17 September 2020

Professional, confidential, friendly counselling in central Exeter

PLEASE NOTE THAT I AM CURRENTLY FULLY BOOKED FOR INDIVIDUALS (17th Sept 2020)


Serious about making changes in your life?



If you are looking for a therapist you have taken a courageous first step. Life can be hard for us all at times.  I love the work I do; helping people to explore what's troubling them in order to live more fulfilling lives.

I work privately from beautiful premises on Southernhay, right in
the centre of Exeter, Devon, with a wide spectrum of people with many differing presenting issues. Professional, approachable, open-minded and non-judgmental, I have the utmost respect for your individuality and life circumstances. 

I draw from several reputable theories of practice enabling me to work effectively, progressively and collaboratively with individuals and couples.

Offering a fully professional service I am fortunate enough to be able to work full-time at my dedicated Exeter practice, seeing clients five days a week. I do short, medium and long term therapeutic and supportive work.

I am committed to facilitating the exploration of the issues you bring. If you are serious about committing the time and energy required I invite you to make contact to arrange an initial appointment.



This site is where you can find out information about counselling and how it can help you, my personal approach and services offered, and some details about my background, by clicking on the information tabs above. 

This is also a blogsite which I use to make regular posts about my work and continuing professional development as a counsellor. Click here for my Articles.

I would be very happy to discuss your requirements should you be interested in coming along for counselling. Embarking on a course of counselling can be daunting and I aim to help you feel relaxed and confident that you make the choice that is right for you.

Regulation 


Please, whoever you decide to have counselling with,  whether individual or agency, ensure that they are registered with an adequate professional body. The BACP is the largest professional body and have a robust complaints procedure which is why I choose to be registered with them. BACP Accredited status is an established, recognised and accepted assurance of experience and maturity as a practitioner. Without membership of a self-regulating professional body then clients have no recourse should they feel that they are being treated unethically. At the moment, there is nothing to stop people practising as counsellors without this protection for their clients. Following the dreadful scandal involving the Exeter based Palace Gate Counselling Service I researched and wrote about this topic on this post about the regulation of counselling and psychotherapy

I spent several years campaiging for the regulation of counselling and psychotherapy along with Phil Dore via the website Unsafe Spaces. I took a step back from this to focus on my practice (March 2018).



Check my BACP Registration entry here  




Registered with WPA Health Insurance 

Imitation is the sincerest form of flattery but in the case of therapists lifting content directly from other therapists' websites I reckon that this is not good for our clients and does not reflect well on either ourselves as practitioners with integrity nor the profession as a whole. We all take inspiration from other professionals but please at least change some of the words and sentences around. I am proud of the content of my website which has been carefully constructed over many years of practice and have been concerned to see some of my site lifted almost word for word on other therapist sites. 

Google Plus 

3 May 2020

Reassurance in light of recent guidelines regarding Coronavirus/COVID-19

**22nd July 2020 - PLEASE NOTE THAT I WILL BE UNABLE TO TAKE ON ANY NEW CLIENTS UNTIL SEPTEMBER 2020

**3rd May 2020 - FOLLOWING CURRENT GOVERNMENT REQUIREMENTS ALL SESSIONS WILL BE VIA VIDEO OR TELEPHONE UNTIL FURTHER NOTICE I will endeavour to return to face to face sessions as soon as possible**

In light of the situation regarding the coronavirus pandemic I have provided some information mainly aimed at existing clients but also useful for potential clients considering starting therapy.

Telephone and video therapy

I am ensuring that I am able to continue to provide therapy sessions via Facetime video (these are both end-end encrypted and therefore more secure platforms) Zoom (regarded largely as secure but have been some security issues during the pandemic) and Skype (this is less secure; there is a very small chance that the conversation may be intercepted). All these mediums are free. I am also happy to have telephone sessions and I will call you (UK only) so no charge will be incurred by you.

We will need to establish connection via the chosen format prior to the session so please provide me with the correct mobile phone number to use (for Facetime) or send a contact request to amandagwilliamson on Skype.

Please ensure you are in a private space. Some therapists have told me that their clients are even using their car for privacy which I think is a good idea in the absence of another suitable private space.

If via video, it is better if I am able to see your head and upper body where possible. It might be worth wearing headphones. I have good data connectivity; it might be worth using wi-fi if your telephone data signal is impaired.

I advise that you give yourself sufficient time and space either side of the session in order to be in the right head space. It can feel a little confusing with no journey to and from the therapy room. I have been doing video and telephone sessions for several years so it is familiar territory for me. I am also suitably insured.


Please refer to the original therapeutic contract in respect of cancellations and sickness:



      Cancellations made at least one week in advance - no fee payable
      Between one week and 48 hours in advance – half fee payable
      Less than 48 hours – full cost of the session is payable

Cancellation charges also apply in the event of sickness and poor weather conditions. Telephone sessions and usually Skype or FaceTime/WhatsApp Video sessions are available by prior arrangement if you are unable to physically attend.



General anxiety around COVID-19

There is quite understandably a lot of anxiety around the ever changing situation. Please limit your exposure to the onslaught of information regarding this pandemic. If we expose ourselves to a constant drip feed of panic inducing articles we do not improve outcome and may even harm our psychological and emotional wellbeing. Of course we need to be prudent in this unprecedented situation and work together to protect the more vulnerable in society. My suggestion is to spend some time once a day, maximum twice a day, reading government updates https://www.gov.uk/government/topical-events/coronavirus-covid-19-uk-government-response which includes a link to the NHS coronavirus updates.

As always I recommend the use of mindfulness apps such as Headspace and Calm (especially their Breathe feature; good for help with calming down breathing). Eating well, exercising (eg walking, running, yoga if well enough) and good sleep hygiene (definitely no reading about coronavirus in bed!) are steps that we can all take to maximise our physical and mental wellbeing.

I recently wrote a blog post about various Apps that can be helpful in reducing in anxiety.

I look forward to connecting and continuing our work together and will contact clients directly should there be any further developments.


Amanda

29 April 2020

Some advice and resources to assist with mental wellbeing during the Coronavirus pandemic

I am one of the people fortunate enough to have some extra time on my hands during the pandemic. I do not have school age children I need to educate at home whilst trying to work. My practice has reduced in size during the pandemic, especially as I can only offer video or telephone sessions during the government mandated lockdown. This has given me some time to process some of the ever-changing situation we are all facing in this unusual and unsettling time. As a therapist I find myself in the unusual situation of being impacted by a situation in similar ways and at the same time as our clients. I have utilised my spare time in what I believe to be the best way possible for me; I have spent time reflecting on the impact of this whole situation on not just me as an individual but also on all people in all the different manifestations of how the virus is disrupting our lives. I have spent time meditating, reflecting, and focusing on being rather than doing; something I have not tended to have the time to do prior to the lockdown.

A recent poll by King's College London and Ipsos Mori shows that half of respondents are more depressed and anxious than usual and 15% are finding the restrictions very challenging.

With that in mind I thought it might be useful to share some things that I personally find helpful in terms of helping with mental wellbeing.

The News as an exacerbator of depression and anxiety

As with during more "normal" times, I advise everyone to avoid the news. The news is not there to make us better people or even to simply inform us. Many sources of "news" are there to also serve as clickbait and how better to do that then to dramatise and find ways to make us react on a purely emotional level? By design the News triggers our fears, uncertainties, anger and anxieties. I am not suggesting we live in a bubble of complete denial (well maybe a smidgen) but watching the news (a reputable source) once a day is all that is required. I would argue that every few days is probably enough but our curiosity and national obsession with the news generally makes that difficult. Ask yourself, when partaking of this compulsion; has it helped my wellbeing in any way to consume this "information"?

I digress. The purpose of this blogpost is to share some information regarding some free resources which I highly recommend clients/friends/everyone consider utilising to assist with mental wellbeing particularly during this unusual time:

1) Thrive

This is CBT therapy based, NHS endorsed App Thrive is currently free. I have been testing it over the last few weeks having been recommended by a therapist friend.

Why I think it is helpful

Even though it is a basic training in CBT concepts, sometimes we need to go back to basics. Even as an experienced therapist, I too sometimes value hearing things in a simplistic way. During this pandemic many of us are noticing that we can be triggered into a Child Ego State, as we feel more vulnerable and uncertain. This is normal. If we are feeling a little wobbly or anxious then some basic and reassuring words can be more powerful than we realise. The narrator on the App has a lovely, calming voice with a  Scottish accent. She talks you through the basics of understanding how our thoughts, feelings and behaviours interact and not always in a helpful way. There are exercises to do and a tool to journal your mood with a Mood Meter. There are also sections on challenging core beliefs.

What I don't particularly like

There are also meditation exercises and a breathing tool. I do not personally rate the meditations or breathing and use different Apps for these (see below) which I find more suitable for me. Please note that the App is not a substitute for one-to-one therapy.

2) Headspace Mindfulness App

I have used Headspace Plus for several years for guided meditations. I find Andy's voice so soothing I have often used it just to help me get to sleep, which is a bit naughty as mediation/mindfulness should be something we do sitting upright and alert. Ah well. I tend to do unguided mediations now anyway but fall back to Headspace for any sleep issues as they recently introduced a whole section on sleep including sleepcasts, stories, white noise etc.

Why I think it is helpful

Headspace are currently offering a selection of meditations free to all, plus you can sign up for a free trial of Headspace Plus and sample more of their package. They are currently offering free access Headspace Plus to all NHS workers. Plus they are also offering free resources aimed specifically at the workplace and also for educators. It is a solid, easy introduction to the basis of mindfulness and there are so many packs one you subscribe that it takes a long time (years for me) to get bored.

What I don't particularly like

I really wish the entire package was free for all at the moment, like Thrive.

3) Calm Breathing Tool

Calm is a mindfulness based app which has a few meditations and a Breathe tool which are free of charge. I have used the Breathe tool for a few years and often recommend to clients. You can choose your own backdrop with a picture and sounds of various landscapes (rainforest, lake, seashore etc) and then use the adjustable breathe tool to guide you to breathe in, hold and breathe out:



Why I think it is helpful

Breathing is a key component in relaxing and calming the body. The tool helps you to focus on breathing in a way that induces a more calm state. It is easy to use and the choice of tranquil background sounds enhances the experience. I have subscribed to the paid Calm package and have worked my way through various meditation courses. I particular like the voice of John Armstrong on the stress and anxiety courses.

What I don't particularly like

The free Breathe function is great. I find some of the voices on the guided meditations slightly irritating.

4) Down Dog

Down Dog is a yoga app which is currently free to use until 1st June. A different therapist friend recommended this to me. I have attended weekly yoga for five years and it is an intrinsic part of my selfcare. For the last three years I have attended Jax's Hatha yoga session at her Lotus Loft studio which is only two doors away from my therapy practice. The classes are now taking place via Zoom however they clash with my therapy practice hours so I have been doing my own routines at home. Five weeks in and I am finding it hard to motivate myself so I have tried the Down Dog app and it is a decent alternative for now. Research continues to demonstrate that yoga is good for the mind as well as the body. Trauma research conducted by Bessel van der Kolk demonstrates that yoga is helpful in healing from trauma (PTSD, Complex PTSD).

Why I think it is helpful

There are many choices of settings on this App so it is suitable for beginners right through to advanced. You can select different components to your practice (i.e. Hatha, Restorative, Ashtanga, Yoga Nidra etc. Yoga Nidra is great for relaxation and helping with sleep.  For some selections you can then choose differing levels from Beginner to Advanced. I initially selected Intermediate 2 (the fourth of five levels) of Hatha Yoga and it was slightly too advanced for me. There's lots to play with and it's an appealing process. There are six voices to choose from! Once you have made your selection a video plays of the session (audio only for Yoga Nidra which is a form of guided meditation). I really like this App!

What I don't particularly like

Nothing so far.


THINK ABOUT WHAT YOU NEED


I do not want to be another voice adding to the endless advice about what you should be doing. As I stated on my Facebook page yesterday:


Please consider investing some time in your own wellbeing. Yoga and mindfulness will help give you the space to reflect and process the fact that the world has turned upside down and that nothing is as it was. This is big stuff.

*I am currently offering online sessions via Zoom, Skype, FaceTime and telephone.

21 November 2019

What to expect from Counselling and Psychotherapy

by Amanda Williamson Reg MBACP (Snr Accred) - A guide to my therapy sessions 

(Updated 21st August 2020 in light of the COVID-19 situation)


The first session



You might be feeling very anxious...

It is completely normal to feel anxious at first, particularly if this is your first experience of therapy. It can take a while to get used to the situation but almost all clients report feeling significantly more at ease as the session goes along. It can be quite a relief to talk about difficult issues with someone who is understanding, who clearly withholds judgment and with whom you do not have an emotional attachment.  


You might be surprised at how tearful you are...

It is also quite common to feel tearful and cry much sooner than anticipated. You might feel surprised by the intensity of feelings but it is completely normal especially after having to hold so much, usually for quite some time. The tears might be as much about relief as about expressing sadness. I have lots of boxes of tissues and am very used to witnessing tears in the therapy room.

We aren't very good at dealing with tears in this society. Because of this we can tend to be very self-conscious about crying in front of others and it's at that stage that I wish I had footage of me in therapy when I was a trainee therapist. It's one of the reasons why therapists who train with reputable and ethical training providers have personal therapy as part of our training. If you could see me having a good, hearty blub with my therapist, complete with blotchy eyes and runny nose, you might not feel so self-conscious about your own tears. 

Most therapists understand what it's like to feel self-conscious, vulnerable, anxious and tearful and I most certainly do. It's also okay and normal to feel no anxiety or sadness.

Making your way to the therapy room for face to face sessions

When you find my premises you will ring my doorbell and I will buzz you through to the hall. It is important that you arrive at the time of the appointment as there is no waiting room and I may still be with a client if you come early.  Pre COVID I would also show new clients the way to my room however you will need to find your way up to my office to limit close contact in line with government regulations. I will give clear instructions before your first session.There are hand sanitiser dispensers at the entrance to the building and before you reach my room on the landing.


The environment

It's a nice spot with a view of some trees and the sky. As a client, I appreciated being able to look outside sometimes. My room is comfortable and pleasant and certainly the nicest of the premises from which I have worked. The other practitioners on the same floor are also therapists and are very professional and considerate.  I am now unable to offer drinks so please bring some water or another drink with you.

Video and telephone sessions
 
I am ensuring that I am able to continue to provide therapy sessions via Facetime video and Zoom (these are both end-end encrypted and therefore more secure platforms) and Skype (this is less secure; there is a very small chance that the conversation may be intercepted). All these mediums are free. I am also happy to have telephone sessions and I will call you (UK only) so no charge will be incurred by you.

We will need to establish connection via the chosen format prior to the session so please provide me with the correct mobile phone number to use (for Facetime) or send a contact request to amandagwilliamson on Skype.

Please ensure you are in a private space.

If via video, it is better if I am able to see your head and upper body where possible. It might be worth wearing headphones. I have good data connectivity; it might be worth using wi-fi if your telephone data signal is impaired.

I advise that you give yourself sufficient time and space either side of the session in order to be in the right head space. It can feel a little confusing with no journey to and from the therapy room. I have been doing video and telephone sessions for several years so it is familiar territory for me. I am also suitably insured.
  
Payment

If paying by bank transfer I require payment in advance of the session. If you are attending face to face and paying in cash or cheque payment will take place at the start of the session.   


Getting started

The first thing I will do is some data gathering. This includes practical details such as address, date of birth, whether you have read the contract or not. Then I will move onto asking you about any physical or mental health issues and medication. I will ask about your family background (parents, siblings, partners, children etc). I will also ask whether you have had any suicidal thoughts, attempts and/or self harm and also whether you have encountered suicide or self harm in a family member or friend. 

Please note that all notes are taken and stored on paper, in a locked filing cabinet in my room. I do not share the room with anybody else. The only person who has access to the filing cabinet is my colleague with whom I  have a "Clinical Will" arrangement in the event of my sudden illness or death.


Focusing in on the therapy

Then I will ask about any life events that may have impacted on the issues you are bringing to therapy and also ask what your goals are for therapy; what was it that lead to contact being made to set up this session? The aim by the end of the session is to have an agreed focus of work for future sessions. It is usual to have gained some insights, perspective  and food for thought by the end of the first session.

Any questions?

Please do have a think if there is anything you might want to ask me during the session, to help make your mind up whether you want to continue with further sessions.

Rebooking

Towards the end of the hour, the question of booking another session is looked at. It rare cases it may be appropriate for me to refer you to another therapist and I will explain clearly why, if this is the case. 
 

Subsequent sessions

We will refer back to the therapeutic goals in future sessions and review how we are doing and whether those goals need to be tweaked or added to in any way. 

During sessions I write down notes in a fairly organic "mind mapping" way. Some clients find it helpful for me to email a picture of these notes as it helps remind them of the themes discussed. It's also okay to not want to see the notes.

I will sometimes ask how you feel about the sessions and whether you feel that we are working on the areas we need to be working. I might also ask whether you think we might be avoiding anything.

I will sometimes bring up the topic of ending or reducing the frequency of sessions and this is never because I am trying to get rid of a client. In fact, if that is the feeling that you get then it can precipitate a healthy therapeutic discussion about perceiving rejection. I bring it up as a therapeutic tool, to see if we are working on what we need to work on, as a genuine wondering whether it would be beneficial to look at reducing the frequency, particularly where it seems that very good progress has been made. Sometimes, by asking the question, it precipitates the opening up of something more for us to work on.

Without reviews and talk of endings I believe that therapy can become stagnant for clients with a potentially unhealthy dependency being fostered. That said, sometimes a long term therapeutic relationship is what is required. I don't think that there is a right or wrong but these things should be discussed to keep the therapy fresh and healthy for the client.

As a therapist I strive to foster empowerment and autonomy in my clients but also endeavour to never push away when what someone needs is the experience of being part of a consistent and safe space for a longer period of time. We are all different.

More details about how I work can be found on the My Approach page of my website.


Ending therapy (sometimes prematurely) and resistance

Most often it is by mutual agreement that therapy ends. Goals have been largely met and it feels right for both the client and myself to end. We can review the goals, discuss the changes that have been made and celebrate the work we have done together. It is an important and wonderful part of therapy. Bittersweet in some ways as I do miss working with clients as we build a relationship and I do genuinely care, But it is also quite wonderful to know that my client does not need therapy any longer. 

Sometimes, a client might start to feel resistant or rebellious. This is within the realms of normal behaviour within a therapeutic relationship. I see this as happening for a couple of reasons:

1) Our back brains resist change - by back brain I am referring to the limbic system and brainstem which learn from previous experiences (particularly childhood) how best to be. These ways of being become subconscious habits and are linked to our very survival as children. These adaptations were probably ideal for the situation we were in as kids but less so now as adults - they have become maladaptive. However, whilst our sensible front brain knows rationally that we need to change these old ways, the back brain begs to differ, and sometimes quite robustly. We might suddenly feel resistant to change and to the therapy.

2) Ideally we are able to go through a healthy teenage phase where we are loved and accepted unconditionally. Even when we are breaking boundaries and forging our independence in perhaps quite unhealthy ways, we need the experience of parents/caregivers who have robust enough egos to allow us to leave and come back, leave and come back. If we haven't had that experience before then being able to disengage from therapy and then choose to reengage again at a future time can be incredibly healing; Phase 2 therapy I call it. The early child stuff is kind of easier for clients and therapists. It's easier to appeal to a younger child so that part of us responds well to therapy. If we are working with our teenage hurt then it gets a bit more challenging, as any parents of teenagers might tell you.

The message is, it's okay to come back. Whether it was a planned ending or a sudden retreat, it is worth exploring the option of working together again.

Ending therapy against my client's wishes

I may have cause to end sessions if it is clear that therapy is not helping or possibly harming my client or if there is a threat to my wellbeing. It is iapprorpiate to continue working with couples where there are issues around domestic violence. It may be appropriate for some clients to be referred to psychiatric services or other. I will always endeavour to treat such cases ethically and sensitively and am aways informed by the BACP Ethical Framework for the Counselling Professions.

If you have any questions at all about any elements of this guide then please do not hesitate to contact me. This guide is intended for new clients of my service, to be read in conjunction with my therapeutic contract and Data Policy.














8 October 2019

File on 4; BBC Radio 4 documentary on the lack of regulation of therapy

Amanda Williamson Reg MBACP (Snr Accred)

Following on from the publishing of mine and a fellow therapist's experience of abuse/attempted abuse in therapy, and due to my public campaigning for the statutory regulation of counselling and psychotherapy, I am regularly contacted by journalists looking to publish articles and documentaries on the lack of regulation. I took a step back from campaigning early last year as I found it an exhausting, futile and thankless task. I also decided to stop assisting journalists researching the topic as I have spent much time doing so which has ended up being ultimately fruitless. Also, I obviously don't get paid for my time either and made the decision to spend my time focusing on my family and my private caseload and making sure that I have enough down time.

A few months ago I was contacted separately by three people asking me to consider chatting to them about a BBC documentary about therapy. I declined on all three counts, then the documentary producer gently persuaded me to have a chat about my interest in the regulation of therapy. He explained that all the messages I had received were in connection with a commissioned documentary that was already being filmed. The producer, Rob Cave, sounded like a decent chap and I agreed to speak to the journalist, Jordan Dunbar. I immediately felt at ease with Jordan and he quickly built trust.

Given my lack of flexibility I found Jordan very accommodating. He came to Exeter to film the interview whilst I was walking the dog. There may yet be a film clip (of Sally dog) on TV at some stage. But for now the interview is part of the File on 4 documentary entitled "The Therapy Business". Inspired by Jordan's experience of unethical therapy, the documentary is pro-therapy and also pro-regulation of counselling and psychotherapy. There are many arguments against regulation but most members of the general public are genuinely perplexed when they find out that there is zero regulation. Instead we have a system of pseudo-regulation run by the quango Professional Standards Authority, called the Accredited Registers. In my opinion this is worse than no regulation as it is extremely confusing and gives an illusion of safety that does not exist. It also implies that a therapist who is newly qualified from a flimsy course with little experience is as competent as an experienced practitioner with more in-depth training and supervised experience.

The documentary includes input from two victims of abusive therapy, Geraint Davies MP who is attempting to put a pro-reg bill through parliament and a BACP representative.



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