The Therapy Hour

15/05/2023

What information do you seek from prospective clients?

• What do you feel you need to know before deciding whether to work with someone and how do you collect this information?

• Do you have an intake form? If so, what questions does it ask? What provision do you make for those who experience difficulty in completing forms for one reason or another?

• Do you gather the information verbally during an initial phone or in-person consultation?

• What do you do if a client is disinclined to answer some questions e.g. sensitive areas such as substance use, suicidal intent or behaviour?

13/05/2023

One of the unseen challenges in private practice is how to best look after ‘at risk’ clients.

In my specialist area (personality disorder), it’s very common to have clients who experience significant degrees of difficulty in regulating their emotions, such that they not infrequently resort to risky behaviours such as self-harm and overdosing in order to cope when feeling overwhelmed.

In preparing to take annual leave, a counsellor or therapist working within an organisation might raise a concern with their line manager and where it is deemed necessary, perhaps arrange for the client to be assigned to a colleague for the duration of the leave period in order to ensure a basic level of safety. Working in private practice, this is much more difficult to achieve for a variety of reasons.

Although I’ve been fortunate enough to avoid clients resorting to actual suicidal behaviour while on holiday, the last time I took a complete break from clients, three of them took such significant nosedives in their progression that it now makes more sense for me to avoid as much disruption to their therapy as possible, such that I will continue seeing those most at risk during a break. Obviously, this means seeing them remotely; for some it may mean reducing the frequency of session from twice to once a week, for others, it may mean a change of day, as I will normally arrange all sessions to take place on the same day in order to look after my own needs.

There’s a huge debate to be had here about the competing needs of client vs. therapist; dependency vs. self-regulation; boundary setting vs. progressive maturation.

What’s your view and how do you manage your riskiest client groups?

07/04/2023

What’s your biggest challenge in working towards accreditation?

Which accrediting body are you with/working towards and why?

05/04/2023

What information do you require from clients on intake and why?

What methods do you use to collect client information (i.e note taking over the phone/in- person, questionnaire etc.)

03/04/2023

https://www.bbc.co.uk/news/uk-65152581

Following recommendations from the recent Independent Inquiry into Child Sexual Abuse, it's going to become mandatory for all professionals to report any indication of child s*xual abuse.

What does this mean for us as private practitioners of talking therapy?

Essentially, there will be a LEGAL REQUIREMENT to disclose actual or suspected abuse. Whether we work with children, adults or a mixture of both, we need to take note of this impending change in legislation because there remain a range of questions as yet unanswered, including;

- Will any government deliver on its promise to have adequate systems for reporting and follow-through in place?

- Clarification about requirements in relation to disclosures of historic abuse by people who are now adults

- Clarification where client discloses abuse not directly experienced by them.

Stay tuned for answers I guess!

Meanwhile, we cover the management of safeguarding & disclosure issues, including recent and impending changes in the law in Lesson 15 of the full PPP programme. Check it out at https://www.thetherapyhour.uk/ppp-intro

Ministers plan to compel teachers and social workers to flag up signs of abuse - or face sanctions.

30/03/2023

What do you do when despite your best efforts, you realise that for one reason or another, you aren’t able to establish a working alliance with your client who still insists on turning up every week without fail?

28/03/2023

Just about every practitioner starting private practice knows that they need to register with the ICO (Information Commissioner’s Office), but do you know what your obligations with regard to GDPR are beyond that?

What are you doing to ensure that your practice is GDPR-compliant?

26/03/2023

FEELING THE FEAR & DOING IT ANYWAY

As someone who has been practising a long time, I can confidently say that there has never been a better moment to contemplate starting to practise privately as a counsellor or therapist.

Demand for our work is through the roof, with would-be clients desperately trying to find someone who has the space to take them on.

This being the case, it is rarely lack of clients that is the challenge for those trying to start up – it’s what’s going on in their heads.

Here’s what Amy and Angelo had to side-step on the path to building their practices.

What are YOUR blocks?

23/03/2023

One of my supervisees brought a thorny problem to supervision last week – how to manage working with client who has really poor personal hygiene in a space with no accessible windows to open.

How would YOU handle it?

20/03/2023

CHARGE OR NO CHARGE?

Opinions vary as to how to handle a first session in private practice.

🔸Do you charge for your first session or is it free?

🔸What are your reasons for operating as you do?

17/03/2023

🎯Are there issues/problems/conditions/client groups you don't or won't work with and why?

🎯How do you protect yourself from agreeing to work in these areas or with these clients?

15/03/2023

🔴What's been your most embarassing/toe curling moment as a therapist?

🔴What did you do to help you recover?😅