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 if what you need is short-term attention or urgent support. Many people benefit from this kind of access, there’s nothing wrong with it, 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. 

In the last 5 or so years, 'counselling' has too often come to mean offering advice and techniques to manage immediate symptoms like anxiety or feeling stuck. The internet is full of advice and techniques, people come for professional counselling because they not enough. When people come for counselling they'll often quickly discover that, say, anxiety is not the problem but a symptom which needs attention so that the anxiety isn't '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 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 very helpful, this is important information. We might be annoying and boring of course, or it may be that when you get annoyed or bored something else is going on that is ready to be addressed. When we can bring careful, non-judgemental attention to familiar feelings, they can be understood better and altered to serve you better. 

In a culture that promises instant fixes and infinite customer choice this may feel unfamiliar, even unsatisfactory. 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 difficulty or an ending. If you're used to feeling disappointed by people, you'll guarantee it.

All clients are completely free to leave without any explanation or notice, and meeting an immediate desire is not inherently wrong: you hand over money, get what you want, feel better, the transaction ends there. Instant relief, flexible supply - food, attention, all kinds of stuff - on demand.

But psychotherapy offers something very different. 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.
Psychotherapy is often about what is being avoided. When the immediate feelings that brought you to psychotherapy begin to dissipate other feelings can emerge and the temptation to cancel or disappear can be powerful. The temptation can be especially powerful if you are used to being ignored when you’re not in crisis, or being discarded when you don't achieve, perform or are 'good’. It can feel safer to disappear than risk being abandoned. 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 return to a relationship that hasn't altered, won't punish or manipulate you, so that you  can face what has been stirred, learn from it, deal with it differently, change, and move forward.

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

The psychotherapy is not designed to offer instant gratification.

You're not broken.

You matter. 



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Discover what psychotherapy students are taught about the frame here.