It is helpful for both therapist and client(s) to be clear about their respective expectations and responsibilities at the outset of a professional relationship. With this in mind, I hope the below information will provide a useful reference point.
I have outlined some issues that commonly arise in a therapeutic relationship, and how I like to address these in my practice. It may be that you have encountered some of these issues in another setting, in this case you may find that some of these guidelines differ from your previous agreements with another practitioner.
Please feel free at any time to raise questions about any procedure you do not understand or feel unhappy about for any reason. The purpose of our work together is to work for you in a way which genuinely meets your therapeutic needs.
You are welcome to arrange an assessment session for us to meet and briefly explore your therapeutic needs. We can discuss any concerns you may have. When booking a single session of therapy, please bear in mind that it may not be possible to guarantee the same time slot for subsequent weeks, unless you book a course of therapy in advance. I will do my best to accommodate your scheduling requirements.
Appointments & Timekeeping
Therapy sessions generally start on the hour and last for approximately 50 minutes. This is the typical length of time for individual therapy or coaching.
We shall agree on the days and times of our meetings in advance, and from then on those days and times will be yours.
Regularity and continuity are both important in good therapy, as they give a reliable feeling of structure to the whole process. For this reason it is rare to rearrange a session.
We can use the first few weeks to decide whether a shorter or longer time span will be most helpful. If we decide to work longer term then the contract will be open ended and we will think about and decide on an ending as the work progresses. It is important to make a planned rather than a sudden ending. I see clients either weekly or more frequently and once we have chosen our session times I will be regularly available at that time each week.
If for any reason you arrive late to a session, we shall finish at the appointed time in any case. This means that I will always be ready for you at your appointment time.
If we are doing couples therapy, both partners need to be present for the session to proceed. The work is with the couple, rather than one or other partner.
Please give me as much notice as possible if you are intending to take a holiday during a course of therapy. It may be necessary for you to pay a reduced fee whilst you are away, to keep your appointment open for when you return.
Fees can be paid by cash or cheque at each meeting. Some people prefer to pay their fees by bank transfer and typically do so for a batch of meetings for which I invoice monthly, in advance.
I understand that life occasionally throws up unexpected circumstances which may make it necessary to cancel an appointment. With this in mind, I will try to accommodate a change, if it is within my power to do so. I do this in the spirit of the relationship which is built upon a mutual respect, and an appreciation of what it is that we are seeking to co-create within the therapeutic relationship.
It is important for the work that we meet regularly. If you take a holiday or, on a rare occasion, need to make a planned change which I can accommodate I won’t charge for the session. It is my policy to charge a fee for cancellations which cannot be rescheduled as replacement sessions. Whilst allowances may be made for extenuating circumstances, due to illness or unforeseeable occurrences, this will usually depend on whether it is possible to reschedule your missed appointment.
If you cannot make a session at less than a week’s notice for whatever reason I will charge; I may occasionally be able to offer an alternative time that week but this is very unlikely to be possible if the cancellation is less than twenty-four hours’ notice. Brief emails can be sent to email@example.com; last minute cancellations are best done by phone.
I ask that you notify me by phone, email and/or text as soon as you know that you will not be able to attend a therapy session. Please ensure that your cancellation is acknowledged, and follow up if you have not heard from me.
If you are unable to attend an appointment for any reason, the fee for that session will be due. If you cancel your appointment with at least a week’s notice, I will not charge for the session. It is sometimes possible to rearrange a session, but only as an exception.
The style of psychotherapy in which I am trained lies between psychoanalytic and integrative. The former means that I consider unconscious processes to play an important part in our experience of ourselves and of our relationships. The latter means that I use a range of ways of engaging and exploring these processes and that I believe the therapist and client jointly search for and create meaning. I therefore welcome your assessment of how you feel the work is going.
In order to work with our unconscious in therapy it is important to have regular meetings and for the relationship to be distinct and clearly defined. Therapy aims to facilitate sharing and exploration of parts of the self that have been difficult to manage. Because the work can take us to unfamiliar places, at times it may feel onerous and strange. The relationship between client and therapist and the moment by moment experience in the room, is itself a central part of our reflection and learning.
Progress within therapy depends largely on your commitment to the process. Therefore, to gain maximum benefit from your therapy it is important to attend therapy consistently, minimising your absences, as well as engaging in any follow up/home practice that is recommended.
In therapy, things can sometimes feel worse before they get better; please remember this, and if you feel yourself to hit a bad patch, don't assume that this means failure. It often means holding on, and trusting the process.
How It Works
Therapy is a space in which to explore your own experience. I am here to help you to do that, by offering the time and space you need. I can offer certain skills and theory which may enable you to do this better or quicker than you could on your own, but basically it is you doing the work, not me doing it for you. The more you put into your therapy, the more you will get out of it.
Openness is the most important thing for you to cultivate in your therapy sessions: openness to your own experience, and openness to expressing that to me. It works best if you aim at total honesty, holding nothing back out of politeness, loyalty, delicacy, decency, rationality, self-justification or a desire to preserve your image. If this is difficult, let it be difficult, and let us explore that too.
I will make suggestions about things you might do during these sessions. It is, however, your responsibility to accept or reject these suggestions. All the time it is you doing it for your own learning, not to please me.
It is good to have an explorative and playful attitude to the work we are doing. Play is really a way of trying out things which are quite serious. Often doing something unusual feels artificial at first, but children don't let this stop them from learning, and adults can learn well this way, too.
Some people ask whether what we are doing is counselling or psychotherapy. There is a huge overlap between them, and these words have never been truly clarified to everyone's satisfaction. The main thing is that the therapeutic relationship helps you consider yourself and your concerns, and provides support, ideas, challenges and opportunities to make changes where desired.
Commitment is necessary if we are really to get anywhere. It is important not to stop if the going gets rough for a while. Therapy is often a long-term job, because what took years and years to build up usually takes some time to change.
We may want to vary the frequency or length of our meetings from time to time, at your suggestion or mine. I usually see individuals for 50 minute sessions and couples for 60 minutes. This can be weekly or fortnightly. I usually start individual therapy on a weekly basis. Sometimes I offer extended appointments when there are more than two of us in the room
Confidentiality is important in therapy. Our conversations will be confidential within the limits of UK law, and with the exception that I consult a supervisor about my work. I keep short notes on sessions – these are not held on computer but are stored securely. Very occasionally it may be appropriate that I be in touch with your GP or another professional involved in your care; this would only be after discussion between us. If I felt that anyone’s safety was at risk I would need to seek outside help but would always seek to confer with you first.
Appointments take place at an agreed time for fifty minutes weekly according to our arrangement. While you are in therapy you are welcome to contact me by phone and/or email should you need to between appointments. Please bear in mind that I cannot guarantee the confidentiality of this form of communication. It may not always be possible for me to reply the same day, but I do my best to reply within 48 hours, unless I am on vacation.
I will let you know my holidays well in advance.
If we agree to work together in an open-ended therapy, ending our work is a decision which is best discussed between the two of us. It is preferable for a decision to end to be arrived at mutually, over time, rather than as a one-sided or impulsive action. If either of us feels that the time has come to close off the therapy, we shall arrange a number of meetings to go into all the issues around ending, and make sure that the decision is a good one.