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How therapy works

You may be wondering how therapy works and what to expect in your sessions. Online therapy works in the same way as face-face therapy.

Therapy can help you by:

  1. Giving you the opportunity to share how you feel ,which can reduce the effect of painful and difficult emotions.
  2. Developing your sense of control over yourself and your life, bringing you more stability and security,
  3. Improving your ability to communicate about yourself and what matters to you.

There are differences in how it works depending on the communication method we choose

For both therapy using video and therapy by phone we have weekly appointments which are one hour long. We work together throughout the session. Sometimes there are silences and that is fine and expected. It is important to have the opportunity to reflect as we go along.

With therapy using email is also a weekly process but we each work in our own time. We use email but we are more writing letters to each other. My emails will include my responses to what you share in your email to me. I will make comments and ask you questions to support you to reflect and explore further.

Walk and talk therapy works differently. We will do a free ‘first session’ from home to discuss whether it is the right approach for you . We will also need to make an agreement on how we will work together.

How the first therapy session works

In our first online therapy session we will need to agree some practical things. These include how many sessions to have, the timings for the sessions and so on. I will then ask you to tell me a little about what you are concerned about. We will discuss whether therapy with me is likely to be a useful approach for you.

I want you to get the right support. If I don’t feel that working with me is the right approach for you then I will say so. In that case I will support you to find an approach that suits you better.
We can then agree what to use the rest of the session to focus on. You will also have a chance to consider whether you would like to go ahead with another five sessions.

What to expect in your weekly online therapy sessions

If you agree to continue with the sessions then we will meet weekly. Each session together we will spend our time exploring how you are in relation to your concerns. How you really are. We will think about what it is that you want to be different for you. I will check to make sure I am accurately understanding what you are telling me. I may ask further questions so that I can understand more. My aim is always to get a closer understanding of your world. I will not judge or compare this with mine or anyone else’s. The things you are concerned about might shift and change as we go along. I will be checking that we are still doing what matters most to you.

The changes you might experience during and after therapy

You are likely to start to develop new ways to understand yourself and to ‘do’ life and relationships. Gradually you are likely to feel more at peace with what has happened in the past. You may become more comfortable in yourself. , happier about how life is and more hopeful and joyful about present and future. You might find that the ways you relate to other people changes. This won’t all happen immediately and there can be no guarantees.

There is lots of research evidence that many thousands of people have experienced positive outcomes from therapy. There is also research evidence that online therapy works as well as face-to-face treatment. A 2014 study ,published in the Journal of Affective Disorders, found that online treatment was just as effective as face-to-face treatment for depression.

You do need to be aware that sometimes things seem to get worse before they get better. This can be a difficult part of the experience of therapy. I will support you throughout if this happens for you. This does not mean that the therapy is not working but is just part of the process sometimes.

I will always allow you to go at your own pace and I will always follow your lead. The idea is that, through your therapy , things will begin to change for you for the better. Of course, that change is different for everyone and can take a few sessions or longer to begin. We will be reviewing and checking out how it’s going at regular intervals.

What if I get upset?

In therapy we will both to get to think about you and whatever you want to talk about very closely. Sometimes this will bring up some strong and even uncomfortable emotions and I will support you around this. Your therapy session is somewhere where you can laugh, cry or be angry without worrying how that will affect me. Swearing is fine too!

You might even get upset with me about something I say or do. If that happens I encourage you to let me know so that we can discuss this and resolve the problem. I do make mistakes and I want to know if this happens.

You might need some space afterwards to reflect quietly about the session or about some of my responses to you. Try not to schedule difficult and demanding activities in the hours after the session if at all possible.

You will need to consider whether this is the right time for you to start therapy sessions. This is important so that your therapy has the best chance of working. This is something we will talk about in your first session.

What will I have to do in my therapy sessions?

You won’t need to do much more than turn up and talk or write to me! A willingness to talk about what concerns you will help but if this if difficult I will support you to do this. Things may need some time to begin to change so giving the process a chance to work will also be important. You might feel uncomfortable at times. I ask, after the first session, that you commit to another five sessions. You are, of course, free to stop at any time if you choose to. We will then review how things are going and then agree to end or to do some more sessions.

What if I don’t know where to begin?

You might worry that you won’t know where to begin. I will help you to find your own way to start telling me about what your concerns are. There are many places you can start and still find your way to what really matters for you.

Will you think badly of me?

I will not be judging you but trying to truly understand how things are from your perspective. You are likely to share about your relationships with others. I will not judge them either but instead just focus on how the relationship with them is for you.

Will you tell anyone else what I tell you?

You can be certain that I am not going to break our confidentiality agreement no matter what you share. There are some limits to confidentiality around your safety and other people’s safety. We will discuss these and agree to to these between us in your first session.

Will you tell me what to do?

No! You are the expert on you and your life. I will support you to discuss options and I can add my thoughts to yours. You are the one who decides what actions to take. I support you to develop the self-confidence to know what you want and what you are choosing.

How will I know when to stop?

Ending your online therapy with care is very important. If at any point you think you want to stop then we can discuss that together in your session. Then we will work out a way to end the work together in the best way for you. This is even more important if we have worked together for many sessions.

Do not hesitate to contact me if you want to know anything further about how online therapy works. You can also use this link to book a free 20 minute appointment to have a chat with me.