What is counselling?
Counselling is, according to the Oxford dictionary, the provision of professional assistance and guidance in resolving personal or psychological problems. Arriving at a definition amongst the people who provide counselling, and their corresponding professional bodies is not so simple.
- British Psychological Society – counselling psychology is a specific discipline of applied psychology that is concerned with the study of being (ontology), the nature of ‘how we knowwhat we know’ (epistemology) and praxis (clinical application.)
- British Association for Behavioural and Cognitive Psychotherapies (1) states that counselling and psychotherapy are umbrella terms that cover a range of talking therapies.
- Irish Association for Counselling and Psychotherapy (2) states it is an activity involving a practitioner, who offers a professional service as a helper, and a client, who seeks the service.
If you are reading this article, you are probably considering counselling. If you have never had therapy before the different titles of the people providing therapy in addition to the different styles of therapy can be confusing. People may have the false assumption that counselling can only be delivered by counsellors, in that they need to have the title of counsellor, but psychiatric nurses, psychologists and therapists all deliver counselling.
I am writing a series of articles to help explain therapy in order to help you make an informed decision. It is important to situate myself in the helping profession. I am a counselling psychologist, which means I have trained to a doctoral level and have worked with all types of mental health problems. This training and experience put me in a good position to explain the world of therapy, as I have both the relevant qualifications and experience to speak about the subject matter.
If you are embarking on therapy, it is important that you understand
- the counselling professions, and
- the theories of the counselling professions
The counselling professions
The helping profession
The helping profession is in essence people who provide some sort of talking therapy. The people who provide the service vary considerably in terms of training and qualifications, who they can work with, and what models of therapy they can provide.
The therapy itself is also varied and somewhat confusing, so I shall start by explaining the types of counselling professionals and their regulatory bodies before discussing the models of counselling.
What is a profession?
Members of a profession can differentiate themselves from people who provide a service on a voluntary basis or where their work is not regulated.
The helping professions consist of different professions, each with its own professional body, which sets minimum standards, regulations and ethical practices.
What are the counselling professions?
Counselling professions include the following.
Each profession has its own regulatory body.
Why do we have professional bodies?
Regulation protects you, the public. This HCPC article explains the need for access to trained, qualified and experienced practitioners.
If you are fortunate enough to avail of counselling through bodies such as for example, the HSE or NHS, your therapist will have met stringent criteria to provide you with a counselling service. However in private practice, for example, it is difficult to navigate through a potential minefield of information, qualifications, and models of therapy. Adherence to the regulations of professional bodies offers protection.
Professional bodies exist to;
- maintain a register of practitioners – this allows you to choose a counsellor who has met certain standards and adheres to the rules and regulations of their professional body.
- outline good practices
- provide a code of ethics, which includes topics such as fitness to practice, respect for the clients, and self-responsibility.
- set minimum standards of education and training.
- inform the general public
How to conduct counselling
There are different models that can be used to counsel and different ways for your therapist to have trained.
Models of counselling and psychotherapy include;
- cognitive behavioural
- private training
- educational setting – colleges
Where do counsellors work?
- Victim support
- Student counselling services
- School-based counselling
NHS and HSE
- Primary care
- Specialist services
- Secondary care
What do people come to counselling for?
Some people seek counselling for support, where they do not want a problem solved or help with a mental health issue, rather they want listened to and supported through a particular time or change in their life.
People are often offered counselling following a crisis such as a bombing or large-scale accident. This type of counselling helps to reduce psychological damage that may occur following the crisis.
Problem-solving and decision making
Counselling can help people with major decisions such as leaving or remaining in their relationship or help with ongoing health challenges.
Help with mental health.
People are often referred by their GP for cognitive behavioural therapy to help with conditions such as anxiety and depression.
What to expect when starting counselling
The first meeting.
The first time we meet is where I take time to find out what your current difficulty is. This is not just a meeting where I listen, although, of course, I shall listen!
In the first counselling session, I shall find out exactly what the problem is, and more importantly, what we can do about it.
Towards the end of our first session, I shall tell you what the problem is, what keeps it going, and what you need to do to make the necessary changes.
I shall also find out exactly what you want to change. I shall be asking you for goals. These might be, for example,
- manage anxiety
- help you with health anxiety
- decrease anger
- help with compulsions, intrusive thoughts, or OCD
- pull up your mood
- help you with work related stress
- stop negative thinking
- get a good nights sleep
- better relationship skills
- improve your confidence or self esteem and help you to feel better about yourself
We discuss goals in the first meeting to allow me to tailor a specific plan of therapy that will help ensure that you get what you need. It also keeps me accountable and focuses me on what it is we need to work on together.
In the first session, I shall tell you if I intend to use a particular model of therapy, for example, CBT (Cognitive Behavioural Therapy). I shall explain the model to you and tell you why I want to use it and why I think it will be helpful.
I will also give you a number of sessions. This will not be vague; I shall give a number and explain my thinking behind this.
I shall also tell you what future sessions will be like and what will be required from you.
Focus on the plan that we arranged in our first meeting. Many people think of counselling as where you come to talk about whatever is on your mind, which can happen within a particular therapy model. Still, I like to keep my counselling focused on taking steps to help you achieve what you discussed with me in our initial session. We could well be working within a model of therapy called Cognitive Behavioural Therapy (CBT) which is highly structured, and you can read whether it really works or not here,
Our future sessions stick to the plan that we both arranged in the first session; think of it as each session builds on the knowledge and progress made in the previous session.
Because of my training, we can ‘pull’ from other therapy models, so to speak, as and when required. If you have read anything about me, you will know my interest and respect for neuroscience, and this shall certainly be included in counselling with me, as you need to understand how your brain works.
Do I have to come to Dublin if I want counselling?
In a word, no. I have designed a series of courses designed to mimic counselling sessions with me (without the trip to Dublin), and these are available to start immediately. If you want to find out more about them, you can view all my courses here.
The NHS has some great content on what to expect from counselling and you can read it here.