FAQ

Frequently Asked Questions

1. How many sessions will I need?

There is no fixed answer to this question - it depends on the problem you want to work on and how long you’ve been living with it. I usually suggest 4-6 sessions to begin with to see if the approach works for you and then we negotiate from there. Some people come for 1 session and others for 50 upwards.

CBT/ACT - The average number of sessions is usually between 12 and 30 for CBT with the option of one-off “booster” sessions after formal therapy has ended.

Schema Therapy is a longer term therapy of 2 years + with the initial year being more intensive and the following year(s) being monthly.

EMDR - can be used as a short-term intervention on its own if you’re focusing on a particular trauma incident, or longer term if we’re using it as a model of the psychotherapy journey itself. EMDR is shaping the way I practice psychotherapy more and more as I integrate Somatic and parts based approaches into the therapy I deliver. In my experience the EMDR journey can take around a year or more depending on the level of complexity.

2. I've heard that CBT is short-term; how short-term is it?

CBT can be as short as a one session treatment for specific phobias or much longer for more complex problems. There is a myth that CBT works in 12 sessions for most problems, but this is based on Randomised Control Trials which screen out participants with complexity. It has also been argued that the “12 session” myth feeds into the demands of private healthcare and insurance systems rather than the needs of people themselves. It’s not uncommon for me to work with someone for a year or longer if that’s what they want/need.

3. How often do I need to attend for therapy?

Weekly or fortnightly sessions usually keep the momentum up but less frequent sessions may also be of use. This also depends on how committed you are to change and undertaking between session skills practices and assignments. My preference is to work longer term with people as this means we can explore the therapeutc relationship in some depth which is where change often happens.

4. How soon can I expect to feel better?

You may feel worse before you feel better at first. This is because you will be turning towards issues that you may have been avoiding or pushing away for some time. People usually know if the approach is working for them by 4-6 sessions. You may not feel better, but you will be aware of changes happening.

5. Who can refer for therapy?

Anyone over the age of 18 with capacity to consent can refer to me for therapy. Psychological Therapy is not for everyone and I will advise you if I feel my approach is not the right one for you. I will also do my best to refer you on to more suitable practitioners. Generally speaking, I work with anger, stress, shame, depression, anxiety and trauma.

7. Do I need a referral by my GP or can I refer myself?

You can refer yourself via phone, text or email. My contact details are here

8. Will anyone else have to be involved in my treatment?

No. Sometimes though, it is helpful to involve significant others in the work and we would discuss this together before deciding on how or if to do this. However, if during our work together I have any concerns about your safety or wellbeing or that of someone else, I have a duty of care to report those concerns and may have to inform your GP or other agencies. It’s also helpful for me to know who else you are seeing for treatments so I can form an holistic picture of you.

9. Is everything we discuss confidential?

Yes. However there are limits to this which are set out in law. I will discuss this with you at our first session. I keep brief notes of our work together and you can request a copy of these if you wish, there is a fee for this. I can also write summary letters for other agencies and there is a fee for this too. My Privacy Notice is here.

10. Will I need medication? Do you prescribe medication?

I do not prescribe medication. Your GP or Psychiatrist would be best placed to offer advice on medication. I have a good knowledge of medications and can help you with thinking about medication management including the decision to take medication or not. However, clinical responsibility always remains with your prescriber. It is not a good idea to stop taking medication without consulting your medical practitioner.

11. Why should I choose CBT over other therapies?

CBT has an excellent evidence base and is considered the “gold-standard” of therapy for most anxiety and depression related presentations. However, there is also contention over what constitutes “evidence” and what “recovery” means in the context of research trials when this is applied to “real life”. I always recommend a sceptical approach to therapy and would advise you to try it and see if it works for you. Personally, I have seen the CBT approach create powerful changes for me, and also the people I work with, but it’s not for everyone.

12. Are there problems CBT cannot help?

Yes. CBT is a rapidly expanding approach to many mental health issues, but the research is still emerging in areas such as psychosis, “personality disorders” and other severe and enduring mental health diagnoses. CBT for psychosis (CBTp) is now offered in the NHS for people experiencing or diagnosed with psychosis and there are plans to offer “personality disorder” pathways too. In many of these cases more specialist approaches such as Schema Therapy, Dialectical Behaviour Therapy (DBT), Attachment Focused EMDR , Somatic Experiencing, the Neuro Affective Relational Model (NARM), or the Internal Family Systems framework may be useful instead.

I am working more and more with Schema Therapy, EMDR and Acceptance and Commitment Therapy (ACT) these days with CBT as a jumping off point for this.

13. Will Psychological Therapy work for me?

The only way to know for sure if Psychological Therapy will work for you is to give it a try. There are no guarantees in therapy and what works for one person may not work for another as we are all different. It's also true that there is no “magic wand” to fix things and you will need to be the main one making changes. However, one of the strengths of Psychological Therapy is that there are a wide number of tools we can draw upon.

14. How can Psychological therapy help me with the past?

There are a number of ways that Psychological Therapy can help with the past. Trauma focused CBT or EMDR can help with processing difficult memories from our past, narrative CBT and/or Schema Therapy can help with rewriting the story we tell ourselves about our past, ACT and Compassion Focused Therapy can also help us to make sense of our past and process the emotional impact of what happened to us. Mindfulness Based Approaches are effective at helping us to sit with and then disentangle from the past. My personal view is that most mental health issues are related to trauma in one way or another so this forms a key part of the work we do together.

15. How does CBT differ from other forms of therapy?

CBT is quite a structured, problem focused, action-oriented approach. It is also goal focused and requires you to do work between sessions. Many counselling based approaches work at a slower pace and over a longer period of time because the focus is on what emerges in the relationship between counsellor and client. CBT focuses on thoughts and behaviours whereas other approaches may focus on emotions or the body first. Different things work for different people and I try to take a pluralistic approach to therapy. For example I have a burgeoning interest in Somatic approaches to therapy and CBT is starting to consider body and emotions more and more in its approach. I also believe that the therapeutic alliance and creating a felt sense of safety are the main change agents in therapy and everything else flows from this.

Schema Therapy - integrates CBT with attachment theory, Gestalt, psychoanalytic and psychodynamic models and is an emotion focused approach which uses the client-therapist relationship to help you with identifying your unmet emotional needs.

EMDR - integrates attachment, neurobiological and somatic approaches to therapy to help you safely process painful thoughts/feelings and memories and change their emotional and cognitive meaning. EMDR works directly on the nervous system, brain and body to help the information we hold about difficult events update itself.

16. What are your own experiences of being in therapy?

I strongly believe that if you provide therapy you should be in therapy and I continue with my own personal therapy now. This is in order to make sure that the therapist is separating their own issues out from that of the clients they are seeing. I have previous experience of being a client in Kleinian psychoanalytic-psychotherapy, person centred humanistic counselling, CBT and Buddhist oriented phenomenological psychotherapy. I know what it’s like on both sides of the therapy room!

17. Who supervises you?

I am committed to my own professional development and receive regular supervision from an experienced, BABCP accredited clinical CBT and EMDR practitioner. I also have monthly Schema Therapy supervision separately from my CBT and EMDR supervision. I also seek out specialist consultation when I am working with ACT, CFT or Mindfulness Based Approaches.

18. I’ve experienced discrimination, how do you consider your own position of power as a therapist working with me?

Psychological Therapies work in a collaborative way so are more democratic than many other psychotherapies. The aim is to help you develop the knowledge and skills to become your own therapist. However, I also acknowledge that intersections of gender, sexuality, class, race, disability status and Whiteness amongst many other factors all play a potentially problematising role in what goes on in the therapy room. As a White male-passing therapist I come with my own baggage, but I am committed to decolonising therapy and dismantling internal and external racist policies. I don’t assume that my experiences of moving through the world are the same as yours or that my knowledge and training is more valid than yours. My aim is to reduce power differentials as much as possible, while at the same time working with them when they arise in our work together. Please be assured that I am doing my own work around these issues.

19. What if I am unhappy with how therapy is going, or want to make a complaint?

In the first instance I would encourage you to discuss this with me if you can. We will have regular reviews of therapy progress every 6 sessions, but you can request this at any time. Ruptures in the therapeutic alliance can be valuable learning points and if repaired can lead to insight and change. However, if you feel that you need to take things further, you can access and use the BABCP Complaints Procedure. It's also perfectly fine to fire your therapist too! As a matter of good manners however, I would ask you to let me know you’ve discontinued therapy even if it’s by text, rather than simply ghosting - the 24 hour cancellation notice would still be required or you will be charged for a missed session.

21. Why are you called Rhizome Practice?

You can read more about why I chose the name Rhizome here.

22. Do you provide counselling?

No. I provide psychological therapy, as a CBT Schema and EMDR Psychotherapist. I focus on CBT/EMDR and its offshoots only, as this is the modality that I have trained most extensively in, and am most experienced with. I do draw upon counselling skills and theory and have training in these areas though. My training is rooted in psychology rather than counselling theory but there is an inevitable overlap and commonality with counselling based approaches. For example, many counsellors will use ACT in their work with clients.

23. What is your approach to therapy?

My practice is existentially attuned, constructivist and postmodern (Worrell, 2023). I draw from the interpersonal-process (Safran and Segal) and emotional schema (Leahy) traditions of CBT. This emphasises the centrality of the therapeutic relationship, emotional immediacy and paying attention to what’s going on in the room as we interact with each other, along with the many useful tools and techniques that come from the Cognitive-Behavioural approach (Beck).

I use “third wave” approaches too such as ACT and Compassion Focused Therapy, which focus on exploring meaning, uncertainty and developing psychological flexibility towards emotions, thoughts and behaviours. (Harris, Hayes, Gilbert etc.) I am Schema Therapy trained and in the process of working towards certification. I also offer EMDR which is an integrative therapy that works directly with trauma memory and emotion.

Currently my interests are in working with anger, stress, shame, trauma, depression, and anxiety in all its forms.

My CBT approach is evidence-based, trauma-informed and attachment aware, influenced by Buddhist psychology, Mindfulness, Somatic Therapy, Acceptance and Commitment Therapy (ACT) and Compassion Focused Therapy. Alongside this I utilise ideas and practices connected with Emergent Strategy, existential-phenomenology, neuropsychology, post-structuralist theory, and the Power-Threat-Meaning framework.

My EMDR approach is influenced by the Somatic Integration and Processing (SIP) model of formulation along with the integtration of attachment, polyvagal, parts-based and somatic models of EMDR.

My Schema Therapy approach is influenced by developments in Australia and the Netherlands which are looking at the overlaps between Schema Therapy, EMDR and Acceptance and Commitment Therapy.

I mostly work with Schema Therapy, EMDR, and ACT at the moment, and less and less with CBT alone.

THERAPIES OFFERED AT RHIZOME PRACTICE:

Cognitive Behavioural Therapy - CBT

Schema Therapy - ST

Acceptance & Commitment Therapy - ACT

Compassion Focused Therapy - CFT

Mindfulness Based Cognitive Therapy - MBCT

Mindfulness Based Stress Reduction - MBSR

Eye Movement Desensitisation and Reprocessing - EMDR