area] who were not in therapy and had lived together anywhere from 1 to more than 37 years.  The mean time in a relationship was 8.7 years, with median being slightly over 5 years. Six stages were identified with the first four occurring within the first 10 years as a couple.  The stages are presented as tentative formulations needing further clinical trial and research validation.  The conceptualization of developmental stages has been very helpful in the clinical approach to therapy with gay male couples.

Stage One: Blending (First Year)

image (c) CarbonNYC - 2009 - http://www.flickr.com/photos/carbonnyc/

Characteristics:

• Blending
• Limerence (falling in love, being romantically in love, intrusive thinking about the desired person, acute longing for reciprocation, sexual attraction).
• Equality of partnership
• High sexual activity

Blending is experienced as the intensity of togetherness gay men feel early in their relationships.  Their similarities bind them, their differences are mutually overlooked.

Stage Two: Nesting (1 to 3 years)

Characteristics:

• Homemaking
• Finding compatibility
• Decline in limerance
• Ambivalence

By the second year, more attention is paid to their surroundings taking the form of homemaking activities.  Couples in this stage also tend to see each other’s shortcomings and discover or create complementarities that enhance compatibility setting the stage for the mixture of positive and negative feelings about the value of the relationship: ambivalence.

Stage Three: Maintaining (3 to 5 years)

Characteristics:

• Individualisation begins
• Risk-taking
• Dealing with Conflict
• Relying on the relationship

Maintaining the relationship depends upon establishing balances between individualisation and togetherness, conflict and its resolution, autonomy and dependence, confusion and understanding.  The intense blending of Stage Two clears the path for the re-emergence of the individual differences, indentified here as individualisation. Individualisation requires some necessary risk-taking.

Stage Four: Collaborating (5 to 10 years)

Characteristics:

• Collaborating
• Productivity
• Establishing independence
• Dependability of partners

After 5 years together, couples experience a new sense of security and a decreasing need to process their interactions.  The individualisation of Stage Three can progress to the establishment of independence, sustained by the steady, dependable availability of a partner for support, guidance and affirmation.

Stage Five: Trusting (10 to 20 years)

Characteristics:

• Trust
• Merger of money and possessions
• Constriction
• Taking the relationship for granted

Trust develops gradually for most people.  The trust of Stage Five includes a mutual lack of possessiveness and a strong positive regard for each other.

Stage Six: Repartnering (20 years and beyond)

Characteristics:

• Attainment of goals
• Expectation of permanence of the relationship
• Emergence of personal concerns
• Awareness of the passage of time

The twentieth anniversary appears to be a special milestone for gay male couples.  A surprising number of couples reported a renewal of their relationship after being together for 20 years or more.

Comparing Marital Stages (E. Street) with Gay Male Partnership Stages (McWhirter & Mattison).

See also Counselling for Gay Couples