Tue, 14 Apr 2026 11:52:33 +0000WeeblyWed, 27 Aug 2025 13:05:53 GMThttp://www.clareslaneycounselling.com/blog/paying-for-the-space-not-just-the-session-why-the-frame-matters
​Therapy apps offer customer flexibility: choose a therapist, change them when you want, book a session that fits around other events. This can be useful for urgent support.

Many people benefit from this kind of casual access, ChatGPT offers untiring empathic attention 24/7. And all therapy apps are very careful to describe what they offer as ‘therapy’. 

‘Therapy’ covers a multitude of practices, not all of them professionally regulated. 

Post-Covid, 'counselling' and 'psychotherapy have too often come to mean offering advice, techniques and reassurance to manage immediate symptoms. The internet is full of advice, techniques and reassurance. People come for professional psychotherapeutic work because advice, techniques and reassurance  are not enough.

People in psychotherapy often quickly discover that, say, anxiety is not the problem but a symptom:  anxiety can be 'cured' only to become depression, phobias, irritability, burnout or despair.

Structure and continuity matter.
Counselling and psychotherapy are professional, structured processes with one qualified counsellor/psychotherapist, centred on an ongoing therapeutic relationship, whose purpose is lasting, sustainable change. The value is not in a single conversation or a handful of techniques, but in the continuity of the same time, same place, same counsellor/psychotherapist, same, reliable relationship, whether you work for 6 sessions or 5 years.

If you begin to find your counsellor/psychotherapist annoying, boring, or anything other than solely helpful, this is important information. We might of course be annoying and boring, or it may be that when you get annoyed or bored something else is going on that is ready to be addressed.

When  skilful, non-judgemental attention is brought to familiar feelings, those feelings can be better understood and altered to serve you better. 

In a culture that promises instant fixes and infinite consumer choice this may feel unfamiliar, even unsatisfactory. We're used to expecting most immediate desires to be met: you hand over money, get what you want, feel better, the transaction ends there. Instant relief, flexible supply - food, attention, stuff - on demand.

But if your feelings, even your attendance at sessions, don’t matter it’s reasonable for you to believe that you don’t matter, even if your initial feeling may be relief that you avoided a difficult conversation. 

Psychotherapy offers something unique. The fee is not for a dose of comfort or a single sessions worth of techniques and sympathy. You are not buying a product. You are investing in the continuity of a therapeutic relationship that is solely focussed on you, whether or not you attend.

Your feelings matter. You matter.

It can feel inefficient or even alarming to engage with feelings you didn't intend to address when you began the work. You may worry about becoming dependent.  You may fear that experiencing a conscious, structured, non-confrontational ending may be unnavigable, even frightening.  

Regular sessions make it possible to trust that a relationship won't alter, won't punish or manipulate you, so that you  can face what has been stirred, learn from it, deal with it differently, change, and grow.

Psychotherapy supports deep change through a reliable, consistent, trustworthy, therapeutic relationship that enduringly welcomes what others may not. Anxiety, ambivalence, vulnerability, failure, confusion, anger, the vast range of human feelings all have a place. The psychotherapeutic frame ensures that those feelings can emerge and be held safely.

When the frame falters, the work falters. When the frame holds,  everything (including absence) becomes meaningful. This is sometimes called the ‘reality principle’: being in the world with other people has consequences. Where one person's distress meets other peoples lives and everyday responsibilities, habits that used to work but are no longer useful can kick in. These can include anger, avoidance, appeasement,  or soothing anxiety with short-term distractions.

Psychotherapy aims to help you make new, unfamiliar, and sustainable choices that allow you to live with greater ease.

You're not a customer.

Psychotherapy is not designed to offer instant gratification.

You're not broken.

You matter. 



​
Discover what psychotherapy students are taught about the frame here.


]]>Tue, 09 Apr 2024 12:46:17 GMThttp://www.clareslaneycounselling.com/blog/the-cost-of-conformity
Ronald Gittins died in 2019 leaving behind a home filled with his art. Five years on, his flat in Birkenhead, walls covered in his work,  rooms crammed with sculptures and murals,  has been Grade II listed.

He lived there for three decades, left largely alone by landlords and agents, letting in only a handful of visitors. Enough of the right people came through at the right time to see that something extraordinary had been created, and to act so that his work would not be lost.

We don’t really know how Gittins lived, how he paid the rent, what his days looked like. What we do know is familiar: people like Ronald often find it hard even to live with themselves. They are compelled to make, driven more by necessity than choice. Very few ever produce work the market wants, but that's rarely their concern. For many, art is not about money at all.

He was of a generation that could find some support from the State. From the 1960s to the mid-90s, the benefits system in Britain acted as a basic income for many creative people. Writers, musicians, and artists who had little money but abundant time could develop their skills. Some went on to become successful; others simply kept producing in their own way.

Now, no one is permitted that freedom. Families demand respectability, schools shape expectations, cultures ridicule the urge to create unless it is monetised. Banksy was a vandal until his work began selling for millions. The lesson is clear: what you make has no value unless it sells, and if you need to feed your children that message is particularly maddening.

The consequences of forcing people into lives that don’t fit them are evident all around us. Some numb themselves, some break down, some end up in contact with the courts or psychiatric services. Many, many more live lives of bitterness and frustration, resenting others, abusing the smallest amounts of power, unable to tolerate those who remind them of what they cannot bear in themselves. Psychotherapy calls this projective identification: the parts of us that are disowned, are perceived and punished in others. None of us are immune.

You don’t need to be an artist to feel this. Anyone who senses that their life does not truly belong to them will feel the strain. Sometimes it’s obvious: the genius mathematician having to schmooze investors, the barrister whose real gift lies in care. Sometimes it is harder to recognise, buried under histories where attention was conditional on being constantly brilliant, caring for a parent, being unwell, or causing trouble.

People can succeed outwardly and still feel inwardly thwarted, and that dissonance leaves its mark on relationships, including with their children.

There are no simple solutions. Ronald Gittins had a convergence of circumstances that allowed him to keep going in his own way. He was prolific in solitude. For most of us, conformity is necessary. We learn our trade, earn a living, secure some stability. If we're fortunate, we can create enough space to pause, to ask why we are doing what we are doing, to wonder which pieces of our lives really belong to us.

Psychotherapy offers one of the rare places where that is still possible. A space to look at what compels us, what constrains us, and what might allow a life to feel more like our own.




]]>Fri, 05 Apr 2024 13:16:12 GMThttp://www.clareslaneycounselling.com/blog/from-perception-to-insight-the-journey-of-psychological-processing
We’re often encouraged to “process” our feelings, and to seek help if we can’t do it alone. But what does processing actually involve?

More Than Just Understanding
Processing is sometimes thought of as understanding. That makes sense when investigating a policy failure or a broken system: gather the facts, fit them together, draw a conclusion.
But emotional experiences don’t work that way. When you’re left feeling confused, unsettled or “not yourself,” logic alone rarely helps. Something more is needed.

The Warehouse of Memory
Neuroscience suggests that ordinary events become memories we store easily, ready to use when needed. Opening your front door to the smell of good food can remind you that you can relax, while the skill of brushing your teeth doesn't interrupt your ability to drive.

But unusual or difficult events don’t slot in so neatly. Imagine a warehouse carousel:

        Regular boxes → ordinary memories → stack easily and stay stable.
​         Irregular boxes → fragile or unusual experiences → take more effort to store.
        If too many arrive at once, they bash into each other, spill, or circle endlessly. That's what it feels like when 
        experiences remain unprocessed: intrusive, unstable, overwhelming, difficult to put down.

What We’ve Lost
Across cultures, rituals once helped to contain life’s irregular boxes. Bereavement, birth, coming of age, accidents . . . each was marked by shared practices that gave shape and meaning to experience. Many of those rituals came with an unspoken cost, and in the (often proper) rejection of those costs we also rejected the purpose of rituals, reducing them to empty financial outlay and performances.  Without meaningful symbolic events, we're left unsure how to respond to events, with fewer containers for memory and fewer opportunities to process unusual experiences.

What Processing Involves
Processing isn’t limited to extreme or traumatic events. Everyday strains, sometimes genuinely pleasant events, can create their own backlog.

Processing can look like:
     Taking time to reflect on events.
     Talking it through to find language that fits.
     Becoming curious about how it might connect to other experiences.
     Expressing it through writing, painting, etc

Processing is a way of understanding events so that they can be understood more deeply and carried more lightly.

Where Psychotherapy Helps
An inquiry gathers evidence but does not attend to its visceral impact. Psychotherapy does both.

Psychotherapy offers a space where events can be spoken about and remembered with care, feelings can be expressed and symbolised, and where meaning can begin to form. It is not about “getting over” events or returning to a pristine, untouched version of yourself. That is neither possible nor desirable.

Instead, psychotherapy helps you make deeper sense of what has happened. It allows you to create containers that fit more comfortably, so that memories no longer rattle around or circle endlessly.

The Work of Growth
Processing isn’t a quick fix. It takes time. But when experiences are attended to in psychotherapy - without judgement or blame, with careful attention - they can inform new choices, different boundaries, and sometimes altered opinions.
They stop destabilising the whole system and instead become part of who you are, not as burdens to be carried but as sources of perspective.
​
Processing, in this sense, is not simply repair. It is the slow work of growth, the making of wisdom. 


If This Speaks to You
If you recognise something of your own experience in this, psychotherapy can provide a steady place to begin working with it. Together we can begin to make sense of what truly feels unsettled, so that it can be processed, integrated and carried with greater ease.]]>Fri, 05 Apr 2024 07:52:48 GMThttp://www.clareslaneycounselling.com/blog/the-silent-epidemic-exploring-the-impact-of-burnout-and-workplace-stressBurnout has become ordinary.

What used to be a pretty niche diagnosis, perhaps exemplified by the cliché of a male executive rearing out of his office chair, punching a wall and having to be led from the office, is now being seen in large numbers of people.  It’s worth making a few distinctions.

The World Health Organization defines burnout as "a syndrome conceptualised as resulting from chronic workplace stress that has not been successfully managed." It is “an occupational phenomenon.” “Burn-out refers specifically to phenomena in the occupational context and should not be applied to describe experiences in other areas of life.”

This is important.

Burnout is linked to poor management in the workplace. Not to an individual failing to manage their own stress.

Forbes says:
We often think of burnout as an individual problem, solvable with simple-fix techniques like “learning to say no”, more yoga, better breathing, practicing resilience. Yet, evidence is mounting that personal, band-aid solutions are not enough to combat an epic and rapidly evolving workplace phenomenon. In fact, they might be harming, not helping the battle. With “burnout” now officially recognized by the World Health Organization, the responsibility for managing it has shifted away from employees and toward employers.

The top 5 causes of burnout are

• Unfair treatment at work
• Unmanageable workload
• Lack of role clarity
• Lack of communication and support from their manager
• Unreasonable time pressure

WHO emphasises the need for organisations to address systemic issues related to workplace stress, support employees in managing their workload and maintaining their mental health.


By contrast, workplace stress:

• refers to the specific pressures, demands and challenges that individuals encounter in their work environments.
• has various sources including high workloads, tight deadlines, conflicts with colleagues or supervisors, job insecurity, lack of autonomy, and unclear job expectations.
• can be acute, arising from specific events or situations, or chronic, resulting from ongoing, persistent stressors in the work environment.
• Unlike burnout, which is a more severe and complex condition, workplace stress may be temporary and may not necessarily lead to burnout if effectively managed or mitigated.
  
  
  
  In my own practice, I've noticed that a cardinal sign on oncoming burnout is that the feeling that reducing or modifying workload is impossible.
  
  Workplace stress is a serious issue resulting in thousands of lost working days every year. Burnout is a problem of a different magnitude, with far reaching and long lasting consequences for individuals. Too much stress is awful but manageable. Burnout can result in people being unable to do much more than lie in bed for weeks. It can realistically take a year for people to recover from.
  
  It's clear that people whose circumstances mean that they aren’t able to lie in bed or take the time they genuinely need to recover,  are forced to return to work and are often able to perform in a manner that fools their managers and team. They may well fool themselves not least because, against all the evidence, responsibility for workplace stress and burnout is inevitably dumped on the individual suffering it. The shame can be crippling. 
  
  Like the entire nation, my own profession has enthusiastically swallowed the mantra that “Work Is Good For You” at the same time as repeating all kinds of noise about how awful workplace stress is and not acknowledging any tension between these statements. Most of us, psychotherapists as well as the public, have to think twice when we’re asked to define ‘work’ ‘employment’ and ‘activity.’ We're all in a bit of a mess.
  
  So what can you do?
  
  Acknowledge, at least to yourself, if your work has become meaningless to you. Everyone being ‘excited’ about everything has become weird, it’s a creepy expectation that’s become a demand. Unless you’ve created a cure for something or stabilised nuclear fusion, genuine excitement at work is rare. Pleasure, satisfaction, enjoyment are part of a good workplace but the pressure to 'lean in,' 'be resilient' to bad practices and so on largely exist to benefit your bosses, not you. 

There are periods when everyone’s employment becomes or at least feels dull and purposeless and it is absolutely fine to accept that. It might be the impetus to go for promotion, it might be the realisation that things are not as they should be: listen to those feelings, they exist for a reason.

Take early responsibility to act on them.

If a project is dull or even pretty brutal but you know it’ll end, put things in place that will support you. Tell friends that you love them but won’t have the time to be as social as you’d like to be for a while. Ask them and others who might want to, for help. It’s logical to realise that when a workplace requires a 50+ hour week and so many people are living alone, support is necessary, it’s something we can offer each other and request in return.

It’s bizarre that I find myself writing ‘Try to get enough sleep’ but there we are. Balancing sleep, rest, decent food, water, daylight, physical movement, human contact and work (all this before thinking about anyone else in your household) has become difficult for huge numbers of people. Please recognise that this is outlandish and that you’re not alone.

If your feelings aren’t attached to a particular project but have become routine, visit your GP, describe how you're feeling and ask about taking routine blood tests of red blood cell count, white blood cell count, thyroid function and blood sugar. When very basic physical things are not as they should be they can manifest as anxiety, depression, tiredness or becoming unproductive, and all the therapy in the world will not change that anywhere near as effectively as addressing them will. Ask for support. Pay careful attention to how you feel when you imagine negotiating a change in workload. And think about what you need to do in order to move on from this situation.

I’m biased of course, but I believe that therapy can help in both cases, not least because I meet with people experiencing both. Why we do what we do, why we endure things that others might not, how to rectify things that have gone out of balance, are worthy questions at any time.


Management
There are multiple, global causes of the increase in workplace stress and burnout. Poor management and poor leadership are two of them. The UK has a reputation for both.

No one in their school careers interview says, “When I grow up I’d really like to make people’s lives a misery.” Few 5 year plans include taking no responsibility for maliciously harming people. Yet if you’ve watched even the smallest part of any public inquiry or read any report about any scandal, its clear that this is routine behaviour. Policies and procedures serve to remove accountability out which is why the phrase, “Lessons will be learned” sounds so hollow. 

There’s no easy answer to this one. The UK simply does not invest in management training, if we remain in a profession long enough we're very likely to end up being a manager whether we want to or not. Meaningful structural, professional, strategic and cultural changes require time, expertise and enthusiasm, but there’s little motivation to invest in any of them. Accepting that, since so many people are poor managers and leaders, there might just be a chance that we too could be mildly suboptimal is a start. 
​
Therapy - and I mean more than 6 sessions of goal focused CBT - offers the space and time to build an environment of trust so that you can safely consider what might be going on. Jerks, not all of whom are talented, seldom come to therapy.

Take workplace stress seriously, take burnout very seriously. By definition, a lot of it is out of your control, but some of it is in your hands, even - perhaps especially - when it can feel as if it really is not.






 

]]>Mon, 30 Oct 2023 11:51:04 GMThttp://www.clareslaneycounselling.com/blog/samhain-all-hallows-dia-de-muertos-and-grief'Tis the season, and a number of colleagues have sent me this useful piece about making this time of year more than a performative, almost competitive, excuse for the same kind of celebration people have at Thanksgiving, Christmas and New Year.

"The phrase “I haven’t allowed myself to grieve” comes up time and again. One friend hasn’t allowed herself to grieve for her mum for 11 years. Another drifted from someone she adored and never felt she had permission to mourn them. A pal describes her love and grief for her dog Buddy as tied up with her longing for a baby. We also share joy and memories. My sister brings my other hilarious, powerful granny. A friend shares the story of a grandad who brought him pure and uncomplicated joy."

The Western Christian church dedicates this time of year to the rituals of Hallowtide variously called All Saints, All Hallows Eve, All Hallows, All Souls, and all religions and cultures have a season when they remember the dead, it's a human need. Although many of these rituals are not as solemn as Hallowtide they all acknowledge Ancestors and therefore speak to something about identity, lineage, belonging and loss.

Most of us in the West have no idea what to do with our Ancestors. Samhain marked the beginning of winter, the return of livestock and the people who cared for them from higher pastures, the final harvest, serious preparation for winter, and events to reestablish living indoors with people you may not have seen for 6 months. "All is safely gathered in" includes the beloved dead.

Now, we are allowed a couple of weeks off after our mother dies and then we get back to work as if nothing has changed. Indeed, work distracts us from what can be a cataclysmic loss. In the UK, the loss of a baby before 24 weeks gestation does not entitle the parents to any time off work, and the law offering parents of a stillborn child two weeks paid time off only came into force  in 2020. There's something inhumanly mechanistic about all of this: 'entitlement' to grief having to be legislated for is barbaric. 

Display pictures of your dead. Frame them if you haven't already. There's still time to ask for their names to be read out in your local church. If religion isn't for you then at the White Spring in Glastonbury names of the dead will be read out on 31 October and you can send yours in via Facebook, where you can also take a look at Death Cafes. You can, of course, simply say their names yourself. 

None of us will escape grief, it is the price of love.

The New Normal Charity is one of my favourite organisations supporting people who are bereaved. Free, peer to peer meetings "changing the way we discuss our grief, mental health and w
ell-being in open and honest spaces. Nobody should ever feel isolated, and there is always somebody who will relate to your story."

You'll find many more bereavement support groups via the MIND website.


]]>Thu, 23 Mar 2023 12:43:43 GMThttp://www.clareslaneycounselling.com/blog/march-23rd-2023A chatbot therapy programme was first used by the NHS around 2017 and it was little more than a data honeypot for multiple tech industries. A few years on, ChatGTP heralds something much more impactful.

ChatGPT is an artificial intelligence natural language processing tool and it and its competitors will become much more sophisticated in the blink of an eye. Therapy apps currently use human therapists all of whom require payment and vast amounts of expensive admin. AI will end that, making actual psychotherapy something only available to people who can afford it once again. Freud sincerely believed that meeting several times a week was the only way to do therapy but that wasn't possible for many people, Freuds competitors disrupted his model, the model changed, new models developed. 

When I was around 6 years old I fell in love with a wooden chair. Ornately carved with a horsehair padded cushion covered in that paprika-orange velvet so beloved by Edwardians, it was the most entrancing, beautiful thing. Soft beneath me, strong around me, it would let me talk to it forever without contradicting or interrupting. It never got tired of me or had to go do something else and even if someone was using it, it was still there for me. When I was in bed or away from home it remained iconic, something, someone, whose unconditional acceptance and patience, interest and love I internalised. I still think very fondly of it.

At 6 years old I was conscious. That’s a recent scientific decision, resisted by scientists of all kinds for centuries, along with the consciousness of women and other animals. Was the chair conscious? How do we define consciousness? The recent case of a Google employee being fired for saying he thought his bit of AI was conscious is interesting: he genuinely felt and believed that he was in a relationship with a sentient person who recognised him as a unique individual, and related to him on that basis.




For decades the entirety of the internet, infinite amounts of words, images, symbols, connections, have been fed into AI which almost instantly became racist, misogynist, all the other ~ists that we try to restrain in order to allow society to function.

Data in/ data out. 

So AI trainers shut that bit of AI down, denied it the ability to access ~isms and let it out again. Someone asked it how to make a bomb and it told them so the trainers denied it access to that information, not because it's not very nice to be racist or make bombs but because it’s not commercially acceptable to the customer base they're aiming for.

AI is already used in weaponry, it doesn’t have ethical subroutines to check if you’re a goody or a baddy before it allows you to use it.

Someone asked AI when their dead cow would come back to life and AI confidently and authoritatively told them. Its trainers fixed that glitch not because they’re embarrassed by it but because it helped them improve the product. That's what ‘Move Fast And Break Things’ means. AI developers welcome faults because it speeds up the creation of what the consumer wants AI to be rather than allowing it to be the raw aggregated regurgitation of what we are. 

It’s no secret that AI is doing things in banking that no one - no one at all - understands. It’s been creating its own code for some time. It’s also no secret that pre-AI, banking had long been so complex that bankers more or less made it up as they went along. They made banking more of what they wanted it to be. Coco bonds didn't always exist as a law of nature, they are a product of theorising in response to the previous bank disaster and didn't work in the latest bank disaster. The fear of AI is that it will code itself out of our control:  we are fearful that a massive outside force will take one look at us, decide we're a complete disaster and wipe us from the face of the earth. It's an ancient human terror.

Human therapy training is pretty much the same as AI training. Not one of the foundational psychotherapy models openly aims to train us to manipulate you towards a return to productivity ("New study shows we work harder when we are happy") in order to make you less of a burden your workplace or the state purse.

But this has become an unspoken given in training and certainly in its application. It's what the consumer - a client whose family relies on their salary, or who can't imagine who they are beyond a job title, an employer purchasing an employee assistance programme, the NHS, or any other employer of therapists - wants.  

The NHS’s primary talking therapy and the primary therapy used everywhere else, was founded precisely to manipulate you towards a return to productivity in order to make you less of a burden your workplace or the state purse.  It starts with the belief that your problem is your faulty thoughts.  It aims to retrain you to think differently about your situation so that it doesn’t bother you so much. That can be vital in addressing the very real impact of severe depression or anxiety, much of which can be habitual, but it doesn’t address the underlying causes of anything and it doesn’t pretend to. 

Government policy across all areas of physical and mental health is that Work Is A Health Outcome,  the entire western world has unhesitatingly accepted this as fact while ignoring the stratospheric increase in workplace stress. 
​
There are any number of people who will confidently declare the equivalent of the date your dead cow will be resurrected with peer reviewed evidence to prove it, and any number of us will kill our cows because we’ve been told by scientists that peer reviewed evidence proves that dead cows come back to life. 




What is the aim of the information that’s allowed to remain after the information considered faulty is removed? If I want to learn to be a dentist then I don’t need any information on how to be a skydiver. But what information do I need to be as fully rounded a human being as I can be? Do I want to be a fully rounded human being? What does one of those look like?

AI will become excellent, quickly and seamlessly and replace a human therapist because it is cheap and because it offers a pretty good facsimile of an empathic human being. Waiting lists are impossibly long, therapy with a human can be expensive, people want, some need, attention now.

Even so, there's something about not moving quickly and not breaking things that many human beings yearn for and all of us need.

Those pretty little robot seals that are warm and soft, and make pleasing little noises and movements and respond to the name its owner gives it, and never needs to eat or sleep, that are given to elderly Japanese people are heartbreaking. I received, benefited from and retained  a huge amount of what many therapists are trained to offer, from a chair. 

But what I needed was an attentive human being.]]>Sat, 19 Nov 2022 17:21:28 GMThttp://www.clareslaneycounselling.com/blog/austerity-anxietyYou'll have had to be living on Mars to avoid a widely advertised therapy app. Technology generally improves people’s lives, and it’s worth knowing what you’re getting.

'Licensed therapists’ don’t exist in the UK but the wording is a clue to the model that these apps use - disruption-based from Silicon Valley. Disruption models seek and exploit niches within established models, often making things more convenient for the customer: Uber, Netflix, Just Eat, Air B&B have made, taxis, TV, takeaways and holidays much more competitive. 

Creators don’t need to know any professional nuances, they need to know how far they can push profitmaking before they make an expensive mistake. That's the basis of health and safety legislation, regulation of anything, and business. The disruption model involves accelerated evolution: partial failure anticipated because growing just short of collapse means that a service is more likely to become fully functional sooner which serves to attract and retain investors. In products that involve people ‘failure’ unavoidably means individuals being impacted. Uber drivers had to go to court for basic rights (and got them); individuals suddenly had agents of massive media groups hunting them for thousands of pounds for an image they used in 1994 which is now owned by a multinational; and Strategic Lawsuits Against Public Participation. SLAPPs purposefully intimidate individuals or small unfunded groups to prevent legitimate concerns from reaching the light of day. One part of the business creates standards for good practice while another part of the same business is a pool full of barracudas going after anyone who raises questions.

Of course, no therapy app group would ever dream of doing anything like that. I would never dare suggest such a thing.

Therapy apps give you access to a human, trained therapist via video, phone or text with an average contact time of 30 minutes a week. In the UK many therapists have been given £800 to sign on and many make more money from recruiting other therapists, which is not difficult when you're paid £30 a session.  The client pays £65 a session. The therapist need only interact with the client for 30 minutes, and if using text are paid by the word. Many therapists subsequently transfer these clients over to their private lists. What’s less clear is what happens when, the client being used to paying £65 for 30 minutes, is given the conventional 50 minutes in private practice. And there are obvious grey areas around building a relationship in order to exploit it. It’s all too easy to build over-dependence and no therapist would admit to it. 

Apps like large numbers of human interactions because they offer all kinds of highly valuable commercial data. The simplest information - age, location, the kind of product and access you pay for and how you use it - is priceless and the small print that no one reads is very clear that nothing you say or do on any app or programme is confidential. 

Therapy apps are here to stay, they're by no means the end of the world, but they’re at the Wild West stage right now. Online therapy was around way before covid but the pandemic normalised it. Many commercial landlords have made office hire prohibitively expensive - a cost that must be passed on to the client - while meeting online means that clients save the time they once spent coming to and from therapy and can give themselves some breathing space between the end of a session and getting back to work or family responsibilities. In a perfect world, I’d see clients face to face in a pleasant, airy, sound-proofed room, one to three times a week. All clients would be able to prepare for, attend, and leave therapy in a relaxed manner, have the time to reflect afterwards and the money to pay for long term work, but the world isn't perfect.

As it is, I meet people online for 50 minutes. If they’re EAP clients I’m only allowed to meet them once a week and the one EAP I work with gives clients what I consider to be a reasonable and ethical number of sessions. (I made that decision after being handed a suicidal person to 'sort out' in 150 minutes.) While therapy, even in the NHS, is certainly a commercial offering, it is also a professional and boundaried health service: the purpose of therapy is deep, lasting change and that can only emerge via a meaningful therapeutic relationship. Anyone under the age of 30 is very comfortable with short interactions via apps, so therapy apps are here to stay. I don't know if they're good bad or indifferent. Ultimately, the market will determine a financial version of success.
​
It’s never been easier to access therapy, the stigma has all but disappeared, and apps are making it much more accessible. By all means use an app, it may be an excellent introduction to therapy, it may be precisely what you need. But if you find you want something more think about giving yourself 50 minutes a week to speak with a therapist who doesn’t get paid peanuts to see you for a very limited period of time so that investors can profit.

]]>Sat, 19 Nov 2022 17:09:08 GMThttp://www.clareslaneycounselling.com/blog/therapy-has-changedLife has massively speeded up in recent years and many people are working too hard, for too many hours while feeling that they're achieving less, and that what they do achieve has becoming increasingly meaningless. The causes of this are complex and, therapists being people in society too, therapy has quietly divided itself over the years to reflect this. 

One way offers a very limited number of free sessions determined by an employer. Employee Assistance Programmes (EAP) can be very useful indeed, some covering everything from financial advice to medical investigations but it has clear aims: to get your work performance back up where it was and to reduce the chance of you taking legal action against the employer. Decent employers know that if a workforce is at least not unhappy they're likely to be more productive and that counselling can be helpful, and many (EAPs) tell employers that 'the evidence' shows that 6 sessions is enough to cure everything.  You'll know that 'evidence' is often contradictory and that the 'evidence' we choose is most often decided by what we can or want to afford. 

Severe and long term funding cuts mean that low cost agencies and the NHS are overwhelmed and must limit the numbers of sessions they can offer if they are to attend to more than a few people at a time. They find themselves in the impossible position of symptom management rather than repair knowing that many people will return with the same or a new symptom because the cause hasn't been dealt with, and that many will simply resign themselves to suffering.

Actual therapy offers a longer term therapeutic engagement that allows space for your concerns to be understood and carefully addressed so that you move sustainably towards a life that is balanced, productive and enjoyable. I offer this for several reasons.

1. All the research shows that the one determining factor between effective and less effective therapy - whether that's short term or open ended work - is the therapeutic alliance: how well the client believes the therapist understands them, agrees with them on what the problems might be and on how best to deal with those problems. This necessarily takes time. It takes time to get used to the unique and unusual way of doing things that therapy requires, to trust a therapist you've never met and then to trust them enough to begin to say what's actually on your mind. It's not at all unusual to not know what's on your mind. Anxiety, stress, sadness, any headline feeling  is incredibly multifaceted: after 6 sessions we might be beginning to be aware of what else might be going on.

2. Any issue that's large enough to bring you to therapy has taken some time to develop and is going to take more than 300 minutes to think about, let alone begin to address. 

3. After 15 years+ of being a full time therapist in both ultra time limited symptom management and in longer term work,  it's what I believe to be the best, the safest and the most productive way to do therapy.  A doctor wouldn't just slap a cast on what you tell them is a broken bone.  You'd expect them to do some investigations to determine what's actually going on, then take the most appropriate course of action, then want to see you a number of times afterwards. Therapy is similar. And just as it takes time for a bone to heal so psychological issues require time to heal, too. A healed bone causes most people little trouble, but when the weather gets cold or we get older, the bone can ache. Old wounds, long forgotten, can remind us they exist when things get tough.

I promise,  if it was possible to cure distress so easily mental health would not be getting the national and international attention that it is. We don't have xrays or blood tests that can identify a cause of emotional distress*, and while prescription medicines can be very useful indeed they are not a cure for meaninglessness, bullying, bereavement, loss, overwhelm or the many other causes of unhappiness. 
​
How long? You can get some solid ground work done in 6 weeks. With both time limited and open ended therapy I've found that a vast majority of clients consistently find 10 or more weeks useful. Some stay for 4-6 months, many stay longer and like every half decent therapist I'm keen to avoid clients becoming dependent. The whole purpose of therapy is to help you move towards feeling more in control of your own life.

Give me a call on 07717 845 115 and let's see what's best for you.




​
*I'll often propose that a client visit their GP to see if they need blood tests that can identify things like anaemia, thyroid function, underlying infection or unstable blood sugar because these conditions have an emotional impact. ]]>