When people hear the word psychotherapy they often imagine a patient lying on a couch talking while a therapist sits behind or nearby taking notes and jotting down thoughts in a little notepad. This is a quite a classic style of talking therapy, however, there are actually a wide variety of different techniques and approaches being used in psychotherapy. The techniques and practices used can depend on a number of things including, the training and background of the therapist, the nature of the problem experienced by the client and indeed the clients’ preferences. Some of the most widely know approaches can be found on our Approaches page.
Psychotherapy and counselling gives you time to talk and think about the issues that are stopping you from living a full and happy life. During the sessions the therapist works with the client to tackle the issues that are a source of stress in the clients life, these issues can be general or specific. Depending on the issue and the therapists approach, a wide range of strategies and techniques can be used. However, almost all types of psychotherapy involve developing a therapeutic relationship, communicating and creating a dialogue and working to overcome problematic thoughts or behaviours. These sessions are carried out in a confidential, non-judgemental and safe space. The treatments is a collaborative process where you and your therapist will work together to discover new and healthier ways of coping; enabling you to move forward in your life.
Counselling and psychotherapy are terms that are often used interchangeably and while they might be similar there are some slight differences.
Within the context of mental health the term ‘counselling’ is often used to denote a relatively brief treatment that focuses mainly on behaviour and actions.
‘Psychotherapy’ is more often a longer term treatment and focuses more on the patients thought process and those things that might be underlying the behaviour. It can be used to gain deeper insight into emotional problems. It is generally longer in duration. It looks at the clients way of being in the world rather than specific problems.
Counselling often works in the present focusing on how the behaviours are impacting the individuals current situation. Psychotherapy often moves between both present and past, using knowledge from decades of research, knowledge and skills to explore the roots of particular issues.
In practice the two can overlap as psychotherapists may also provide counselling in specific situations. As a general rule psychotherapy involves knowledge and skills that allow for deeper exploration. A trained psychotherapist is qualified to provide counselling however, many counsellors may not possess the necessary skills and training to provide psychotherapy.
In terms of training, it generally takes 4 years to gain the necessary qualification to become a psychotherapist. A counsellor can become so in under two years.
The main thing to ask yourself here is What do you want out of therapy? A huge amount of success between a client and a therapist depends on your expectations. Success in therapy can depend on you wanting it to succeed also, what you expect to happen in the therapy and whether those expectations match up to what the therapist can and will do.
Your reasons for going to a therapist can be many and can be a worthwhile experience. Therapy can be good for times when you are feeling low, for dealing with life’s anxieties, interpersonal problems and other things that cause stress in your life.
Going to a therapist can be a worthwhile growing and stabilising experience, good for times when you have specific problems, interpersonal problems, or generally feeling down. You can go to a therapist once, for a few months or embark on long-term therapy–each depends on your different expectations and goals.
It is generally during crisis when most people go to see a therapist. These are times when one can feel in danger, can feel suicidal or having difficulty living your life in a normal or productive way. There are many reasons when crisis can occur and can include; the breakdown of relationships, death of a loved one, in times of depression, life transition or if you have been harmed in some way. The reason people seek therapy at these times is to be able to find stability so that the feeling of threat to their life is reduced. These visits can be short in duration with the therapist providing ‘intervention.’
Other times people go to therapy for more common problems such as, low grades, insomnia, procrastination or feeling low/depressed. Here there is not an immediate threat to one’s life but the person has identified an issue or problem to be worked on.
People can also go to therapy to work on their personal development and growth. Another reason people can go into psychotherapy is so to work on psychological problems. This can range from being abused and having intimacy problems or maybe issues around food.
You don’t need to have a “major” problem to go to a therapist. Just feeling unable to deal with your problem or feeling unhappy makes you a good therapy candidate. Therapy should be viewed as a *tool* which can be used to help you work on problems you consider important to you.
This can depend on the reason you want to go to a therapist, while other times it can amount to personal preference.
Sometimes this depends on the reason you want to go to a therapist, while other times this only amounts to a personal preference. It is important that the therapist you see has experience working with clients, is compatible with you problems and fundamentally one you feel comfortable with. You need to feel you can trust your therapist and are compatible with you.
Therapists or trainee therapists should have:
A Masters in Counselling and Psychotherapy or the equivalent. This is generally four years in duration (two years for Counselling). The Masters will include a research thesis in an area linked to the field of Psychotherapy or Psychology.
Also, psychologists and psychotherapists can be broken down by their emphasis, such as psycho- analytic, Rogerian, Integrative, Humanistic, Cognitive Behavioural etc. Most often therapists will use the most appropriate techniques that work best with different disorders or different people.
A therapist can cost up to €100 an hour but the average is €60-€70, cost is often a big factor for most people. There is a chance your insurance may cover therapy but it would be advisable to check this out first. Money can be a big factor so decide what you can afford. People do better in therapy when they view it as an investment, you will be less likely to skip sessions if you have to pay something. You will also be more active in doing what you need to do in order to ‘get your monies worth.’
Unless otherwise specified you will agree the figure with your therapist and pay them at every session.
The first visit gives you a chance to assess the therapist and get to know if they are the best fit for you. Most therapists are willing to meet with people and generally conduct a preliminary session. This session not only allows you to determine if the therapist is a best fit for you but also allows the therapist to decide whether they feel they can work with you. Below are some things you might consider asking or telling them in this first meeting:
Tell them why you have come to see them and that you are just ‘shopping around’. This will help the therapist know exactly what you want from that session.
Tell them why you want to be in therapy and ask if this fits in with their training.
Ask them what kind of therapy they suggest and how much is costs.
Be very aware of how you feel, you will be working with this person so try to get a sense of this person. It is normal to feel a little nervous and possibly a little uncomfortable; sharing personal information can be really difficult. However, listen to yourself, do you feel you could trust this person. You can even express how you are feeling and see how they deal with it.
There are no hard and fast rules around this, it would be unfair to answer this question with an either/or answer. Trust is possibly key here, being able to trust someone and be comfortable with someone will possibly override gender. We can often move towards the gender we are most comfortable with however it can often be worthwhile working with someone of the opposite gender. It is important to note that not all personalities are typically male or female; a male therapist could have pronounced female qualities which in turn can make it difficult to decide whether someone is a good fit using gender alone. In terms of change it can be the techniques used to bring about that change and not the gender or indeed race, class or colour. The rule of thumb for yourself might be to go to someone you feel you can trust.
Be sure to pay close attention to your progress and your level of comfort, it can be helpful to discuss these kinds of issues with your current therapist or indeed a prospective one.
Reflecting back outside the therapy room on what you and your therapist discussed when in the session.
Take it easy and be patient, it can often be the case that the times of greatest productivity are those session where you might be feeling really frustrated or very low.
Keeping a journal of things that come to mind when you are not with your therapist. You can write down moments of progress or times when you slipped up and you can bring these back to your therapist.
It is important to note that therapy is hard work. You are investing in your mental health and the rewards can be invaluable.
Reward yourself for doing the work. Every day do one nice thing for yourself. Therapy will be helped by you taking time to appreciate yourself.
You may have been already informed about the cost of the service when you made the appointment, if not, this will be agreed upon in this session.
The first couple of sessions will be different to sessions in the future, the sessions thereafter will be more therapeutic in nature. This first session will be a period for you and your therapist to get to know each other. You will get a sense of whether or not you wish to proceed and indeed, whether or not your therapist feels they can work with you.
As psychotherapy can be a long process it is important to know that expecting instant solutions on your first day is unrealistic. This type of work is about equipping you with solutions for the long term and is not about a quick fix.
In this session you will be asked what has brought you to therapy. You will be asked to explain any symptoms you are experiencing, what you feel is not right in your life and your history. In relation to your history you will be asked about education, relationships (romantic, family, friends), your career, your living situation and other questions that might be relevant to the therapy.
You may also discuss the methods that will be used, patient/ therapist confidentiality and limitations to confidentiality.
Other things to be discussed might be medication, a next of kin contact, the number of your GP.
Below are some questions you might wish to ask, although many will probably be covered through the course of conversation.
- What is your academic background and what has your training been to prepare you to practice as a therapist?
- What professional associations do you belong to?
- What are your fees?
- What techniques do you use? (mostly talking, role-playing, visualising, relaxation/meditation)
- What are your office protocols? (booking appointments, payment for missed appointments, emergencies, building access after hours, etc.)
- What can I expect to happen in my sessions.
- How long will each session last?
- How many sessions will it take to resolve my issue?
- How will my confidentiality be assured?