Frequently Asked Questions

What is the difference between counselling and psychotherapy?

I think this is a common confusion because we can use both terms interchangeably and, as I do, some therapists offer both, and not all counsellors and psychotherapists agree on the difference. My view is that counselling is shorter-term work on more specific, defined issues, while psychotherapy is generally longer-term exploratory work at a deeper level. And we can also move in and out of different levels of working.

How many sessions will I need?

This is very individual and usually impossible for me to say at the outset because there is no magic number for the most effective number of sessions as it depends on you and the issues you bring. If you really want to manage the therapy within a certain timeframe we can sometimes do that, as long as I feel it’s ethical, safe and worthwhile therapeutically and you understand how this might limit our exploration. Some people with specific issues to address can achieve what they came to therapy for in around six to 12 sessions. Most clients usually have between 20 and 30 sessions, and it’s quite usual to work together for a year or more. Sometimes people will stay in therapy for many years if the reasons that bring them to therapy are particularly deep-seated or complicated and they need the ongoing support. Sometimes people prefer to do therapy in several stages with short or long breaks inbetween. There is no one size fits all. 

If I start counselling I’m worried that I’ll end up having to do it for months and months?

I understand that it can sometimes be hard to trust that you won’t be drawn into going deeper and for longer than you anticipated. I know as clients we can feel less powerful and less in control than our therapist and I do my best to work with an awareness of this power imbalance. I work collaboratively, inviting clients to tell me how we are doing and how we’re progressing, often reminding my clients that we can discuss and decide whether to continue or end.

Ideally therapy takes the time it takes, and we agree an ending when we reach the point where client and therapist are both satisfied that it’s enough and it feels right to draw the work to a close. When that time arises it is usually very clear. For most people, the end point comes when you begin to feel you could manage without the sessions, and when that happens it’s something for us to celebrate. But sometimes we may have to end our work because either yours or my situation changes, or less often because something significant has changed about the work or something has gone awry between us. 

Wherever possible it’s important we be able to organise at least one ending session so we can draw our work to a close with mutual understanding. The ending of the work can be as important and as rich as the beginning. If we’ve been working together for a longer time, I would want us to have two, three or more ending sessions.

How regularly do I have to come to therapy for it to be worthwhile?

Out of an understandable concern about the time and money commitment required for therapy, clients sometimes hope they will be able to spread the cost if they can have fortnightly sessions. And some therapists are happy to accommodate this, and feel that it works well. However, in my experience, weekly therapy provides the discipline and momentum for the work to be most effective. It also doesn’t usually work well for me as I can have spaces that are only filled on alternate weeks. For this reason, on the occasion it does feel therapeutic to offer fortnightly sessions, I will charge a higher session fee. 

There are so many different types of therapy, does it matter which modality or theoretical base my therapist uses?

I believe the most important thing is that you feel you can gel or have a ‘good fit’ with your therapist. For most therapists the theory they use is a bedrock to support the work behind the scenes, but what’s important in the room with the client is whether you feel like your therapist gets you, that you feel like you’re on roughly the same wave length, that you feel understood and met. However, there are some important differences in style of therapy depending on the theoretical background of the therapist. Clients often ask me if I sit in silence and leave them to do all the talking or whether I take a more active role. I usually find this has arisen because they’ve had an experience of feeling exposed by a therapist who perhaps works in a more traditional way. I explain that as a humanistic practitioner, I work quite interactively. I invite my clients to take the lead in the sessions so that we are focussing on what is important to them rather than to me, and while there will be silences as we contemplate and process, generally I explore with my clients, checking out my own sense with the client’s sense. And if something in the way we’re working feels uncomfortable, then I invite them to let me know as that can really help us to understand their process. Therapy shouldn’t be an entirely comfortable process. If it’s not uncomfortable at times we are not likely to be doing the work, but it’s about us working together to find a level that feels bearable.

Therapy seems really expensive. Why is that?

I know that for many people, the private fee for therapy each week can represent a lot of money and I’ve experienced this myself. I do believe that counselling should be more widely available at rates that most people who really need it can afford, but not if that means highly trained therapists need to work for free or at low cost. It’s a tricky balancing act. A therapist has to be able to look after their own needs and earn their own living to be able to be fully present with the needs of their clients. Otherwise I think there is a risk that it becomes a job only those with alternative incomes can pursue, which is not good when all kinds of clients need all kinds of therapists from all kinds of backgrounds. Access to effective therapy for people of all backgrounds is a wider political issue.

That said, I also believe that while it may be a big sacrifice, if you can afford to do so spending this money on yourself is likely to be worthwhile, and have knock on effects in your relationships with your family and friends, in your work life too, in ways that may make the money feel very well spent in the longer run.

Clients may also find it useful to understand that there are lots of behind the scenes overheads, from insurance, professional organisation membership, marketing and directory subscription, room rental, supervision, personal therapy and continuing professional development which is an ethical requirement to keep your skills up to date. Most therapists in private practice are self-employed and are covering their living costs, holidays, sick leave and pensions out of the fees clients pay. I try to set my fees at a rate that allows me to both make a reasonable living and a healthy lifestyle. By looking after myself in this way, I am able to offer clients a safe, stable, space for us to focus on them.

I would feel bad talking about my family members. Would I have to do this?

It’s really common to worry about what we might talk about as part of our work together and many clients worry about being disloyal or mean about their partners, parents or other family members, and whether this might damage their relationships. We do need to explore your relationships in our sessions because you don’t exist in a vacuum and how you relate with those around you is usually important to the work we would do in understanding you. But when this worry comes up I ask clients to bear in mind that the focus of our work is understanding you not picking apart your family members, who I only meet through you anyway. Therapy is also not about finding others to blame for your problems. It’s about developing understanding of your experiences.

However, I can’t promise that psychotherapy doesn’t sometimes send some difficult reverberations into client’s relationships. If a client is trying to address a stuckness in their life for example, the work we do may well impact on anyone who’s involved in that stuck pattern with them. Change is not easy for anyone who is involved.

Finally, it is really important to be able to discuss your relationships as freely as possible in therapy which is also why it can be useful to remember that it’s confidential, but if you do have any concerns I encourage you to raise them with me so we can work them out between us.

Isn’t psychotherapy just about being charged a lot to go down a lot of pointless rabbit holes?

There is still a lot of prejudice and stigma around seeking counselling and psychotherapy. I think this is mostly because the work is not well understood by people who may never have tried it or who have unfortunately had a bad experience with a counsellor or therapist who was not a good fit for them or their friend or family member.

This prejudice can unfortunately be transmitted by people who work in the medical and mental health sectors such as doctors, nurses, psychiatrists and psychologists. I think we can sometimes get caught up in a battle about whether the medical model or alternative treatments are better. My view is that this is something of a false division and we would all do better to be open to the ways in which we can work together to focus on the best outcomes for people who are hurting or in distress, whatever forms that may take.

However, suspicion also exists as a result of the counselling and psychotherapy industry being largely unregulated. This understandably leads to fears about falling into the hands of cowboy practitioners who don’t have a lot of training and sometimes charge a lot of money for an unethical, unprofessional practice which can be very damaging. Sadly, these are usually the practitioners that make the news or who are depicted on our screens. To avoid this risk, it is vitally important to ensure you seek a counsellor or psychotherapist who is accredited by a professional organisation which ensures that everyone on their register has a high standard of training and experience, that they are working ethically and following professional guidelines. You can check out the standards required to be on the UKCP register by following the link below: 

https://www.psychotherapy.org.uk/about-ukcp/our-register/

Do you offer a trial or exploratory first session?

Yes I offer all prospective clients a free-of-charge brief phone call to talk a bit about what brings you to therapy and to deal with any questions you may have. If we want to we can then book an initial session. The initial session allows us to see how it feels to meet in person or via Zoom and what it’s like to start to explore further together. I charge my full fee for this.

Where will the therapy take place?

I work from private, comfortable, well-positioned rooms in both Central London at City Therapy Rooms, near Chancery Lane tube station, and in Central Tunbridge Wells at rooms on The Pantiles. Both rooms are well connected to public transport links, and there is good parking near The Pantiles. I also have a private consulting room at home where I meet clients, both in person and online. This is also well served by public transport and there is on-street parking. We would meet in the place that best suits you as the client, and that would usually be the same place for the duration of our work together.

Can we move between online and in person working?

If a client agrees to work in person or online, I would usually expect us to stick to that mode for the majority of the time, however occasionally I am happy, if agreed with enough notice, to change mode to keep up the continuity of our sessions. And sometimes if the internet connection is poor, we may also have our session by phone or audio only.

How do I know if I need therapy?

If you’re struggling, whether it be with day to day activities, or with your emotions, your relationships, or your work, even if you don’t know why, it’s a good sign that it’s worth looking for a therapist who might help you work out what’s going on. It can take some time for people to take the plunge, from thinking about counselling to looking at options, to contacting any therapists, to setting up an initial phone call, to actually making an appointment for an initial session, and that’s ok. It’s all part of the process. And if you’re not sure there is no harm in emailing to ask about setting up an initial phone call to talk about whether this could be right for you. For me, this is an important first step with any potential new client. And if I don’t have any availability or I wouldn’t be the right therapist for you, I may be able to recommend a colleague who might have the space or skills you’re looking for.