Counselling, Couples Counselling and Psychotherapy
in Richmond

Robert Hill MSc, BACP Accred Counsellor, UKCP Reg Psychotherapist

Frequently Asked Questions

What is the difference between talking to a counsellor/psychotherapist and talking to a friend or family member?

The first thing to say, is that I believe being able to talk through our troubles with friends and family is often really valuable. And in my experience, one of the outcomes of successful counselling/psychotherapy is often that the client finds it easier to be more open with people close to them and that helps them immensely in their future life. In other words, the sessions have acted as a ‘bridge’ for the client towards sharing more of themselves with those around them.

However, there are key differences between talking to counsellors/psychotherapists and talking to friends and family.

• Unlike friends or family members, counsellors and psychotherapists have extensive professional training and experience in in how to listen, support and help clients understand what they are experiencing.
  
• Counsellors/psychotherapists are more independent and detached from the client’s life than the people around them. Because of this they hopefully do not have their own ‘axe to grind’ and can instead focus on standing alongside the client and exploring their unique perspective.
  
• Because of the therapist’s independence and emotional robustness, the client does not need to fear upsetting the therapist or hurting their feelings in the way they might with people close to them.
  
• Talking to a counsellor/psychotherapist is confidential.
  
• The client is in control of how much they chose to share with their therapist – and they may not feel this with friends and family.
  
  
  What is the difference between Counselling and Psychotherapy?
  
  Different counsellors and psychotherapists will have their own individual answers to this question – there is not a single right answer.
  
  Personally, I regard the focus of counselling as helping the client manage their distress and come to terms with something in their life which has knocked them off course. When this is complete – and the client feels ‘back to their normal self’ then the job is done. Go to Counselling page for more detail.
  
  In the case of psychotherapy, the client may be distressed, but is also experiencing some underlying set of problems which need to shift or change in some way for them to lead the life they want to. The focus is less on ‘getting back to normal’ and instead on ‘finding a new way of doing things’. In other words, I view psychotherapy as more foccused on change than counselling. Go to Psychotherapy page for more detail.
  
  
  Does it mean that I’m “ill” if I am thinking about getting Counselling or Psychotherapy?
  
  Sometimes my clients come with a sense of being ‘ill’ in some way and they may, for example, have been prescribed drugs by their GP or by a psychiatrist. In which I make a point of exploring whether the drugs seem to be helping them and what the perspective of the doctor is on their situation.
  
  But many of my clients do not view themselves this way and in the work I do with clients I myself very rarely find it useful to ‘frame’ the client’s issues in terms of illness. In this sense, I am not committed to the so-called ‘medical model’ of counselling and psychotherapy – in which the client is seen as ill and the therapist’s role is to ‘cure’ them. I am normally much more focussed on whether and how the client feels they are not living or functioning as they want to rather than in diagnosing them in terms of mental illness.
  
  
  Will I get more upset by talking about my problems?
  
  In some cases this may happen. For example, some clients are struggling precisely because they have not yet found an outlet for their upset and yet know that they are in some way, weighed down by this. For these clients, it can be very beneficial to feel the full impact of what they are struggling with. This can be hard, but also a relief, and sometimes is key to allowing them to ‘move on’ and make changes.
  
  But this is not necessarily the case, and for other clients it may be counterproductive for them to simply re-cycle and re-experience distressing emotions.
  
  In either case, the key is that the client and I together keep an eye on their level of distress throughout the work and jointly explore whether what is happening is therapeutic or not.
  
  
  How often and for how long do I need to come?
  
  In my experience, it is most effective to meet regularly at the same time each week. Sometimes this is not possible because of the client’s schedule – in which case we have to work around this. Although if the sessions become much less frequent than once a week, then the work can drift and lose focus.
  
  The time that it takes for the counselling process to work varies widely - from just a few sessions through to many months. Psychotherapy normally takes longer and, in some cases, can take several years.
  
  
  Will what I say be kept confidential?
  
  Confidentiality is central to the way I work and to the ethical guidelines of my professional bodies. Everything clients tell me is confidential with the only exceptions being:
  
  
• If I believe that they are a risk to themselves or others then I am ethically obliged to work with them to prevent this happening and if necessary to break confidentiality,
  
• As with all properly accredited practitioners, I undertake regular supervision in which I talk about clients – but on a basis which does not disclose their identity.