what does it involve 
Before counselling begins you will meet with a doctor of clinical psychology for an initial assessment. Here you will discuss the problems that have brought you to counselling and the changes that you would like to make. This will enable the doctor to decide if they can help and to then describe to you how counselling could enable you to resolve your problem. If you decide to begin a course of counselling you will initially meet with the doctor for a session once a week. As your problem improves the frequency of these meetings will gradually decrease to enable you to practice managing more independently. At the end of your treatment a 3 month and 6 month review session will be offered to ensure that you have not experienced a relapse in your problems.
The period of time over which you meet will depend upon your the severity and chronicity current or your difficulties, however on average for mild problems with a relatively recent onset 10-15 sessions are offered, for moderate problems 20-30 and for more severe problems 40+ session are recommended. The counselling programme is reviewed on a regular basis to ensure that satisfactory progress is being made and that you are comfortable with all aspects of the treatment you are receiving.
What to expect when you start
When people come to counselling they often expect that they will start to feel better straight away and that things will continue to improve in a linear way. However, this is rarely the case. By talking and thinking about your problems in counselling they will be thrown into sharper focus along with the emotional distress that they cause. So the first few weeks of counselling can be particularly difficult, you may feel worse than you did before. As a result people frequently drop out of counselling in the early stages thinking “this isn’t working, I felt better before”. However, this phase of heightened distress is part of the recovery process. Your therapist will teach you skills to cope with this phase, but if you can anticipate it; this will take away a lot of its power to defeat you and stop you moving forward.
With time (usually a few weeks) you will start to feel better as you begin to step back from your problems and understand their origins and the factors that prevent them dissipating on their own. Gradually you will start approaching your problems in a different way and your mood will lift as things start to shift and you feel a growing sense of control and calm. However, progress never runs a smooth course. You will experience good days and bad days, depending on what is happening in your life and in the counselling session themselves. Nevertheless, what you will find is that your bad days become less frequent and intense and your good days increasingly more the rule than the exception.
When thinking about the course you will take in counselling it is useful to imagine travelling from the east coast of South America (Santiago) to the west coast (Rio de Janeiro). You initially hoped that you would be able to cut across country, but are told by your guide that this will not be possible and that you must trek around the coastline. The first part of your journey takes you south, in what seems like the wrong direction. However, as you round the most southerly point you begin to travel north, more obviously heading towards your destination. The journey is a difficult one, and often you have to head inland for a few miles in order to keep on track, this can feel as if you are not progressing or worse still are going back on yourself. But as with the initial phase of the trek, this too is part of the journey.
Will it work?
There are many people whose lives have improved beyond recognition as a result of counselling. It may at times have been a struggle but it has been worth it. Profound changes have taken place and they know whatever happens, they will not experience their old problems again.
Others know that they have at least experienced some benefit. They may understand themselves better and have more positive lives. The good periods may last longer and the bad times may be more manageable.
Your own attitude towards counselling can definitely make a difference. If you go along determined to make the most of every session and be completely honest about yourself, it is more likely to work. If, as a result of what you learn about yourself, you are prepared to face your fears and risk making changes in your life, it is more likely to work.
It is useful if you can be clear about how you hope to benefit from counselling. It will help you to make the best use of your sessions and also decide if it is proving to be useful for you. Research suggests that the most important ingredient for success is that you and your counsellor make a good relationship with each other.
To help you decide if this is the way forward for you, it may help to read some of the evidence available on the effectiveness of counselling.
