A checklist for clients interested in receiving counselling, psychotherapy or hypnosis

In the past 12 months counselling and psychotherapy has received negative publicity on television, radio and in the press. In particular, the potential exploitation of clients by counsellors, psychotherapists and hypnotherapists has been widely reported. In the past 20 years this exploitation has been well documented and is not just media hype (e.g. Gabbard, 1989; Pope, 1990; Russell, 1990; Szymanska &: Palmer, 1993; Taylor & Wagner, 1976).

Most information that clients can obtain on finding a suitable counsellor concentrates on the different approaches to counselling, what they entail, the cost, choosing the right counsellor, and confidentiality. The issue of the possible problems that can occur in counselling and psychotherapy are seldom explicitly stated in the information sheets or booklets especially in Britain (e.g. BAC 1992, 1994). However, a slightly more enlightened approach is taken in North America.

To aid potential clients in asking their counsellor the right questions and to avoid any pitfalls, the authors have developed a brief checklist (see adjacent). This can be given to the client by the counsellor, health centre, or medical practitioner before the first counselling assessment session. Due to its brevity, the checklist is easy and cheap to photocopy. Since its first publication (Palmer & Szymanska, 1994a) it is now being used in health centres and has been recently revised (Palmer & Szymanska, 1994b). Although it can not stop exploitation from occurring it may alert clients to the more usual warning signs.

The authors are keen to receive feedback from REBT counsellors and psychotherapists on the content and wording of the checklist.

References:

BAC, (1992). Information sheet 5. Rugby: British Association for Counselling.

BAC, (1994). Counselling and You. Rugby: British Association for Counselling.

Gabbard, G. O. (Ed), (1989). Sexual exploitation in professional relationships. Washington D.C.: American Psychiatric Press.

Palmer, S. and Szymanska, K. (1994a). How to avoid being exploited in counselling and psychotherapy. Counselling, Journal of the British Association for Counselling, 5, 1, 24.

Palmer, S. and Szymanska, K. (1994b). Referral guidance for participants attending stress management training courses. Stress News, Journal of the International Stress Management Association, 5, 4, 10- 11.

Pope, K.S. (1990). Therapist -Patient Sexual Involvement: A Review of the Research. Clinical Psychology Review, 10, 477-490.

Russell, J. (1990). Breaking Boundaries: A research note. Counselling, Journal of the British Association for Counselling, 1, 2.

Szymanska, K. and Palmer, S. (1993). Therapist-client sexual contact. Counselling Psychology Review, 8, 4, 22-33.

Taylor, J. and Wagner, N. N. (1976). Sex between therapists and Clients: A review and Analysis. Professional Psychology, 7, 593-601.

Correspondence: To either author at Centre for Rational Emotive Behaviour Therapy, 156, Westcombe Hill, London, SE3 7DH

Issues For the Client To Consider
In Counselling or Psychotherapy

Here is a list of topics or questions you may wish to raise when attending your first (assessment) session:

1. Check that your counsellor has relevant qualifications and experience in the field of counselling/psychotherapy.
2. Ask about the type of approach the counsellor uses, and how it relates to your problem.
3. Ask if the counsellor is in supervision (most professional bodies consider supervision to be mandatory; see footnote).
4. Ask whether the counsellor or the counselling agency is a member of a professional body and abides by a code of ethics. If possible obtain a copy of the code.
5. Discuss your goals/expectations of counselling.
6. Ask about the fees if any (if your income is low, check if the counsellor operates on a sliding scale) and discuss the frequency and estimated duration of counselling.
7. Arrange regular review sessions with your counsellor to evaluate your progress.
8. Do not enter into a long term counselling contract unless you are satisfied that this is necessary and beneficial to you.
9. If you do not have a chance to discuss the above points during your first session discuss them at the next possible opportunity.

General Issues

10. Counsellor self-disclosure can sometimes be therapeutically useful. However, if the sessions are dominated by the counsellor discussing his/her own problems at length, raise this issue in the counselling session.
11. If at any time you feel discounted, undermined or manipulated within the session, discuss this with the counsellor. It is easier to resolve issues as and when they arise.
12. Do not accept significant gifts from your counsellor. However, this does not apply to relevant therapeutic material.
13. Do not accept social invitations from your counsellor. For example dining in a restaurant or going for a drink. However, this does not apply to relevant therapeutic assignments such as being accompanied by your counsellor into a situation to help you overcome a phobia.
14. If your counsellor proposes a change in venue for the counselling sessions without good reason do not agree. For example, from a centre to the counsellor's own home.
15. Research has shown that it is not beneficial for clients to have sexual contact with their counsellor. Professional bodies in the field of counselling and psychotherapy consider that it is unethical for counsellors or therapists to engage in sexual activity with current clients.
16. If you have any doubts about the counselling you are receiving then discuss them with your counsellor. If you are still uncertain, seek advice, perhaps from a friend, your doctor, your local Citizens Advice Bureau, the professional body your counsellor belongs to or the counselling agency that may employ your counsellor.

Footnote: Counselling supervision is a formal arrangement where counsellors discuss their counselling in a confidential setting on a regular basis with one or more professional counsellors.

The New Zealand Centre for Rational Emotive Behaviour Therapy maintains a list of REBT practitioners throughout New Zealand who are available to take referrals. To find out about your nearest therapist, click here.