What is psychotherapy / how does therapy work?

You may have come across many terms for therapy – such as psychotherapy, counselling or talking therapy. Essentially, all these words describe the same process – a relationship which offers people a non-judgemental space to talk and be deeply listened to. As both client and therapist work together to help the person explain and explore their life, this may be the first time the client feels able to talk openly about some issues. Sharing with a therapist who fully accepts the client as they are helps to facilitate understanding, new ways of framing the past, and the strengthening of inner resources and growth of new skills.

In my practice, I have observed that, once trust has grown and the client’s story starts to emerge, I often become a mirror for what the client needs – but has been unable – to reflect back to themselves. My presence in the physical and emotional space of the room provides a safe container to enable the client to uncover their truths for themselves – they find the courage to say out loud what has long been buried in the subconscious or stuck deeply in the body. And in doing so, they are able to reveal to themselves who they are beneath the trauma, their pain, anger, anxiety, fear, sadness – their true self, their core.

What should I look for in a therapist?

Research shows that the most important indicator for successful therapy is the relationship between therapist and client. Therefore, please do take time to find the right therapist for you. There are many modalities in therapy and each therapist will adapt those modalities to suit their own personality and interests. Some may listen and help you express and understand your feelings, others may focus on exploring your past and the impact of that on your present, some work somatically by suggesting ways to tune into the sensations and experiences of your body. Spend time browsing different websites and profiles, contact a few and maybe arrange a consultation or initial session to find out how that therapist works and how it feels to sit with them. Imagine working with them longer term and try to get a sense of whether that feels like a good fit.

To find out more about my approach, check out these areas of my website – About Me and How I Work; then please get in touch to arrange a free 20 minutes consultation (either through an online or phone call) to explore starting therapy with me.

What is the purpose of the free 20 minutes consultation?

Starting therapy can be a big step. You might not know what to expect or be unsure about making that investment in yourself. This initial consultation gives you a chance to ask questions about working with me, exploring your hopes or fears, and finding out more about me and my approach. You will be able to explain what you wish to work on, your goals for therapy and find out if my approach matches your expectations. As stated in ‘Where do I work’, I prefer to work in person; however, if that is not possible for you, then we can discuss whether working online would best suit you.

Either at the end of or following your consultation, if you decide that we feel like the right fit, we will arrange your first appointment, which usually then becomes your regular session time.

What is the Psychotherapy Service Agreement?

Contract- Fiona Mcalister Counsellor Islington LondonOnce we have agreed a date for starting therapy, I will send you my Psychotherapy Service Agreement for your perusal. This is the contract between us that provides a framework and container in which the therapy takes place. The Agreement sets out how we will work together, detailing what you can expect from me and what I expect from you in return. This includes confidentiality, payment, holidays and cancellations, and information on how I protect and process the personal data I hold about you (also see my Privacy Policy here).

Please read this Agreement carefully and, if you need me to clarify anything, we can discuss via email or during your first session. Once we have both signed this Agreement, it forms a contract between us.

Where do I work?

Due to the way I work, I prefer to meet with my clients in person. Therefore, prior to your first appointment, I will send you information on how to find me for in-person sessions. As I value flexibility, I also offer online sessions for existing clients who are unable to attend the therapy room from time to time (due to childcare, work or other commitments).

However, if you are interested in working with me but are unable to visit the therapy room for regular sessions (perhaps due to accessibility, work or travel, or maybe you live outside the UK), then we can discuss working online from the get-go. We will talk that through during the consultation and explore how that would work for your therapy and our therapeutic relationship.

What takes place during our first session?

Meeting- Fiona Mcalister Counsellor Islington London

Some people feel understandably nervous or other unsettling emotions when coming into their first therapy session. Please be assured that I will take the time to help you feel more comfortable, both with me and the therapy room.

Although this is our opportunity to start our relationship and get to know each other a little better, we do not have to rush. We will take our time to work at your pace and are unlikely to touch on any painful material at this early stage. Instead, we will talk generally about the issues that have drawn you to therapy and you can ask me any further questions about my practice or the therapeutic process that will help you feel comfortable.

We can also discuss the length of therapy that might suit you and explore questions you might have about the therapy contract.

How long will therapy be?

I offer open-ended therapy, which means that we will work together for as long as you wish. People generally choose to attend on a weekly basis, though I may be able to offer a more flexible arrangement if needed. Therapy is most effective if you can commit to the process and so I recommend that you attend your therapy sessions regularly to ensure that you get the most out of our time together.

In terms of the length of therapy, you may know what you want before we start; but if not, we can discuss this in the consultation or first few sessions. Short-term therapy of a few weeks / months may be all you need to work through particular issues; however longer-term therapy may suit those wanting to make changes at a deeper level or struggling to process long-held unhelpful beliefs and traumas.

Periodically we will review this and, at the appropriate time, work towards ending. It is usually a good idea to use our final session to reflect on the work throughout our time together and for you to consider your next steps for the future.

How do I make the most of therapy?

My prime role as your therapist is to create a safe environment in which you feel able to be truly yourself. My hope is that, once safety and trust are established between us, you will feel able to speak freely during our sessions. At times, I may suggest somatic work – that you explore your inner physical experience and / or move your body in the room. All this may take time and we will go at your pace; however, getting the most from therapy requires courage, a willingness to feel pain and an ability to open one’s heart and mind and be curious about what emerges in the space between us. I will help you through this process by, for example, sitting calmly and compassionately with your vulnerability or participating with you in any movement I suggest.

Periodically either you or I will suggest we review the work so far, maybe reflecting back on progress in relation to your initial goals and considering whether new issues have arisen during our work. To support your freedom to speak your mind openly, I welcome your feedback – if you have goals we have not yet focused on, if I am using an approach that feels uncomfortable to you, have said something that does not make sense to you or if I have made an error, please do let me know. As well as helping me know whether I need to adapt the way I work to meet your needs, talking through differences and mistakes can lead to new insights and give an opportunity to practice new skills.

Therapy works best when you apply what you learn here to your life outside the therapy room. Between sessions, make a note of areas in your life that you would like to explore in therapy or try out new ideas or skills we have discussed in the session.

What about confidentiality?

As stated in my Agreement, I treat all information given and discussed during our therapeutic relationship as confidential. Exceptionally, I may need to make limited disclosure to a third party when I have good reason to believe that the safety of yourself or another is at risk and / or where I am legally obliged to disclose material, such as in cases of child protection or drug trafficking. Where possible, I will discuss such concerns with you first.

Additionally, for the benefit and safety of my clients and as required by my membership body, BACP, I have regular supervision to ensure I am working ethically and competently. I discuss sessions with my supervisor, but do not give any personal data about my clients; my supervisor is also bound by confidentiality.

As many of my clients live in the area near my work place, if we bump into each other outside sessions, I will not proactively greet you if either of us are with others.  If you acknowledge me openly, then I will respond.

What is the next step?

If you would like to find out more about starting therapy with me, please get in touch to arrange a free 20 minutes consultation and we will take it from there.

Anything else I need to know?

I have full public liability and professional indemnity insurance.

For details of my therapy qualifications, please look here.