Blog post by Lloyd, one of our CBT Therapists.
In last month’s article I introduced the topic of goal setting for those feeling overwhelmed and struggling with symptoms of depression and or anxiety. I ended by suggesting you may want to contact our service for further help. However, for many, contacting Redbridge Talking Therapies can be anxiety provoking in itself. For others with depression, it may be a goal which is added to the list of other goals and tasks, which you never appear to get round to. You may procrastinate in asking for help and for others, they may ask, am I even ready for therapy at all?
Therefore, this month I would like to explore what we in the service, as mental practitioners, describe as readiness for therapy. I will use the term therapy within this article, as a capture all term, for a range of psychotherapies and counselling interventions, and whether it be individual or group-based treatments. Put simply, I am going to describe the core ingredients needed to be present at the beginning of therapy, in order, to give you the best chance of recovery or at least provide some reduction in your symptoms. If you are thinking of attending therapy, let us now look at these ingredients which have been found to increase the chance of recovery for those suffering with poor mental health.
It may come as no surprise, as discussed last month, you need to have a specific goal or goals before entering therapy. Ask yourself, what is it I want to achieve by engaging in therapy. Maybe you want to be more assertive or be able cope with attending social events which may be causing you anxiety. For some people with specific conditions, like Obsessional Compulsive Disorder (OCD), it may be to reduce handwashing throughout the day, and only wash your hands when it is completely necessary. For others with general anxiety, it may be to reduce your worry throughout the day and then actually do something about the worries. If you are having difficulty finding goals for therapy, and your thoughts just lead you to wanting to feel better, ask yourself, what would I be doing if I was not suffering with depression, anxiety, or a specific condition? The answer is likely to be your goal or goals for therapy.
The next question to ask yourself is can I commit to regular therapy sessions? If you are found to be suitable for a talking therapy, dependent upon the level of intensity and type of therapy, you will be required to attend on a weekly basis for between 30 minutes to up to 2 hours. Although we generally offer between 6 to 12 sessions, your mental health practitioner may suggest more sessions, or that you return to therapy at another time to complete more work on other problems or symptoms. Put simply, there is a regular time commitment required.
Regular attendance of the appointments is not the only commitment required. A willingness to work on your problems, and a commitment to work on your difficulties outside the sessions is also needed. Many of the approaches we use in therapy require you to carry out homework between the sessions. The term homework may scare some people. However, it is the term mental health practitioners use for tasks which many involve monitoring your everyday thoughts or behaviours and then practising new ways of thinking or carrying out new behaviours during the week. Homework is likely to be specific to you, your goals and is likely to be challenging. Remember nothing which was ever worthwhile in life was easy. This said, you and your therapist will discuss and agree on the homework and will start with very easy tasks. Even if the homework appears easy at first, completing it, still remains a core condition of therapy.
The next ingredient for successful therapy is very subtle, but nevertheless, is central to your success in therapy. This is being prepared for therapy sessions. I have discussed homework, which is part of the preparation, and attending at a regular time. However, you will be required to complete weekly questionnaires before the start of each session. Most of questionnaires are technically referred to as psychometrics; these are psychological measures of symptoms which we use in the NHS, and which have been validated through many years of research with thousands, if not hundreds of thousands of people. Your therapist is trained to read them, then adjust your sessions accordingly, which make them an essential part of the therapeutic process. They can take up to 10 minutes to complete each week, if they are not complete before the appointment, it will eat into the therapy time and affect the course of your treatment.
By now, I imagine some people may be reading this and thinking, this talking therapy sounds a bit like hard work! It may sound offer putting at first, especially when you are struggling with your mental health. Nevertheless, I can sum up the ingredients required for successfully therapy in two works, personal responsibility. No matter how experience, trained, qualified or skilled your therapist, if you struggle to attend, and are not completing homework outside of sessions. Then spending the first 10 minutes of the session completing questionnaires, you will be facing an uphill challenge. If any of these behaviours continue to be present in therapy, it may suggest you are not ready for therapy at this time.
Additionally, successful therapy is teamwork, between you and your therapist, which demands commitment by both parties. For example, I regularly ask people I work with to email their homework before the appointment, which I then read, and it helps me to prepare the sessions. Although therapy may feel a little dauting after reading this article, please remember as therapists we will always work within your capabilities. As part of the initial telephone assessment, we will gauge the appropriate level of therapy for you, which is likely to bring about the greatest success. For many, therapy is the development of the skills over time and clients can increase their commit to more intense therapies at a later date. Therapy is a process and is not about pass or fail, it is simply about giving it a go!
If you feel you may be ready or if you are unsure if you are ready for therapy, but want to discuss your options further, please contact the service on 0300 300 1554 option 1 or if you prefer you can self-refer online at https://www:talkingtherapise.nelft.nhs.uk/redbridge
Just recognise by contacting the service, you are actually showing personal responsibility and a commit to bring about a change in your life.