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Considering therapy, but not sure….?

Posted 22nd February 2019

When our emotional or mental health issues impact on our daily lives this can leave us feeling isolated and despairing. The thought of going to talk to someone about our thoughts, feelings and struggles can feel scary for a variety of reasons. We might worry what someone else would think of our thoughts, or that it would be hard to explain them, or worry that if we told someone else they wouldn’t “get it” or would think we were making a fuss.  Even if we believe in theory that talking therapy might help or this has been recommended to us, in reality the prospect of opening up to a stranger can often feel much harder. Loyalties to one’s own family may also feel like a barrier to seeking help. Also, building a relationship with a therapist in which issues are respectfully thought about, without judgement or criticism, can be complicated due to our own internal beliefs, thoughts and past experiences that impact on how we see the world around us.  Some people feel like they “should” be able to cope, or that it’s a sign of weakness to need to talk.  Or we might worry what our friends would think, or how family might view it….

Taking the first step to see a therapist can take a lot of courage for so many reasons.  However, beginning to unpack difficult thoughts and feelings can help us start to make more sense of what is going on, leading to a better understanding of ourselves and why we feel and behave the ways that we do. Seeking therapy can be daunting, but taking a risk to trust a therapist can be the start of things changing…

So which difficulties is it worth talking to a therapist about?  There’s no short answer to this – if an issue is bothering you (or your child) then it may help to talk to someone about it, there are no “boxes” you need to tick.  Here at The Bridge we see people for many different reasons including (but definitely not limited to) depression, anxiety, self-harming, issues around eating, when parents’ have separated, issues within a relationship, bereavement, social anxiety, worries about the future, difficulties fitting in, worries about exams / school / university, difficulty sleeping, issues between siblings, concerns about sexuality or gender identity, children’s behaviour….  And so many other reasons.

So what do you actually do in psychodynamic therapy (the sort of therapy we offer at The Bridge)?  If you’re a teenager or adult it’s going to involve talking about whatever is in your mind, there’s no “agenda”.  This might include your day-to-day life, your memories, your worries, your dreams, your anxieties or just whatever pops into your mind while you’re in the appointment – sometimes the most apparently “random” thoughts turn out to be really important and can lead to new understanding.  It’s impossible to “get it wrong”.  In your first appointment you’ll probably be asked a bit about what your reasons are for wanting therapy & a bit about your life so far, including what is going well & what’s not going so well.  Younger children will be given toys to use as well, as for children a lot of communication is through play, and if even if you’re a bit older you might also be asked if you’d like drawing materials, or fidget toys etc. if it makes it a bit easier to talk…  The therapist will help you to work out how to get your thoughts into the open, & they will be very used to helping people who are a bit nervous about therapy or who have never tried this before.   You’ll be offered some sessions to try out how therapy feels & whether or not it seems useful.  For children and younger adolescents parents will also be involved in this process of “trying it out” and will be part of making decisions about whether or not to continue, and a therapist will talk with you about the sorts of difficulties your child is having and the kind of help that’s needed.

What’s the evidence that this sort of therapy works?  This would need a whole lot longer answer, but as a starting point if you take a look at https://www.nscap.org.uk/content/evidence-of-effectiveness this provides some evidence for the effectiveness of psychodynamic psychotherapy for young people & for children.  Psychotherapy works because it’s often the thoughts and feelings that we don’t want to think about and maybe that we have managed to hide even from ourselves that cause the most bother – the therapist is there to help these thoughts and feelings come out in a safe place and also to help you to identify patterns of thinking or behaviour that you might not have noticed before.  For example, the therapist might draw attention to ways that you behave in similar ways in different situations, or might highlight times when you divert away from thinking about a particular topic (which turns out to be important), or they might make links between past events and the current situation.  For younger children they might comment on some themes that emerge through the play and might help a child by putting some of these themes into words, also the therapist will help & support parents to understand what is going on a bit better or maybe to try things a bit differently….  What happens in the therapy room between the therapist & client (of any age) can often help with understanding things that go on outside of the therapy room, so the therapist will be paying close attention to everything that goes on in the room & might draw your attention to things you hadn’t noticed yourself….

If you’re looking for therapy in Bristol, there are various options.  Here at The Bridge Foundation we offer a fee-paying service for children, families, young people up to 25 and couples / relationships, where you would be offered some initial sessions with a therapist to “try it out” and explore with a therapist whether therapy suits you or not and whether or not you wish to continue – take a look at the rest of our website to find out more. If you are under 18 the NHS CAMHS (free) service may also be able to help (speak to your GP), and if you are over 16 then you can refer yourself to Bristol Wellbeing (also knows as IAPT), where you would have a choice of different types of therapy and counselling including coming here to The Bridge.  If you are adopted or if you have yourself adopted a child, you can apply for funding from the Adoption Support Fund, which you can use for therapeutic support either for a child / young person, the adoptive parents or the whole family, depending what is needed.  There’s also the personal health budget that you might be entitled to if you fall into certain groups (including children in care) which might be used to fund your psychotherapy – see https://www.england.nhs.uk/personal-health-budgets/what-are-personal-health-budgets-phbs/frequently-asked-questions-about-phbs/#6

(NHS guidance on the personal health budget states: “If someone is interested in a personal health budget for themselves or someone they care for, they should talk to the local NHS team or health professional who helps them most often with their care – this might be a care manager or a GP.  Currently only adults who are eligible for NHS Continuing Healthcare and children in receipt of continuing care have the legal right to have a personal health budget, although all areas across England are expected to offer personal health budgets to additional groups of people, based on local need, including people with a learning disability and/or autism.)