Way of Working with Clients

My psychodynamic training over four years was punctuated by workshops, reading and courses in transactional analysis and humanistic theories. Subsequent to qualifying I worked in different agencies and jobs and attended numerous workshops which included person centred, solution focused, Egan and cognitive behavioural therapy. So whilst my essence is still psychodynamic; my personal therapy, varied supervision, diverse agency experience and training over 17 years of practice has influenced and shaped the integrative way I now work. This integrative approach is tailored to client needs, adapted for gender, culture and disability, modified by whether the therapy is short or longer term and how it is structured.

Clients come for counselling seeking help. They may be distressed and feel disturbed by issues which have and are seriously intruding into their lives and which they wish to change. Often they come in the belief that the counsellor will provide them with answers or offer a solution to their problems. I believe that people have the right to find their own answers and the counselling process can offer the time and space to do this. I am persuaded that this therapeutic process comes not only from my long counselling practice but critically from my own experience of being a vulnerable client and an increasing tolerance of my own uncertainty and a willingness to stay with unknowable feelings.

When I first meet a client I do not always know what has brought them. Some will have had an assessment interview and in these cases I will have an insight of the problem which they presented and how they engaged. Whilst I can find this referral helpful I am also comfortable in working with a 'blank sheet of paper'.

From the first point of contact I try to be aware of the different ways in which my clients communicate and consequently the way I work. I feel it is essential I meet the client where they are and to engage in their own language, also to be aware that the agenda they bring may not only be apparent in the spoken word.

When a new client arrives I will firstly check out what it is like for them to be here. Then I will let them know clearly the terms of the contract on offer and we make our agreement, with private clients I give them an information sheet they can take away with them. This contract sets out the therapeutic boundaries and the way I maintain and manage these boundaries is of the utmost importance.

I believe that counselling should offer "containment". A client brings problematic issues which need to be "held". This holding happens when a client is heard and when the material they bring is respected, valued and acknowledged. I also believe that this process can only work if a "good enough" relationship evolves between the client and the counsellor; often understood as a therapeutic alliance. I think that it is the containment of the client and the holding of the boundaries that creates a "safe enough" environment for this relationship to grow.

In the early sessions I work to provide this safe enough space. For many of my clients this is the first time they have been listened to and that their primeval feelings, often raw, have been heard and respected. Whilst this lack of a previous non judgemental and understanding process can be experienced as nurturing, for others it can be an overwhelming and scary experience.

As our relationship evolves patterns begin to surface and it is these patterns of relating that I begin to understand where my clients 'defences' and masks lie. I'm aware that during the course of my life I have found ways of coping and surviving. I have engineered different strategies to protect myself and others around me on whom my emotional survival depends. In the safety of the holding I have been gradually able to acknowledge and respect these defences and also gain awareness as to why these blocks were necessary and whether or not they are now appropriate to leading a more fulfilled life.

Working essentially with the psychodynamic model and using transference and counter transference skills, I work with the relational dynamic in each session. I listen attentively to the feelings of my client and my own and in the parallel process ponder on what it is like for me to be with them. I am able to reflect back, use open ended questions and encourage my clients to explore the issues they bring and those that surface in the session. As the narrative unfolds we struggle together and in the process sometimes get lost, fail and experience despair but also in the unveiling process gain a net understanding. In staying with the uncertainty I allow the process of grieving to unfold. We begin life with loss and I instinctively know it is a core issue in my counselling work.

Supervision is an integral part of my work, providing me with the unhurried opportunity to reflect, with both support and challenge. The supervisory process in turn offers me "containment" and is the place where I can safely explore and separate out my own issues should a client's material touch them. This ensures that the counselling space remains as open and clear as possible for my clients use.