The BACP Define Counselling as: ‘Counselling and psychotherapy are umbrella terms that cover a range of talking therapies. They are delivered by trained practitioners who work with people over a short or long term to help them bring about effective change or enhance their wellbeing.’
Counselling provides a regular time and space for people to talk about their issues and explore feelings in an environment that is safe, free from interruptions and confidential. A counsellor should respect your viewpoint while helping you to address specific issues, cope with crises, improve your relationships, or develop better ways of living.
Counsellors do not offer advice, but help you to gain insight into your feelings and behaviour and to change your behaviour, if necessary. They do this by listening to what you have to say and commenting on it from their particular professional perspective.
The aims of humanistic psychology are to explore how people perceive themselves ‘here and now' and to recognise growth, self-direction and responsibility. It is an optimistic approach and attempts to help people recognise their own strengths by offering a non-judgemental experience. There are several different approaches within the Humanistic school.
Person-Centred Counselling is based on the principle that human beings have an innate tendency to develop their full potential, although this may be blocked by our life experiences, in particular those who tell us we are only loved or valued if we behave in certain ways or have certain feelings. We have a need to feel valued, so we tend to deny to our awareness our inner experiences that we believe will not be acceptable. The counsellor aims to provide an environment in which the client does not feel threatened or judged, this allows the client to experience and accept who they are as a person, and reconnect with their own values and sense of self-worth thus enabling them to find their own way forward. The counsellor works towards understand the client's experience from the client's point of view and to positively value the client as a person, while aiming to be open and genuine. This will only be helpful to the client if the client experiences the counsellor’s attitudes as real so the relationship the counsellor and client create between themselves is vital for the success of therapy.
Gestalt Therapy looks at the whole of an individual's experience, focusing on the here and now: what is happening from one moment to the next. The aim of the approach is for a person to become more self-aware and a counsellor will aim to promote this, sometimes using experiments (possibly role-play) created by the counsellor and client. Improving the ability to support ones emotional feelings are important in gestalt therapy.
Transactional Analysis is interested in an individual's growth and development and how our past influences decisions we make. TA recognises three “ego-states” - Parent, Adult and Child. The parent state is a set of thoughts, feelings and behaviours we have learnt from important people (usually parents) in our lives. The adult state relates to responses to the here and now, which are not influenced by our past. The child state is a set of thoughts, feelings and behaviours learnt from our childhood. The states are useful for analysing unconscious scripts people play out. TA looks to identify repetitive patterns that limit a client’s potential. It encourages clients to analyse previous decisions they have made in order to understand the patterns of their life for themselves. It helps clients to trust their decisions and think as an individual improving the way they feel about themselves.
Cognitive Behavioural Therapy combines cognitive and behavioural therapies, and focuses on changing the way a person thinks (cognitive) and how that person responds to these thoughts (behaviour). It tends to be more interested in the here and now effects rather than of the root cause of a problem, and breaks complex problems into smaller and more manageable components. These smaller components can be described as thoughts, emotions, and actions and any one of these components has the ability to affect the other: the way you think may affect how you feel and ultimately how you behave.
CBT follows the principle, that people learn unhelpful ways of thinking and behaving over a period of time. By identifying these thoughts and how they may be problematic to feelings and behaviours can enable a person to challenge negative ways of thinking, leading to positive feelings and behavioural change.
The emphasis of the therapy may vary depending on the issue: the emphasis may be on cognitive therapy when addressing an issue such as depression or the emphasis may be on behaviour therapy when addressing an issue like obsessive compulsive disorder. CBT is a practical therapy, which works best addressing a specific problem and how to overcome it.
Psychodynamic counselling has its roots in psychoanalytic theory, but tends to focus on more immediate issues, it tends to be more practically based and shorter term than psychoanalytic therapy.
Psychodynamic therapy examines unconscious thought processes which manifest themselves in a client's behaviour, it aims to increase the client's self-awareness and understanding of how the past may have influenced and shaped present thoughts and behaviours, by examining unconscious patterns. Clients are encouraged to examine unresolved issues and to talk about significant events and relationships in their life.
Integrative counselling is a blend of specific types of therapies. The approach is not linked to one particular type of therapy; integrative counsellors do not believe that one approach works for each client in all situations. Integrative counsellors draw on the different types of behavioural therapies, psychodynamic therapies and humanistic therapies, and the client’s issue is dealt with systematically, as it would be if only one type of therapy were being used. It allows the counsellor to explore an issue from a variety of distinct theoretical perspectives and use concepts and techniques from each.
People come to counselling for many reasons: a few of the more common ones are listed below ... but we are all individuals with our own unique set of circumstances, issues and objectives.
There are many aspects to abuse, it may be physical emotional or sexual. A main characteristic of an abusive relationship is control, when one person is doing something to control the behaviour of the other. The resulting lack of confidence felt by the abused may see them unable to break the cycle and they become totally dependent.
Abuse can start slowly, initially welcomed as jealousy or insecurity, allowing the partner to feel needed and wanted, but abusive relationships usually progress; the needs of one partner increase while those of the other disappear along with their self-esteem.
Counselling can assess whether a relationship is truly abusive or just unbalanced. Counselling can help the abused person, detach themselves from their partner’s behaviour, help restore self-esteem and look at healthier ways of relating.
Addiction is an inability to stop a repetitive behaviour despite the harmful consequences. Addictions allow people a temporary escape from their problems, they develop from many activities; alcohol, drugs, eating, gambling, shopping, sex and use of the Internet.
Counselling can be an effective form of treatment, and may help sufferers to recognise their addiction and try to understand it. It can give an individual a chance to acknowledge real emotional needs, offer the chance to build self-esteem and self-respect and be a start to building a new, healthier life.
Anxiety is a blanket term which can cover a wide range of problems. It can be a temporary state or a long-term condition; it can affect not only the sufferer but indirectly those around them and close to them. It will be experienced by a large percentage of people at some point in their life.
Counselling can help to define, understand and manage most common anxieties. Cognitive Behavioural Therapy can look at a person’s unhealthy thinking and can use exercises in desensitisation and exposure to help those people face their fears and anxieties. Psychodynamic therapy can look at the origins of the anxiety.
Everyone’s experience of grief and loss is unique. It is normal to feel sad and even angry when a person close to us dies (people can also experience similar feelings when a relationship ends).
Mourning is a ‘cycle of loss’ which often includes denial, fear, loneliness, grief, anger and letting go. It is a painful process but allows us to come to terms with the loss.
Counselling can offer an understanding of the mourning process: a chance to explore areas that may be preventing you from moving on, help you adjust to a new sense of self and consider if the mourning has turned to depression. Keeping things bottled up and denying the sadness can prolong the pain, a loss needs to be acknowledged for us to move forward. Bereavement means finding a suitable place for the lost person to allow life to continue, it does not mean forgetting or wiping out the memory of that person.
Bullying has three components; deliberate aggression, unequal power and distress. It operates at all levels of society and within all age groups. It is seen in the workplaces and within families (where it often originates). Bullying in early life can fix a person into an unhealthy way of relating which can have consequences in later life.
A counsellor may help a victim or bully to understand their relationships and to look at issues of anger and passivity. Counselling may be useful to establish positive patterns of thinking and to examine unhealthy beliefs. When a person finds they are repeatedly bullied it may be beneficial to look at the personal investment in this process in a non-judgemental environment. Transactional analysis and cognitive behavioural therapy can be helpful approaches for bullying.
Depression will affect one in three people at some time in their life. It is a complicated illness with many symptoms and causes. Understanding depression and its triggers can be helpful for sufferers. Counselling can help address low self-esteem, or relationship issues or persistent negative thinking; it is effective in treating mild to moderate depression.
Eating disorders are extremely common, they can be serious and life threatening if appropriate action is not taken. Many people are affected by eating disorders and every year many die, because their disorder goes unrecognised for too long. The main characteristic of an eating disorder is the person’s obsession with their weight and these obsessive thoughts can lead to severe consequences.
Self-confidence is about trusting your own judgement and feeling comfortable with your own ability: It is the means to realise your full potential and be the person you want to be.
Counselling can offer a safe environment to consider what is realistic and achievable and to explore disappointments. Strategies can be developed to build your self-confidence and modify negative thinking.
Self–esteem is how we think and feel about ourselves; this may be positive, negative or continually shifting between the two, effecting how we live our life and make our decisions.
Change might mean taking a hard look at ourselves and feeling strong enough to change the things that we don’t like: a counsellor can be a huge help on this journey. Person-centred counselling may help us to focus on our needs. Psychodynamic counselling may help us understand more about the origins of our low self-esteem: a new objective view of our history can allow us to see more clearly our present situation without feeling blamed and to see if early patterns and habits are repeated in our current relationships.
As many as one in four pregnancies end in miscarriage. Many women are reluctant to talk about miscarriage and wish to put the experience behind them as quickly as possible, others need to process their feelings more slowly. While many women who have suffered a miscarriage spend time grieving then look forward to planning another pregnancy, others find themselves unable to move forward as grief turns into depression. Relationships can suffer as it can be difficult to express openly the emotions felt following such a disappointment.
Obsessive Compulsive Disorder
When an individual’s life is dominated by a behaviour such as compulsive hand-washing they are often suffering from Obsessive Compulsive Disorder. The repetition usually brings no pleasure and is usually seen as irrational to the sufferer.
Cognitive Therapy can offer stepped exposure to address the anxiety and an alternative response to negative and unrealistic thoughts.
Counselling can offer the chance to examine how we interact with those around us in order to improve our relationships with work colleagues, friends and partners. Any destructive patterns of relating can be recognised, communication can be improved and possibly abusive relationships and domestic violence can be acknowledged. Counselling can help us to recognise and understand habits that we may have inherited from the family we grew up with.
Self-harm is defined as a self-inflicted physical injury that damages body tissue, in an attempt to alter mood or physiological state. Damage to body tissue is regarded as tears, bruises or burns to the skin. There are numerous reasons for self-harm, but it is ultimately a coping mechanism and provides a temporary release for the emotional problems a person may be experiencing.
In counselling, the individual can talk through their issues, and work out what is at the heart of their need to self-harm, in a non-judgemental and confidential environment. Distraction and identification of triggers can be used to help break the behavioural pattern of self-harming. A counsellor and client can work together to set up a strategy of what to do in the event of any relapse which may occur, perhaps on the anniversary of a significant event.
Relationship problems often arise from sexual issues, but these issues may just be an indication of other problems in the relationship. Sexual difficulties can emerge at any time, but often at times of stress.
Control is often an issue in sexual difficulties as one partner may unconsciously attempt to exert the control they feel they lack in other aspects of the relationship. Withdrawal of sex can be a last ditch attempt to express anger or disappointment. Counselling can explore what sex means to a person.
Sexual orientation indicates who a person is sexually and emotionally attracted to, it is not the same as a person's sexual actions because not everyone openly expresses the way they feel. Many gay, lesbian and bisexuals find the experience very confusing and often lonely. In counselling people can talk through their feelings in a safe environment without having to confide in someone they know.
Stress is the pressure under which we are placed by daily life. It can be a positive experience and enable us to perform a task well; but too much stress can put our health at risk and leave us unable to function. Counselling can allow the sufferer to make a more realistic assessment of their abilities and can help them to be more assertive.
Trauma occurs as the result of a traumatic event; it makes us question our beliefs about safety and destroys our assumptions of trust. A traumatic event involves an experience that overwhelms our ability to cope or understand the notions and emotions involved with that experience. These experiences are beyond what we expect and provoke reactions that we do not feel comfortable with. Although these reactions may be unusual and disturbing to us they are ‘normal’ responses to abnormal events.
Work Related Issues
We spend a significant percentage of our adult life at work, often we find
it enjoyable and it gives us a sense of purpose and enables us to finance our daily
living but it can often cause stress and have an effect on our health. Counselling
can help examine our patterns of relating to people, and show us how to examine our