There is an increasing tendency towards a technocratic and reductionist approach to mental health care, in which psychological difficulties are classified and matched to predetermined treatment protocols. This assumes that human suffering can be understood and addressed through the application of standardised interventions, rather as though people were machines requiring repair. Although such approaches can be useful, they risk overlooking the complexity of individual experience and the particular circumstances, relationships and meanings underlying psychological difficulties.

Many people who approach my practice have tried everything they know to help themselves using technocratic, symptom-focussed approaches, without resolving their difficulties. As a result, some have resigned themselves to always being the way they are.

I believe it is important to understand the particular person, their life and circumstances, and what they want before deciding what needs to change. This means looking beyond standardised approaches and trying to understand what may be contributing to and maintaining their difficulties. It doesn’t mean endlessly analysing the past or avoiding practical change.

Good psychotherapy requires understanding, creative intelligence, a practitioner who is unafraid to be authentic, and the right kind of action. Sometimes a sufficiently deep understanding produces change in itself; sometimes it clarifies what needs to happen next. Occasionally, it indicates that psychotherapy is not the most appropriate form of help.

Clinical judgement lies in knowing the difference.

An Introductory Meeting is a no-obligation opportunity to discuss what has brought you to therapy and consider whether working together might be productive.

You can explain what you are experiencing, what you would like help with and what you hope might change. You can also ask questions about my approach and consider whether you feel comfortable talking with me.

I’ll also consider whether I’m the right person to help you. Another therapist, service or form of help may sometimes be more suitable. There is no obligation to continue after this meeting.

If we decide to proceed, I’ll ask you to read and sign my professional boundaries agreement before assessment begins. This sets out the conditions under which we work together with mutual respect and trust.

Psychotherapy Assessment

Psychotherapy assessment is more detailed than counselling assessment. You will complete an initial form, and we will explore your history, current difficulties, relationships, circumstances, ways of coping and what you would like to change. A comprehensive assessment may take up to four sessions on average.

The purpose is not simply to identify symptoms or assign a diagnosis, but to understand how your difficulties have developed, what may be maintaining them and what might help. We will also consider any obstacles to the work and areas that may need attention.

I’ll discuss my understanding with you throughout the assessment so that we can decide whether ongoing psychotherapy is appropriate and, if so, what form it might take.

If my practice doesn’t seem suitable for your needs or circumstances, I’ll explain why and, where possible, suggest other forms of help.

Counselling Assessment

A comprehensive assessment is generally unnecessary for counselling. We will discuss your history, current difficulties and aims sufficiently to establish whether counselling is appropriate. You will normally only need to provide your details through my assessment form.

Assessment does not guarantee that a regular space will be available. If psychotherapy appears appropriate but no suitable space is available, you may be offered a place on my waiting list.

Sessions normally take place at the same time and on the same day each week, either in person or online. Regularity provides continuity and momentum for change. Less frequent attendance may sometimes be possible by booking advertised appointments.

Sessions are led by you, rather than directed by your therapist, but remain guided by your overall aims. What you bring to explore, your thoughts and feelings, and what you need from the sessions determine their focus. This differs from following a course or programme designed by, for example, a coach or personal trainer.

You decide how to use your session time, taking responsibility for what you say, feel and do. This helps develop a greater sense of agency and choice. What happens in the therapeutic relationship can also be a focal point for understanding your way of being.

Sessions normally last 50 minutes and take place weekly, with a regular day and time reserved for you.

Duration

The length of therapy depends on what you want to work on, what you hope to achieve and the depth of the difficulties involved. Some work is brief and focused; longstanding difficulties, complex or developmental trauma, and deeply ingrained relationship patterns may require longer-term psychotherapy.

We can review the work as it develops and consider whether the approach and frequency remain indicated. An initial six-week period after assessment also allows us to establish whether we can develop a sufficiently collaborative therapeutic relationship.

Frequency and Attendance

Weekly attendance is usual. After assessment, an attendance policy allows up to three absences and three appointment changes in any 12-week period.

Sessions are secured by prepaying each appointment one week in advance. Less frequent appointments may sometimes be available, as advertised on the Appointments page.

We can periodically review how the work is developing, whether your aims have changed, what you have gained and what still needs attention. You can also request a review at any time.

When you feel ready to finish, the final sessions provide an opportunity to reflect on what you have learned, what has changed and what you want to carry forward.

You can stop therapy at any time. Where possible, giving at least seven days' notice helps us bring the work to a considered conclusion. We can also discuss follow-up sessions where you might need them.