The 4 Stages Of Counselling For Anxiety

The 4 Stages Of Counselling For Anxiety

One of the most common reasons for people either delaying seeking professional support or not doing it at all is anxiety around what will happen during counselling.

My aim with this blog is for you to understand a bit more about how counselling with me works and for you to feel less anxious about it.

Counselling itself is a relatively straightforward process and if you’re seeing a therapist who is making the whole experience completely baffling then you’re seeing the wrong therapist!

How we would work is influenced by my training which was focused on building a strong therapeutic relationship. Added to this is my personality (which includes a good dose of attempted humour!), the methods which other clients have found to be helpful and, of course, you.

Exactly how we work to achieve your goals will depend on how you want to work. Some clients like to work in quite a structured way, others prefer total freedom to choose what to discuss each session. Some enjoy being creative and want to use their creativity during sessions to help tell their story.

Most clients will make use of a mixture of these methods to achieve their goals.

Step 1: An initial discussion

The first stage of our work together is an initial meeting which I don't charge for and there is zero obligation for you to continue seeing me after.

The discussion lasts up to an hour and is a chance for us to talk about the problem(s) that you’re experiencing and what you would like to achieve by being in counselling. I will give you some information on how we might work together to achieve your goals and then you have a chance to ask me any questions that you may have.

If you decide that you would like to work with me then our counselling sessions will begin. These will usually be weekly and last for an hour but I can be flexible depending on your needs.

Step 2: Assessment

The first couple of sessions will be used for us to complete an assessment of the anxiety that you’re experiencing. A lot of therapists don’t complete assessments which is a real shame because the benefits can be huge.

The first benefit of an assessment is understanding – it allows for me to fully understand what is going on for you. This is important because it is through understanding that we can build a therapeutic relationship and find a way forward together.

The second benefit is that completing the assessment allows for a case formulation to be created. A case formulation is a bit like a map of the anxiety that you’re experiencing. Having this map can help us focus on the things that will benefit you most. Not having this map can be frustrating for you because getting to the point where you want to see a therapist usually means that you have been struggling with anxiety for quite some time, the last thing you want to do is waste the first few sessions not getting anywhere!

The third benefit of an assessment is that it can help us to check that the work that we are doing is helping you. During the assessment, we will complete a couple of different questionnaires which evaluate how your general mental wellbeing is and the extent to which anxiety and depression are affecting you. We can then complete these questionnaires periodically and use the results to see if counselling is helping you.

I know that the thought of having an assessment can be scary but I promise that this one isn’t. One of the reasons that it can take a couple of sessions to complete is that we will go at your pace to discuss what you need to discuss. Most clients say that the assessment itself is helpful because it is a chance to share all of the things that are upsetting them. The chance to simply talk about things in a safe and supportive environment is hugely beneficial.

What if you don’t want to have an assessment? One of my beliefs about counselling is that you are the expert on what you need and so if you don’t want to complete an assessment there is no pressure to do so.

Step 3: The counselling

Now we can really get to work on achieving your goals!

Guided by the case formulation and by how you’re feeling we will start working on the issues that brought you into counselling. As I said above, there are a number of different methods that you may find useful. These include:

Cognitive behaviour therapy (CBT): which is particularly useful at helping to break your anxiety down into manageable chunks and dealing with each one in turn to resolve it. We will be looking at how patterns in your thoughts and behaviour link with how you’re feeling and find ways to modify the patterns into ways that allow for you to live a happy life.

Humanistic therapy: This is a way for us to explore what is going on for you at your pace and in a direction that you want to go in. We will be looking to find new perspectives on your experiences and new ways of living your life free of the problems that brought you into counselling.

Creative techniques: such as drawing and using clay. This is a great way of helping to manage your anxiety during sessions because it can feel less threatening and gives you something to do rather than having to sit still for an hour (great if you like to fidget when you're anxious). Also, working creatively can enable you to express how you’re feeling in ways that you may not be able to with words.

Long word alert! Psychoeducation: We can use psychological and therapeutic theories to explore what may be going on for you in a more educational way. An example would be for us to look at how you communicate with people, how they communicate with you, and how you can improve your communication skills to help manage anxiety.

Whichever way we work to achieve your goals the main experience of your counselling will be that I am a friendly and supportive professional who wants to see you manage your anxiety and take control of your life.

You will never be judged or criticised by me and everything is confidential (there are some legal and ethical exceptions but I will explain these to you when we meet). I definitely won’t think that you’re weird and you won’t shock me.

Counselling tends to last for between 6 and 20 sessions although it is not uncommon for clients to come for longer than this. During counselling, we will regularly review what is going on and if it is helping you to reach your goals.

Step 4: Ending

Once you have met your goals and taken control of your anxiety it will be time for the counselling to end. This can simply be you coming in one day and telling me that you’re now happily living your life and you don’t need to see me anymore.

Alternatively, you may find it useful to have a couple of final sessions spread out over a few weeks. This allows time for you to practice any anxiety management techniques that you have learned. It is also an opportunity to identify if anything else needs to be looked at before you leave counselling.

I hope that you have found this guide useful for understanding what will happen if you choose to meet with me. If you have any questions please don’t hesitate to contact me. I’m not a salesman trying to get as many clients as possible and I will never pressure you into having counselling, I genuinely just want to help you take control of your anxiety.

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