Only if you don’t want to come for another session!
Many therapists, particularly when newly qualified, will offer a free first session so you can see how you can get along. My way is to insist on payment for the first session, usually in advance, with a guarantee of a refund of that payment if either of us doesn’t want to continue for any reason at all after having attended for the first session.
Yes, if you come to the first session, you are welcome to leave, having had a full session, and with a refund, if you decide for any reason that you do not want to continue.
So, what’s the difference? In practice very, very few clients fail to show up for the first session if they have paid in advance. This is very much to their own benefit, as if they just vanish without attending or paying, they are not going to come back and give therapy a chance to make a difference in their lives. And it has been proven over and over that therapy can make a huge difference in their lives. So I don’t want to discourage them from having that opportunity to better themselves.
It’s true that most clients who come for the first session will continue for a course of sessions, be that six sessions – my suggested course – or longer. And the overwhelming majority of those clients will come to feel that the experience offers extraordinary value for money. But if they don’t want to return I am delighted to offer a refund. In a way it could be argued that I’m paying these clients not to return! Why? – because I only want to work with clients who really, really want to work with me.
Of course,on occasion, I believe that I am not the right therapist for a client. Obviously they get a refund, and suggestions as to other therapists who may be more suitable. Sometimes, I want the client to think hard about their motivation and expectation of therapy before coming for a course of sessions. In those cases I will insist on giving a refund immediately. If the client then decides they want to return for a course (and it has to be said that most do), they will pay me for the first session too.
My sister is waiting to see if she has bipolar disorder, and it is affecting our whole family. Would a few therapy sessions with you help while we wait for an NHS appointment for her? (You did not leave me an email address so I am replying to your questions here, having changed some of the details).
A diagnosis of bipolar disorder is life-changing for the sufferer and for their families, so here we might actually have two questions:
1. Would counselling help me, as a family member, cope with the stresses of living with my sister – yes it would, but it is probably not practical on a long term basis because of the cost. Perhaps occasionally when things are getting on top of you. Do keep a look out for support groups, often run by e.g. Mind, as they can be an alternative to therapy for the families of patients.
2. This really is a question for your sister, not for me. If she feels it will be of help to her to have somewhere to vent her frustrations while she waits for the NHS to come up with some help, then yes, it will. If she doesn’t think so she is very unlikely to attend often enough for therapy to help.
Unfortunately many sufferers of bipolar disorder, particularly in the “up” phase, are very resistant to attending therapy sessions or taking medication, and the patient’s willing cooperation is crucial when it comes to having private counselling.
There is no reason that I know of where counselling of itself would be unwise. Counselling/psychotherapy, along with medication, is the recommended treatment for bipolar disorder. Waiting times are a big problem still for mental health services, although the suicidal ideation that frequently accompanies bipolar disorder will mean that the appointment will be quicker.
The important thing is that the research shows quite clearly that it does work.
Oh, I can give you half a dozen theories, that’s one advantage of having an MA, but I quite like the following explanation:
It’s a special kind of conversation where two people get to know one person (you) better. While we both get to know you better, many of the problems in living that caused you to attend seem to resolve, or fall away, and be seen in a different light.
Sometimes missing life-skills can be identified, and we can agree on coaching to rectify these gaps in skills, such as deep relaxation, or assertiveness.
Or we can just agree it’s magic, and let it go at that!
(if you still want a more scientific explanation, here’s one – link – that’s pretty close)
I’m not a great fan of internet lists, although it’s difficult for me to resist titles like this one. It isn’t original, unfortunately, although I am very familiar with these seven, and several more too.
This list, and several others to do with therapy, was published by Ryan Howes, in Psychology Today (link), and includes the following ways of not helping yourself when working with a therapist:
- Choose your therapist quickly
- Don’t ask questions
- Make hints and speak in riddles
- Triangulate (spend the time talking about other people’s troubles, rather than your own)
- Compartmentalise (pretend that one area of your life is completely disconnected from the rest of your life – the connection is you, of course)
Ryan gives some explanation on each in the article.
In practice, it is very difficult to avoid what’s on the list. I would go as far to say that if you can avoid everything on this list you have probably had a lot of therapy already! So it is more something for us both to keep in mind during therapy, to watch for ourselves doing it, and ask why (if we can!)