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Does this sound like good psychological therapy

24 replies

Walkingwounded · 25/01/2021 12:50

I had a session with psychologist today and just can't work out if it's working really well or if I am missing something. Am all stirred up after the session, and hoping someone can advise.

Background: Had an awful, abusive childhood. Married into abusive relationship (coercive control). Got out a year and a bit ago, had lots of counselling. Doing loads better but felt that counselling was just touching the surface, so decided that the next step was psychological treatment to help me address childhood issues.

Just had 3rd session today. Completely appreciate that psychologist has to take history first. The first session was about general stuff, what I want to achieve etc. The second was an overview of my childhood. Today, she used a diagnostic tool, again covering my childhood.

My problem is that today, we just seemed to be going over the same ground as the last two weeks. So first question today, where was I born. Second question, who were my grandparents. And so on. 30 minutes into the session, we were just covering the same stuff, once again.

And with each session at the moment, there is nothing constructive 'coming back' at me, iyswim. She just nods, says yes and writes things down. I honestly don't feel like I'm learning anything at all. Instead, I just leave the sessions feeling all stirred up & upset, having talked about horrible childhood, and it's 'goodbye see you next week'. Takes at least a couple of days to settle down.

I asked about treatment plan, and she said she had to take history first before she could make a plan. Which I really appreciate, but after 3 sessions, should I not feel I am getting something out of it?

PLus there are some minor things....She arrives dead on time, but by the time she's made some tea, got her notes out of her bag and there's been some general chit-chat, it's 10 past the hour...And this costs over £100/hr. The next client is scheduled directly after me, and today knocked on the door today at the start of his session. So I just had to leave without having a moment to ask her 'so how do I cope this week with having all these memories stirred up.'

I don't know, just the counselling - for all it was limited - seemed more professional somehow. But I am being unfair? Is this how psychologist usually work? Have nothing to compare it to. Thankyou!

OP posts:
riotlady · 25/01/2021 13:01

In my experience (as someone who's had a lot of counselling and psychological treatment, not a counsellor myself) psychologists who are doing a specific treatment do tend to be more structured and do a lot more formulation, which is all the background-y stuff at the beginning. So I wouldn't necessarily balk at doing a lot of that, but I would be annoyed at answering basic questions over again.

However, I do think there should absolutely be some degree of containment/calming down at the end of the session. In my experience some people do this explicitly by getting you to do grounding exercises, and some just do it subtly by guiding you away from the more intense stuff back to more neutral ground. But there should be something, it's irresponsible to dredge up trauma and then just abruptly end and send you on your way. I know I would have struggled with that massively and I don't think it's fair.

mindutopia · 25/01/2021 13:01

I'm not a psychologist and I did therapy with a psychotherapist, but I would imagine the process is similar. 3 sessions of history taking seems extensive, but I would perhaps wait and see what happens next session. It's normal to take 5-10 minutes to ease into a session, but I would expect her to be ready at the time your appointment starts, to have already made her tea, gotten her notes out before the appointment time. It sounds like she isn't managing her time well. There is usually a gap between appointments in my experience, so if you are 1-2, then next appointment would be 2:15-3:15. Other clients should not be showing up and banging on the door, for confidentiality and data protection reasons, if nothing else. I never saw any of my therapists other clients because she always appropriately staggered our start and end times and she used the toilet, made tea, etc. in the gaps between.

Walkingwounded · 25/01/2021 13:05

Thanks so much to you both. I am really struggling a bit after today's session. It was really disconcerting having the next client bang on the door when I was in the middle of talking about some really traumatic stuff, and then just have to go.

I asked her mid-session if we really needed to go over all this stuff again and she said 'Well what would you like to do then?' I don't know! I was expecting her to guide me!

Thanks again. Maybe will see how it goes next week and ask for a clear treatment plan.

OP posts:
WhereDoMyBluebirdsFly · 25/01/2021 13:20

My therapy used to be from (say) 10am to 10.50am, with her next client at 11am. From about 10.40am she would guide me into more neutral ground so I wasn't leaving in an upset state.

It does sound like she's organising her time badly.

Stompythedinosaur · 25/01/2021 14:26

What model are they using? Talking through trauma can help in processing.

If you'd prefer something more structured (I would too) then you might dp better with something like CAT or possibly EMDR.

Walkingwounded · 25/01/2021 18:39

I don't know what model, she didn't say. I explained I'd had counselling, and that I wanted to get to the deeper issues.

So far she's just said she has to do the assessment before developing a treatment plan. Which is fine but....For three sessions now we have covered the same things!

OP posts:
Greenleaf2 · 25/01/2021 20:35

I’ve had lots of therapy and I wouldn’t be happy with this. Your psychologist should be managing her time better so you can be getting the most from these sessions. At the very least she should ensure her clients are kept apart for confidentiality - that’s just basic professionalism. And £100 a session is a huge amount to pay - I’ve never paid more than £65, and that was with an excellent, experienced practitioner, and I’m in London.

Is there someone else you can try? I’m a strong believer in gut feeling for things like this, and if it’s not feeling right at the beginning, now may be the time to try someone new before you get too far down the road.

Good luck.

Walkingwounded · 25/01/2021 22:35

Thanks so much. I’ve had a think about the comments and you’re all right. I don’t feel right about it, and think I need to try someone else.

For the price - and it’s actually over £100/hr - I should surely be getting more out of it than this, even at this stage. Basic professionalism would also be good.

Thankyou all.

OP posts:
Rainbows89 · 25/01/2021 22:41

You have to ask OP. For £100 per session please ask!

You can google breathing and grounding exercises for now.

Do self care. Reach out to a friend. Go for a nice walk. Whatever fills your cup.

Sending hugs xxx

Krazynights34 · 25/01/2021 23:11

Op I’ve recently had EMDR. I have counselling for years and years (well 7, since my daughter died)
The EMDR was about a particular recent trauma experience.
The first two sessions were a bit like you described.
BUT no tea making!!!! I’ve never had a counsellor have a drink of anything in a session with me!!
That’s out of order.
It might seem like nothing but actually it’s very unprofessional.
Can you call her and ask what the next session will consist of because you are struggling and might change your plan...?

Lightsabre · 25/01/2021 23:21

I think you have a gut feeling about whether it will work out with this particular therapist or not. I'd look elsewhere. I had a very experienced older female psychotherapist a long time ago and felt very comfortable with her from early on. She helped me to process feelings but not in an obvious way. She had a proper couch and everything but it took months to get to that stage. She had a particular approach (gestalt) which I felt worked well for me.

jendifer · 25/01/2021 23:26

Who is she accredited to - UKCP or BACP? Google her and those acronyms if needed. I’m confused if it is a therapist or a psychologist though- they are very different roles.

Gooseygoosey12345 · 25/01/2021 23:38

Honestly, apart from the unprofessional behaviour, it doesn't sound like she's the right fit for you. You have to be able to relax and have a rapport and it doesn't sound like that's going to happen if you're constantly thinking about who's going to knock on the door next or waiting for her to make herself a cuppa! If you're wanting to stick with her I would definitely question why formulation has taken 3 sessions and bring up the time. You're paying a lot for the hour so you should get the whole hour. I'd also question which model she's using, at least so you know to ask for something else if it doesn't work out for you.

Jellycatspyjamas · 26/01/2021 00:03

That’s doesn’t sound ok, she should be ready to work as soon as you arrive - you’ve basically paid her over £50 to make tea and gather her notes.

She should have enough now to have some kind of plan - is she experienced in working with early trauma? I’d expect her to make sure you’re on an even keel before ending the session and to schedule her time to make sure you don’t run into other clients.

Walkingwounded · 26/01/2021 07:07

Krazynughts, I’m so sorry for your trauma.

She’s a ‘counselling psychologist,’ ‘health care and professions council registered.’

Starting to calm down this morning after bringing up all the memories, but am going to find someone else. This is just not right. Thankyou all.

OP posts:
jendifer · 26/01/2021 07:19

Maybe see a counsellor or therapist instead - a psychologist will have a different way of working and it doesn’t sound like it is what you need.

ginandbearit · 26/01/2021 08:57

She sounds unprofessional with all the faffing ( is she newly qualified?) but also seems to want you to fit her theoretical approach rather than find out what works for you ..not uncommon amongst practitioners sadly .

GothamGirl1970 · 26/01/2021 09:12

OP I am really glad you posted ( and an opinion)

Opinion; I would never go back to either of those “therapists” again. Just send a test that it didn’t feel right for you, there was no time to establish ”in relationship in the room and it was too much too soon for you and simply a style mismatch and close politely.
.

Here are some facts about the U.K. and therapy that scare the hell out of me so I refuse to work as a PhD Psychoanalyst here . Let me explain why, and provide some links for backup
in the country I was educated ted in a minimum 4 year BS in psychology and also the compulsory coursework in actual therapeutic practicum of a heat whereby you were the patient and a Doctor who was one of the Department Heads was your therapist for 1 session per week during term time, concurrently you as a student has 2 clients a week under the guidance of a supervisory therapist, I can’t see any lesser way because sticking your fingers in a stramger’s mental health, thoight patterns or even a serious PD an uneducated person know what he is dealing with. After you pass your uni, before you can even offer a session, you must pass a rest after be licensed at the Federal level, a member in good standing with the AMA and pass the license requirement for every place you plan to practice in. (of course there are many, different therapeutic modalities and specialisms) these are just the requirements for a garden variety therapist. Unless all the therapist wants to do is marriage counselling, the majority of the newly minted therapists go on to specialise which is usually personal to them and is usually a patient population and diagnosis or suspected diagnosis aka young adults presenting around 16 with bipolar. They may see other types of clients but that could be a interest personal to them for some reason. In fact it is a good idea to get into a practice if that’s your career aspiration fulfilled because: if you aren’t a psychiatrist you can’t prescribe medication nor can you make a diagnosis yourself.

I didn’t stop there I carried on because I fell in love with different specialities and needed to dig deeper. I knew child psych was not for me. Maybe Moral? Social? Psycholopathology? Back to university for 2 more years. There are about 20 fields, didn’t list mine here asa red herring, now the question becomes what is the best technique/ modalities for treating these clients, did I believe it? And most clients think their problem is X. Turns out the trauma Z is casual and X is merely the physical manifestation.
When I received my Doctorate I think I had to take 4 more governmental exams to receive further licenses etc. It keeps me comfortable that this clinical treatment is overseen, and regulated by the government and medical boards that can disbar bad therapists.

OP like you I need feed back when I am the client. It has to feel like a dialogue. It’s a very personal relationship. All therapists WILL ask you family history but anyone who tries to get to the minutiae of your childhood trauma is completely unacceptable.

The usual process is for an hour free session to see if you can work together. I feel this is completely necessary because if we chose to work together I will know everything about you metaphorically stripped to the skin, you trust me with your life and work TOGETHER to resolve past issues and chart your future to wherever you desire. My personal style is a synthesis of 'Rogerian ' and 'Jungian' approaches, working therapeutically through the relationship. My primary focus is upon us creating a safe and strong enough container to allow you to do whatever inner work you need us to do to heal you. Rogers was the originator of the Person-Centered Approach, which encompasses more than therapy and has, in recent years, become very popular in humanistic circles. His fundamental model suggested that as a bare minimum, and perhaps all that was needed, for people to heal themselves, was a radically genuine and respectful way of relating. Authenticity and a relationship of unconditional positive regard have emerged since then as the 'sine qua non' of therapeutic relating. Indeed these days psychotherapists of all traditions accept that the quality of the relationship is primary in successful therapeutic outcomes. I was trained as a ‘Rogerian’ and have worked with this ethos for all of my professional life.

Carl Jung was a disciple of Freud, the father of psychoanalysis. He disagreed with Freud, particularly over the nature and function of dreams and struck out on his own. After many years his experiences with his own psyche and investigations into others led him to develop what is now often referred to as depth psychology.

Here is the punchline a very sad one. The U.K. requires no education, has no regulatory for therapists of any kind. If you’re bored this afternoon paint a sign that says “Marriage Counsellor “ stick it out front and you’re a therapist.

From Tavistock:
“Clinical” or “Counselling Psychologist” title is professionally restricted which means it's illegal for anyone not properly qualified to call themselves a Clinical or Counselling Psychologist. Psychotherapist – a blanket term given to anyone who treats psychological distress through some kind of non-medicine therapy.

Wikipedia

Counselling in the United Kingdom
From Wikipedia, the free encyclopedia
Jump to navigationJump to search
In the United Kingdom, counselling is not under statutory regulation, and is overseen and supported by several organisations, none of which are officially recognised by the government.
National regulation[edit]
In 2007 the Health Professions Council (HPC), which is independent of any professional body, released a white paper, Trust Assurance and Safety – The Regulation of Health Professionals in the 21st Century, which said that the Government intended to introduce statutory regulation for psychotherapists and counsellors.
The HPC set up a working group of stakeholders, known as a Professional Liaison Group, to consider and make recommendations to the HPC about how psychotherapists and counsellors might be regulated, in light of the statements made in the white paper. The HPC held a public consultation on the PLG recommendations, which ran for three months in 2009. Following the consultation, the PLG was reconvened and had its last meeting on 2 February 2011.
In February 2011, the Government published a command paper, Enabling Excellence, which set out the coalition government's policy on professional regulation. The paper outlined a system of what it called "assured voluntary registration" and said that in the future statutory regulation will only be considered where there is a "compelling case", and where "voluntary registers are not considered sufficient to manage this risk".[1] Later that month, the HPC's Chief Executive Marc Seale wrote to Anne Milton MP, then Parliamentary Under-Secretary of State for Public Health, seeking clarification of the coalition government's policy on the statutory regulation of psychotherapists and counsellors.
At its meeting on 31 March 2011 the Council discussed the response received from Anne Milton MP. The letter said: "...it is not currently our intention to proceed with statutory regulation of psychotherapists and counsellors".[1]

What is available and more terrifying is that all these non educated , non licensed hell I will call them clubs which also have 0 oversight by the Royal College of Medicine or any government office not even PHE they just elect their own member as the head of the club and if you learn the secret handshake voila you are now sanctioned by them.

I can give you a list of questions to ask any future prospective therapists to try to keep you as safe and comfortable as possible.

Cyberworrier · 26/01/2021 09:21

Hi OP,
I’m sorry you’ve had such a difficult time over last few years. I think your instincts are right that it wasn’t a good fit with this person, you need to feel comfortable with the person to be able to get the most out of therapy and her lack of professionalism doesn’t sound acceptable (like a PP, my therapist would wind the session down so it wasn’t upsetting to be suddenly on the street by myself after opening).
There’s a group of therapists called Mind Reframed who do EMDR and DBT, maybe check them out. They’re both techniques/schools of thought aimed at trauma survivors. I have found DBT hugely helpful in recovering my life and confidence. Or maybe look for someone on the BACP website who does DBT.
Good luck.

Jellycatspyjamas · 26/01/2021 10:09

@GothamGirl1970 statutory registration doesn’t in and of itself make a good practitioner or guarantee a level of competence. There are pros and cons for both sides of the argument. Any therapist worth their salt should be open about their qualifications and experience, I’d look for someone with decent post graduate qualifications and good experience in working with people. I’d also want them to be able to explain to me up front their approach to therapy and why they think that might help me, and I’d want someone who has undergone their own extensive personal therapy. I wouldn’t work with anyone who wouldn’t answer those questions before our first session.

GothamGirl1970 · 26/01/2021 10:20

@Jellycatspyjamas I agree but. also supervisory years and most important things as the 2 day license tests, medical malpractice insurance and a super enhanced CRB check which are not even asked for here. Of course there are crap therapists no matter how much training they have had, but no criminal check? That’s reckless and dangerous in my view.

Jellycatspyjamas · 26/01/2021 10:51

All the therapists I know have monthly supervision throughout their careers, carry professional indemnity insurance and have a clear CRB - I’d add them to the list of things to check. It may not be a regulated profession but that doesn’t necessarily mean unprofessional, it just means people need to check carefully and follow their instincts if the fit doesn’t feel right for any reason.

GothamGirl1970 · 26/01/2021 11:06

@Jellycatspyjamas that’s because you have friends with integrity. Their moral compass compels them. Unfortunately you have exceptional friends.

Also a person generally seeks therapeutic treatment because of a life crisis and may not know to ask those questions or be able to.

jendifer · 26/01/2021 12:33

It depends who you are accredited to. I am wirh BACP and UKCP and I need DBS, supervison and insurance.

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