What is therapy?

What is counselling and psychotherapy?

Counselling (sometimes called therapy and/or psychotherapy) is not simply passive listening or advice giving, in fact it is the opposite; counsellors strive to empathically listen to your difficulties in a non judgmental atmosphere.  Counselling works with you by encouraging you to express your feelings about the emotional  or life difficulties troubling you that may have prevented you from thinking clearly about decisions you have to make. 

How can therapy help me?

Therapy can help you to express emotional difficulties without fear of judgment or criticism, allowing you to work through difficulties and dilemmas.  Expressing yourself in this way can help you to explore the options open to you in order to enable you to make decisions and move forward in your life.

Counselling is often offered if you are dealing with grief and loss,  pregnancy, birth and fertility issues, life difficulties such as separation, job loss and other painful life transitions such as your children leaving home, caring for ailing parents, and adjusting to your own loss of health or disability.

You may also have experienced difficult relationships with your parents and/or early caregivers which can have a significant impact upon your life now. Sometimes, the link to these early experiences are not always obvious to what you are experiencing now: such as relationship difficulties, low self esteem, anxiety etc.  Counselling can help you to explore these experiences, and seek resolution.

If you have specific difficulties at the moment, you may find other pages on this site helpful, where you may be interested to know more about common emotional difficulties, such as bereavement, depression and anxiety.  Please contact me if you have any further questions.

Specialist Counselling/Psychotherapy

Trauma & PTSD
If you are experiencing symptoms of trauma or PTSD, then there are specialist types of therapy available. Please see trauma pages to learn more.  People often assume that PTSD is only experienced by veterans, and it is of course true that combat veterans experience PTSD. However,  if you have experienced sexual or physical assault, a road traffic accident, a signifiant personal injury or childhood neglect and abuse, witnessed the death, or near death of another, then you may be experiencing symptoms of traumatic  stress or PTSD.  If you think you may be experiencing symptoms of trauma, it is highly recommended that you seek help from a specially trained trauma therapist.

Nicola is a qualified EMDR therapist. EMDR is a NICE approved, evidence based therapy for trauma and PTSD. Please see her trauma pages to learn more about how these therapies can help you.

Self Harming & Suicide
Sometimes people feel so overwhelmed by their emotions and difficult experiences that the only way they can alleviate these feelings is by deliberately harming themselves (cutting,burning, taking poisonous substances, to name a few), or ultimately by making attempts to end their life, or feeling like they want to end their life.  There are specialist, evidence based therapies that can help you to learn to cope better with these feelings and ultimately reduce these behaviours.  FIND OUT MORE HERE.

Nicola is a qualified Dialectical Behaviour Therapist (DBT).  Please see the pages on DBT to find out more.

The first steps to getting help is arranging a consultation session.
What is this?

The first appointment you will be offered is called the consultation session and this lasts for one hour. Prior to this initial session, you will be sent a registration form to complete and either bring with you to your consultation, or return by email.

Depending on the difficulties you describe during the consultation, a number of therapy options will be discussed with you.  Sometimes it may become clear during the consultation that therapy is not suitable for the difficulties you describe; if this were to be the case I would discuss this with you, and help you to find an alternative and more suitable source of support.

At the end of the consultation, you will understand the type of therapy that is being offered to you, what the focus of the sessions will be, and the initial number & frequency of sessions.

You will NOT be asked to agree to commence therapy there and then. You will leave the consultation without any requirement to continue with therapy. Should you wish to continue with therapy, you will then contact Nicola after the consultation session to book in for further sessions. She will not contact you to follow up, and this fits with the principle of autonomy in therapy; the notion that you are in charge of the choices you make.

To confirm your consultation session, you will also be asked to pay for your session in advance by BACS payment.  If you cancel your session with less than 24 hours notice, or do not attend your session, you will still be charged the full cost of the session. 

The cost of a consultation session is £60.

What happens during therapy sessions?

During counselling sessions, you will be encouraged to talk openly  about things that may be difficult or painful for you.  Your counsellor will not judge you or tell you what you should do, instead will listen empathically, and help you to process any painful feelings that you have, without fear of judgment or criticism.  Your counsellor will work hard to try and help you to understand what you may need to begin to feel better.

How many therapy sessions will I need?

The therapy offered is time limited, meaning that sessions do not run continuously without you understanding how many sessions to expect.  Initially, therapy should take place on a weekly or fortnightly basis.  At the consultation, we will agree an initial number of therapy sessions, and this depends upon a number of factors, including the extent of the difficulties you are experiencing.
Four sessions are usually offered initially, followed by a review and together we will decide how many further sessions you may need. The number of sessions required is reviewed regularly as circumstances change.  Sessions are usually 50 minutes long, and to gain the maximum benefit from your session, it is important to arrive promptly as the therapy session will need to end on time. The number of sessions is offered as a guide only, and you have the right to withdraw from therapy at any time; you are not ‘contracted’ into a set number of sessions.

Will therapy make me feel better straight away?

Many people sit before me in the hope that counselling will make them feel better quickly and painlessly, and an important part of my role is to manage expectations about what happens during counselling sessions.  Sadly, usually the reason you may be seeking counselling is because something very painful has happened, or you are experiencing difficulties that you have not been able to resolve.  Often when difficult things have happened, it seems like a good way of coping is to shut these feelings out, as they are too painful to think about.  Whilst blocking out can be a helpful measure in the short term, over the longer term, some people find that they experience emotional difficulties as a result of these painful feelings and experiences remaining unprocessed. Therapy encourages you to open yourself up to discussing these feelings or experiences, and explore them safely with your therapist, who will help you to work through, and make sense. This is known as the ‘process’ of therapy.  This process can take time, particularly when things have been buried or hidden for a long time, and this can be a very painful process, with the aim of ‘working through’, supported by the warmth, understanding and encouragement of your therapist.  Therefore, things can feel worse before they feel better, and that is a natural and necessary part of therapy.

Is therapy confidential?

A vital aspect of developing an atmosphere of warmth and trust is knowing that what you tell your counsellor won’t go any further. Counselling sessions are confidential, meaning that the information shared between you and your therapist is held confidentially including the notes that are taken as a record of your session.  However, in order to work legally, ethically and to promote your safety, there are some circumstances in which this confidentiality agreement may be broken, and these are outlined below.

Quite often people seek therapy when they feel they are in some sort of crisis, and may even feel suicidal.  Counsellors and Psychotherapists are used to hearing these ideas, and an important part of therapy is to explore these feelings with you fully; more often than not these feelings subside as a result of them being better understood by being discussed openly.  In the rare event of these feelings becoming worse and you believe that you may take action to seriously harm yourself or another then additional support is required. In these circumstances I will discuss this with you, and hope to gain your consent to contact other medical professionals to enable us to keep you safe, and this is usually your GP. In addition, I may seek to contact the emergency contact that you provide in your information sheet.  This means that I may need to break our confidentiality agreement in order to protect you.

Additionally, the protection of children and vulnerable others is paramount, and if you were to disclose any information to indicate that a child or vulnerable other has been harmed, or is in danger of being harmed, I would need to share this information with other agencies. In addition, from a legal perspective, I am required by law to report any information that is shared regarding serious organised crime such as dealing in weapons, terrorism, money laundering, or drug or human trafficking.

In any of these circumstances only relevant information will be shared with relevant agencies, this means that a lot of the information that you have shared with your counsellor will still remain confidential.

Where will therapy take place?

Face to face sessions will take place at my wellbeing centre ‘Nine Wellbeing’, Wirral. In some cases, sessions can take place over the telephone, or via Skype.

What should I look for in a therapist?

Choosing a therapist is a very personal process.  As an example, some people find that working with someone of the same gender is more comfortable. Some prefer a younger therapist, and others an older one.  We are all different. What is important is that you feel comfortable with the therapist whom you are working with, and that they are in a position to work ethically.  Qualifications are also important, counselling and psychotherapy are complex processes, and you have every right to ask your therapist to see their qualifications.  Membership of a professional body such as BACP, BABCP, HCPC is essential, as if you have any concerns about the way in which your therapist is working, or have a complaint, the therapist’s professional body is where you can take these concerns to, for investigation.  Your therapist should also hold indemnity and public liability insurance. 

How much are therapy sessions?

Individual counselling sessions cost £60 per session.  Sessions usually last between 50 minutes and 1 hour. Specialist counselling sessions cost more, as the sessions generally last longer. A session of EMDR/Trauma-Focused CBT or DBT can last up to 90 minutes and costs up to £120 per session. 

I am interested in therapy but I’m not sure, what happens next?

If you would like to discuss your needs further, or have any questions, please contact me and I will be very happy to help.
We can have a brief discussion by telephone, or by email. You may contact me by text to arrange to speak or email, but consultation sessions will not be scheduled via text message.

If you have any special requirements in order for you to access these services, then every effort will be made to accommodate your needs and respond appropriately. Please do let Nicola know straight away if you have any particular requirements.

If you decide you would like to proceed with therapy, we will arrange a date for you to come in for a consultation, and I will send you an appointment letter, and a registration form for you to complete and bring to the consultation session with you.  You will be required to pay for your session in full and in advance of your session, to confirm your appointment.

Nicola Forshaw holds a Masters Degree in Counselling (with distinction), a diploma in Cognitive Behavioural Therapy, and a certificate in Dialectical Behaviour Therapy.  Nicola is a highly experienced trauma/PTSD therapist and is and is fully qualified in EMDR (Eye Movement Desensitisation and Reprocessing). She is accredited by BACP (British Association of Counselling & Psychotherapy), and is also a registered member.