Counselling and Psychotherapy

What does a Counsellor or Psychotherapist do?

A Counsellor or Psychotherapist works towards the improvement of the health and well being of our society. They help people to talk about their experience and their feelings, to think about their choices or behaviour, and to make positive changes in their lives.

The counselling professions include a range of different titles and specialisms often dependent upon the setting in which the person is working, for example, a psychotherapist working in a hospital is likely to be more concerned with severe psychological disorders than a psychotherapist working in private practice.

Here the terms counselling, psychotherapy and therapy are used interchangeably because the differences between them are not absolutely definitively defined outside of specific settings.

Why do people come to Counselling?

People come to counselling to help them to resolve emotional, psychological and relationship issues. They may be experiencing difficult and distressing events in their lives such as bereavement, divorce, health issues or job concerns, or they may have a more general underlying feeling of anxiety or dissatisfaction with life.

Some clients feel isolated and as if they have no one else to talk to; but even people within a supportive network of family and friends can find it difficult to talk to them about feeling anxious or depressed. It is often easier to talk about such personal, family or relationship issues with an independent and professional therapist.

What does Therapy involve?

Therapy involves a series of formal sessions where the therapist and the client talk about the client’s issues and feelings. Even short term therapy typically involves six to 24 sessions. The sessions take place at a regular, agreed time in a confidential place where the client and therapist will not be overheard or interrupted. In this therapeutic space the therapist facilitates the person in exploring their inner experiences.

Therapy may involve talking about life events, feelings, emotions, relationships, beliefs, ways of thinking and patterns of behaviour. It is a careful and collaborative process of noticing with a view to the person gaining a stronger sense of their own true nature. The work also has the potential to establish a secure base within the client’s inner world so that they are better able to tolerate and withstand uncomfortable feelings.

The therapist will listen, encourage and empathise, but will also challenge to help the client to see their issues more clearly or in a different way. It is not about giving advice or opinions, nor is it a friendly chat with a friend. The therapist is there to help the client to understand themselves better and find their own solutions to resolve or cope with their situation.

Approaches to the Work

There are many different ways of working with clients, usually referred to as ‘theoretical approaches’ or ‘modalities’. These range from the original psychoanalysis to humanistic psychotherapy, centred on personal growth and self- development, and the behavioural therapies such as Cognitive Behavioural Therapy (C.B.T.) used for specific phobias and anxieties.

Three types of psychotherapy are briefly described here; psychodynamic, Gestalt and existential. A psychodynamic psychotherapist is interested in working with the unconscious content of a client’s psyche in an effort to alleviate psychic tension and the work is grounded in the interpersonal relationship between the client and therapist . A Gestalt therapist emphasizes personal responsibility whilst focusing upon the individual’s experience in the present moment, again the therapist–client relationship, the environmental/social contexts of a person’s life and self-regulating adjustments that can be made. Existential psychotherapy is more philosophical and operates in accord with the belief that the inner conflict within a person is due to that individual’s face to face encounter with what are called the “givens” of existence, namely the inevitability of death, freedom and the responsibility that comes with it, existential isolation, and meaninglessness.

In addition to these three approaches to psychotherapy, there are many other approaches, schools and theories that have evolved over the years. Therapists may use different techniques where they think it would be helpful for a client, or use specific approaches for specific issues. An integrative psychotherapist will work in an “integrative” way, drawing upon material from any or several of the numerous established models as the work demands.