How Do We Get Started?

The Assessment Process

In order to ascertain what is needed from a therapy intervention, it is important to do a full assessment. This helps us all understand the issues at hand and whether this form of psychotherapy is right for you. My assessment differs depending on the age of the potential client. When you contact me, we can arrange a 30 minute telephone consultation which is free of charge. This enables me to find out a little about what you are looking for and to see how you would like to go forward. We could, at this stage, agree on a one-off face to face meeting where you can tell me a little more about your situation, and I can explain a little more about how I work.

Child Assessment

If you are enquiring about therapy for your child, I would then offer you a 3-session assessment. This involves:

1) an in-depth meeting with the parents (both parents if possible) during which I will take a family and medical history;

2) a meeting with parent(s) and young person in which we can discuss how the difficulties are perceived by each individual.

3) a meeting with the young person on their own, giving them opportunity to experience a therapy session on their own.

Sometimes the assessment process raises questions not previously considered and you may find powerful emotions can surface. It is important for us to make time for these responses as they will inevitably give us useful information about what is happening. For this reason, I ask for a commitment to the 3 sessions so that we can explore what emerges.

Teenage/Adolescent Assessment

Due to the nature of this stage of development, it is often difficult for an adolescent to express themselves in front of a parent. Therefore, within the 3-session structure, there is more flexibility for parents to wait outside the consulting room if this feels appropriate.

However, in any work with young people, the parents and family structure are an essential part of the process and it must be understood from the outset that we are all engaging with the process in order to help with whatever difficulties the young person is experiencing. Regular reviews of the work are offered and encouraged.

Similarly with the Child Assessment, I ask for a commitment to the 3 sessions so that a full picture of what is needed can be gained.

Young Adult Assessments
(18-25)

The first contact I have with young people is usually through their parents. However, for the young adult, it is often not desirable for the parents to be involved in our meetings. This can create some conflicts as it is usually the parents who settle the invoices!

When starting out with this age group, I encourage a 3-session assessment period, during which we can get to know each other and decide if psychodynamic therapy is what is required.

Often, work with young adults raises questions which are unresolved from childhood: relationships, gender, sexuality, adolescence, independence etc. Studies in child development show that unless we are able to process each stage of development, it will come back to haunt us at a later date. So even though the family is not present physically in adult therapy, they are nevertheless present in the mind and in the therapeutic relationship.

Ending Therapy
The ending of therapy is as important as the beginning.

Regardless of who ends the relationship, emotions will be stirred in the client. These range from abandonment to anger, rage, sadness, relief, happiness, pride at achievements etc. Making time to end and express these emotions is essential for how an individual moves forward, and whether they feel able, if necessary, to re-engage with therapy in the future.

Just as in the therapy itself, observing our conscious and unconscious responses is part of the tapestry of a relationship and cannot creatively be avoided. Making time to grieve and laugh together, therefore, is vital, regardless of how long or short the therapy has been.

This can be difficult to understand for a parent bringing a child or other young person, and not actually experiencing the therapeutic relationship themselves. But to protect the child and their development, a notice period of at least 4 sessions is required for this process to take place. (Payment in lieu will be required.)

A similar period is required for adults but it is hoped that conversation will be ongoing and an ending may become obvious to both parties.