Counselling and Psychotherapy
Some people use the term ‘counselling’ and ‘psychotherapy’ interchangeably. Others, from well-established traditions, distinguish between them. There is much overlap between the two and, as practitioners will want to be sure that what they offer is appropriate for you before there is any commitment on either side; they will be happy to explain their approach to you.
Counselling and psychotherapy is a contractual arrangement by which a practitioner meets a client, in privacy and confidence, to explore distress the client may be experiencing. This may be a difficulty; their dissatisfaction with life; or loss of a sense of direction or purpose.
One of the main aims of counselling is to ‘guide us from feeling victims of circumstances to feeling we have some control over our lives’ (Hetty Einzig)
Counselling and psychotherapy are always undertaken at the request of the client and no one can properly be ‘sent’ for counselling or psychotherapy. There are many situations these days where people with influence in our lives (perhaps a relative, manager at work, or teacher). This should be offered without any pressure or strings attached.
Counselling and psychotherapy will help you make decisions but a practitioner will not tell you what to do. If that is what you want, you need to look for some other type of help, such as information and advice agencies, telephone help lines, support or self-help groups.
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Counselling Psychotherapy
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Situational Issues arising from personality
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Problem-solving Analytical
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Conscious awareness Unconscious processing
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Emphasis on working with people who do not have severe or persistent emotional problems
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Emphasis on working with people with severe or persistent emotional problems
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Focus on the present Focus on the past
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Short- term contracts Long – term contracts
What is Counselling?
Counselling is an activity involving a counsellor, who offers a professional service as a helper, and a client, who seeks the service. The term “client” may include individuals, couples or groups of people. In what follows, the terms counselling/counsellor subsume the terms psychotherapy/Psychotherapist.
The counsellor offers an impartial relationship in which the client can explore specific issues and develop more satisfying and resourceful ways of living. Confidentiality is recognised as a vital basis for such a relationship. The counsellor respects the client’s values, personal resources and capacity for self-determination. Unlike friendship counselling is formal activity: both parties explicitly agree a contract about participation and procedure.
To ensure that their practice remains effective and appropriate, counsellors are obliged to meet regularly with a supervisor, who is an experienced colleague with whom they review their work. Information discussed during supervision is regarded as confidential.
A counsellor is trained to listen carefully to your problems and to support you while you find your own solutions. The relationship between a counsellor and a client is confidential and is based on respect and trust. Counselling helps you to discover the reasons for negative feelings and to work out ways of dealing with them. It is a time for you to express difficult feelings such as fear, suspicion and jealousy in a safe, supportive environment. You will not be criticised, nor will you be put under pressure to do or feel anything. The counsellor will help you find solutions that are realistic and workable for you.
Counselling should help you to take control of your life and to understand the reasons why you feel depressed, which may help you handle these feelings in the future. You may learn different ways of communicating with others so you can become more assertive, or you may develop greater self- respect. Often it is only when we talk to someone unconnected with our lives that we begin to hear what we are really saying and feeling. Counselling offers you this opportunity.
Why go to a Counsellor?
Most people feel worried or depressed at some time in their lives and it helps to have someone to talk to. Friends and family can be supportive but they may have problems of their own or you may not want to share intimate details with them.
People see counsellors for a wide range of reasons – they may be dealing with problems such as unemployment, domestic violence, bereavement, anger management issues, relationship problems or family conflicts. They may suffer from eating disorders, panic attacks, insomnia, stress or anxiety – sometimes with no obvious reason. Sorrow, pain, rejection, confusion or anger may be interfering with their day-to-day lives. Sometimes feelings of despair and hopelessness can be overwhelming. Emotional problems don’t necessarily go away if we ignore them so it makes sense to deal with them as soon as possible.
What should I ask a Counsellor?
The first one or two meetings with a counsellor are your chance to see how you feel with the counsellor and decide if you can work together. The more information you have about and what to expect, the more satisfied you are likely to be with the counselling you have. A good practitioner will expect you to ask questions and will be happy to answer them. Remember that as a consumer you have rights of choice.
Questions you might ask:
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What kind of counselling do you offer and what is it trying to achieve?
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How long is a session and how often are they held?
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How many sessions might I need and how does the counselling end?
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When should I expect to feel some benefit?
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Can I contact you between sessions if I need to?
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What training have you had and how many years have you been practising?
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What professional organisations do you belong to?
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Have you had experience of working with people with similar problems to mine?
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Is counselling confidential and when might confidentiality be broken?
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How much do I pay per session and is there a cancellation fee?
Making your choice
It is likely that there will be more than one practitioner to choose from in your area of the country. Both the Irish and British Associations of counselling recommend that, for preference, you should choose a registered practitioner. IACP/BACP Registered Counsellors, Trainers and Supervisors have achieved a substantial level of training and experience approved by both Associations.
Only you can decide whether a practitioner will be right for you. Before deciding on your therapist, do not be afraid to ask questions or request further information. Most practitioners will be happy to provided additional information over the phone. Then ask yourself if you would feel comfortable telling this person intimate details of your life. Do you feel safe with them? Do you like their manner towards you? Could you be completely open with them?
Starting the counselling relationship
Your first contact with your chosen practitioner may be by telephone. Often you will get an answer phone, used by the therapist to avoid interruption during counselling sessions. Do not be put off by this – the practitioner will telephone you if you leave your name and number.
The first appointment will be an opportunity to discuss whether continued counselling would be appropriate to your needs and therefore it is without obligation on either side. The following might be considered:
Practical considerations such as time, place, cost and duration of meetings will need to be decided, and you should feel free to ask questions about the counsellor’s professional background.
All that takes place between counsellor and client is treated with respect and discretion and agreement is usually made during this first session about confidentiality. If exceptional circumstances arise, your consent will be sought for a change in this agreement.
It is a good idea to ask if notes are kept; if so, for what purpose and who has access to them. Access by you to any notes should be agreed at the outset of counselling.
There is no need to commit yourself to a long-term contract unless you are satisfied that this is what you want. Arrange a regular review of sessions with your counsellor to evaluate your progress and perhaps renegotiate the contract.
By the end of this appointment, you should be able to decide if you wish to work with the counsellor. What you agree now will form a contract between the two of you. Many counsellors are putting their contracts in writing to avoid misunderstandings, but a verbal contract is still valid.
Code of Ethics and Practice
IaAM adheres to the highest professional standards and as such has adopted the following codes of ethics and practice as a guideline for all its work. This summary is intended to give you the essence of the code. For a full copy log on to the IACP or BACP web sites.
Preamble
The first paragraph of the Preamble defines counselling as a professional activity involving counsellors and their clients. The counsellor offers an impartial helping relationship, which respects the client’s personal values and autonomy. Counsellors recognise the importance of confidentiality in establishing such relationship. Unlike friendship, counselling is a formal activity involving an agreed contract. To maintain their effectiveness, counsellors review their work regularly in a confidential setting with a supervisor.
In joining a professional body, counsellors agree to comply with the provisions of the code. The code applies to their professional sphere. Non-members of the professional body are not bound by the code or its associated disciplinary procedures.
To ensure that they behave in an ethical manner, counsellors are required to use a formal procedure in examining ethical aspects of their work. In situations where ethical decisions can be complex and difficult and different ethical principles may be in conflict, the best decision comes from considering issues systematically. Details of the recommended decision-making procedure are presented in the full code.
Like all other citizens, counsellors are subject to the law, and their practice must conform to the law.
Content of the Code
The Code is based on four overall ethical principles, under which specific ethical standards are elaborated in greater detail.
Principle 1: Respect for the rights and dignity of the client:
Counsellors are required to treat their clients as persons of intrinsic worth with a right to determine their own priorities, to respect client’s dignity and to give due regard to their moral and cultural values. Counsellors take care not to intrude inappropriately on clients’ privacy. They treat as confidential all information obtained in the course of their work. As far as possible they ensure that clients understand and consent to whatever professional action they propose.
Principle 2: Competence:
Counsellors are required to monitor and develop their professional skills and ethical awareness on an ongoing basis. They recognise that their expertise and capacity for work are limited, and take care not to exceed the limits.
Principle 3: Responsibility:
In their professional activities, counsellors are required to act in a trustworthy and reputable manner towards clients and the community. They avoid doing harm to clients. They refer clients to colleagues and other professionals, as appropriate, to ensure the best service to clients. They act positively to resolve ethical dilemmas and conflicts of interest.
Principle 4: Integrity:
Counsellors take steps to manage personal stress, maintain their own mental health, and ensure that their work is professionally supervised. They are required to be honest and accurate about their qualifications and the effectiveness of the services, which they offer. They treat others in a fair, open and straightforward manner, honour professional commitments, and act to clarify any confusion about their role or responsibilities. They do not use the professional relationship to exploit clients, sexually or otherwise, and they deal actively with personal conflicts of interest. They take action against harmful or unethical behaviour in colleagues.
The need for a code of ethics
Whatever the theoretical approach taken by the counsellor, the counselling relationship is usually characterized by inequalities of knowledge and power. To protect the client, and ensure that counsellors remain alert to possible misuse of their greater knowledge and power, they accept the necessity for a code of professional ethics.
The purpose of the code is to encourage optimum levels of practice, to establish and maintain ethical standards, and to inform and protect those who seek and use the services of counsellors. In joining a professional body, members agree to adhere to the provisions of the Code. The professional bodies have a complaints committee, which respond to and deals with complaints. The code applies to members’ professional activities, but not their personal conduct, unless the latter impinges on the professional sphere.
To ensure that they behave in an ethical manner, counsellors are required to use a formal procedure in examining ethical aspects of their work. In situations where ethical decisions can be complex and difficult and different ethical priorities may be in conflict, the best decision comes from considering issues systematically.
Like all other citizens, counsellors are subject to the law, and their practice must conform to the law.