Frequently asked questions

What does the counsellor do?

Careful listening is the largest part of what all counsellors do. They make sure clients have defined the problem areas in their own terms and help them define what they wish to do next. Some will then be more active, offering suggestions for further ways of investigating or beginning to resolve the problems; others are less interventive and let the work proceed more at the client's pace.

What do I say?

It doesn't really matter how you present your problem. You can say whatever you like. Sometimes there is silence; sometimes you might find yourself saying things you had not expected to say. The counsellor will help you explore the matter and will keep referring to you to clarify his/her understanding. The sessions are long enough for you to return to the different areas until you are happy that you have expressed what you are really feeling.

Does the counsellor take notes?

Counsellors keep brief notes of a session to help them reflect on it later. Counsellors usually rely on their memories in the sessions and do not make notes, although they may write the occasional phrase or name.

Will the counsellor give me advice?

Counsellors don't ever give advice of the "I'd leave university if I was you" variety since the purpose of counselling is to help you make your own decision. They will never make a moral decision about the course of action you ought to take. They may sum up what they understand you have been saying so far in order to help you move on and form a plan of action. They can offer pointers to how others have successfully dealt with common problems and may also make suggestions of the "have you thought of the following" variety. These suggestions will be drawn from their training in what is helpful and their experience of what has helped others and of course can be rejected if you feel they are unhelpful.

How long will the counselling last and how often are the sessions?

The service is aimed to offer short-term interventions and the majority of clients find between one and three sessions is adequate to help them. There is a limited facility to offer longer contracts if this seems more helpful to you. Sessions are usually weekly. Experience has suggested that this is a convenient interval for our type of work - short enough for the sessions to link up effectively; long enough for you to reflect on what has gone on. It also fits well with the lecture timetable and is easy to remember and administer.

Do I have to pay?

No. Basic counselling is offered free of charge to current students of the college as part of the support system designed to help them make the most of their studies here. If you need more specialized or more intensive support than the college service can provide, you may be referred to an outside service. Some of these are free of charge; others do make a charge.

Will they think badly of me for getting into a mess?

No. Counselling is based in the belief that most people naturally strive to make the best use of themselves. When something goes wrong, it is usually because we are pushing ourselves too hard; because we are in a muddle for reasons we don't fully understand or because we are actually are suffering some form of mental distress which is distorting our view of reality. Therefore judging clients is not helpful or relevant; they need to be supported in finding their own way out of the problem.

How can it be right to be in need of help?

Many of our problems arise just because we are human - we normally have to learn, have to make mistakes, have to have several goes before we get something right. Needing help is a normal part of this process. You could only label it as failure if you had already decided you must succeed entirely on our own - which is not a burden you have to impose on yourself. If you think you've failed, the counsellor might help you see that this is not all there is to it.

Doesn't asking for counselling mean admitting failure?

Paradoxically it can be seen as a matter of strength to ask for counselling. Many people think that they are being strong in not seeking help whereas in fact those who can admit to their difficulties could be considered the strong ones. Asking for counselling often mean you have taken the first difficult step on the road to resolving the problem.

What if I still feel ashamed of my problems?

Counsellors do accept that it is natural to want to appear successful and that most of us feel some shame when we have problems and so don't want to advertise our difficulties. This is one of the reasons we place a great emphasis on confidentiality.

Will you tell anyone such as my department about my problems?

No. Counsellors work to a strict Code of Ethics (the BACP Ethical Framework) which means they must inform you of the limits of confidentiality and then stick to these rules.

What are the limits of confidentiality?

Everything you say is kept confidential to the Counselling Service unless there is clear evidence someone may be at a severe risk.

So other members of the Student Counselling Services might know what I have talked about?

Yes. Counsellors are bound to discuss their work with their supervisor, although they do not reveal the client's identities to them. The team discusses their work together in confidence, so the other counsellors may get to know about your problems. The secretaries will know some details as they receive references, pass messages and type referral letters. However all these people are strictly bound to keep what they learn confidential.

What do you mean by someone being at severe risk?

If we fear a client may attempt suicide we will involve others - normally a GP, but sometimes a member of College staff. This is normally done with the client's agreement, but may be done without if no other reasonable course can be agreed and the risk of immediate serious self-harm seems very high. The same applies if we fear a client may be at immediate risk due to severe mental illness. If we fear another person is very much at risk - maybe because the client is intent upon a serious criminal action or tells us of someone else who is - we may have to make a disclosure. However, normally we will discuss the issue with the student and arrange for them to deal with the problem themselves without there being a breach of confidentiality.

Do you have to tell the police or the College authorities if I tell you I have committed a criminal offence?

No. We would only want to make a disclosure if there was real evidence that someone was in imminent danger of further harm in the future. Otherwise everything you say is kept confidential.

What about if I have been the victim of a crime which I want kept confidential?

The Counselling service would be able to guarantee confidentiality in all but the rarest of cases. Normally until the victim is ready to speak of their experiences outside counselling, there is little point in disclosure to prevent a repetition of the crime. The most likely cause for exception would be if the potential risk was very great - e.g. of murder - or if the potential victim was very vulnerable - e.g. a child.

Should I be worried about the limits of confidentiality?

Generally research shows that clients of counselling services find the level of confidentiality is higher and more effective than they have expected. Often the worry about disclosure lessens when the client has had a chance to discuss the problem. When the counsellor speaks to others, it is usually because the client wishes them to know; disclosures made against the clients wishes are extremely rare. However, if you are worried about the implications of any breach of confidentiality you may wish to:

Speak to a counsellor in general terms first in order to see how our Code of Ethics may apply to your particular situation.

Consider getting yourself anonymous help through a telephone line. the Samaritans (0345 909090) can be a very good starting point for the number of other help-lines. There is also a good list of help-lines in the back of the Student Union handbook.

Where can I get further information?

You can look at our page on ethics or consult the British Association for Counselling and Psychotherapy website|. A copy of our Code of Ethics is available in our office.

Do you have any evidence counselling works?

We have carried out a survey of our clients in a recent year, and their feedback indicates students find counselling most useful. Many have told us they would have left RHUL if it had not been for the service, but instead have stayed and resolved their problems.

How does it help?

Nobody is sure, but it is probably due to several reasons. Here are some suggestions the team has made:

• Counselling gives you a space to get something off your chest and so lets you move on more freely.
• Human beings are sociable creatures. We all need someone to bounce our ideas off. Sometimes this is too difficult to do with family, friends or academic staff so a counsellor is the next best thing.
• Most problems assume a less frightening dimension once they are aired and then you can gain a new perspective and focus on the real issues.
• A clearer view of things may give you increased self-confidence and enable you to free yourself of unwanted thoughts and feelings like worry, anxiety and depression.
• If you get on well with the counsellor, this generates support for you to start looking at old problems in a new way and so gain insight.
• The counsellor may be able to make some specific suggestions for ways of helping yourself which you had not considered and then help you put them into practice.

Isn't there a controversy about some forms of counselling?

Yes. This is dealt with elsewhere. It doesn't however apply to the types of counselling offered in the College.

Does it work for everybody?

No, but it seems to offer at least some help to the majority so is worth a try. Your counsellor will check out with you to see if talking is helpful - and if not will help you look for something else.

Are the counsellors qualified?

Unless you are told otherwise, your counsellors will be trained and experienced and hold as a minimum a diploma-level qualification. Permanent staff have satisfied the criteria which entitles them to be on the United Kingdom Register of Counsellors - the current standard benchmark of an adequate qualification for counselling. We usually also have a small number of counsellors in training doing limited work under close supervision. They already have some experience and training. The clients of counsellors in training report a high degree of satisfaction. However, you will be told if your counsellor is in training and will be given the chance to discuss any worries you may have.

Does it matter which counsellor I see?

There are pros and cons to how you choose a counsellor. Choosing a counsellor who is similar to you - in age, gender, nationality etc. - has the advantages that you might feel initially more at ease and better understood. If you feel the problem is a very intimate one you may feel only able to discuss it with a counsellor of the same sex. However, all counsellors are trained to work with all problems, and clients often report that the fact the counsellor was slightly different from their ideal was in fact helpful. The Service does not generally try to match counsellors and clients in detail and requesting a particular counsellor might limit when you can be seen. We will however try and accommodate any requests you may have.

What if I definitely want a male or female counsellor?

Some people have a very strong feeling about wanting a male or female counsellor. It is OK to express this when making an appointment and we will definitely respect an individual preference for a counsellor of a particular gender. As the service's staffing reflects the gender balance of the College, such a preference will only be a problem if you wish to have an appointment very short notice.

Will the counsellor have experienced problems like mine?

Very probably. Having problems is part of being human. Many counsellors come into the work because of their experience of successfully resolving personal problems through therapy. All will have had their own experience of being a client. Therefore although the counsellor may not have experienced the particular problem which you bring, they will all have had experience of being in distress and of seeking counselling help from another.

What gives the counsellor the right to suggest what I might do?

Clients make a contract with the counsellor to work together on a problem. Part of that contract will involve the counsellor using their skill, their training and their experience to indicate possible ways forward that might help you. Most clients find this a valuable part of the service. However, you don't have to do anything which seems unhelpful to you, and you should always raise the matter with the counsellor if you feel you are being manipulated in any way.

What if I don't get anywhere with my counsellor?

Do raise your worries with the counsellor. It is important that you feel comfortable with the way the counselling is progressing. In most cases the problem can be resolved and a different approach tried. The counsellor will be happy to be open about putting choices before you. If there seems no obvious solution to why the work is not progressing, the counsellor will refer you to a colleague who uses a different approach.

Wouldn't I best trying to sort it out myself?

Of course there are ways you can help yourself apart from counselling - counselling is just one of the answers. Many problems can be sorted for yourself - however it doesn't need to be an either/or situation. Counselling is a resource for when you need extra help.

What about talking to my friends?Many of the reasons that make counselling effective also apply to talking with friends. Therefore a talk with a friend may well be helpful and counsellors often encourage clients to use their social support network. However there are some drawback to using friends as your only confidants and support.

• Friends might feel a conflict of loyalty and find it hard to keep things confidential
• Friends might become upset themselves by what you are telling them
• Friends might be put out if you don't accept their advice
• If you need lots of help friends might begin to feel resentful and you might feel guilty
• Counsellors have had training and have formal support and a work structure which helps them to deal with upsetting and difficult situations; friends may begin to feel overburdened, especially if they have their own problems too.
• Finally, sometimes we need slightly more specialist help than friends can provide.

Some people have suggested I just have a stiff drink and pull myself together.

Alcohol is very useful for enhancing a positive mood or a pleasant occasion. Sometimes a drink can revive flagging spirits and help you relax. However alcohol doesn't really help solve significant problems. It can even worsen the situation because of its tendency to cause depression and other problems if you drink too much.

Does seeing a counsellor mean I am ill?

No, seeing a counsellor doesn't mean you are ill. The vast majority of the clients of the student counselling service have no significant clinical illness. However, where there are some symptoms of an illness - depression, anxiety etc. - counselling can be helpful. Counsellors will not treat you as a sick person, but rather as someone going through a bad time.

Is counselling like psychiatry?

Counselling bears little relation to psychiatry except that both deal with emotional and mental processes. Psychiatrist are trained doctors, who work largely through diagnosis of illness and then by prescribing a treatment - usually involving medication. Counsellors are normally non-medical personnel who work by talking and encouraging you to find your own solutions. Counsellors can however recognize the symptoms of severe mental distress, and will suggest you contact a GP if this is appropriate.

Will I become dependent on my counsellor?

No. The types of counselling used by the service encourages clients to take control of their own lives. You may choose to rely on the counsellor for a bit, but you will not be encouraged to become dependent. Counsellors aim to make the client independent of them; the aim is for you to become self-motivated and empowered.

Will counselling make me worse?

This is a common fear, probably prompted by the fact that when we first begin to look at a problem that we had been avoiding, we can begin by feeling slightly worse rather than immediately better. However, research into the type of counselling offered at RHUL suggests that people begin to feel less stressed very quickly indeed - usually after a single session. There is no evidence of long-term negative effects from this type of counselling.

Why has there been criticism in the press about counsellors then?

There is a controversy about some forms of long-term counselling, about the claims some counsellors make and about some forms of therapy which rely on "recovered memories" from the past. It has been alleged that some counsellors have tried to strongly influence their clients to follow a particular course of action. Part of the problem is that in the outside world anyone can claim to be a counsellor without needing any formal training or regulation. However, you can rest assured that none of these controversial practices form part of the College Counselling Service's approach. Here the counsellors are all appropriately trained and selected; use conventional and well-researched approaches that have a proven history of success; are working to a set Code of Ethics and are well supervised.