Monique Spokes

Verified Verified Professional
Verified Professional

Every professional displayed on Counselling Directory has been independently verified by our team to ensure they have suitable credentials to practise.

her/she
MA

About me

I am an experienced integrative psychotherapist specialising in Obsessive Compulsive Disorder (OCD), anxiety and related difficulties, alongside my work with individuals and couples experiencing relationship and attachment difficulties.

OCD is an area I understand from both sides of the therapy room. Alongside extensive postgraduate psychotherapy training and continued specialist training in OCD, I have my own lived experience of OCD. This has given me an understanding that goes beyond knowing the theory: I know how convincing OCD can feel, how exhausting the search for certainty can become, and how frightening or shameful it can feel to say certain intrusive thoughts out loud.

My lived experience does not replace my clinical expertise — it deepens it. It is one of the reasons I feel so passionately about this area of my work.

A significant part of my practice is dedicated to people living with OCD, particularly presentations that can be hidden, misunderstood or extremely difficult to disclose. I work with contamination and checking OCD, harm OCD, Relationship OCD (ROCD), sexual orientation OCD, religious and moral scrupulosity, health and existential OCD, false-memory and real-event OCD, “just right” OCD, predominantly mental OCD (“Pure O”), and intrusive thoughts involving harm, sexually inappropriate thoughts OCD (POCD), sex, relationships, morality, religion, identity and other taboo themes.

I also work extensively with the less visible side of OCD: rumination, reassurance seeking, mentally reviewing events, checking memories and feelings, confessing, researching, avoidance, testing reactions and the relentless need to establish certainty.

If you have never told anyone the true content of your intrusive thoughts, you can bring them here. My role is not to judge or be shocked by what OCD is telling you. We can understand what is happening and work with it together.

My approach to OCD is active and evidence-informed. I use Exposure and Response Prevention (ERP) alongside cognitive and behavioural approaches, including REBT, within my wider integrative psychotherapy framework. Rather than simply talking about anxiety or providing reassurance, we identify the obsessions, compulsions, avoidance and beliefs that are maintaining the OCD cycle and work purposefully to change your relationship with them.

However, I also believe there is more to a person than their OCD.

My extensive psychotherapeutic work with attachment, early childhood experiences and emotional wounds allows us to work at greater depth where this is helpful. Alongside addressing the processes maintaining OCD in the present, we explore your psychobiography — the relationships, experiences, environments and narratives that may have shaped how you experience uncertainty, responsibility, safety, guilt, control and yourself.

I don't assume that childhood experiences caused your OCD, and deeper psychotherapy does not replace evidence-based OCD treatment. What I offer is the opportunity to do both: to work directly with the OCD while also understanding the person experiencing it.

This combination of specialist OCD treatment, integrative psychotherapy and lived experience is at the heart of how I work.

I also work with couples and relationships, particularly where there is repeated conflict, communication difficulties, emotional disconnection, attachment difficulties, loss of trust or intimacy. My experience with OCD can be particularly valuable when anxiety or OCD has entered the relationship and a partner has become involved in reassurance, checking, avoidance or accommodating compulsions.

My style is warm, engaged and straightforward. I don't believe therapy should consist solely of me sitting back and listening. Feeling genuinely understood matters, but so does understanding what is happening, what is maintaining the difficulty and what we can actively work on together.

Ultimately, my aim is not simply to help you manage symptoms. It is to help you understand yourself more deeply, loosen the grip that OCD, anxiety or longstanding emotional patterns have on your life, and create meaningful and lasting change.

I work with adults and couples in Bristol and North Somerset and online wherever you are located. I also offer focused and intensive OCD treatment where appropriate (Please contact me directly for more details on booking your intensive treatment).

If you recognise yourself in any of what I have described — or if your experience doesn't fit neatly into a particular OCD presentation — you are very welcome to contact me. We can talk about what you are experiencing and whether I might be the right therapist for you.

Training, qualifications & experience

Professional Training & Clinical Experience
My training as a psychotherapist has been extensive and in-depth. I hold a Master’s degree in Integrative Psychotherapy from Middlesex University, following seven years of clinical and academic training.

My clinical training was undertaken at the highly respected Bath Centre for Psychotherapy and Counselling (BCPC), where I developed a strong foundation in integrative, relational and humanistic psychotherapy. This depth of training enables me to work beyond presenting symptoms and to understand the wider emotional, relational and developmental experiences that shape each person.

I have over six years’ experience in private clinical practice, working with adults from a wide range of backgrounds and with complex and varied psychological difficulties. This has given me considerable experience in understanding how anxiety, relationships, attachment, early experiences, self-beliefs and patterns of coping can become interconnected.

Alongside my individual psychotherapy practice, I have undertaken additional specialist training in couples and relationship therapy, enabling me to work with relationship dynamics, attachment patterns, communication difficulties, conflict, intimacy and emotional disconnection.

Postgraduate Specialist Training in OCD
Obsessive Compulsive Disorder is a particular area of specialist interest, advanced study and clinical focus within my practice.

Following my core psychotherapy training, I have continued to undertake postgraduate specialist training in the assessment, formulation and treatment of OCD, building upon my wider psychotherapeutic knowledge with approaches specifically designed to understand and treat obsessive-compulsive difficulties.

My specialist development includes training and continued study in Exposure and Response Prevention (ERP) and cognitive and behavioural approaches to OCD, alongside understanding the often less visible processes that can maintain the disorder — including rumination, reassurance seeking, avoidance, mental reviewing, checking, thought suppression, compulsive analysis and the pursuit of certainty.

My interest in OCD has also formed a significant part of my academic work. My Master’s dissertation explored the development and treatment of OCD in relation to attachment disturbances, allowing me to examine in depth the relationship between established approaches to OCD treatment and the wider developmental and relational experiences of the individual.

This remains an important part of how I think about my clinical work today.

I believe effective OCD treatment requires a clear and informed understanding of the mechanisms that maintain OCD and the ability to work directly with them. At the same time, my extensive psychotherapy training allows me to remain curious about the whole person experiencing the OCD — their attachment history, early relationships, emotional wounds, beliefs and wider psychobiography.

This combination of advanced psychotherapy training, postgraduate specialist OCD development, focused academic research, clinical experience and my own lived experience of OCD gives my work a perspective that is both specialist and deeply personal.

I continue to undertake advanced professional development and specialist training in OCD, ensuring that my clinical practice continues to evolve alongside current understanding and evidence-informed approaches to treatment.

Member organisations

Registered / Accredited

Registered / Accredited

Being registered/accredited with a professional body means an individual must have achieved a substantial level of training and experience approved by their member organisation.

UKCP
UK Council for Psychotherapy (UKCP)

The UK Council for Psychotherapy (UKCP) is a leading professional body for the education, training and regulation of psychotherapists and psychotherapeutic counsellors. Its register is accredited by the government's Professional Standards Authority.

As part of its commitment to protect the public, it works to improve access to psychotherapy, to support and disseminate research, to improve standards and to respond effectively to complaints against its members.

UKCP standards cover the range of different psychotherapies. Registration is obtained by training or accrediting with one of its member organisations, or by holding a European Certificate in Psychotherapy. Accredited by the Professional Standards Authority.

Accredited register membership

UK Council for Psychotherapy
Accredited Register Scheme

The Accredited Register Scheme was set up in 2013 by the Department of Health (DoH) as a way to recognise organisations that hold voluntary registers which meet certain standards. These standards are set by the Professional Standards Authority (PSA).

This therapist has indicated that they belong to an Accredited Register.

UK Council for Psychotherapy

Areas of counselling I deal with

Therapies offered

Fees

£95.00 per session

Additional information

Fees & Sessions

I offer individual psychotherapy, couples therapy and specialist intensive OCD treatment.

Initial Assessment Session - £100

Individual OCD Psychotherapy — £95
50-minute session

Individual Psychotherapy — £85
50-minute session

Couples & Relationship Therapy — £110
50-minute session

Intensive OCD Treatment — Price on request
Intensive treatment is individually designed around you, your presentation of OCD and your therapeutic needs. Unlike my standard 50-minute sessions, the length, frequency and structure of an intensive programme are tailored specifically to you following an initial discussion and assessment.

Please contact me directly if you would like to discuss intensive OCD treatment, including the different options available and associated fees.

When I work

Mon Tue Wed Thu Fri Sat Sun
Early morning
Morning
Early afternoon
Late afternoon
Evening

Downend, Bristol, BS16

Stoke Lane, Westbury on Trym, Bristol, BS9 3RW

Type of session

In person
Online
Phone
Home visits

Types of client

Young adults (18-24)
Adults (25-64)
Older Adults (65+)
Couples
Groups
Organisations
Employee Assistance Programme

Key details

DBS check

In England and Wales, the Disclosure and Barring Service (DBS, formerly known as CRB) carry out criminal records checks for individuals working with vulnerable groups, such as children. To find out more, visit gov.uk , or contact this professional directly

Wheelchair user access
Wheelchair user access

Wheelchair-accessible premises should have step-free access for wheelchair users and individuals who are unable to climb stairs. If a Counsellor's premises aren't step-free, they may offer alternative services such as telephone/web-based appointments, home visits, or meeting clients in different location, so you can choose the option that suits you best.

You can contact the Counsellor to discuss the options available.

Under the Equality Act 2010 service providers have a duty to make reasonable adjustments to ensure that individuals with disabilities can access their service. You can read more about reasonable adjustments to help you to access services on the CAB website.

Online platforms

Microsoft Teams
Zoom
FaceTime
Google Meet
Whatsapp

Social

Monique Spokes
Monique Spokes