Help for students and pupils

Counselling (or therapy) is provided by qualified practitioners working under a code of good ethical practice. They will have completed between 400 – 450 hours of training and will be associated with a professional body such as The British Association of Counselling and Psychotherapy

Other professional bodies include;

• The United Kingdom Council for Psychotherapy
• The British Psychoanalytical Council
• The British Psychological Society

If you need further clarification of someone’s qualifications before embarking on counselling their professional body will be happy to help.

To find a qualified counsellor or psychotherapist in your area, you can access a list through the BACP website. Throughout the following descriptions the term ‘counsellor’ is used synonymously with psychotherapist/therapist.

What happens in a counselling session?

You can expect a counselling session to last approximately 50 minutes. You will usually be offered a series of sessions – between six and eight sessions is typical, although this will be discussed. Your counsellor will have been trained in a particular clinical approach and will make their style and specialisms clear with you before you start working together. A good counsellor creates a safe, trusted and confidential space where you will feel able to work at your own pace. You will be supported to share your thinking and feelings with a non-judgemental expert. You will also be encouraged to create your own way forward with encouragement and guidance. Suggestions and recommendations for further activity and resources may be offered.

It is not unusual to believe our issues are overwhelming or too complex to be solved. We might also feel that personal problems are in some way insignificant, especially if we are experiencing guilt, thinking that others are worse off than us. Counsellors have experience across the range of human emotion and adversity. The areas you wish to address will always be respected. If you feel that you have not connected with your counsellor on first meeting, this does not mean counselling is not for you. You may find that you need to contact a different counsellor.

Cognitive behavioural therapy (CBT)

CBT is a therapeutic intervention commonly employed by counsellors. It is a practical talking therapy focusing on the links and patterns between feelings, thinking (cognition) and action (behaviour). The intention of CBT is to break negative and unhelpful thinking patterns. A counsellor using CBT methods will work with you to explore your thinking, feeling and behaviour. He/she will create understanding around and how faulty thinking can lead to distress. The process is future focused and goal oriented. It is designed to change behaviour, replacing negative behaviour patterns with more helpful approached. Discussion is generally about the present and future with little emphasis on the past. Many people find this refreshing as they prefer not to talk about childhood or traumatic past experiences.

CBT can also be delivered online, in groups and through books. It is important to remember that as with any mental ill-health intervention, CBT does not work for everyone. This does not mean that your issues cannot be resolved.

Other therapeutic approaches including psychodynamic therapy, dialectical behaviour therapy and eye movement desensitisation and reprocessing (EMDR) are described here http://www.bacp.co.uk/seeking_therapist/theoretical_approaches.php

Mindfulness is the practice of present moment awareness. It is a secular concept based on ancient Buddhist practices of contemplation. In its simplest form, mindfulness is pausing to notice your present experience. This grounds us in reality and can help move us away from unhelpful thinking patterns about the past or future. Regular mindfulness practice (usually in the form of meditation) has been shown to reduce levels of stress, depression and anxiety. Considerable evidence is building to support mindfulness as a brain training tool to increase resilience, improve decision making and boost focus. Mindfulness is also being used to support people who wish to alter unhelpful relationships or habits with food and other aspects of life. Neuroscientists have been able to demonstrate physical brain changes in the brains of participants which indicate that mindfulness practice can positively alter brain function and human behaviour.

There are a multitude of mindfulness resources available including smart phone apps , books and online courses. Many people find that face to face teaching sessions are most beneficial as this provides a robust foundation on which to base daily practice. This approach also ensures that any challenges can be discussed with an expert.

Mindfulness involves being with your thoughts, observing them and noticing your emotional responses to thinking patterns. This ‘sitting’ with emotions is counter to our societal norms which generally involve avoidance and distraction. The experience of ‘being’ can initially feel overwhelming. We spend much of our lives on ‘autopilot’ moving from one task to the next. As a legal professional you doubtless experience a permanently ‘busy brain’. This can be an inevitable consequence of an intellectually demanding role and balancing the demands of family life. Taking time to slow down and focus initially requires support from an experienced mindfulness practitioner.

Those currently experiencing mental ill-health or with a diagnosis of depression, anxiety (or other mental health condition) are advised to carefully consider the capability of their teacher before embarking on a programme of training. Mindfulness is not currently regulated in the UK. This means anyone can claim to be an expert in mindfulness and offer teaching free or for profit.

A reputable mindfulness practitioner will have been trained according to the guidelines of the UK network for mindfulness based teacher training organisations. This requires a high level of personal and teaching practice, including supervision by more experienced practitioners.

Mindfulness can be a transformative experience for many. However, as with CBT and other wellbeing interventions it does not provide a guaranteed solution.

• http://www.rcpsych.ac.uk/healthadvice/treatmentswellbeing/faqshowtogethelp/faqdifferencesbetween.aspx
• http://www.itsgoodtotalk.org.uk/
• https://www.youtube.com/watch?v=t-olXvqgttk&feature=youtu.be
• http://www.itsgoodtotalk.org.uk/assets/docs/Key-fact-sheet-1-What-do-counsellors-and-psychotherapists-do_1276789241.pdf
• http://www.itsgoodtotalk.org.uk/assets/docs/Client-information-sheet-1_1445260033.pdf
• http://www.itsgoodtotalk.org.uk/what-is-therapy/types-of-therapy
• http://www.headspace.com
• http://www.bemindful.co.uk

Consulting your GP is a positive first step. Being proactive as soon as you suspect you may be depressed will help you feel more in control of your situation.

If you are diagnosed with depression or anxiety (for example) your GP should offer a range of support.

Take a look at this short video clip from a GP about the approach to depression typically taken in UK general practice.

Your GP will ask you some clarifying questions and may work through a simple survey which might look similar this to http://www.nhs.uk/Tools/Pages/depression.aspx. He or she will be particularly interested in whether you have been feeling low for a period longer than two weeks.

Your GP should offer a number of options including a range of talking therapies. One option may also be anti-depressant medication, which can be very supportive for addressing the symptoms certain types of depression. If you do wish to take this route, forms of anti-depressants include:

1. Selective serotonin reuptake inhibitors (SSRIs)

These are the most commonly prescribed forms of anti-depressant medication and are often known by the brand names; Prozac, Seroxat and Cipramil.

2. Serotonin noradrenalin reuptake inhibitors (SNRIs)

These are sometimes prescribed for people who do not respond well to SSRIs. Efexor is an example brand name.

3. Noradrenaline and specific serotonergic antidepressants (NASSAs)

Prescribed for people unable to tolerate SSRIs. Similar side effects. Brand name example Zispin

4. Tricyclic antidepressants (TCAs)

An older medication no longer commonly prescribed. Sometimes used for other mental ill-health diagnoses including bi-polar and obsessive compulsive disorders. Examples include Tryptizol and Anafranil.

Medication will usually take at least 7days dosage (and often longer) before positive impact will be experienced. All medication carries the risk of side effects and these should be fully discussed with your GP. You may be able to try another medication if the first produces unpleasant or intolerable side effects. Medication does not always work for patients with depression and/or anxiety. It is also worth remembering that whilst anti-depressants may resolve symptoms, the source of your depression is likely to require talking therapy or another intervention in order to effect long lasting change.

You can find out more about anti-depressants here http://www.nhs.uk/conditions/antidepressant-drugs/Pages/Introduction.aspx

If the GP feels additional expertise is necessary, you may be referred to see a psychiatrist. A psychiatrist is a medical practitioner who can prescribe as well as diagnose and treat chronic and complex forms of mental ill-health.