Therapy: How to get the best out of it

Let's talk about Therapy

Have you been considering therapy but just don't know where to start or what to ask for.

It can feel overwhelming knowing you want to seek help but not knowing how to ask for it. Either asking for therapy within the GP practice or where to start looking for a private therapist.

In this Blog we will look at, getting the best out of therapy, from accessing the type of therapy you want, to talking about your mental health needs with professionals, family and friends. Asking for help can feel difficult and there can be negative emotions and thoughts attached to this which can make it feel even more difficult to access help, The important part here is recognising that you need and want help and that you are absolutely worthy and deserving of that help and support.

You also don't need to be experiencing mental health difficulties to access therapy or counselling, it can be helpful to anyone wanting to understand themselves, others and the world around us better. Therapy really is for anyone for any reason.

Hopefully after reading the first in the Therapy series: Therapy: Exploring Counselling and Therapy

You will have a better idea of what therapy and counselling is and what types of therapy there are to choose from.

So when is the best time to access or try therapy for the first time, well simply,

whenever you want to!

Therapy is and should be for everyone at any time, when you need it or want it,

you should be able to access what you need.

Ideally accessing therapy before we reach our crisis point is better for us, but reaching this point does not mean it's too late to go to therapy, but does mean that you have exhausted yourself of coping and may be struggling to get to where you want to be. If you need help, reach out to the people around you, to your GP and ask for the help you need.

When is the 'right time' for us to try therapy for the first time? We may want to access therapy because we want and are ready to learn more about ourselves, deepen our understanding of ourselves and reach our best potential. When we are ready to start having more beneficial and rich relationships with ourselves and the people around us. Or we may have noticed something about ourselves that we would like to explore more or understand. Or we may be experiencing mental health difficulties and realise that we want to address these, to best support ourselves through a difficult time.

There may even be no 'right' time, just an awareness of needing or wanting help to manage and cope with difficult emotions or circumstances.

Where then can we access therapy?

We can request therapy or counselling services from the GP, your GP might refer you to a suitable service after speaking to you – that service will then get in touch with you.

Any therapy provided through the NHS should be free of charge.

You may also be able to complete a Self-referral, some areas run services which you can contact directly to refer yourself for a talking therapy. Your GP will be able to provide information and contact details of any or a number of services you can call, to make a self referral.

If you prefer to look into things by yourself then you will also be able to find information and services in your area on your local authority website. Usually if there are services accessible in your area then you may be able to access the information from the website and make inquiries directly.

You may also be able to access help and support from 'psychological services' Or Psychological Wellbeing practitioners, through your GP. Psychological wellbeing practitioners are professionals who generally work within the GP surgery and are able to, in some places, offer talking therapies for common mental health problems.

In some localities you can also, often refer yourself, without going through your GP.

How long can this take?

Unfortunately it's very common to have to spend time on a waiting list before getting therapy through the NHS or from your GP surgery. While you're on a waiting list it might help to:

Ask your doctor to give you a contact number to ring to check how long you have to wait.

Explore any alternatives to therapy which might help in the meantime.

Try some mindfulness, meditation or other self therapy tools to support you

Look for local support groups

Charity and third sector options

Some community and charity sector organisations may offer free or low-cost talking therapies. For example:

Your local Mind, local Rethink Mental Illness, or local Turning Point branch may be able to offer you talking therapies. Sometimes these local organisations may also form part of a local service with the NHS.

Mental Health Matters (MHM) offers a telephone counselling service and talking therapies in some areas.

Anxiety UK offers talking therapies for anxiety. There is a fee but they do offer reduced costs for people on a low income.

Cruse Bereavement Care may offer free counselling services if you have experienced the death of someone close to you.

Rape Crisis centres offer counselling to survivors of sexual abuse and sometimes to their families.

Private therapists

There are many reasons you might consider going private, although it's not always a possibility or a viable option for everyone as it can be expensive. If you would like to explore the options of private therapy, it's a good idea to look for a therapist on professional sites, which only lists therapists who are registered with a professional body. For example:

The Counselling Directory – for all kinds of counsellors and therapists

The British Association for Counselling and Psychotherapy (BACP) – for all kinds of counsellors and therapists

The British Association for Behavioural & Cognitive Psychotherapies (BABCP) – for cognitive behavioural therapy (CBT) practitioners

The UK Council for Psychotherapy (UKCP) – for psychotherapists

The British Psychological Society (BPS) – for local therapists

Pink therapy – for therapists with LGBTQ+ experience.

Paying for therapy can be a big expense, before committing to paying for therapy it may be helpful to make sure you ask some basic information, such as:

How much does the therapist charge per session?

Do they offer a free introductory session to allow you to decide whether you can work together?

Do they offer reduced rates for people on low incomes?

Do they charge for missed appointments (and if yes, how much notice do you need to give them to avoid being charged)?

What qualifications does the therapist have?

What type of therapy do they specialise in?

How long have they been practicing?

What's it going to be like?

If you have been able to access therapy either through the NHS, a charity organisation or privately then you may now be wondering what it's going to be like....

Let's talk about First times:

What will happen the first time I see a therapist?

So you have decided to work with a therapist - What next? How will I feel? What should I do?

These are all questions you may be thinking, perhaps even worrying about. It is ok to feel nervous, apprehensive or even scared at the thought of starting therapy, acknowledging these feelings and letting them pass, or even writing them down can be a helpful exercise. In doing this we can allow ourselves to feel the emotions and acknowledge the concerns but then to let them pass.

We can take them to the session with the therapist as a starting point, if we felt this would be helpful. Having these thoughts, feelings and emotions is normal, it may even ensure that we have something to say in our first session and confirm we are ready to start therapy.

If it helps for you to prepare yourself you can always write a list of questions to ask your therapist at the start of your session, when you get started you may even find you didn't need them.

Some therapists might call your first session an 'assessment', a 'consultation' or an 'getting to know you session', but these generally mean the same thing and the first session generally involves the same information sharing.

It is usually a good starting point for the therapist to start the session by explaining, or answering any questions you may have about:

their confidentiality policy

the type of therapy they practice

how long the therapy will last and what the sessions will be like

what to do if you they have to cancel a session or you miss a session

if there is any cost involved (this usually applies to private therapy)

Discuss boundaries for example: Are they contactable outside work hours in a crisis

What additional sources of support can they offer

It may be helpful to also ask any question you may have or share any concerns or worries you have about the therapy or explaining to the therapist what you want to get out of the therapy.

If you're unsure or do not understand some of the information then it's ok to ask your therapist questions at any time before, during or after your sessions. You might also find that you feel overwhelmed in this first session, particularly if you have been waiting a long time to start. Give yourself some time to adjust to the session, and if you really can't remember what the therapist told you then you can always ask for important information to be shared with you in writing. That way you can always have something to go back to a check if you need it.

So, first session done, what is it going to be like now?

Well it's your therapy, how would you like it to go? It can be really helpful to explore with your therapist your expectations, concerns and hopes. This can mean you are able to work in partnership to tailor therapy to you. You may have no expectations and are content to see how things work out, that is absolutely fine too.

How sessions are structured can vary depending on depending on the type of therapy you're getting and the issue or problem that brought you to therapy

Therapy can be both time-limited, meaning your therapy will come to an end after a set number of sessions. This is generally true of most therapies provided through the NHS, generally you will be offered time-limited sessions of anywhere between 6-8 sessions. Or therapy can be open-ended, meaning it can continue for as long as you need it. This is something that is more commonly offered by private therapists.

One-to-one sessions typically last between 50 minutes and an hour, generally sessions are once a week, at the same place and time, but you might also agree to see your therapist more or less often than this, or on a variety of times and dates that suit you.

Sessions may take place in an appropriate meeting room owned or rented by your therapist (or by the organisation providing the therapy, such as the NHS, a charity organisation)

Sessions can also be provided over the phone or online using an internet calling software, in current times this is becoming more common. This virtual type of therapy also allows for sessions at out of hours times and can mean that accessing therapy is much easier.

What will we be talking about?

As we have talked about through this blog, what you talk about is totally up to you, it is your session to use how best suits you. Therefore what you might cover in therapy sessions also varies, on what you are looking to achieve, or what is important to you in that session.

The type of therapy you are receiving may also impact on what you are talking about, For example, your therapist may go through specific exercises with you, if you have previously agreed to work on a specific issue you have already identified.

Or if you are working in a more broad approach you might have a more general discussion about how you're feeling, seeing where that leads you in the session. Your therapist may ask you questions to help you in exploring and learning about yourself. You may find it helpful to discuss your current and past relationships, your childhood and past experiences, how you feel, how you behave or what you think about things. You may also find during the session you explore a 'break through' and wish to revisit issues that have come up in previous sessions in more detail.

But it's important to remember that you don't have to talk about anything you're not ready to talk about, or do anything you don't want to do.

How will I feel after a therapy session?

It's common to feel a range of emotions after a session, For example, you might come out of your session feeling:

Relieved, or a weight has been lifted if you've shared something important and felt heard and understood or validated.

Energised, if you've started to understand something new about yourself or set yourself a new goal to work on, it can be exciting to feel like you are progressing, or that you are better able to cope.

Exhausted, if you've found the session challenging or hard work, sometimes it can feel like we are wading through mud, or just not getting anywhere fast. Therapy is a journey, keep going.

Frustrated, if you didn't get what you wanted out of your session or haven't felt heard or understood. Maybe your therapist said something that angered you, maybe you realised something that happened was more upsetting than you really acknowledged. Keep going there could be more to this.

Upset or overwhelmed, if the session has brought up very painful or difficult memories or feelings.Sometimes therapy sessions can bring up feelings that are difficult to cope with, and you might feel nervous about going back, or like you don't want to continue with the work and that you want to quit.

These feelings can be exhausting, frustrating and painful, especially when you feel they are unresolved, or you have little power over them. There are some things that can be helpful to focus your feelings and thoughts during the break between sessions, or help you stay focused on the end goal of your therapeutic work.

Firstly planning something you enjoy for after immediately each session as a little treat, or to help you relax. Meeting up with friends or going for a quiet walk can be immensely helpful in giving yourself space and time to process some of the content of your sessions.

Trying some mindfulness, meditation or focusing on a mantra such as 'I am worthy of therapy, I am doing well in my therapy' 'I can keep going because I know where I want to be' can be helpful in refocusing us to what we want to achieve.

Talk about it, this could be with a listening service like samaritans or someone you trust, such as friends or family, it could even be with yourself, talking to your reflection or writing down and journaling your thoughts and feelings can help them feel external to you and less overwhelming.

Journalling can be really helpful between sessions to support your learning and to help you bring things back to the next session to work on more. It may also be helpful to start your next session by telling your therapist how you felt after your last session, and give them a chance to reflect with you and offer support.

What if you feel unsafe after a session?

If therapy is bringing up feelings that feel too big to deal with or has left you feeling vulnerable and raw and concerned that you can't cope .You may even feel like you're in crisis after a session, if this happens then you can contact a crisis service in your area and seek urgent help. Tell your therapist how you are feeling and ask for emergency contact details.

What if I'm offered therapy I'm not interested in?

Getting the most out of therapy can sometimes feel difficult, especially if you're offered a type of therapy that you feel isn't exactly right for you, or is a type of therapy you don't know much about, or worry that you've not been offered enough sessions to make a difference.

While these are all valid concerns there are positive steps you can take to get the most out of any therapy you're offered.

Getting the most out of what is available to you, first starts with you, have you considered all of the options we have discussed above. Are there any other options you haven't considered, such as does your workplace offer therapy sessions?

Most importantly making sure talking therapy is the right choice for you just now. Ask yourself, am I ready to explore my feelings and behaviour? If you are then perhaps trying the type of therapy offered to you would be helpful regardless. If you feel able and ready to open up about things that are very personal or hard to talk about, or starting to do the therapeutic work then perhaps what you are offered will be the start of that work, and hopefully further to a better state of wellbeing.

Deciding what you want to achieve from therapy can be really helpful in your engagement with therapy, even if it isn't the therapy style you wanted. It can help to set some small goals which you feel are achievable. Discuss this with your therapist so you can both aim to reach a shared goal. You may find that just by starting you are able to make the most out of the therapy and can reach your goals, regardless of the type of therapy you receive.

Understand the type of therapy you're going to be getting, before we write something off because it isn't what we wanted, why wouldn't we first look at it in more detail. you could even discuss with the therapist how they think this kind of therapy can help you, and what to expect from it. To get the most out of anything we first need to try to understand it, understanding is important when we are looking to apply something to ourselves. Is this a style you can work with, is the therapist someone you can work with, ask them to explain in detail what the therapy is, do some research. Sometimes some help is better than no help, you may even come to find that it can be a bigger help if you let it.

Start talking about what's most important to you, as we have touched on throughout this blog therapy sessions are your time for you, and you shouldn't feel pressured to talk about something you don't feel is important. Talking about what you want to achieve and how you see yourself achieving that with your therapist can be really helpful in finding a productive way of working together. Remember just because the therapist is a professional doesn't mean they know what you're thinking, or what is right for you, they are simply there to support you and guide you to what you want. This is also important to Tell your therapist what's working and what isn't. They might be able to change the sessions so that they suit you better, or you might be able to find a new way together.

Make it work for you, if you need to make the room feel more comfortable and safe. You want to bring something that gives you comfort, do it. The therapist isn't going to judge you for wanting to make yourself comfortable and relaxed. Bringing an item can also help you feel most grounded in the session, or help you redirect energy that is unhelpful. For example, you could ask to change where you sit, or adjust the lighting or the temperature of the room, or you might want to hold a teddy or stress ball to support you.

If you know the session is likely to be difficult for you, have a plan. That could be having someone you trust nearby. It could be planning a treat for yourself after your session . Anything you feel could be helpful to your support and relaxation after the session.

You have got this!