Getting more out of counselling

From this page, you can download worksheets to help you think about what you want to take to counselling, what questions you have for the counsellor or service, and what kinds of additional support or accommodations might help you.

Download worksheets (Word format)
What am I bringing to counselling
What questions do I have for the counsellor
Access needs

What is counselling?

Counselling (or psychotherapy) is a form of help for anyone experiencing emotional, psychological or interpersonal distress or who needs time to talk, explore, identify and work through personal issues or difficulties. 

Counselling provides a confidential, safe, reliable and regular space where together with a professional you can explore the issues troubling you. Some counsellors are interested in looking at your childhood and earlier life as this can provide useful insights into how you ‘operate’ in the world today. Some counsellors only look at your current life experiences and others make use of how you are with them in the counselling room.

The range of issues that folk can bring to counselling is vast, but what is common is that individuals seeking counselling tend to be distressed, confused, uncertain, unhappy or worried.

What can I bring to counselling?

People encounter all kinds of difficulties and challenges as they go through life. Sometimes they are able to navigate them themselves, or with the help of friends and family, and sometimes they can’t. Counselling can help with working through the emotional and psychological difficulties that life can bring up, whether they are causing worry and confusion, or significant distress.

Counselling can help with specific mental health difficulties, such as depression, anxiety, trauma, etc, but you do not have to have specific mental health difficulties to get something out of counselling.

Counselling is not something that is ‘done’ to the individual, but a collaborative process between them and the counsellor. Individuals should never be forced to go to counselling – it has to be a free choice.

Different counselling approaches – what does that mean?

There are many different types of counselling and psychotherapy, with practitioners having slightly different ways of working with clients. For example, some counsellors work more actively with distressing symptomology or difficult feelings (or no feelings); some counsellors may use worksheets with you; some may suggest activities to do between sessions; while some may largely listen and reflect back what they are hearing and what they might sense underneath what you are saying. Some, more integrative counsellors (counsellors who bring different counselling approaches together) may incorporate a range of working practices. Counsellors also vary in being non-directive through to being quite directive. For example, some counsellors will give you complete control of the session and what you talk about, others may have a very structured way of running the session, while others may have more of a mix of some structure and some openness to what comes up on the day. 

As well as many different counselling approaches, there is also a wide range in the knowledge and experience individual counsellors bring to their work. All counsellors, however, should see the people they work with as unique individuals with unique needs, positive qualities, and strengths.

How does counselling work?

Counselling can take place with just you, as part of a couple, part of a family or a group of people. In this handout we are really only thinking about one-to-one counselling, which is just you and the counsellor working together. 

Although in general counselling takes place in a ‘counselling room’, it is also possible to have counselling at home, via the telephone, by video call, or out walking. Currently most counselling is likely to be done remotely by phone or video, due to the pandemic.

Counselling can be time-limited (where you have a set number of sessions) – usually with charity-based counselling, or the NHS, or it can be open-ended when there is no set number of sessions. When the number of sessions is not restricted, it is worth speaking with the counsellor about what you want to achieve from counselling and how many sessions they think that might require. It should be noted that this will be a rough estimate, as it is impossible to know with any certainty how many sessions will be needed, but it does give you a sense of whether they feel that this will be closer to 3 months or 3 years.  

The aim of counselling is to empower individuals through a growing self-awareness, and where appropriate help them to achieve a better understanding of the nature of their problems, what keeps them going, and how to deal with them in a constructive way, preventing further distress, leading to help them live a more satisfying life and fulfilling relationships.

What counselling is not

Counselling is different from friendship, befriending, mentoring, coaching, advocacy, mediation, psychiatry or clinical psychology.  

Counselling and psychotherapy: What’s the difference?

Some people might say that psychotherapy training courses take longer, cover more mental health subjects, and require that trainees undergo personal therapy for the duration of the course.

However, there is no agreed, recognised difference between counselling and psychotherapy in the UK, either in practice or in training, and often practitioners will refer to themselves as both a counsellor and psychotherapist.  

In this handout, counselling refers to counselling and psychotherapy, and makes no distinction between the two. 

Do clinical psychologists and psychiatrists do counselling?

Being a clinical psychologist or a psychiatrist doesn’t mean that the practitioner has had counselling training, although some might – but that would be separate training in counselling. Clinical psychologists generally have a psychology degree followed by clinical psychology training. They tend to specialise in pathologies and may diagnose (which counsellors can’t). Psychiatrists are medical doctors with psychiatry training and can prescribe medication. Both clinical psychology and psychiatry are very different as professions from counselling and psychotherapy.

So what qualifications does a counsellor have?

While there is no legal definition of counselling in the UK, there are several recognised membership organisations that counsellors can belong to, which ensure their members have a specific minimum level of counselling training, experience, ongoing professional development, and abide by the same ethical standards. These organisations also handle complaints procedures against their members. While there are also some more specific organisations, the main UK counselling and psychotherapy organisations covering a broad range of approaches are: COSCA (for Scotland), UKCP, NCS, and BACP.

In order to become a member of these organisations, counsellors need to have: undergone an approved counselling/psychotherapy training course(s), have a minimum number of client hours, have ongoing supervision with a minimum number of hours, minimum number of professional development hours each year, have appropriate insurance, and abide by the organisation’s ethical standards. Some organisations and training courses also require counsellors to undergo their own therapy during training.

Counsellors tend to list what organisation(s) they belong to on their websites, but you can also find lists of counsellor members on the organisations’ websites.

What do I need to do in counselling?

While there’s nothing you absolutely have to do when you go to counselling, to get the most out of it, you should try to: turn up regularly, make time between sessions to reflect on what was discussed, think about what you want to get out of each session, be potentially willing to try different things and consider different ideas. Ultimately though, these are your sessions, and you are in control. You shouldn’t feel pressured to do anything you don’t want to do.

It is worth remembering that (with the exception of things like never showing up, never participating, or being threatening) you can’t really get counselling wrong. If there is anything you’re unsure or unhappy about, or something you want to suggest or try, the counsellor should be willing to listen and discuss it.

How do I know if counselling is working?

Some things to think about to assess if the counselling or a counsellor is working for you:

Do you feel safe and listened to? Do you feel that the counsellor puts your needs and concerns first? Do you feel that the counsellor considers and answers questions that you ask them? Do you feel that you are working towards your goals for counselling?

Of course, counselling can take time, and not all of these things may be true all of the time. However, sometimes a counsellor or approach might just not be a good fit for you. If you are not sure whether a counsellor seems right for you, you may need to have a few sessions with them to find out. And remember, counselling is not always easy, but it is important that you feel supported, listened to and understood, as well as challenged. 

How does counselling end?

While some services (and the NHS) will have a clearly set-out limit on the number of sessions you get, open-ended or longer-term counselling (more typical in the private sector) is less likely to have a fixed end date when you start out. The counsellor should, however, be regularly reviewing how things are going – this does not mean that they are telling you it’s time to end. Counselling ideally comes to an end either when your goals feel met (whether they are the goals you started with, or new ones you picked up along the way), or you feel like you’d like to end or pause.

You don’t need to have a reason for ending, but it can be good to discuss the ending with your counsellor, and most counsellors will suggest at least a session or two before the end.

The idea of ending counselling can feel quite difficult or daunting for many people. This is a normal reaction, for any number of reasons, and should be discussed with the counsellor, who should be understanding and help prepare you for the ending.