QUESTIONS PEOPLE HAVE WHEN STARTING THERAPY

Once we first begin fascinated by accessing remedy, questions can whizz round our mind and maintain us up at evening. It may be onerous to know the place to place them. We’d not ensure methods to ask and typically won’t even ensure fairly what it’s we’re asking.

We’ve collected a bumper record of questions that we’d have when beginning remedy. Although we intention to reply every as typically as we are able to, it’s vital to examine with particular person therapists, centres, and companies for extra particular, private recommendation.

IS A THERAPIST THE SAME AS A MENTAL HEALTH NURSE?

Individuals in jobs that require speaking to those that want psychological well being assist and/or remedy, come from a variety of backgrounds. This might embrace counselling, social work, nursing, mentoring, teaching, artwork remedy, music remedy, drama remedy, dance remedy, occupational remedy, speech and language remedy, and extra.

Right here, we use ‘therapist’ as a catch-all time period.

WHAT DO ALL THE ACRONYMS MEAN?

The world of remedy accommodates many acronyms. Fortunately, we’ve jargon-busted numerous them in a useful downloadable e-book.

WHAT HAPPENS IF I DON’T KNOW WHAT I NEED?

Typically we don’t know what we want, we simply know that one thing is fallacious. We are able to’t ask for what we want after we don’t know what it’s we want aside from ‘to really feel higher’.

Not figuring out precisely what we want is extra widespread than we’d suppose. Being open with our therapist about it might probably assist them to know the place we’re at, and as our therapist will get to know us, they need to be capable of assist us to unpick a few of our challenges.

CAN I ACCESS THERAPY WITHOUT LEAVING THE HOUSE?

Sure. We’d not have as a lot alternative as if we did depart the home, however many NHS companies and different remedy companies now supply on-line appointments. Alternatively, some will even come to our home.

One factor it’s value being cautious of, although, is contemplating whether or not we’re avoiding one thing that we need to work on. If that sounds acquainted, then it’s value elevating it with our therapist.

WILL EVERYONE KNOW I’M HAVING THERAPY IF THEY SEE ME WALK INTO THE BUILDING?

This actually is dependent upon the place the constructing is, how apparent the signage is, and whether or not there are different issues in the identical constructing.

Some buildings are onerous to search out, however that makes them pretty nameless. Typically, completely different companies will share the identical constructing, so it might not be clear why we’re popping in.

If somebody spots us and we’re uncomfortable with them figuring out that we obtain remedy, we are able to at all times be very obscure in the event that they ask us about it. Please bear in mind, although, that there’s completely no disgrace in needing assist.

CAN I GET TIME OFF WORK TO GO TO THERAPY?

This is dependent upon our job. Some workplaces do permit some paid break day for medical appointments. Others will function a flexitime coverage whereby we’re allowed to take the time we want however might want to make that point up.

Some employers aren’t in any respect versatile. Typically it’s because they’ll’t be, typically it’s as a result of they don’t need to be. Talking to our HR group and asking for an occupational well being appointment may assist us to search out out extra about our rights and what our employer might or might not be capable of supply. If we’ve a contract or intranet, they could additionally clarify our employer’s place.

If we’re actually struggling then we may use our annual depart (though we shouldn’t need to!) to take the odd afternoon off. We may additionally communicate to our therapist – they could supply night or weekend appointments.

DO I HAVE TO LIE ON A COUCH?

We’ve all seen the movies the place folks stroll right into a therapist’s workplace, (which often has darkish wooden panelling and plenty of many books) and instantly lie again on a ‘sofa’ and pour their coronary heart out.

The truth is that as a rule we’ll both be sitting on a chair or doing an exercise. There is likely to be situations the place we’re supplied the chance to lie down if that’s what we need to do, however often, it’s as much as us to decide on how we’d prefer to be.

SOMEONE TOLD ME THAT THEIR THERAPIST GIVES THEM HOMEWORK. DO ALL THERAPISTS DO THAT?

Typically, remedy includes reflecting on, monitoring, or attempting various things. Some use worksheets, others don’t. It actually varies based on the sort of remedy we’re accessing, and the best way our therapist works.

If that is one thing we’re involved about, the very best factor we are able to do is to ask our therapist about it.

HOW DO I KNOW WHICH THERAPY IS RIGHT FOR ME?

With so many various kinds of remedy on the market, it isn’t shocking that they may work in another way for various folks.

Some therapies are extra appropriate for some diagnoses than others. The Nationwide Institute for Well being and Care Excellence (NICE) presents tips^[1] on therapies for various diagnoses. It may be useful to debate our choices with our GP or a possible therapist, too.

Typically, we’ve a particular aim which can hyperlink to a particular sort of remedy. We have to focus on this with a therapist to make sure that we obtain the proper assist. Typically, the therapist we communicate to might inform us that they’re not a specialist in an space, however they know somebody who’s.

Sadly, typically it’s a case of trial and error. We’re all completely different. We’ve completely different wants, communication types and objectives, so it is sensible that we want barely various kinds of remedy.

CAN I CHOOSE DIFFERENT TYPES OF THERAPY THROUGH THE NHS?

This varies vastly from place to position. Some companies function a really restricted variety of remedy choices. Some supply ‘first line’ remedy to everybody by Enhancing Entry To Psychological Therapies (IAPT) and solely supply additional remedy in the event that they really feel it’s wanted. Others ‘triage’ folks, which suggests they may supply a number of appointment(s) to evaluate our wants. Typically, some therapies are solely out there to these with specific diagnoses.

A number of psychological well being trusts, Scientific Commissioning Teams (CCGs) and GP surgical procedures have sections on their web sites explaining what is obtainable within the space. If we really feel that we want a particular sort of remedy, then chatting with our native psychological well being belief or GP may help us to know our choices.

THE THERAPY I NEED ISN’T AVAILABLE THROUGH THE NHS IN MY AREA – HOW CAN I GET FUNDING?

There are typically particular person funding choices for particular therapies if our wants differ from a ‘typical’ case and meet sure necessities. This varies relying on the place we dwell. Typically, GPs can apply to our CCG utilizing an ‘particular person funding request’.^[2] Alternatively, our GP or psychological well being service could possibly refer us to an ‘out of space’ service who do supply the assist we want. It’s going to range lots from case to case.

WHERE DO I FIND A THERAPIST?

If we select to entry NHS remedy, then we may undergo our GP or contact our IAPT service.

For non-NHS companies in our space, our GP might need an inventory. Hub of Hope will present some native companies however sadly may miss some. Our native Healthwatch might need gathered an inventory of native assist companies. We’d have an area journal that lists them. Aside from that we might have to do some looking out ourselves.

For a person therapist versus a service, the British Affiliation of Counsellors and Psychotherapists (BACP) have a search instrument to discover a therapist in our space who covers the subject we want assist with.

HOW DO I KNOW IF A THERAPIST IS RIGHT FOR ME?

Typically we’ll meet a therapist as soon as and instantly know whether or not we’re going to have the ability to belief them, or whether or not our battle/flight mode is kicking in.

If we’re paying privately then we may first inform our therapist how we really feel, if we need to, to see whether or not our considerations might be resolved. If they’ll’t, or we don’t need to focus on it with them in any respect, then it’s comparatively easy to say “I’m afraid I don’t suppose we are able to work collectively” and check out another person. It could actually really feel fairly awkward to try this, however our therapist might need additionally picked up the identical feeling as us.

With the NHS it may be tougher to alter the particular person we see as usually we’re allotted the primary one that has area on their caseload after we attain the highest of a ready record. Within the first occasion, it’s value discussing this with our therapist if we really feel capable of. There is likely to be considerations that they’ll alleviate. If we’re struggling to speak our considerations or we really feel as if they’re not being heard, then we may contact our native Affected person Recommendation Liaison Service (PALS) who ought to be capable of assist us in speaking with the service we’re beneath.

I’VE BEEN TOLD I NEED TO BE SOBER TO START THERAPY. BUT I NEED THERAPY TO GET SOBER. WHAT DO I DO?

That is such a standard story. It’s a catch-22 scenario.

Firstly, we’d counsel chatting with those that informed us we’ve to be sober earlier than we are able to get remedy. They can counsel a service we are able to get some assist from to work on our sobriety. We won’t be the primary particular person on this place.

Our GP may be capable of advocate a service and there could also be a drug or alcohol service in our space. We may additionally attempt assist akin to Alcoholics Nameless, Gamblers Nameless or Narcotics Nameless.

I’M NEURODIVERGENT, DO I NEED TO TELL MY THERAPIST?

As neurodivergent brains course of data in another way from neurotypical brains, the kind of remedy we want may differ. Typically remedy will must be tailored to go well with our processing, so it’s usually useful to inform our therapist of our prognosis (or self-diagnosis). Nevertheless, we don’t need to if we select to not. Though it’s value being conscious that whether it is on our NHS data, and we’re seeing an NHS therapist, then our prognosis could also be communicated when a referral is made.

When selecting a therapist, if we’re self-funding, we are able to completely ask them about how a lot expertise they’ve in working with neurodivergent purchasers. If we particularly need to work with a neurodivergent therapist, then the Affiliation of Neurodivergent Therapists could be a good start line.

I HAVE A PHYSICAL DISABILITY OR CHRONIC CONDITION, DO I NEED TO TELL MY THERAPIST?

Once more, that is very a lot as much as us, though if we’re receiving NHS assist it might have been included in our referral.

If we’re seeing our therapist in particular person, and our incapacity or sickness impacts our mobility, then we might have to examine that the constructing is accessible.

In any other case, it’s value contemplating whether or not our situation interacts with our psychological well being. For instance, if identified with bronchial asthma nevertheless it’s typically well-controlled, it won’t be one thing we need to elevate. If we’ve important fatigue and are at all times in ache, each of which influence our temper, then it is likely to be value mentioning.

If we select to see a non-public therapist, then we’re effectively inside our rights to ask them how a lot expertise they’ve in working with these experiencing long-term well being circumstances.

DO I HAVE TO TALK ABOUT THINGS I DON’T WANT TO TALK ABOUT?

No. No person can power us to speak about something that we don’t need to speak about. Typically it might probably take a very very long time to really feel capable of focus on one thing (if we ever do). We are able to merely say “I don’t need to speak about “.

If one among our goals of accessing remedy is to work in direction of discussing troublesome issues, then we’d discover it useful to inform our therapist that there’s one thing we’re not comfy speaking about but, however we need to work as much as doing so.

DO THERAPISTS WORK WITH PEOPLE IN CRISIS?

Some therapists don’t work with those that might current a threat to themselves. That’s not as a result of we’re dangerous folks or we don’t deserve assist. It’s actually because they aren’t capable of give us the assist we may have, and may’t simply escalate any considerations they could have. If we’ve considerations about this, it’s value discussing them with our therapist.

WHAT HAPPENS IF I NEED MY THERAPIST OUTSIDE OF WORKING HOURS?

That is one thing our therapist ought to focus on with us after we first begin seeing them. Totally different therapists and companies might need barely completely different boundaries and methods.

Exterior of working hours, there are at all times helplines out there. We’re by no means alone.

IF I TELL MY THERAPIST THAT I’M SUICIDAL, WHAT WILL THEY DO?

Usually, our therapists are sure by confidentiality until they really feel we’re a hazard to ourselves or another person. In the event that they really feel that we’re a hazard to ourselves, they’ll escalate their considerations. This will contain contacting different workers or companies.

They need to maintain us knowledgeable each step of the best way, and ought to be working in, what they really feel, are our greatest pursuits.

It’s additionally value noting that there’s a distinction between being actively suicidal and passively suicidal. Our therapist ought to be capable of focus on this threat with us.

WHAT HAPPENS IF I OPEN UP AND THEN RUN OUT OF SESSIONS?

This can be a actual concern for a lot of. Usually NHS companies and charitable organisations will solely be capable of supply a set variety of periods attributable to funding. If we’re self-funding, then we’d solely be capable of afford a set variety of periods.

It will range vastly relying on the service and our wants. Step one is to inform our therapist and make them conscious of our considerations. They will then assist us with any decisions or selections we have to make.

In some circumstances, there could also be an choice to have a second ‘block’ of remedy with the identical therapist. Alternatively, we is likely to be supplied one thing else with the identical service. Sometimes, a service may apply for funding particular to our wants.

Typically, we may resolve, with our therapist, that there are particular issues it wouldn’t be secure or moral to delve into within the time we’ve.

If paying privately, many therapists supply stepped pricing. These on low incomes pay much less per session. Talking to them to search out out the choices out there to us permits us to make knowledgeable selections.

CAN I PAUSE THERAPY IF I NEED A BREAK?

Normally, sure. Life might be unpredictable and typically “stuff” occurs and we’ve to shift our focus for some time. If we’re able the place we’ve an excessive amount of occurring for remedy to be useful then our therapist may even counsel a break to us. This may range between companies or people, although, so it’s at all times value asking to double-check.

WHAT DO I DO IF I’M CONCERNED THAT MY THERAPIST IS WRONG ABOUT SOMETHING?

This could be a actually troublesome scenario to handle.

Within the first occasion, if we’re capable of, it’s usually useful to have a dialog with them. They may have misunderstood one thing, or we might have misunderstood one thing. There might be some confusion round wording, and even regional language variations.

If we’re unable to speak to them about it, or we attempt to discuss to them however nonetheless really feel that they’re fallacious or aren’t listening to us, then it might probably negatively influence our therapeutic relationship. Typically it’s tough to know methods to deal with that.

When receiving remedy by the NHS, we may contact the service we’re beneath or use PALS if wanted. If we’re beneath one other organisation then they need to have a ‘issues have gone fallacious’ process.

With a non-public, particular person practitioner, it may be tougher to know what to do. If we really feel that our remedy relationship is irreparable, then we are able to cease seeing the particular person. We may clarify why and ask if they’ll advise one other therapist. Alternatively, we may simply allow them to know we received’t be returning.

It’s vital to do not forget that this isn’t simply on us. Our therapist has as a lot of a duty to deal with any relationship fractures as we do, if no more in order they’re the skilled.

WHAT DO I DO IF MY THERAPIST SAYS OR DOES SOMETHING THAT HARMS ME?

Sadly, there are instances the place a service or therapist harms us. This may fall beneath iatrogenic hurt.

In some circumstances, that is unavoidable. A service has to do one thing to maintain us secure, though it’s traumatic. Nevertheless, they need to at all times take the least-restrictive choice(s) and may at all times inform us of our rights and clarify what’s occurring.

Usually, hurt is avoidable and somebody is appearing in a manner they shouldn’t.

If we need to complain and we’re utilizing an NHS service, we may contact the complaints group and even the CCG. All different companies ought to have a complaints process that we are able to observe.

The British Affiliation of Counselling and Remedy have an entire web page devoted to supporting these in remedy who’ve considerations. They are going to have handled comparable conditions to ours earlier than.

Lastly, if we’d like an neutral ear to hearken to our considerations however not essentially as a part of a proper criticism then a spread of charities and helplines supply assist.

Please assist us to assist others and share this submit. You by no means know who may want it.