The importance of choice in therapy
- Counselling; A time to end and a time to begin1st March 2017
- Counselling and the art of giving back1st February 2017
- And this year I will…..1st January 2017
- Social Anxiety, Counselling and Christmas1st December 2016
- Couple Counselling – and just when is a discussion an argument1st November 2016
- Therapy, Mobiles and the Challenge of Choice1st October 2016
- Counselling, September and an Ellison’s Orange 1st September 2016
- Counselling – A room with a view1st August 2016
- Counselling: Choices and Decisions1st July 2016
- Counselling, Musee d’Art et d’Histoire and the Inevitability of Change1st June 2016
- Counselling and the art of Ambiguity. 1st May 2016
- Repetition; Normality or Folly. A Counselling Perspective1st April 2016
- Lions, Lambs and Therapy3rd March 2016
- Valentines Day, Counselling and the Great Unknown1st February 2016
- Janus Faced? The New Year, Counselling and Psychotherapy1st January 2016
- So which road do we travel this Christmas...1st December 2015
- Counselling, Guy Fawkes and Scapegoating1st November 2015
- Counselling Work and Narrative Therapy1st October 2015
- Counselling, Therapy and the end of Summer1st September 2015
- Wheat, Rye and Counselling1st August 2015
- Counselling and a break away3rd July 2015
- Counselling and the unexpected1st June 2015
- Counselling, Elections and our opportunity to choose1st May 2015
- Therapy, an April fool and the art of lost memory1st April 2015
- A Spring Clean Therapy and Counselling1st March 2015
- Couple Counselling & Valentines Day1st February 2015
- Nothing changes if nothing changes but this year can be different!1st January 2015
- Social Anxiety Disorder A Christmas Concern1st December 2014
- SAD & those dark Winter nights1st November 2014
- Existential Counselling A useful approach or pretentious jargon?1st October 2014
- Counselling, Therapy and a return to work1st September 2014
- Holidays, Counselling and your Shadow1st August 2014
- Couple Counselling and Choice1st July 2014
- Counselling, Jules Rimet and you A therapeutic perspective1st June 2014
- Counselling and Mayday A different take on a familiar story?1st May 2014
- Useful Therapy and not an April Fool1st April 2014
- Counselling, Floods and Pandoras Box1st March 2014
- Counselling and the art of being normal1st February 2014
- The New Year and a time for change?1st January 2014
- Christmas & Counselling The first Noel1st December 2013
- Counselling, Broomsticks & Halloween1st November 2013
- Couple Counselling and just what is a successful relationship?1st October 2013
- Counselling An issue of choice?1st September 2013
- Existential Counselling From Yalom to Basingstoke1st August 2013
- Counselling and the art of reframing1st July 2013
- Counselling - Change or Conformity?1st June 2013
- May Day Counselling - Celebration or Conflagration ?1st May 2013
- Summer Time & the Counselling Room1st April 2013
- Depression a useful diagnosis or an unhelpful label?1st March 2013
- An Emotional Timeline3rd February 2013
- Resolution, Revolution & Counselling1st January 2013
- Christmas, Carols & Counselling2nd December 2012
- Seasonal Affective Disorder and the SAD Season4th November 2012
- Psychotherapy & Counselling A Stoic Perspective17th October 2012
- 10th October 2012 - World Mental Health Day5th October 2012
- A First Meeting Explanation or Exploration?5th September 2012
- CBT, Mental Filtering and the Olympics19th August 2012
- I am not an angry man 14th July 2012
- Art, Counselling & Interpretation26th June 2012
- Murder Mysteries and Psychotherapy25th May 2012
- The importance of choice in therapy29th April 2012
- Reflections on Spontaneity6th April 2012
- A personal trainer for the mind 12th March 2012
Choice has recently become a mantra which is loudly chanted in an increasing number of locations. Whether we are considering hospitals, schools or energy companies, there is a loudly and now oft repeated suggestion that true satisfaction will only come about when the user is able to exercise choice.
Yet not everyone seems to buy into this idea. On that unfortunate day when an arm is broken or when the electricity supply fails, it seems that many people are happy just to have things quickly fixed. But what of the counselling world? How important is choice when it comes to selection of therapy? There are some who will argue robustly for the importance of variety and choice in counselling and there are some very good reasons for that.
Counselling or therapy is for the most part a voluntary activity. Clients usually walk into my counselling room in the outskirts of Basingstoke in Hampshire because of a sense that the time is now right to do something. I often see a mix of bravery and desperation reflected in that initial walk. Bravery because it is not always easy to talk to a stranger about personal and intimate aspects of life; and desperation because the counselling room can for some represent the place of last resort.
Yet despite the constancy of this mix of bravery and desperation, much else can be very different as far as each individual is concerned. Clients come into counselling with diverse issues, and experiences. People will often want to work in very dissimilar ways. A common tool in the counselling room may be language but how the words are presented and used can vary enormously.
Some clients will want to talk in a structured, linear way and tell a story from start to finish. Others will want to play with words, to toss them around and see what can emerge. Some will simply want a place of safety which will allow for a gradual uncovering until they are ready to reveal some hidden part of themselves to another person.
The variation in those preferred approaches suggest that very different forms of counselling may be needed. It suggests that for some the structured approach of Cognitive Behaviour Therapy (CBT) may be an ideal technique, whereas for others a more holding modality such as person centred work could provide a more appropriate fit.
For clients who want to remain very much rooted in the here and now, and remain with the exercise of choice, gestalt or existential work may provide the key to emotional resolution. Others who want to move more quickly may prefer to work with a solution focussed technique. Alternatively those who need to understand and wish to delve into the deeper recesses of their emotional being may want to work in a psychodynamic way.
The actual descriptors of the various techniques can be bewildering. The terminology within the counselling world can be unnecessarily complex. Therapists sometime seem to compete with areas such as the computer industry or business consultancies in using terminology and initials which seem intended to confuse rather than clarify. Yet that terminology does albeit clumsily, reflect the very different schools of counselling and therapy which exist.
The choice of modality can remain key to a good outcome from the counselling experience. The client who wants to take time to understand her or his inner being may be frustrated by the CBT specialist who wants to work in a more structured and focussed way. Equally the client who needs to urgently conquer an obsession in order to be able to once again travel in crowded trains or subways, is likely to be irritated by a slow psychoanalytical journey around the misty lanes of yesterday.
In addition to a choice of technique, the selection of the right counsellor is also seen by many as crucial to the success of the work. There is an often repeated suggestion that the relationship between therapist and client can be more important than the specific counselling technique adopted. This relationship is sometimes referred to as the therapeutic alliance and that concept of a good working alliance between therapist and client can be regarded as crucial to a satisfactory outcome.
Whichever technique and whichever counsellor is selected, the challenge for us as therapists is to treat all clients with the utmost respect. We need to ensure that we take time in the counselling room to allow for transparency and to explain the process. Choice is only meaningful if it is informed choice and that means helping clients to understand what support is available.
I am not certain that as therapists we are always as clear as we could be in explaining our particular modalities. Sometimes that may be a deliberate approach on behalf of the counsellor. There will be some therapists who prefer to present as a blank canvas in the room and who fear that to respond to any technical questions around process will somehow jeopardise the eventual outcome of the work. I do not share that view.
Clients should be given the information that they need to allow reasoned choice to be made. Counselling should not become education but the initial assessment can be informative for both client and counsellor. In walking into our consulting rooms for the first time, clients will be seeking as well as giving information and we should encourage that process of exploration.
Perhaps with choice may come a greater degree of commitment. That could explain in part why this phenomena of choice is now seen as so important for consumers. Whatever the benefits, we should always remember that within the counselling world, clients have the right to choose. As therapists we should do all we can to facilitate that expression of choice.
added on 29th April 2012
Please feel free to leave comments on this blog using the form below.