To have concerns about counselling

[navymack]

This isn’t about individuals who I am sure mean well and genuinely want to help. But AIBU to worry that some of the treatments offered, at great personal expenditure, are ineffective or even counter productive in some cases?

The costs are really concerning to me - it seems that a lot of money goes into this with universities offering degrees in counselling and individuals charging anything between £30 and £70 per hour.

I have seen over the years people raise concerns about inappropriate things counsellors say to them, and the fact that it isn’t recommended for those in abusive relationships makes me wonder if in fact it is the solve-all it is often presented as being?

I know that individuals will state counselling was helpful to them, but what specifically is so helpful? Is it just having time and impartiality?

I think research has shown that the counsellor is important.

Has been for me actually. I first tried counselling aged about 19 at university. One session and cancelled the rest. Was not comfortable with the counsellor.

Second experience in 30’s was the great one.

When I go again (will be approaching 50) I will be looking for a good fit. Someone who can challenge me but not make me feel bad about myself.

If I go somewhere and don’t like the person then I’ll try another.

(I had forgotten about the university experience).

I’m unclear what you mean devilish

Do you think ‘it is always helpful, if it isn’t for you, you just need to find the right person.’

I’m not sure. I think that if it is a procedure that works, then it should work.

@navymack , this is clearly an important issue to you. Your response is strong. It sounds as if your mandatory and unhelpful counselling made you quite cross. Because what you are describing in terms of insistence on counselling is not really what happens in my observation.

The thing is it’s not a ‘procedure’

It works because of the relationship between the two people taking part. You can’t reduce it to a ‘procedure’.

You have to have the right person (for you), at the right time (for you).

There are 100s of studies showing the efficacy of counselling.

I don’t think it is an ‘important issue’ to me I hardly walk around all day ruminating on it. If we could stick to the point rather than trying to ‘help’ me, that might be best

Yes, it was fucking annoying having to spend £50 on something I didn’t need, but compared to the £21,000 it faded into insignificance somewhat.

Fair point!

Well there’s the problem.

With counselling it’s never going to always work for everyone every counsellor, that’s completely unrealistic. Both the therapist and the client are fallible human beings and the reality is sometimes the fact that it doesn’t work isn’t always the therapist’s fault. They can’t physically fix every client’s life or past or cognition! They can’t force a client to stick with it or be truthful or take certain action. It’s not a miracle one size fits all cure and I can’t recall anyone ever saying it was!

I don't want to derail the thread but as there are people with experience of counselling both good and bad, what do you think is right and professional in terms of note taking by the counsellor either during or after the session and how the counsellor should handle privacy if they are working from their home or similar where clients might see each other on the way in or out?

I think notes should be brief and made after the client has left with no identifying information contained. My counsellor never asked for my last name or address for example. If the client asks the counsellor should be able to say how records are kept, how long for, if anyone else has access and why etc.

When working from home, I think counsellors should allow enough of a break (20 mins?) between clients that they wouldn’t pass each other when going in and out. Many counsellors also now offer Skype sessions, which is what mine did.

Thanks Shady. I asked because of my awful experience. The counsellor never remembered what had been discussed from one week to the next. She didn't take notes during sessions. After sessions she couldn't have because towards the end of the session the buzzer would go and it would be her next client. You had to let them in on your way out. If that wasn't bad enough, she was located close to my workplace because that was the only way I could go. One day when leaving and letting the next client in I found it was someone from my team at work and I was his line manager Fortunately we got on well and discussed it later but it was embarrassing for both of us. He felt she was rubbish and stopped seeing her. I stupidly stayed on for a while longer.

I've been in and out of different therapies since I was 7 and I agree there is this idea that a vague concept of therapy/counseling/help that is a cure-all. I think this is true of many chronic conditions and issues, not just mental health, that if we only did these things "right" or tried hard enough then things would be better.

There does need to be accessible, clear information on different types of therapies and the evidence of their effectiveness. There are large differences and people should know what they're walking into, what is expected both of them and what to expect of the professional, and so on. Likely something like that does exist but sifting through the internet for it, through the ads and sites, is a struggle before even getting into the issue (much more common to my knowledge in the US but I do know this happens in the UK as well) of religious or ideological 'counselors' who are more there to keep people in-line and feedback to others than any help.

I think there are likely better ways to teach mental health care techniques and systems for many people than the common image of counseling. The best I've had is the group therapy which taught coping and life skills when I was in middle school - still use it now and I wish more people had the opportunities I had to learn and practice those skills with people who care even though it was years afterwards (and being out of a horrible environment) before much of it fully clicked for me, the foundation was still there. It is a struggle to know what to recommend people and I've found recently I'm just as likely to recommend a book or a video series or a website that discusses mental health skills as I am to recommend looking into talking therapies because it is hard to know what is out there at times.

I think that if it is a procedure that works, then it should work

It’s not a procedure. Studies have shown the therapeutic relationship is important (& that the individual counsellor is more important than the type of therapy). Although I guess that may be less important in things like CBT (which let’s face it now get delivered by computer programme - how effective that is I don’t know).

I don’t insist anyone does anything. So I don’t have a fixed line. I suppose if I thought someone may benefit from counselling but had had a bad experience I might share my story with them. might not, I only ever suggest counselling - it’s nothing to do with me whether they try it or not.

I think most people have the potential to benefit from counselling but needs to be the right person and needs to be the right time. I include myself in this. I’m not getting counselling now because I don’t think I can benefit from it at the moment - I need the distress to stop first of all (which is entirely outside my control and completely situational). I know that when I do go for therapy it needs to be with someone who understands the very alternative universe I have been living in. And I will search for for someone accordingly.

I also agree that counselling is often trotted out as the solution to any kind of emotional issue. I too have my doubts. I've seen both a clinical psychologist and a counsellor, both highly regarded and qualified but I never found the process to be particularly helpful. I found the things they say to be blindingly obvious and I never had an 'aha' moment where they helped me to see something from a perspective I hadn't considered. In fact a lot of their stuff makes me cringe a little bit - the reframing of what you're saying ('it sounds like you're saying'...), the obvious attempts at active listening etc.

I'm sure it helps a lot of people, but it's certainly not for everyone.

I don’t understand why people are saying, oh I’d rather GPs prescribed counselling than drugs.

All drugs and other medical treatments that are actually effective also have side effects. If there are no side effects, it’s a pretty good indication that there aren’t any effects either. Some proposed treatments have only side effects and no real benefits, and these (should, hopefully) get withdrawn or never come to market. Evidence based medicine, indeed all decent medical practice, is about prescribing only treatments where the benefits outweigh the risks and unwanted effects.

Why would we imagine that counselling has only positive effects and can’t possibly produce negative effects? Either it can’t produce side effects/unwanted effects, in which case that’s a pretty good indication that it isn’t doing anything helpful either, or it can help but it has side effects, in which case we need to know what those are so we can balance the risks against the benefits.

Counselling has done me far more harm than drugs ever did.

Counselling has done me far more harm than drugs ever did.

I am sorry to hear that. And it can be a side effect. Same as some medications don't work for everyone.

I wonder if there is a way to identify people it's less likely to work for.

Personally I think both medication and counselling should be available. Neither are a cure all for all people.

Most counsellors would agree that there should be restraints on who can call themselves a counsellor.

Yes, sometimes people do work in counselling that they're not stable enough to do or which upsets the apple cart for them. There is a risk.

Sometimes it helps, sometimes it doesn't. Physiotherapy is exactly the same (and some physiotherapists feel that healing sometimes occurs when treatment is stopped and the body has a chance to find its own way of going).

It's definitely a growing industry with no real recognition that it's not right for everyone. Mainly because GPs need to have something to do with people who aren't coping, in the absence of a properly resourced mental health service.

I have to say I always veer towards older female ones

Female because I personally feel myself more comfortable

Older because I genuinely think life experience and having seen a bit really helps them

But that’s just me ! And as I am paying I can select one that suits me

OP, you seem to be fixated on therapy not always working, from your OP: makes me wonder if in fact it is the solve-all it is often presented as being? to your post above: ‘it is always helpful, if it isn’t for you, you just need to find the right person.’

There is nothing that always works, not paracetamol, antibiotics, exercise, having a cup of tea. Nothing. However it is important to find the right therapist, so it's OK for strangers on the Internet to say it to someone seeking advice.

You may not be unreasonable to have concerns about counselling. You are unreasonable if your concern is that counselling should always work for everyone.

Then in that case dione it shouldn’t be presented as if it does. I’m glad we agree.

Navymack - I understand you concerns. Choosing a good counsellor is a minefield.
I have friends/aquaintences who trained as “counsellors”, trained with a reputable organisation (course was only weeks/few months long) are allowed to see clients. They are not the sort of people who I would ever seek advice from. I am surprised they can do such a delicate job with vulnerable people.
I would choose only to see a qualified clinical psychologist with the relevant experience specifically in the area of difficulty. At least then you can be sure they have a certain level of intelligence and wisdom - it is extremely tough and competitive training and not as accessible as counselling courses. From what I can see they don’t charge significantly higher prices either.

Potplant - I am saying it because psychiatric drugs are some of the worst for causing lifelong damage and this is often underreported.

My son has been left with tardive dyskinesia (watch some videos of it - it’s exhausting) and stuck on a drug that makes him nauseous (possibly for life) which he should never have been prescribed in the first place. Certainly not at the stage it was (NICE guidelines were not followed). When I raised concerns that he was showing side effects (first raised concerns within 3 weeks of him starting them) my concerns were dismissed.

I not saying meds should never be used - just that they should not necessarily be the first point of call. And if NICE guidelines say they should be last resort after trying non-pharmaceutical alternatives then that should happen.

It isn't presented as "it always works". I can and does help a lot of people, but as I said there is nothing that always works. Any counsellor who says otherwise should be avoided.

But I am afraid it often is, especially when coupled with ‘you weren’t ready / working hard enough / with the right therapist.’

I swear I've read this thread before.