Useful information

Helen Maggie Watson


Useful Information

This is where I try to answer some broad questions about therapy. If you have any specific question then please get in touch using the Contact page and I will gladly respond to your enquiry within 48 hours. There's a lot of information here but I hope you will scroll down and find this page helpful.

What is therapy?

Therapy (counselling and psychotherapy) offers you a safe, confidential place to talk about your life and anything that may be confusing, painful or uncomfortable. It gives you a space to talk with someone who is trained to listen attentively and to help you improve things.

In therapy you can explore various aspects of your life and feelings, talking about them freely and openly in a way that is rarely possible with friends or family. Bottled up feelings such as anger, anxiety, grief and embarrassment can become very intense and therapy offers an opportunity to explore them, with the possibility of making them easier to understand.

Therapy is a way of enabling choice and change, or of reducing confusion. It does not involve giving advice or directing you to take a particular course of action. Therapy can change your life and sometimes others around you may resist your changes and growth; they may need time to adapt to the new you.

Therapists do not judge or exploit their clients in any way.

What happens when I make an enquiry?

Following your initial enquiry we will speak on the phone. This will enable me to understand the nature of what brings you to seek help from a psychotherapist. During our conversation I will have made an initial judgement about whether or not I will be able to meet your needs. There are various things which will influence my decision which include: the level of complexity of your issues; how your availability matches with my availability; how working with you may impact on the balance of my current caseload; and my competency in relation to your unique concerns.

If we decide to meet for a consultation, either in person or online, this will take thirty minutes and if we decide to go ahead with therapy this is when we will contract.

What is a therapy contract?

The therapy contract is how we agree to work together and at your consultation appointment I will tell you about confidentiality and how I work as a therapist. You will have an opportunity to ask me any questions if you are unsure about anything or if there are other things you would like to know.

What can I  expect at my first appointment?

If you decide that therapy may be for you, at the first session you will be invited to talk about yourself and what it is that brings you here now. Don’t worry if you are entering therapy for the first time and you don’t have any sense of what you need to happen, other than you want to feel better than you do now. This is quite normal but if you can, try and express this to me. If you can, it might be useful to talk with me about what your expectations are; also, if you are able, let me know what you need from therapy. Just like any other relationship, the more you know and can communicate what you want and need from our relationship, the better chance, I will have to give that to you, and you will have of receiving it.

You may be worried or scared. What will happen at the first session? How will you tell me what’s wrong? What if your problem isn’t really important enough and you’re wasting my time? You may be embarrassed. What if I think you’re really strange (I won’t)? What if your problem is embarrassing? Maybe you should just deal with this yourself and not bother with therapy. Experiencing any of these feelings is not unusual.

Will you carry out an assessment?

The assessment process mostly takes place in the first phase of therapy and may take several sessions but it is ongoing throughout the therapy process. This is when we work out what to do; we start deciding exactly what you want to work on. This process will involve me asking you questions about you and your experiences. I will ask about your health, work and relationships, your family, friendships, things you have experienced which you have found particularly challenging along with what you have found good in your life.

In this first phase of therapy we will be developing a relationship. We are unlikely to be completely comfortable with each other at the beginning. As we talk more you will become more open about what you are experiencing, thinking and feeling. This is the time we begin to build a rapport; I will validate your experiences, truths and struggles; I will help you to feel safe and to develop trust. Sometimes you will begin to feel different or a little better.

This is a good time to ask any questions about how your therapy will work because as we progresses we will be focussing on the matters which brought you here and you may forget as we explore more deeply.

How many and how often will I have therapy sessions?

Therapy takes place by appointment usually at the same time each week and sessions last for an hour. The therapy process may be short term and take six to twelve sessions. This is usually counselling and focusses on a specific issue which is troubling you currently. Longer term therapy may last for several months or longer. This is usually psychotherapy and addresses aspects of your life which have developed over time and which take more in-depth work to understand and heal. In both short term and longer term therapy we will review things regularly; this is to make sure that therapy remains beneficial for you.

How will I feel?

Therapy is a very personal process. Sometimes it is necessary to talk about painful feelings or difficult decisions, so you may go through a period of feeling worse than when you started. However, therapy should enable you to feel better in the long-run. If you do experience a period of feeling worse, please talk to me about it to ensure you get the best out of your therapy.

Therapy is often hard work, and sometimes it can be emotionally draining; after an intense session you may feel exhausted. Sometimes, therapy can release emotions that have been ‘locked in’ for many years. Change can be difficult, so don’t be surprised if you are tempted to stop therapy right before some real changes or breakthroughs are about to happen. Usually it will take a number of sessions before it starts to make a difference.

What factors might affect my therapy?

Everyone’s therapy journey is unique and things which will have an impact include:

  • What brings you to therapy
  • Your unique story
  • How you have adapted to the challenges life has given you
  • How you make sense of your present in light of your past
  • Your curiosity about yourself and how you relate to others and the world
  • Your commitment to the process and the work you do between sessions
  • If you find it less difficult or more difficult to trust people
  • Your level of self-awareness and your understanding of your process

Why should I choose you?

I am what’s called an Integrative Psychotherapist and I work relationally. As therapists all work a little differently I will explain briefly here about how I work.

It’s very important for me to understand how you feel and what it’s like being you and I won’t always get this right. I’m sorry in advance for when I get things wrong. I understand that sometimes, even the idea that another person gets remotely close to understanding what it’s like to be you, might feel uncomfortable or unsafe. That’s why we will only work at your pace.

My philosophy is, how we feel and our relationships are tied up in a jumble and sometimes we can need help to untangle this jumble and find some clarity and insight. In our work together, we may talk about the links between how you feel and your current relationships, relationships from your past which will have affected how you felt then, and how these may play a part in how you feel now.

Our relationship is part of the process too, when we are working together if you feel judged or misunderstood in some way, it’s important we spot this and sort it out together. It’s okay for you to let me know when I get things wrong and, you may get fed up with me reminding you that I am okay with you telling me.

Part of working in a relational way means I am not going to be an objective observer of what’s going on for you. I hope there will be times when we can laugh together, and there might be times when we cry together. There might be times when what you need is for me to simply be with you and hear you. I also understand that it can be really difficult to begin to work out what we really feel and even more difficult to be able to share that with someone.

The therapeutic relationship I provide will give you the safety and space to do this at your own pace.

How does therapy end?

Once you feel like you’ve accomplished everything you want to do or can with me, it’s time to consider leaving therapy. Keep in mind you might not reach this point for some time and some people stay in therapy for years, although this isn’t the norm in the UK, this is okay if it’s what you think is right for you.

It may be that you need to change therapists if you feel you have reached a limit with me or, there is an option to stop therapy and come back when or if you think there is more work to be done.

If therapy is about finding a solution to a problem, a way to feel better or work through issues then once you have accomplished this, there is no reason to continue. If therapy is a lifelong journey for you to develop and maintain good mental health then you may not be concerned with reaching an end.

Once you arrive at this phase, you can decide which of these best fits you. There is no correct answer and although they are different they are all valid and equal.

When you decide to end, you might feel sad. This is not unusual and I will feel a similar sadness which is a normal response that comes with the ending of a relationship with someone when you have shared a closeness which develops in therapy.

I will help you to have a sense of closure and although we will feel sad we will also hopefully be celebrating your journey and the changes you have worked hard to achieve. This is a time to reflect on everything you have accomplished and feel proud. You will have done something not many people have the courage to do.

Why pay for therapy?

We are fortunate in the UK to have the NHS and therapists who work in the NHS do a great job under challenging circumstances assisting those more vulnerable. However, there are several advantages when you decide to pay for your therapy and these include:

  • You will experience much shorter waiting times which means you are able to get the support you need when you need it. I get referrals for clients who have been waiting five and six months to see an NHS practitioner.
  • You have a choice about who you see, where you see your therapist and when you have your sessions. NHS patients have little say about who, where, when, how long their therapy lasts or, the type of therapy they receive.
  • You have a choice about the approach. The majority of NHS patients receive Cognitive Behavioural Therapy (CBT). CBT is reasonably successful, quick and cost effective at treating the symptoms associated with anxiety and depression. This can enable you to achieve a level of functionality which will get you back to work. However, NHS practitioners may not have received training beyond CBT nor have the discretion or time to implement other ways of working. As a private client you have the choice of various practitioners and approaches which allows you to find the right combination specific to your needs.
  • You can get tailored therapy which works for you. Research demonstrates that success is not primarily determined by the type of therapy received. The key to effective therapy is a combination of establishing the kind of therapeutic relationship with the kind of approach which is most appropriate for you. To do this you need to find a therapist with the flexibility and expertise to deliver the specific therapy to meet your unique needs. A one size fits all approach is based on what sometimes works in general but this does not consider your individual  history and this will impact what will work for you specifically.
  • You experience confidentiality and greater discretion. You may be understandably wary of sensitive information about you being disclosed. You may not want a mental health diagnosis to become part of your NHS medical record. NHS practitioners are duty bound to disclose concerns regarding risk to fellow professionals whether you agree to this or not. As a private practitioner I do have legal obligations and a duty of care to you, however, I am not bound by the same systemic rules and regulations as my colleagues who work within the NHS.