What is the evidence base for psychodynamic therapy? There is a growing evidence base supporting the efficacy of psychodynamic therapy, with research indicating that effect sizes for psychodynamic therapies are as large as those reported for other “evidence-based” treatments such as Cognitive Behavioural Therapy (CBT). The benefits of psychodynamic therapy are found to last, and extend well beyond symptom remission, with benefits often increasing after therapy has ended (source: Jonathan Shedler , “The Efficacy of Psychodynamic Psychotherapy”, American Psychologist, 65-2, 98-109). This said, it is impossible to know with certainty, in advance, whether any form of therapy will be helpful to any given individual.
Is it confidential? Yes. I take confidentiality extremely seriously, and I do not routinely disclose anything that you have told me to any other party, other than in clinical supervision, in which I am – like all therapists – required to consult regularly with another counsellor/psychotherapist to review and enhance my clinical work. However, there are limits to confidentiality: if I were to have concerns that you or another person were at risk of significant harm, I may seek to obtain additional input from other professionals. In each case, I always aim to discuss any such issues and agree a plan of action with the client, except in emergencies where I may need to take immediate action.
Do you have a code of ethics? Yes. My work is subject to a comprehensive code of ethics and complaints procedure, as outlined the British Psychoanalytic Council (BPC) Code of Ethics. What this means in practice is that my overriding responsibility at all times is to be mindful of and act in such a way as to promote your best interests.
What problems can you help with? Common emotional, psychological and relationship problems such as: depression, anxiety, adjustment disorder (difficulty making significant transitions in life), bereavement, low self-esteem, work-related stress, difficulties with academic or professional achievement, medically-unexplained symptoms, lack or loss of meaning in life, emotional and interpersonal difficulties secondary to personality disorder. Psychodynamic therapy can be particularly helpful where there are clear difficulties but not clear reasons for them.
Who do you work with? I work with people from all walks of life who are 18 years of age or over; my door is open to people of any gender, sexual orientation, religion, race or nationality. While it is impossible to be sure in advance whether any kind of therapy will be helpful to any given individual, my experience suggests that psychodynamic therapy can be a particularly good fit for people who: want to understand themselves better; value an in-depth exploratory approach, and have a desire for change.
What does it cost? Weekly sessions are for 50 minutes and my standard fee is £55 per session. I do offer some reduced fees for students (where there are significant financial difficulties), people on low incomes and trainee counsellors, although this is negotiated on a case-by-case basis.
How long does it take? Psychodynamic counselling and therapy can be time-limited, but the emphasis is not on quick-fixes; accordingly, my way of working tends to be longer-term – with the work usually taking months rather than weeks, and often a year or more. As a guide: work on mild problems of recent onset is likely to be concluded more quickly than more diffuse, severe or longstanding difficulties. Having said this, clients are free to come for as many or as few sessions as they wish, and I am respectful of the fact that it is the client’s prerogative to choose to end therapy at any time.
What happens when I book an appointment? When someone contacts me to request counselling, I will offer an initial assessment appointment at a mutually convenient time. Ahead of this, I will send you a copy of my treatment contract for your information, along with a brief questionnaire, and some forms requesting basic information (name, address, date of birth, GP etc.).
The assessment session is an opportunity for us to meet and get a sense of whether we would feel comfortable working together. During the appointment we will usually: 1) talk about the problem that brings you into therapy; 2) discuss something of your background and history; 3) review some information about my way of working; 4) address any questions that you might have; 5) establish whether psychodynamic therapy is likely to be appropriate for you. Sometimes this process is spread over the first two or even three sessions.
What happens in ongoing sessions? The simplest way of putting it would be to say that we have a kind of conversation. Whereas in the initial assessment session this conversation will usually be quite structured (in that there are certain practicalities to attend to, and I will generally ask some factual questions about your background and the matters that bring you into therapy), once we begin ongoing sessions, there is often a shift towards a more exploratory discussion, and I generally won’t need to ask so many factual questions.
At the beginning of the sessions, I will usually wait for you to begin with whatever is uppermost in your mind. I will be listening and will leave space for you to talk as freely as you can about what is of concern to you at the time of the session, or anything else that comes to mind at that time – and that could include memories, dreams, mental images and associations. You may also have thoughts and feelings about therapy itself – perhaps even about me, and I would encourage you to talk to me about such thoughts; this is because it can help us to assess whether the therapy is meeting your needs, and it may also allow us another way to understand more about your psychology.