Therapy: Frequently Asked Questions

Here are a bunch of Frequently Asked Questions about working with me and about therapy in general. Click the question to expand the answer.

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Trouble viewing? Here’s a long flat version.

>>>>> The Basics

How can we start working together?

Contact me and we can arrange an initial meeting to talk about what you’re looking for, what I can offer, and make a plan about how or if we’re going to work together.

Please note that there is usually a waiting period between contacting me and having an initial meeting.

Where are you based?

My therapy room is in London E15, close to Stratford Station, and bus routes.

I also work via Skype with people elsewhere in the UK or British people living abroad. See FAQs below for Skype.

How much does it cost?

Each session is £60 for 50 minutes.

When are sessions available?

Weekdays and some weekday evenings.

How often do we meet?

Usually once a week.

How long do we see each other for?

I tend to work in an open-ended way. This means that you come and see me for a period of time and we end when you’re ready. That period of time can be months, or longer, it really depends on what you’re bringing to work on. Perhaps you have a number of problems that need attention, or you’re not sure about what’s going on, you only know that you feel terrible. You might see therapy as a means of self-discovery, something positive to do for yourself, a space to think and breathe. Maybe you’ve never had therapy before and want to see what it’s like.

I’m also happy to work in more time-limited ways. This is for people who have very clearly-defined things that they want to address. I usually offer six sessions.

We can decide the best approach for you when we first meet.

What kind of people do you work with?

I think that therapy is for everyone. I welcome people from every kind of background, aged 16 and over.

I also welcome people who might need or want a therapist who won’t make a ridiculous fuss about their particular situation. This includes but is not limited to academics, activists, anarchists, bisexual people, club kids, disabled people, feminists, gay people, geeks, goths, lesbians, people in poly relationships (or who are thinking about it), people who do BDSM, people with autism and Asperger’s, people affected by HIV/AIDS, poets, punks, queer people, sex workers, trans and gender variant people, drag queens, working class people, writers, and so on…

I actively oppose oppression and discrimination against people because of their background and identity including gender, race, nationality, ethnicity, disabilities, sexuality, size, age, beliefs, class, HIV status, citizenship status, or because they have been in contact with mental health services. I undertake regular continuing professional development to build on my anti-oppressive practice.

What sort of issues do you work with?

I work with all kinds of issues, everyone is different.

I also have experience of working with these common issues that people often bring to counselling/psychotherapy: abuse, anger, anxiety, bereavement, body-related issues, break-ups, bullying, depression, dealing with stigma, oppression and discrimination, fear, feelings of being different or of struggling, free-floating sadness, friends and family, feeling unfulfilled, feeling stuck, general emotional pain, getting older, hopelessness, housing, identity issues, illness, isolation, loneliness, loss, love, low self-esteem, money stuff, obsessions, problems concerning eating, relationships, self-harm, sexuality, stress, suicidal feelings, transitions, trauma, unresolved problems, wanting to find some meaning in life, work… and many more things.

Sometimes people have experienced a crisis, other times they want to deal with things that have been making them unhappy for a while, other times they just feel that life could be better.

Perhaps you only know that you feel awful. My job is to help you identify what’s going on and work towards gentle change.

If I feel that I do not have the competence to work with a particular issue, I will say so and do my best to refer you to someone who can.

>>>>> Skype therapy

How do you set up Skype sessions?
  1. We arrange a session via email.
  2. We become Skype contacts.
  3. You pay me for the session in advance via PayPal.
  4. At the arranged time and date, we both go online and I call you.
  5. During the first session, we discuss how we are going to work together, and then we will have weekly sessions for as long as you choose.
What do I need?
  • A working webcam and microphone on a desktop, laptop or tablet computer
  • A broadband connection
  • A Skype account
  • Some experience in using online video calling software
  • A quiet space where you will not be interrupted or overheard during the session

Get in touch to see if we can find another solution if you don’t have access to these resources.

I’ve never really used Skype before, does that matter?

Ideally you should have some experience of using online video calling software, even if it isn’t Skype. This is because we might both find it frustrating if the sessions you were paying for were spent learning how to use Skype rather than getting on with the work of therapy. If you don’t have experience, it will probably be much better to practise beforehand with a friend, if possible. If this is not possible, drop me a line and we can work something out.

I don’t have a PayPal account

It doesn’t matter, you can use the PayPal site to pay via credit and debit cards. If this doesn’t work for you, get in touch and we can make alternative arrangements.

How is Skype therapy different to face-to-face work?

You don’t have the immediacy of being in a room together as therapist and client, so communication is different; the limitations of technology can intrude; and payment is handled differently. Instead of coming to my therapy room, people have sessions in their own space, usually at home.

Apart from that, the content is the same, beyond the differences mentioned above, I don’t treat people differently onscreen, the material you might bring to sessions as a client is the same, and I have supervision to ensure that I am practising effectively and ethically.

Skype sessions cost the same as face-to-face sessions (£60), and I have a few places available at reduced cost for people on low incomes.

Face-to-face therapy is not better than Skype, it is just different. Some people prefer one over the other, but it just depends on the person and what they’re looking for.

What are the benefits of using Skype?

Session times are more flexible because you don’t have to include travel time to my therapy room; you can do therapy in your own home; access is less of an issue for people with mobility impairments; you don’t have to live close to the therapist; some people find it easier to talk to someone on a screen rather than in person. Other reasons? Tell me!

Is the Skype therapy service available to anyone, anywhere?

At the moment I can only offer sessions to people in the UK, or British citizens living abroad. This is because different places have different rules about who can practice as a therapist. Client safety is very important to me, and people living beyond the reaches of the British Association of Counselling and Psychotherapy, my professional organisation, or the British legal system may not be protected if something goes awry.

Where will you be during the session?

I will be sitting at my desk in my therapy room.

How do I know that nobody is in the room with you, hiding from the webcam, and listening to me?

I take confidentiality extremely seriously and do not share any details of client sessions with anyone except my supervisor. There is no way I would allow anyone to secretly sit in on a session. My therapy room is private and secure and you will not be overheard or seen by anyone except me.

Can I ask someone to sit in with me?

For individual therapy it is better if you are alone and in a quiet space where you won’t be interrupted for the 50 minutes of our session. This is to enable you to be able to speak freely without worrying what other people might say or think. If there are other reasons why you would want someone in the room with you, please drop me a line and we can discuss this.

Can I record our sessions?

Yes, though please do not do this without discussing it with me first, and let me know when you are recording and what you intend to do with it. Bear in mind that I may say no. I respectfully ask that you do not post or share material from the sessions online.

How secure is it?

Please note that Skype is not encrypted, and neither are email or texts used to communicate about appointments or emergencies.

I’ve chosen Skype because most people I’ve talked to seem familiar with it. It is as secure as any online video application, but it is not encrypted and you may want to read Skype’s privacy policy in order to understand the limits of confidentiality offered in using this service.

Can I turn off the video and just have sound in the sessions?

No. The point of using Skype to do therapy sessions is that it includes visual cues via video. These are important to me as a therapist in understanding what is going on in the session. If you feel as though you want to turn off the video, please talk to me, it may be a sign that something needs addressing.

I don’t like Skype, can we use another online video service?
Can I call you if I see that you happen to be online outside sessions?

No. I don’t have contact with clients outside of session times.

In the case of a crisis please contact The Samaritans ( 08457 90 90 90) or NHS Direct ( 0845 4647). We can also make an alternative crisis plan in the sessions, or talk about why you were thinking of calling me when you saw me online.

Can we be friends on Facebook?

I don’t socialise with clients. This means I won’t respond to friend requests, chats, Tweets, blog comments or other potential online interactions with you if we are working together as therapist and client. If we already have contact via social networking sites, I will unfriend you for the duration of our counselling relationship.

Can I switch to face-to-face work?

Yes, as long as there is an available time slot that’s convenient for you.

>>>>> Practical details

How accessible is your therapy room?

Accessing my therapy room requires navigating five steps and a raised door threshold. If this means my practice is inaccessible to you, please contact me and we can make different arrangements. If you have other access requirements, please also get in touch.

Do you have a parking space?

Yes, and you can use it if you let me know in advance.

What if I have to miss a session?

At the first session we will make a plan for what to do if you miss a session, or are likely to be away.

Can I bring someone with me?

Individual therapy is usually undertaken alone, but talk to me if this is likely to be a problem.

How confidential is the service?

I don’t discuss your private life with other people, and I take your privacy very seriously. In supervision, I talk about the clinical issues that come up, so that I can work effectively, but I do not share your personal details. There are some legal limits to the confidentiality that I can assure, relating to UK laws about terrorism, for example, but we will talk about this in the initial session and you can decide for yourself how you want to proceed.

Do you keep notes? What happens to my private information?

I keep contact information separately from session notes, which are identified with a code only. I keep session notes to keep track of the work we are doing. They are stored in encrypted and password-protected files on a computer. I am registered with the Information Commissioner’s Office and take data protection seriously. You are entitled to view any information I have stored on you. After seven years I delete and destroy your files securely.

I’m worried you’ll judge me if I come and talk to you

My work is to listen, to understand, to support and care for you. My approach is based on accepting people as they are and building a working relationship based on trust. You don’t have to say anything you don’t want to. I will do all that I can not to judge you, but if you feel judged we can talk about it and work it out.

I’m worried that if I come to therapy I’ll be so upset that I’ll never stop crying

You might cry if things are sad, it’s allowed. You might cry a lot if things are really sad, and that’s allowed too. You might feel really upset when you’re thinking about difficult things. I am here to support you in dealing with this stuff. Everybody stops crying after a while, and people experience many other emotions in the therapy room too.

I’m worried you’ll get me committed if I come and talk to you

I have no powers to get anyone sectioned. If I think you are a danger to yourself or others, I will talk to my supervisor about my ethical and practical responsibilities. But none of this will happen without you knowing about it and being able to make your own decisions about what you want to do.

What if I know you in real life?

It is not ethical for us to work together if we know each other very well. I understand that some of the groups of people I work with have fairly small social circles, and it is possible that we might know of each other. If this is the case, get in touch and we can decide what to do and if it would be ok to work together.

What if I see you in real life?

I don’t socialise with clients. We can make a plan together at the beginning of therapy to work out what we will do if we see each other outside therapy, for example if we bump into each other at the same event.

Do you work with couples and groups?

At the moment I work only with individuals.

Do you work in languages aside from English?

No, though it may be possible to work with an interpreter.

What do I do if I am not happy with your service?

If you can, you should raise it with me first and we can try and sort out the problem together.
Because I am a member of the British Association for Counselling and Psychotherapy, you can contact their Professional Conduct department, and they can launch an investigation.

>>>>> About counselling and psychotherapy in general

What happens in counselling/psychotherapy?

We sit in a quiet room for 50 minutes and talk. You do most of the talking and I listen and do my best to understand you. Sometimes I ask questions or make observations about the things you are saying. We develop an understanding of what is going on, and we work out ways of making things better.

You might want to talk about the past, or things that are recent or happening in the present. Maybe there are things in the future that you want to work on. Sometimes people talk about hopes, dreams, fears and fantasies, and we work out what they’re about. There is no limit to the kinds of things you might bring to talk about. Sometimes people bring photographs, or little video clips on their phone, or small objects, or drawings and diagrams they’ve done that they want to talk about. That’s ok too. At times some people find it difficult to talk, it can take a while before you feel safe enough to speak about what’s bugging you, but there’s usually no hurry and we will take things at your own pace.

How can counselling/psychotherapy help me?

Taking a good look at your life, identifying and carrying out plans for improving things, is a beneficial thing to do. It can help you sort out problems, feel better about things that are bothering you, heal ancient wounds, improve relationships, or just understand yourself, to name a few of its qualities. Therapy is a space where you are free to think and address any thought, no matter how strange, awful, funny, or socially unallowed. Sometimes this work can enable big changes to happen in your life, sometimes smaller changes. Therapy is a way of doing this ‘looking,’ which can be complicated, with somebody who wants to help you, who won’t judge, in a supportive environment.

People generally feel better through having therapy, according to research evidence, though this can depend on factors such as having a trusting relationship with your therapist; choosing to go into therapy voluntarily; using therapy as part of a mixture of treatments for depression or anxiety.

What’s the difference between counselling and psychotherapy? How come you do both?

Some people argue that counselling and psychotherapy emerged from different historical and philosophical traditions, others distinguish them by the training that people have had. I treat them as the same because there is no difference in the strategies that people use that they call counselling or psychotherapy.

What’s the difference between psychologist, psychiatrist and what you do?

Psychology is a big field and different kinds of people can be called psychologists. My own counselling and psychotherapy training took place within psychology departments in educational institutions, for instance, even though I don’t think of myself as a psychologist.

Psychologists involved with talking therapies and psychiatrists tend to come from a medicalised background and are concerned with diagnosing and evaluating mental health, and treating it. Psychiatrists and some psychologists’ titles are protected in the UK by the Health Professions Council, and are more likely to be able to prescribe medication and treatment.

Some psychotherapists and counsellors may also have backgrounds in psychology and psychiatry, but generally we come from different traditions, and these are not necessarily medical. As a therapist I don’t diagnose people or have the authority to prescribe treatment or drugs, neither would I want to because I work with the whole person within their social contexts in ways that are meaningful to them, rather than just their illness. At the moment ‘Psychotherapist’ and ‘Counsellor’ are not protected professional titles in the UK, though this may change.

Will I have to lie on a couch, listen to whale songs, do weird things in a sandbox, role-playing exercises, primal screaming or anything else that I will find really embarrassing?

No, but you can if you want to.

>>>>> About me as a psychotherapist

What do your clients say about you?

I ask for feedback during sessions to make sure that I am working effectively, but this is not for public consumption.

Clients may not want to tell the world that they have been doing therapy, and there are ethical reasons not to solicit testimonials from people you are currently working with, so it is quite difficult for people to say publicly what it is like working with me. However, sometimes people are generous and offer comments that they are comfortable with being made public after we have finished being therapist and client. Here are two such examples:

“I saw Charlotte for a dozen or so sessions and it was a great short term revisiting of needed therapy. She listened and reflected back helpfully. Charlotte was able to help me think through a lot of intense changes that have happened in a short period of time.”

“I saw Charlotte weekly over several months during a time when I felt frequently overwhelmed by events both in my daily life and in my past. I found her to be a therapist I could wholly respect and trust, who gave me the space and guidance to work through complex feelings and get to a point of greater self awareness and acceptance. As a therapist I found her warm, sensitive and acutely perceptive – enabling a safe, non-judgemental and healing environment I haven’t found elsewhere.”

You’re a writer and a journalist, you do research, does that mean you’ll talk about me in public, or use our sessions as source material?

Absolutely not. I do not share anything about you with anyone, although I talk about how I work with my supervisor, who is also bound to confidentiality guidelines.

It is completely unethical to use clients as source material for anything without their fully-informed consent from the outset. Your safety and privacy is of great importance to me. The work I do elsewhere is separate to the work we do together.

How do I know you are any good?

Although counselling and psychotherapy are currently unregulated in the UK, there is a voluntary register, administered by the British Association for Counselling and Psychotherapy (BACP), which is one of a handful of regulatory professional bodies in the UK. You have to be able to demonstrate certain competencies to get on the register. I am on the register and I am also a Member of the BACP and am bound to its Ethical Framework. In addition, I undertake regular supervision with a more experienced and qualified practitioner to ensure that my work is competent and ethical. This, alongside my qualifications, experience and continuing professional development, is evidence that I am fit to work as a counsellor/psychotherapist. I am also working towards accreditation with the BACP, another voluntary process that supports my professional identity and fitness to practise as a therapist.

What are your qualifications?

I have a fair bit of higher education, but these are the qualifications that are most relevant to this work:

Postgraduate Diploma in Counselling and Psychotherapy (2006-2008, University of East London)
This involved over 400 hours of classroom contact and clinical practise, and 100 hours of work as a volunteer counsellor. I worked at an award-winning community practice for LGBT people in East London. In addition, I undertook Continuing Professional Development classes.

Postgraduate Certificate in Peace and Reconciliation Skills (2009, Coventry University)
This involved learning strategies for identifying, mapping and de-escalating conflicts at cultural and interpersonal levels.

Doctor of Philosophy (2008-2012, University of Limerick)
This took the form of a research project and 100,000 word thesis. Its grounding in sociology enabled me to think about how human activity is located in broader social trends. In terms of counselling and psychotherapy, this is useful in thinking about how people’s behaviour and beliefs are affected by the social contexts in which they live.

I have also worked as an in-house therapist to a couple of community groups, and have several years of co-counselling experience under my belt.

What’s your approach, and what does that mean?

I work in an integrative way. This means that I use tools and techniques from various therapeutic frameworks, am not limited to one school of thought, and that I integrate them with the client’s worldview and my own, depending on what comes up in the sessions. I work to a model developed by Gerard Egan in his book The Skilled Helper, which is concerned with identifying issues and developing productive ways of managing them. My approach is non-medicalised, concerned with social contexts, holistic and client-centred (ie. I listen and don’t force my own viewpoint on you). I’m sympathetic to mindfulness, and some Cognitive Behavioural Therapy strategies, but I think that listening, reflecting and gentle questioning is generally the way to go.

Have you ever had therapy?

Yes, a few times in the past when I have needed to talk to someone about a problem I couldn’t figure out by myself. I wouldn’t rule it out for the future either.

Why do you do this work?

I’m interested in helping people in a constructive and ethical way. I also find the challenges of doing this work very rewarding, I like getting to know people in the counselling room, and the conversations we have there. I like working for myself. I think of counselling and psychotherapy as part of a bigger project of social change that brings people happiness and fulfilment in life.

Weren’t you the therapist at Ladies Rock and Hamburger Queen?

Yes. In 2007 I worked as a therapist for a feminist DIY event called Ladies Rock. I’ve written an account of that experience over on the event’s archival blog: I was the Ladies Rock Therapist

In 2013 I was honoured to serve as Hamburger Queen’s in-house psychotherapist. I wrote a full account of that over on Obesity Timebomb.

I am really interested in developing community therapy like this in the future; making it available to people organising things, for example, or making it present so that people at events can ‘have a go’ at having therapy if they’ve never tried it before. There may be other ways of developing it too.

Please get in touch if you would like to book me to provide therapy at your event, or if you would like to discuss any of this further.