What to expect from therapy

Counselling and psychotherapy can play a key part in helping you feel better and making positive changes in your life, either by having just a few sessions or over a longer period.

Here I’ll give you an idea of what it’s like having therapy with me. If you’re new to therapy, or still considering whether to contact me, this information might help you decide, or provide reassurance if you need it, and if you have further questions please feel free to phone or email me.

My therapy room in Culvert Lane, Uxbridge.

What happens during an initial therapy session?

It’s important in therapy that you feel okay to talk about your difficulties. Meeting a therapist means you can find out what you think about having further sessions with them, ask questions, and check the practical arrangements and setting.

In an initial session, which like all my appointments lasts 50 minutes, I’ll go through some paperwork with you covering confidentiality and ethics – then we can get on to what’s brought you to therapy and what you’d like from it.

Towards the end of our meeting we can either decide together what steps to take next, perhaps booking a further session if you’d like to, or if you prefer, going away and to decide what you’d like to do next.  My initial sessions are at a reduced fee of £25 and sessions after that are £55.

How do you help?

The kind of therapy I offer doesn’t follow a set pattern because it’s not a one-size-fits-all approach. It’s tailor-made for you, depending on what your difficulties are and what would help you most.  It’s a dialogue where we’ll both be making contributions, and the more you can share your concerns the better, even if it’s not your usual role to be in the spotlight.

Many people find that just talking things through with a therapist can bring great relief, and what you talk about helps me understand you and what might help you. Therapeutic listening – which you may find similar to what friends and family do, or sometimes completely different – can help you see your issues in a different way, even without directly looking for solutions. Talking to someone who’s not involved can help you find a fresh perspective on your own thoughts and feelings, which is not always possible to achieve by thinking things through alone. If you’ve been round in circles trying to work things out, you’re definitely not alone, and therapy can be a way to find an exit.

Whilst you might be doing quite a lot of the talking – and I’ll help you if you find it difficult to know what to say – from my side I’ll be asking questions to check my understanding or clarify what’s going on for you, as well as sharing information, observations or suggestions I think might help.

If I think it might be helpful, I sometimes share relevant psychological theories, or explore with you some actions or ‘tools’ you could consider using. My contributions will arise out of a combination of what you share about yourself and my knowledge of human psychology and what helps people change.

Will I get a diagnosis?

Diagnoses such as depression, anxiety, schizophrenia or personality disorders are made by GPs, psychiatrists or other medical professionals who may also prescribe medication if needed. Whilst I don’t give diagnoses, I have a working knowledge of mental health conditions, so if you have a diagnosis already I can work with that, or if I feel it might help for you to see your doctor I’d discuss that with you.

Sometimes clients want to know what I think is ‘wrong’ and to have an advance plan of what’s going to happen in the therapy to address the problem – the same sort of approach used by doctors.  Because therapy with me is specific to your individual problem, needs and personal style, and can change direction as we start to look at things in more detail, it evolves as we go along.

How much therapy should I have?

The short answer to that is ‘it depends’ – including on what you are trying to achieve, the background to your difficulties, and your own personal investment in making changes. Sometimes a single session is right for someone, sometimes what therapists call ‘short term work’ – usually 3-6 sessions – can help them make the progress they need, and in other cases more time can help. 

How much therapy you have depends on many factors, including: how complex the causes of your problem are; changes you may make between sessions; the time, energy and budget you invest in understanding yourself and what’s going on for you; and the kind of end result you are looking for. There is no real rule of thumb to calculate how many sessions, especially because therapy is an ongoing process – somethings things are easier to address than it first appears, and sometimes the turn out to be complicated than it seemed initially. Complex and longstanding problems, or issues from major trauma, are likely to take more time.

If people want to continue after the initial session I normally agree with them either a number of sessions, perhaps with the option of continuing at the end of these if that would be helpful, or to take it session by session if that seems best.

How do I know if my therapy’s working?

At regular intervals during therapy I check out with people how they feel they’re are getting on, if they’re finding our work helpful, and if we need to adjust the direction or style of the work. It’s also very helpful if clients let me know at any point if they have any comments or thoughts about how things are going, including if they’re unsure or something isn’t going right for them, or if they’re feeling ready to end. Changes of direction and re-setting goals can be a normal part of therapy, and are often a consequence of gaining a better understanding of the issues and making progress.

When and how does therapy end?

Regular reviews will help give us an idea about where we are in the process – whether you still want and need support, or whether you’ve got what you need for now and it’s time to look at ending. Finishing doesn’t mean you can’t come back if you want to – it means you’ve done what you need to for now.

Most therapists think it’s helpful to have a final ‘ending session’ to tie up any loose ends and formally finish the work that’s been done, and I would always encourage this if you feel you can and there’s nothing practical stopping you.

Some people feel uncomfortable with endings or even hate them full stop, but therapeutic endings can be a great opportunity to learn something about how to have a ‘better goodbye’ and to avoid the annoying feeling that you’ve left ‘unfinished business’ behind you.

What’s it like being in therapy?

Being in therapy can be a great relief – saying things out loud to someone who’s really listening, putting down your burden, finding hope of change and solutions when you might have felt stuck or not known where to turn. It can even bring those ‘aha’ moments, put you back in touch with the best self you can be, and sometimes help you find strengths and abilities and you didn’t know you had.  It can also help you find a sense of peace and acceptance about yourself and things that have happened in your life that may not have seemed possible before either.

Therapy is not always an easy process as it may involve connecting with difficult emotions and experiences, but this can be crucial in order to deal with them constructively.  Sometimes it takes time and patience to make changes or come to the conclusions you need to, and this can be frustrating at times, especially when things are not clear cut or you have difficult choices to make in order to move forward. Accepting the things we may not be able to change in our lives can be a key part of changing what we can, and everyone battles with this.

However, these struggles can be critical steps on the journey of finding what you need in yourself in order to change, and in ultimately feeling better and more in control. Many clients who have used counselling and psychotherapy have made important and valuable changes in their lives as a result and would tell you that while it may not have been easy, it was well worth doing. And I’ve had my own therapy too, so I’ve been in your shoes too (or should I say your chair), and know what it’s like to be a client as well as a  therapist – and if it hadn’t worked for me I wouldn’t be prepared to do the job now.



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