Counselling frequently asked questions

How do you know if you need counselling or psychotherapy?  
This can vary from person to person.  People start on a series of counselling sessions for a number of different reasons.  Some wish to gain clarity on an issue whilst others want to change old patterns or unravel complex personal issues.   A common motivating factor for seeking counselling is as a result of a personal crisis, or having being encouraged to seek counselling by family members, friends or colleagues. Others seek out counselling services for self-development purposes.

How much will it cost?
Paying for the cost of counselling or psychotherapy in private practice can vary enormously from one counsellor to another and from venue to venue.  There are many low cost charitable counselling centres that offer low cost therapy and indeed many counsellors in private practice often offer concessionary rates for students and unwaged. As a general rule of thumb expect to pay around £40 per hour as a minimum and anything up to £80 per hour with additional higher rates for counselling services at Harley Street practices in Central London. Remember too that your GP practice may have a counselling service within its range of services and you could therefore, subject to a waiting list, be referred for free.

What happens in a counselling session?
This is a difficult question to answer since there is no typical counselling session. A counselling session is time set aside for the client and what you talk about will vary according to your goals and needs. Typically, you will be assessed by the counsellor at the first meeting.  However, if you apply to a counselling centre the counsellor undertaking the assessment may turn out to be a different person who sees you on a regular basis.   This is because the centre may employ an experienced counsellor to perform the assessments and allocate clients to appropriate counsellors within the practice according to the presenting issues.

Within a counselling session you are free to discuss whatever you wish.  You may wish to discuss family issues, work matters or relationship problems or you may prefer to discuss your dreams, anxieties or fears.   The counsellor will aim to provide a safe containing environment for you to explore your issues and work towards self-improvement goals.

Will my counselling session be confidential?
Check that counsellors adhere to a code of ethics and practice.  A common framework is the BACP Code of Ethics and Practice which applies in all aspects of the work, including confidentiality. Counsellors aim to respect your autonomy as far as possible. However, counsellors might be be obliged to break confidentiality if there was a distinct possibility you intended harming others or yourself, particularly children as this would be a safeguarding issue and they might be required by law to inform the authorities. Counsellors might also have to breach confidentiality if you said you were planning terrorist activities. It is best to check with the counsellor what their policy is.

How do  I know which type of treatment approach is best for me?
There are many established therapeutic approaches to counselling work. Please see the section on counselling approaches. You may already have an idea that a particular approach would be best suited to your needs. Or you may wish to discuss beforehand with a counsellor, or you can have a consultation to explore your options with an assessment therapist.

Can a counsellor prescribe medication?
Generally no. A psychotherapist would need to be medically qualified in order to prescribe medication.  You may see a medically qualified psychotherapist in an organisational setting such as in the NHS or in private practice.  However, most counsellors and psychotherapists are not medically trained.

Should I see a psychiatrist?
Remember that psychiatry deals with psychosis and mental illness and medication is generally prescribed as part of psychiatric treatment.   If you are experiencing symptoms of psychosis you will perhaps need a consultation with a psychiatrist. You may end up seeing a psychologist or psychotherapist whilst under psychiatric care but this will be under the supervision of the consultant psychiatrist.

If you are experiencing a crisis, call your personal therapist, go to your local hospital accident and emergency room or dial 999. I wish you all the best.

See also

Counselling in South West London
Counselling in North London
Counselling in Mayfair
Counselling in Chelsea
Counselling in Wandsworth
Counselling in Notting Hill