Finding a therapist
How do I find a therapist?
This information looks at "What should I look for when I choose a
therapist?"
- How do I know the therapist is genuine?
- What may be the warning signs that this is not ok?
- How do I know the therapy / therapist ok?
- How do I select a type of therapy for me?
- What types of therapy are there for people with eating disorders?
- What is right for me?
- How much can I expect to pay?
- Questions for interviewing my therapist - checklist.
In looking for a therapist you need to make sure:-
That the therapist or health profession you see is registered therapist
with their professional body, check for links on search.atomz.com/search/?sp-q=professional%2Bbodies&sp-a=sp092b3400
People may have an additional specialisation in CBT, CAT, DBT, IPT,
but should have a main professional body to give them clinical practioner
status. You can look up in The Nice guidelines
www.nice.org.uk and
use the advanced search for "Eating Disorders" to find the
NHS recommendations of treatment of Eating Disorders
The definitions of these can be found on the talking therapies website www.phobics-society.org.uk/talkingtherapiestext.html
Types of therapy are also listed www.find-a-psychiatrist.com/modules.php?op=modload&name=News&file=article&sid=60
There is also a lot of information on www.mentalhealth.org.uk/index.cfm
The National Eating Disorders Association has a site that gives practitioner
lists in each area of the country, which you may wish to look at www.edauk.com/list/index.htm
The first meeting
You can ask to see your prospective therapists;
- Qualifications
- Insurance
- Registration number
- Information of the professional body
- Ask them what to do if you aren’t happy with therapy
- If they are registered, approved of and insured for private practice
- Do they have regular supervision?
You can ask to arrange an initial assessment meeting where you talk
to the therapist about your situation. You can ask them about their work,
style, qualifications and decide if you feel comfortable with what they
can offer you. They will also assess whether they think they can offer
you what you need. If not they may well make suggestions of where and
who may be more helpful to you. If you gut feeling say 'no' don't sign
up for the session talk to a friend, your nurse or doctor your family
and look for another therapist.
- You can expect to be offered a regular weekly session of 50 minutes
- 1 hour on the same day and same time each week, or more regularly
if required. This may be different if you need to arrange therapy around
shifts at work and college training sessions if the therapist is able
to offer you this flexibility. Not all therapists can or will do this.
- Make sure you know how much it will cost and how you are expected
to pay e.g. monthly, weekly, with cash or cheques and if you can have
a receipt
Also check:
If there are any additional costs e.g. phone calls, invoices, and receipts.
What happens if you are sick and cancel?
What happens if they are sick?
- Ask about length of term of work (short/long and what that means)
and check how often this will be reviewed and what to do if you do
not like the sessions. Some people like to set up 6 or 8 sessions to
see how it goes before engaging in long term therapy.
- Do not part with anything such as direct debits, credit cards,
bank details, passports, driving licences, benefit books etc. This
is ethically inappropriate for a therapist to ask you to surrender
any personal items, even if it is to help you "stop bingeing." You
will find a way to binge and unless you are ready to stop, so taking
away money will not help.
If you want to have limited access to money make an agreement with
a very best friend, your bank or your family.
Professionals are not allowed to look after clients’ money or valuables.
If you are asked to do these things please report it to their professional
body or ask someone to do this for you. Even if you don’t think it
is a problem it could be for someone else.
If you are asked for these say you need to think about it then talk
to their professional body, your G.P or SWEDA www.swedauk.org,
or www.nhsdirect.nhs.uk or
ask in Citizens Advice.
Hospitals will have a secure system in place with regular policies
and procedures around looking after inpatients valuables. Make sure
you read and understand any forms you are given before signing them.
Remember to keep a copy of the form and a list of all the things and
values of things you give in for safe keeping. Check you have everything
back afterwards. If not ask about how to log this and register a complaint.
- Therapy should be a non-judgmental supportive space for your own
life journey. The work comes from you so do not expect to be told what
to do or to be instructed on how to recover. Some therapists may help
you with weight and food management/diaries/binge management and may
set you tasks to do in between sessions. In order to make the most
out of your therapy you have work hard!
Through your therapeutic journey you will build trust with your therapist
and should then feel able to talk about how things truly are for you.
If you are not able to do this it would be good to explore why not.
Then work with your therapist to see what you can both do about this
situation whether it is working together or finding someone else who
you can work closer with. It is best to not scarper because you can
not say something, try and work it out together.
- If a therapist begins to tell you things that don't fit for you,
you need to be able to say "no", that is not my truth/how it is/was
for me.
- Check their policy of confidentiality and make sure you understand
it. If not ask them to explain it and to explain when they may break
this. For example if they feel you are at significant risk. Then ask
how they would work with you on this, maybe you would look to call
your G.P. together. In most circumstances a therapist will support
you to tell an appropriate person how things are so that you get the
best help for you. They should definitely tell you if they are significantly
concerned and ask for your consent to tell your doctor.
- You may be asked to go to your GP health centre to be physically
monitored for your own and the therapist's safety. Some therapists/counsellors
may have a BMI cut off for safe working. Check this out before
you engage in therapy so you know their baseline and agree to work
within these boundaries.
Some counsellors will ask you to go to your doctor to have your weight,
bloods (potassium levels), heart, bone density checked. They may feel
that this is an appropriate way to see if they should be offering you
therapeutic work or if you need a more specialized service. You may
agree with your therapist for them to have consent to talk to your
GP, and to ask your G.P. if you become at a physically unsafe place.
Ultimately it is your choice to decide how you wish to work. Some counsellors/therapists
will not be happy working alone with you if you are at a critical place
in your personal safety. This may be very low BMI or potassium levels
or if you have apparent poor physiological health.
You may be relieved that someone is interested in your personal and
psychological safety. This may also terrify you right now. It may make
you feel angry and rejected that these measures of physical health
seem to come before how you feel. Talk to the therapist / counsellor
and your G.P. about this.
Again you have the choice of whether to engage in therapy and can
always ask advice from the NHS www.nhsdirect.nhs.uk for
support via GP and secondary Community Mental Health Team or specialist
Eating Disorders Service. "Tough love" and firm boundaries
are for your own safety even though it can be painfully hard to hear
and accept this and to work within someone else’s limits.
- Even if the therapist you find is state registered or nationally
accredited they may not be the right therapist or be offering the right
therapy for you so shop around, look at several before you decide what
you need.
- Before embarking on private therapy/counselling, make sure you have
- The money to sustain therapy (2004 Price Scales £25 -£50 / hour.
Sometimes there are sliding scales for students)
- The time to do therapy
- Reliable transport to get there.
It can be really hard to start therapeutic relationships and not be
able to keep it going.
It is really important to give yourself enough time to end a
therapeutic relationship. Sudden endings can be very difficult and make
things hard for you now and in the future. You may also want to check
with the NICE guidelines 2004 to make sure if your GP/secondary service
should be offering you an NHS service, and if what it suggests could
be right for you. The options range from self-help to inpatient work. www.nice.org.uk/cat.asp?c=101239
SWEDA re setting up a supported self help package with a helpline
supporter so you can access support in your college or home. Please
contact the SWEDA admin line and ask for information. 01458 448611
or "18-25’s" 01458 837900
What therapy to choose
There are various therapies that people with eating disorders choose,
some of these are very structured programmes others are very client centred,
which means that the therapist follows where you need/want/choose to
explore.
Some therapies are "proven" to be useful with certain types of eating
disorder e.g. bulimia and CBT. There are also many therapies which are
effective but have not been clinically run as I wonder how you would
measure recovery your from an eating disorder? What we know is that it
is more than weight gain/management and behaviour modification but how
your relationship is with yourself and how if feels to be you and how
your inside world is.
The usefulness really comes from you and the relationship you create
with your therapist and the timing of the intervention i.e. when you
are ready and motivated to use the type of therapy.
Types of therapy
You may want to check our information on finding a therapist.
Make sure that the therapist or health profession you see is registered
therapist with their professional body, check for links on www.webhealth.co.uk/professional_bodies.html
People may have an additional specialisation in CBT, CAT, IPT, but should
have a main professional body to give them clinical practitioner status.
You can look up in The Nice guidelines www.nice.org.uk and
use the advanced search for eating disorders. This will give you the
NHS recommendations of treatment of Eating Disorders
The definitions of these can be found on the talking therapies website www.phobics-society.org.uk/talkingtherapies.html
There is also a lot of information on www.mentalhealth.org.uk/index.cfm
The National Eating Disorders Association has a site that gives practitioner
lists in each area of the country, which you may wish to look at www.edauk.cam/list/index.htm
If in doubt check it out.
Voluntary Organisations - there is a register of voluntary organisations/charities bubl.ac.uk/uk/charities/s.htm and
web pages of directories of professional registered and accredited therapists www.hpc-uk.org as
well as on this page.
By using this you can check out their legitimacy, code of ethics and
conduct before using a service. Sometimes there are organisations/therapists
who do not work within the guidelines of their professional codes of
conduct and in your interest so feel able to check them out!
Do I really need therapy?
Not everybody chooses to engage in therapy to find recovery from their
eating disorder. Sometimes people find something new to do and refocus
their energy - and give them an alternative coping strategy. There are
many ways to find recovery and the life you want to live.
So seek support to find what you want and need. At different times in
our life journey we have different needs; there is no shame in needing
support and therapy. It takes a lot of courage to do this.
This may seem to feel harder and more in your face as you begin to engage
in a process. This is normal. Talk about it! Do you remember as
a child learning to paint and how messy that got before you learnt to
use brushes and paints and gradually the picture became recognisable?!!
Sometimes if we knew how hard things were going to be it may stop us
giving it a go and stop us finding what there is to discover and enjoy!
We may also do therapy for a while get to where we need to for now and
stop. Then after a break you may choose another form of help/support
for the next part of your journey.
Remember there are similar things in people's journeys, but each journey
is individual and no two journeys are the same. So do yours the way you
want/need to.
When am I ready to use help?
I am ok I don’t have a problem
Perhaps you are in a stage where you are living with your eating disorder
and do not feel it is getting in the way of your life. Maybe you don’t
have a problem with it. Perhaps it feels like other people seem to have
the difficulty. Maybe at this time you are not thinking about making
any changes but a G.P. or nurse may ask to monitor your physical safety.
I am fed up of it all and scared
Maybe you get to a stage where you begin to get fed up of people trying
to help you. You begin to see how your eating disorder is getting in
the way of your life, your studying and having fun and are not quiet
sure how you would manage without it. It has been a familiar friend but
now is a bit in the way and you are afraid not to have it by your side
incase things go wrong. You may be thinking about making some changes
and not sure how to do this. A therapist may be helpful to listen to
your thinking and help you think about what you want and need in your
life right now. Together you may be able to think about how to get what
you want in your life.
I have had enough of it. My Eating Disorder is getting in the way
of my life.
Enough is enough. I will not let it steal my life any more.
Now you may think you really have had enough. You may seek active support
to make changes in your life style. This help maybe from a specialist
team, your GP and mental health team or another health practitioner.
This will be a tough and rewarding part of the journey. You may feel
that in order to do this you need to take some time out of studying and
defer for a year in order to sort out your inside world and outside life
style. Ask your student welfare workers for advice on this. You may ask
for more support to do this therapeutic journey alongside your studying.
Sometimes you may think I am exhausted this is all such hard work. Is
it worth it? Then you may temporarily blip and dip back into living in
the "problematic Eating Disorder rules of life." All journeys
have ups and downs. The road to recovery is not a straight line.
Perhaps after awhile you will see what is happening and seek help to
actively get out of the clutches of your eating disorder again. This
time you will learn something new and find how strong you were to get
back on the road again. Do seek the active support you need and go for
it!
The journey has many dips and peaks; it is all part of finding the
richness of your life.
Mastering Life without hurting myself
Living in the solution of your life without food problems takes again
energy and can be really hard with the temptress of dipping back in to
the problem way of life. It may feel like that would shelter you from
all that you now see and feel and think. It may seem like you want protection
from facing the outside world, like:-
- Eating with people
- People seeing you
- People commenting on your body
- People noticing your health changes
- People seeing the emerging you
Often in making these steps to maintain the solution you will need even
more support and encouragement form friends and professionals to
keep well. This step will involve facing things that you have not been
able to manage for a long time.
Contacts
Somerset and Wessex EDA
Admin./Fax 01458 448611
email:
admin@swedauk.org
www.swedauk.org
01458 448600
an answerphone is available when the helpline is closed.
Mindinfoline 08457660163
NHS direct 08454647
Saneline 08457678000
Samaritans 08457909090
Mindline 01823 276892
Mental Health South West 01823 337879
National Self Harm Network PO Box 16190 London, NW1 3WW
Rethink 02089746814
PAX 02089746814
No Panic 01952 590545
Eating Disorders Association 0807703256
Checklist for clients looking for a therapist.
- Are they registered with professional body? Yƒ N
- Are they insured for private practice?
- Are they approved private practitioners?
- Do they get regular supervision?
- What does supervision entails
- Can they offer you a regular time(s) and day(s) each week?
- Do you understand how therapy works
- Have you made a contract with them
- How many sessions have you agreed to
- When will you review therapy?
- What is their confidentiality policy, when would that be broken?
- What happens if you are ill/cancel/die?
- What happens if they are ill/die/cancel?
- Do they keep records/notes? Where are they stored?
- How much do they charge?
- How do you pay?
- What happens if I need support in between sessions?
- Do they have experience of working with eating disorders?
- How does that change the way they work?
- How/to whom do I complain if I am not happy with what you offer me?
SWEDA
are setting up a supported self help package with a helpline supporter
so you can access support in your college or home. Please
contact the SWEDA admin line and ask for information - 01458 448611. |
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