What comes to mind when you think of therapy?
A man sat behind a desk scribbling in a notebook?
Or
A woman whose personal life is a complete mess but manages to live vicariously through her clients?
For years counselling and psychotherapy have been portrayed as something only for the wealthy, a luxury or for those suffering from serious mental health conditions. Often this is reinforced by TV and films, in the way they portray therapists. Sopranos is often spoken about, the therapist from Fleabag and more recently Wendy Rhodes in Billions are all examples of how short snippets of therapeutic information are portrayed and then seen as fact.
I aim to always provide information as a way to take the fear out of reaching out to a therapist by exploring common terms, answering questions and dispelling the many myths about counselling and psychotherapy that circulate.
I intend to add to this should any more be highlighted, so if you think I have missed one please give me a shout.
Myth 1 – People who seek therapy are either weak, mentally ill or crazy!
Asking for help is frequently perceived as a sign of weakness as if we should be able to solve all difficulties on our own! Therapists will see people who are suffering from psychological trauma, depression and anxiety as well as people with low self-esteem, stress and relationship problems.
The most difficult barrier to overcome is admitting you need help and that requires guts. It takes insight to deal with situations proactively and responsibly before they negatively affect your physical and emotional well-being, as well as your relationships.
Myth 2 – I can dip in and out of therapy when I am in crisis!
Although as a therapist I will always try to help, this isn’t always possible. Therapy works by attending regularly and although it may appear that attending only when in crisis for ad-hoc sessions is enough, it isn’t.
Going to therapy before you are in a crisis makes a big difference, just like catching any physical illness early makes medical treatment easier. When you begin to open up, your therapist will understand you better and be more effective in assisting you to develop strategies to address what’s bringing you to therapy.
Dipping in and out of therapy means that no rapport is built with a therapist, particularly if there are significant gaps between sessions, effectively you are starting fresh at each ad-hoc session which means that any benefit will be limited if any.
Myth 3 - A counsellor does not know me and can’t help me!
One of the main reasons why therapy can be successful is because the therapist doesn’t know you. Therapists offer impartial and unbiased support, that aims for you to explore openly the reasons you have attended. The therapeutic relationship is unique where are you challenged and encouraged to find what is right for you.
Myth 4 – Counsellors sit behind a desk, write notes, nod and occasionally introject with “How do you feel about that?”
Most counselling and psychotherapy centres know about the positioning of furniture and although most will have a desk in the room, we tend to have armchairs, sofas and if you are really lucky, floor cushions.
On occasions, we may ask a client if we can make a note, but this is a certain circumstance such as initial assessments or noting all the names of a large family. But in general, notes are made post-session.
Although we may throw the odd nod or how do you feel about that question (the stereotype has to come from somewhere), we are actively engaged in every client session asking questions and using interventions to help you forward.
Myth 5 – Once you start therapy, you’ll be having it forever!
The number of client sessions is dependent on the individual’s presenting problems. motivation and goals.
Short-term counselling can last between 6-12 sessions and general is one or two topics specific, with long-term therapy including deep-rooted challenges related to childhood trauma, individuals struggling with an eating disorder, or those having received a personality disorder diagnosis.
Myth 6 – Therapists should be available 24/7
This is a common myth and also humanly impossible, to be available 24-7 would be both unethical and unsafe for everyone involved. Often backed up by how therapists are portrayed in films and TV programs, unconsciously shaping an unrealistic view that when a client calls, the therapist is always available no matter what.
Every therapist will provide information about their working hours and a rough guide to their response rate to messages; just as it would be unethical for a therapist to pause your session when their phone is ringing it would also be unethical for them to answer in another person's session. Most of us will turn our phones on silent or completely off if we are working.
We fully understand crises happen therefore, if you are in urgent need of help and unable to wait for a response then helplines such as ChildLine or the Samaritans and/or the NHS service are there 24-7, and need to be contacted.
Myth 7 – Therapists are only in for the money!
Although it is easy to see how this myth has risen as fact and I have tried to explain therapy costs in a previous blog post (HERE), the reality is there are many occupations that any therapist could have chosen that pay a lot more money.
Counselling and psychotherapy are generally considered vocational occupations, with therapists wanting something more than a wage at the end of each month. Many therapists are what are commonly referred to as “wounded healers” and from their therapeutic journey want to pay it forward by helping others. Others are interested in human behaviour from a theoretical viewpoint.
A therapist's aim will always be to help you overcome your problems and support you in understanding yourself better.
Myth 8 – Therapists will tell me what to do!
It is not our responsibility as a therapist to give advice. The only exception is when you ask for assistance, for example, how to deal with depression or anxiety symptoms or enhance communication with your relationships, and if appropriate recommend visiting experts such as financial advisers, solicitors or doctors.
The reason for this is that your therapist is unable to provide an answer as we honestly do not know which option is best.
Myth 9 – I can have an appointment on the same day as contact!
Therapy differs slightly from other personal appointments such as hairdressers or GP appointments in which walk-ins may be accommodated. Most therapists operate the same day and time each week and can only offer flexibility if their diary allows, which means they know their availability often a month in advance.
In general, we do not book an appointment unless we have spoken to a client by phone first. This helps to ensure that before an initial assessment appointment, we have an idea of working ethically and provide information about the way we work. The reasons therapists carry out an initial call include:
We need an overview of why you want to attend. Text messages and emails do not provide enough information to see if we are working in the realms of my training and competence, for example, further qualifications are required to work with adoption, young persons, couples and family counselling
The person requiring an appointment needs to be the client, due to GDPR and confidentiality
AND
Although we fully understand a parent's or partner's concern if someone is over 18 (16 if the therapist works with young people), therapy can only help if the person wants to attend.
Personally, I do not mind an initial text or email, I will always respond with my availability, fees and a sensible referral to the centre I work at should affordability and availability not match. Should a client wish to book I arrange a brief telephone call before booking and confirming an appointment.
Myth 10 - When a therapist says they are at capacity it means they don't want to see you!
I feel like this is an extension of Myth 2 and 9 and one that has come up a lot in recent weeks. In general, if a therapist says they are at capacity it means that they are unable to take on any more clients and this will be for a variety of reasons.
Every job will have a different ethical code and counselling and psychotherapy are no different. Within counselling and psychotherapy, we have an ethical duty to look after ourselves as well as look after our clients and sometimes this means we know that a sensible referral is the ETHICAL thing to do.
At capacity is not an “I just don’t want to see you” and it can mean many things to different therapists as we are individuals. So when a therapist says they aren’t able to, it could mean:
They currently are working at a level which could cause burnout – therapists work with complex and emotional situations to be switched on and ready for every client means that ethically we limit client hours and numbers.
Each therapist has a maximum number of clients that they can see each week which is determined by their circumstances which are both personal and professional.
In general, therapists work on a same-day and time appointment system. We therefore often know months in advance our availability.
Individual clients presenting problems can also be a factor. Complex cases often impact a therapist greatly and this could reduce the number of client hours they can offer.
A therapist may have committed to an additional and extensive training course, therefore not only need to reduce client numbers but also create space should case studies be required e.g. young persons, couples counselling etc.
They may themselves be experiencing personal or lifestyle changes and to ensure ethical working have opted to reduce client numbers and hours e.g. bereavement and/or health.
Working hours also include the behind-the-scenes admin such as clinical supervision, business administration or short continual professional development courses. Business admin and clinical supervision hours can increase due to complex cases or times of year. For example requirement for more, supervision, end-of-year accounts, or the need for reaccreditation with membership organisations can be a lengthy process.
And
above all else, your availability has to match the therapists but potentially room availability as well, which is why therapists tend to work specific days and times.
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