What is counselling and psychotherapy?

Counselling and psychotherapy are pretty much the same thing. Some clinicians might say counselling if the work is on the short side (1-18 sessions/weeks), and psychotherapy if it’s longer than that, but generally these are two words for the same thing. It means talking about whatever feels important to talk about with a professional, trained in applying psychological theories and research to help you. You would usually see the same therapist at the same time and at the same place every week for an agreed number of weeks (though it can be open-ended). Many people find the experience of talking to someone bound by confidentiality laws, whom they don’t know and isn’t a part of their life outside of their weekly sessions, as incredibly freeing in itself. On top of that, I’ve trained for many years to help people uncover, unravel and untangle the things that keep them trapped, stuck or distressed.

Can you help me?

Therapy is often talked about as treatment for mental health issues. Depression, anxiety, panic, PTSD, eating disorders, sexual trauma, OCD, bipolar disorder, personality disorders etc. I’m trained to help with issues like these, and have many years of experiences doing so. However, a large proportion of my clients don’t have severe mental health issues, or a specific diagnosis, but would like help understanding why they feel, think and behave the way they do, and want to change.

Some of the people I work with have traumatic experiences in their past that they feel might still be affecting them. Others find themselves moving from relationship to relationship, unsure why they struggle to invest in another person. Others have a constant sense of anxiety and worry in the back of their mind. Some are constantly trying to prove themselves, but feel that there is something fundamentally flawed about them. Others feel demotivated and low, and that life is meaningless. Some are constantly stressed, but just can’t seem to slow down. Others tell lies, but they’re not sure why. Some of my clients simply want to understand themselves better. The list goes on.

What we know from decades of research into the effectiveness of psychotherapy and counselling, is that it works. Whatever is going on for you, there’s a good chance talking to someone about it can help. It does not mean you have “mental health issues”, or are have an illness. Shoot me an email, and we can discuss what’s going on and whether psychotherapy might help you.

How does therapy work?

That’s a very interesting question, one that has been researched extensively. What differentiates psychotherapy from medicine, is that every person is so different. Most broken arms are more or less the same, and can be treated more or less the same. When it comes to our personalities, psyche and wounds, feelings and behaviours however, it’s not that simple. Two people who both describe themselves as anxious, or even have a diagnosis of Social Anxiety Disorder, might have completely different underlying reasons for their anxiety. Therefore, it’s a lot harder to delineate exactly how therapy heals than it is for a medical doctor to explain how a broken arm heals.

However, there is plenty of great research that has tried to unpick the factors that help a person improve and change in therapy. What consistently comes up, is that it is the relationship between you and your therapist (the therapeutic relationship) that largely determines the success of the therapy (we often say the relationship is the vehicle of change). For example, one very interesting study (1) that is cited a lot estimated that about 30% of the outcome of therapy is determined by the relationship between therapist and client, whilst the specific type of therapy and techniques the therapists uses only accounts for about 15% of change. In other words, your relationship and connection with your therapist and is around twice as important as what sort of therapist they are.

Thus, the most important thing is finding a therapist who you trust, feel safe with and connect with. That’s one of the reasons why I’ve written so much on my website, so you can get a bit of a sense of who I am and what I believe.

1. Asay, T. P and Lambert, M. J (1999): 'The empirical case for the common factors in therapy: quantative findings', in M. Hubble, B. L. Duncan, and S. D. Miller (eds): The heart and soul of change: what works in therapy. Washington, DC: American Psychological Asociation, pp. 351-357

How long does therapy take?

I’m afraid there is no good answer to that question. The number of sessions is something we normally discuss in the first appointment, and review as we go. Because every person is vastly different, even if they have the similar issues and challenges, it is impossible to predict exactly how long something will take. My experience is that other issues often emerge in therapy, and sometimes things that seem very defined turn out to be linked to many other things.

How do I know therapy will work?

You don’t. But, research has made it clear again and again that psychotherapy is a very effective treatment for most mental health issues, as well as for more general distress or suffering. Even if you don’t fit into either of those categories, part of the power of therapy is that it helps explore you and why you do the things you do, and helps you change and grow positively.

What is the difference between a counselling psychologist, a clinical psychologist, a counsellor, a psychotherapist, a psychiatrist and a doctor?

I get this question a lot, and all these professions overlap quite a bit. I’ll try to explain the difference below:

Clinical and counselling psychologists are two different subtypes of psychologists (other types are educational, sports, health, forensic etc) with slightly different emphases in terms of their training and focus. There is a large degree of overlap between clinical and counselling psychology and psychologists from both fields may be involved in assessment, treatment (typically psychotherapy/counselling) and research. In fact, differences in emphases generally has more to do with the personal preference of the individual psychologists more than whether they are from the clinical or counselling tradition. Very roughly we can say counselling psychologists focus more on treatment, providing psychotherapy and counselling for clients across the spectrum of struggling, whereas clinical psychologists may emphasise assessment work more.

Counsellors and psychotherapists are generally focused on delivering treatment (psychotherapy/counselling) to clients. They overlap considerably and in the end it is often down to individual preference whether practitioners call themselves psychotherapists or counsellor. Very generally we can say psychotherapists often have longer training than counsellors, but this if not always the case.

Psychiatrists are all medical doctors who have specialised in treating mental health after they’ve completed their training, just like surgeons, paediatricians etc. Though many psychiatrists are trained in some models of psychotherapy, they generally focus on assessing mental health problems and using medication, such as anti-depressants, to treat patients.

How do I choose the right therapist?

Interestingly, there has been considerable research looking at ‘therapist effects’, that is, trying to determine which therapists have best results. What the research shows is that level of education/training, gender, model of psychotherapy and even experience don’t account for differences in outcomes (1). In fact, research tends to show that some therapists are simply better than others and that it doesn’t depend on differences in training or gender. That means that just because I have Dr. in front of my name doesn’t necessarily mean I am a better practitioner than someone who does not (see the questions about the difference between psychologists, counsellors, psychotherapists and psychiatrists). Research also shows that the main determinant of the success of therapy is the quality fo relationship that is built between the therapist and client (as discussed under How Does Therapy Work?'). So, when looking for a therapist, it is important to find someone who works well for you and with you, someone you can open up to and talk to. Research suggests their level of training is secondary to that. So if you find a counsellor you think/feel you can connect with better than with me, I would absolutely go for them.

1. Okiishi, J, Lambert, M. J, Nielsen, S.L., & Ogles, B.M (2003): Waiting for the Supershrink: An empirical analysis of therapist effects. Clinical Psychology and Psychotherapy, 10, 361-373.

How much does therapy cost?

My fee is $180 (excluding 15% GST, which makes it $207) per 50 minute session. In your first session I’ll ask about how you’d like to pay, either with cash or by bank transfer. If you pay by bank transfer I’ll email you an invoice after the session.

Why is therapy so expensive?

It varies quite a lot how much therapists charge, often depending on the length of their training and their level of experience. I’ve spent 7 years training, having done a doctorate in counselling psychology, and so I’ve tried to set my fees as low as I can, whilst also reflecting my level of training. Most counsellors and psychotherapists tend to have postgraduate diplomas or masters degrees, and some of them might charge less than I do. However, from looking at what other clinicians in the field charge, I believe my fees are competitive.