Counselling - a process not product

Whilst watching an interview on TV recently I heard a celebrity stating they’d ‘had’ counselling, which bothered me but I couldn’t put my finger on why. I’ve heard similar language many times before, usually from potential clients referred by GPs saying "I’ve been told I need to ‘get’ some CBT" or "my friend ‘had’ counselling which really helped so they recommended I get some too". Reflecting on those conversations I realised what it was that was bothering me – the intonation and phraseology used.  

Words such as ‘get’ ‘had’ and ‘got’ suggest counselling is a product, a commodity, some kind of treatment that is done ‘to’ them. Discussing with them further this was indeed generally their expectation and perhaps hope, and it’s not so surprising I guess. We go to the GP, who on hearing our symptoms prescribes medication for us or perhaps a treatment/procedure which is done to us – all we need to do is turn up and say what’s wrong. So thinking from the perspective of someone looking up counselling, for the first time I Googled ‘what is counselling?’. 

Much is written and spoken about it in terms of differing theoretical modalities, the provision of a safe and non-judgemental space for clients to talk, a place to be listened to and talk about your problems etc. I read countless definitions which in their own way were all correct but there was something still missing for me and I now realise it is the role of the client in the counselling process and the work they have to put in rather than have counselling ‘done to’ them.

The following came up from the BACP and the NHS:

‘Therapy provides a safe and confidential space for you to talk to a trained professional about your issues and concerns. Your therapist will help you explore your thoughts, feelings and behaviours so you can develop a better understanding of yourself and of others’ - BACP

‘Counselling is a talking therapy that involves a trained therapist listening to you and helping you find ways to deal with emotional issues’ – NHS

Neither talk about counselling as a treatment or product as such and indeed they both say ‘help’ but still, and perhaps it’s just me, it feels weighted heavily towards the counsellor being the proactive one and the client being the recipient. 

But what about the role of the counsellor?

The above definitions suggest the role of the counsellor to be that of an enabler and not someone to fix. This in no way diminishes the need for a skilled counsellor but does require both parties to actively come together to work towards an agreed goal. I am there to facilitate, support, encourage, empower, educate... but none of this is done ‘to’ my clients, it will only work if they are receptive and ‘work with’ me.  

What does work for the client look like?

During sessions:

As mentioned above, one aspect of client work is collaborating with the counsellor and actively engaging with them during conversation which might take the form of:

• asking for clarification if we are not sure of something, even if hesitant to do
• not actively hiding things 
• being open and receptive, not dismissive of suggestions before even trying them
• contributing to the conversation rather than just saying ‘I don’t know’
• turning your phone off during session time
• turn up, and on time
• if something about the process is confusing/worrying, telling the counsellor - they can’t help if they don’t know 
• being courageous and honest, not answering differently to how we are feeling in order to be the ‘good’ client - the counsellor is not a mind reader
• take along anything the client has agreed to work on between sessions for review/discussion 
• taking notes to refer back to so as not to forget everything after leaving the session that day
• role playing a situation 

Outside sessions: 

Commonly, sessions are usually weekly and for an hour. With effective counselling the majority of the work is done outside of sessions so what might this work look like?

• reflecting on things discussed in session and making notes if not done so during the session
• journaling
• completing therapy worksheets
• proactively practising new strategies discussed
• self-education on the presenting issue – watching videos, reading books etc. 
• refraining from old unhelpful behaviours 
• putting into place new routines eg. regular bedtime 
• increasing physical activity/getting fresh air 
• sitting with uncomfortable feelings that may have arisen rather than suppressing them 
• reaching out to join other sources of support eg. a group or educational programme
• carrying out an activity plan agreed with the counsellor

The NHS refer to counselling as talking therapy but as I suggest above, there is more to the client role than just talking. Doing the work and actively participating in the ways discussed can help you get the most out of your experience.