What to Expect in Therapy
I usually suggest that we take at least two appointments, each lasting 50 minutes, to meet to begin with. This will allow me to hear what has led you to consider therapy and give you a chance to begin to get to know me and consider whether you feel I am the right person for you to be working with. During these two meetings you will have a sense of my response to what you have said and how, at this early stage, I understand it. At the end of these meetings we will discuss together whether therapy with me is appropriate for you. If we agree that it is not, I will, then, help you to consider other therapeutic approaches and suggest how you might find other qualified practitioners, who, hopefully, will be better able to work with your particular needs and how you approach them. Sometimes a longer period of assessment is necessary. And, as our work proceeds, either of us can suggest, from time to time, that we assess how the work is going. This can help its evolution.
Coming to these initial sessions in no way commits you to proceeding with therapy with me. There is often a week between the two appointments to allow for reflection about this important decision. It is not always a good idea to start therapy too close to a holiday break like Christmas or Easter. This can leave people on their own with difficulties that they have just begun to talk about. However, sometimes, rather than wait, people find it helpful to complete the initial assessment before a break. Then, knowing that the therapy 'proper' will soon begin, they are able to wait. Which of these is the right approach for you, will be considered when we arrange our initial appointments.
I am seeking to offer a reliable space for our work. For me this involves us meeting at least weekly, and at the same time each week. Once we have agreed this time, if, occasionally, you cannot attend, I do not rearrange the appointment. Instead, when it is appropriate and relevant to you, I seek to work through the feelings that such an experience of not attending evokes. It might, for example, resonate in some way with the concerns and issues that you are bringing and provide an opportunity for them to be addressed directly between us. The experience of missing an appointment would then be of therapeutic value - although, of course, only within the framework of regular attendance.
Starting therapy can be a stressful process since it involves getting to know someone new in a situation that is unfamiliar, while at the same time beginning to talk about complex and/or distressing aspects of yourself that may have been hidden for a long time. I would encourage you to share any difficulties you experience in doing this. It can ease these difficulties and, through you doing it, we can often learn a lot about the concerns you are bringing.
At the outset of therapy people usually want to know how long the process will last. Not surprisingly this is difficult to say. If you are bringing a fairly focused problem, then we may work for a few sessions, or months. If, however, there are deeper, or more confused concerns then we will ideally be working for longer. Generally speaking change at depth takes time to complete and can involve work of years rather than months. Sometimes people feel that things are ‘sorted’ after a few weeks but then realise that this ‘sorting’ has only taken place at a relatively superficial level. Under pressure they find themselves reverting to the old defensive and entrapping ways of behaving that had brought them into therapy in the first place. Then they see that ‘feeling’ different, as opposed to ‘thinking’ they are different takes time and involves a process, just as the development of the troubling behaviour and concerns involved a process and took time in the first place.
My fee per session is currently £60. I offer a small number of spaces at reduced rates for people who are on a low income. These are sometimes available. Apart from the initial assessment appointments, when I ask for payment on the day, I normally I invoice you on the last day we meet in the month. As I am aiming to provide a reliable space for our work, once we have arranged a regular time for your appointment(s), I charge if you do not attend, whatever the reason. The aim is for us to meet regularly, as this is what will allow us to work through, rather than avoid, difficulties, as they emerge. Of course, I do not charge when I am not working, and I usually give two to three months notice of my planned breaks. I review my fees annually. When they increase, it is usually by a small amount.
It is, perhaps, important to say that charging for missed sessions, in the way that I have just described, is standard practice in the analytical psychotherapy profession. Please discuss this further with me if you wish.
If I am seeing you as an individual I will not normally see you with any one else, for example your partner. This is so that I can work exclusively with your perspective on your world and your relationships. Only if I do this can I hope to help you challenge and broaden this perspective. For only if I see things along side you, will you be able to begin to believe that any challenge I make is made with your exclusive interest in mind. For this reason, at least during the time of our work together, I will not accept referrals, from you, of your friends, relatives etc.
Finally, as is maybe becoming clear, therapy is a challenging process that people can find unsettling and difficult as well as helpful. It is often when the work is at its most difficult that it can be particularly beneficial for you to keep attending. This is because the processes, which make a difference to how we ‘feel’, as opposed to how we ‘think’, are often becoming active at such times. Although you are, of course, entitled to end whenever you wish, therapeutically once we have started ongoing work it would be beneficial to you for us to plan our ending. I would normally suggest at least a month to work this through properly.