|
First Considerations:
In the UK, there are in essence four ways of finding a therapist or counsellor (in this document, the terms are used interchangeably):
- Through the National Health Service (NHS), for which you’ll need a referral from a GP/doctor. The quality of support can be very good, and when you get there, it’s free of charge. But waiting lists can be several months long, especially outside the South-East of England.
- Through your employer’s confidential counselling programme, if they have one. Most larger organisations do, and freelancers and staff, as well as their close family, are usually equally entitled to use the service. In general, though, only five sessions or so will be funded in any one year.
- Through a charitable agency such as CRUSE bereavement counselling or RELATE, which specialises in working with couples. Again, waiting lists can be long. See below for other suggestions.
- Alternatively, and perhaps most reliably if you wish to start soon, you can look for private therapy, for which you yourself pay.
What Kind of Therapy?
Journalists, like anyone else, can experience a range of emotional difficulties that aren’t always just about trauma. You may be going through a period of depression, or dealing with acute anxiety. You may be having difficulties in your relationship, or with alcohol or drugs.
Before you start, consider what do you want to address in psychotherapy? What specific problems or situations do you need help with? Are there issues that you might want to address but feel ambivalent about? If you could imagine your life “better”, what do you envision?
As you probably know, there are large numbers of different schools of therapy, ranging from classical Freudian five-times-a-week psychoanalysis over many years to much briefer solution-focused approaches that take just a few sessions.
The range of approaches can be quite confusing, so take time to explore different options. You might want to ask friends or colleagues for personal recommendations.
There is now much good research confirming the effectiveness of what are known as cognitive-behavioural approaches, or CBT, focusing on your thoughts and beliefs. For trauma in particular, exposure-based treatments use techniques of confronting, remembering and/or reviewing painful memories and situations from a safe place.
Clinicians also might recommend a form of therapy known as Eye Movement Desensitisation and Reprocessing, or EMDR, which allows someone suffering from PTSD for example to work through the trauma they have experienced in a safe and structured way, and “reprocess” how it’s stored in the memory.
Anti-depressant and other medication can also be very effective, especially when combined with support from a skilled therapist.
For more information on what is recommended in the UK for treatment of various emotional issues see the website of the National Institute for Clinical Excellence (NICE).
Guidelines for PTSD are at http://www.nice.org.uk/page.aspx?o=CG026.
For depression, see: http://www.nice.org.uk/page.aspx?o=cg023
For Anxiety, see: http://www.nice.org.uk/page.aspx?o=cg22
For treatment of PTSD, you may also wish to consider advice issued by the International Society for Traumatic Stress Studies (ISTSS).
Finding a therapist:
A skilled therapist will talk with you about your specific needs, with a view to matching his or her response to what will work best.
Even if you expect the therapy to take only a handful of sessions, finding the right person to work with is vital. It’s OK to decide after meeting a therapist for the first time that he or she is not for you.
Ask yourself some questions before you start:
- Are you comfortable approaching your GP about this? Would you be willing to use your employer’s confidential counselling service? Do you have reservations about others—your family, for example, your friends or colleagues—knowing that you’re asking for help?
- Do you want to work with someone who knows your trade from personal experience? Does their race or gender matter to you? Ethnicity? Language spoken? Religion? Sexual orientation?
- If you’re going for private therapy, what can you afford to pay? Like all professionals, psychotherapists need to earn a living and cannot offer free services, although some do have sliding scales. Look at your finances and consider what you could afford and for how long—and bear in mind that effective therapy can require significant and sometimes long-term commitment, both of time and of money.
- Can you free up the time to attend regular weekly sessions? Are there work or childcare arrangements you might need to make?
- Do you have views on whether or not you would be willing to take medication if recommended.
- If you are a journalist often on assignment or with unpredictable hours, you may wish to seek a therapist who can adjust to your schedule without penalties for missing a session. It’s important to discuss these issues early.
If you believe that you might be experiencing PTSD and want specific trauma-related support through the NHS, make that clear when you talk to your GP.
Not all doctors in the UK are yet fully conversant with the best responses to trauma, so don’t be afraid to ask to be referred specifically to a dedicated trauma-treatment centre, of which there are several excellent ones in London in particular.
If you or someone you know is having frequent thoughts of wanting to kill or harm themselves, it is very important to seek expert medical advice. Appropriate help can be obtained via your GP or Hospital Emergency Department.
Assessing a Therapist’s Suitability:
Formal registration for psychotherapists and counsellors is now being considered in the UK, but at the moment, anyone can call themselves a therapist or psychotherapist. So it’s important to assess that person’s qualifications.
Look for professionals who are registered with (not just members of) the BACP, the UKCP or for example the BABCP or BPS. At the risk of generalisation, you will find that those on the UKCP list tend to be therapists with experience of longer-term and deeper client work.
Whatever their training, a good psychotherapist must be able to apply knowledge to an individual situation, display compassion, and communicate well.
Bear in mind that not all therapists and counsellors to whom you might be referred will necessarily be experienced in issues of trauma and journalism.
Don’t be afraid to ask about an individual’s training, approach and experience. Initial questions might include:
- What are your areas of expertise and specialisation?
- What are your credentials and training? Especially, if relevant, in dealing with trauma-related distress.
- How long have you been in practice?
- Can you tell me about your supervision arrangements? What types of details will be shared about my case when you consult with others?
- What is your general approach to treating survivors of traumatic stress?
- What typically works for your clients? What do you think will work for me? Can you tell me about any scientific evidence which supports your approach?
- Is there one principal technique that you tend to use with most of your clients? (Therapists who insist on one technique for all client problems may not be as suitable as those who use broader, more integrative approaches and adapt the techniques to the particular client.)
If you are uncertain what you are looking for in a therapist, try comparison shopping. Talk with two psychotherapists in person and reflect on your reactions to each. Did you feel more comfortable or compatible with one therapist? Trust your reactions and use them to inform your decision.
Although some professionals may need a few appointments to get to know you and make a detailed treatment plan, during the initial session you should be informed about general approach, fees, cancellation policy, confidentiality etc.
You should get a general idea about how many sessions you may need, or at least how you both will know when it is time to stop.
Good therapists and counsellors typically address the benefits and risks associated with the treatment and discuss alternative and supplementary things you can do to support yourself. Good professionals can often give you this information in writing if you so wish, or refer to you to websites.
Other issues to keep in mind:
Be prepared to do “homework”—to practice or consider issues outside the therapy hour. This is an especially important part of CBT.
Be prepared to be completely honest with yourself and your therapist. Ask as many questions as you need to ask. It is important to let your therapist know your reactions to what is happening in your work together.
It is not a good idea to see a therapist who is a good friend of yours or of your closest friends. (In fact, this is considered unethical in many fields.) However, if you live in a small community, it may be impossible to avoid a therapist who is connected to your social network. If this is the case, discuss with your therapist any concerns you may have.
Although you will want your therapist to be responsive to your questions and give you information, be wary if your therapist tells you too much information about his or her personal life.
When you start therapy—and at times during its progress—you may feel that things are worse than they were before you started. Be reassured that that is often just part of the process of healing—and that the night, as they say, can be darkest before the dawn.
However, if you feel horrible after all your sessions AND have not seen any progress in your goals at all, discuss this with your therapist, and seek a second opinion if needed. Bear in mind, though, that dealing with trauma is usually hard work and does involve feeling painful feelings.
Sexual relations of any kind between patient and therapist are inappropriate, unethical, and if they happen, seriously damage the therapeutic process. If your therapist makes a sexual advance, you may wish to consider reporting the incident to his or her accrediting body.
Not all treatments work for everyone. Matching the right treatment to the person make take some time. Don’t give up if one approach doesn’t seem to be working.
And Finally:
If you have read this far, you may well already have made the most important step towards healing and recovery—which is recognising and acknowledging that a problem exists.
Good counselling or psychotherapy can build on that. Remember also what we’re told by all the research into trauma and recovery, which is that most people are resilient and recover well, and that the right kind of treatment can make a real difference, often in quite a short time.
|
