Here we answer some common questions about counselling and how we work.

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Question marks standing for commonly asked counselling questions

Frequently Asked Questions

You may wish to embark on a series of counselling sessions for a number of reasons: to gain clarity on an issue, change old patterns, untangle complex personal issues or for self-development. You may seek counselling as a result of a crisis, or you may be encouraged to seek counselling by family members, friends or colleagues.

There is no typical counselling session. It is time set aside for you, and what you talk about will vary according to your needs. You are free to discuss what you wish, from everyday events, dilemmas, feelings, thoughts, regrets, aspirations, memories and dreams. Your counsellor will provide a safe environment in which to explore your issues and work towards your self-improvement. If you prefer to approach your issues in a more practical way, then cognitive behavioural therapy may be a good choice.

Clients present with wide-ranging problems including anxiety (panic attacks, agoraphobia, generalised anxiety problems, social anxiety, claustrophobia), stress in the work place, work-life imbalances, relationship issues (break-up, divorce, affairs, choosing inappropriate partners, loneliness, life adjustments, marital problems, arguments, jealousy, wedding & premarital issues), sexual problems (impotence, internet/pornography/sex addiction, loss of desire), infertility, trauma (including post-traumatic stress disorder from accidents, rape and other attacks/incidents), obsessive-compulsive disorder, eating problems (including bulimia, binge-eating, negative body image), depression (including suicidal thoughts, low mood, social withdrawal), phobias & fears, addiction, low-self esteem & confidence, addiction & substance misuse, abuse (including verbal and sexual abuse), and bereavement/grief/loss. At Harley Therapy, the most common reasons for searching for a counsellor are stress, anxiety, depression and relationship difficulties.

Many types of people can benefit from counselling. Therapy is frequently conducted on a face-to-face level with individuals. However, counselling is also beneficial with couples, families, adolescents, teenagers and children. Counsellors-in-training (supervisees) are usually required to be in supervision with experienced counsellors. Our client group spans across cultures, gender (male, female), sexual orientation (straight, gay, bi-sexual, transsexual), religion (Christian, Catholic, Muslim, Jewish, Atheist and others) and employment groups. We welcome diversity and our discreet and professional counsellors can accommodate a wide client group.

To book a general consultation, please phone, book online or email for an appointment time at our Harley Street or City of London Counselling Centres. If you prefer a specific counselling or psychotherapy approach (cognitive behavioural therapy - CBT), psychodynamic psychotherapy, existential therapy, person-centred counselling), we will match you up with a suitable psychotherapist or counsellor according to your presenting issues. In the event that the assessment therapist feels you would benefit from a different counselling or psychotherapy approach, they will normally recommend another specialist for you to consider.

The number of counselling sessions depends on you as an individual and your unique presenting issues. A first consultation will enable you to see if counselling is indicated. Usually you will start with six sessions and review after that. Cognitive behavioural therapy is designed to be short term and lasts 6-20 sessions. Psychodynamic, psychoanalytic and existential therapies tend to be longer term and many last for many months or even years. Since our counsellors work privately, you are not limited in the number of sessions you can have.

There are a number of established therapeutic approaches to counselling work. These include humanistic counselling (also known as person-centred), psychodynamic psychotherapy, psychoanalytic, existential, gestalt, transactional analysis, cognitive analytical therapy and cognitive behavioural therapy. You may have an idea that a particular approach would be suited to you. If not, you may wish to call us to discuss beforehand, or you can book in for a general consultation to explore your options with an assessment therapist.

Counselling sessions are confidential with the exception that if you pose a danger to yourself or others, then the relevant parties will be notified.

Our counsellors are not eligible to prescribe medication. We have an onsite private consultant psychiatrist who can assess you for a prescription, and this can complement your therapy work. Please note that the fee for psychiatry is higher than for counselling.

The first consultation will give you the chance to bring in any questions, to find out more about how you will work together and to discover if you connect. The counsellors do not make themselves available prior to your appointment. If you wish to find out about the therapist’s background, please read their profiles on the website - ‘Our Therapists’. Whilst the majority of first consultations will proceed to a full course of treatment, neither you nor the therapist are committed to continue beyond the first counselling consultation session.

Our counselors will be available to you at your scheduled appointment time. They are not able to provide an emergency service to you, and you will need to seek other resources for help during a crisis. In such cases, you should contact your GP, the Samaritans (08457 909090 or, if necessary, emergency services.

This depends on the nature of your policy. Do check with your provider to see whether counselling sessions will be covered, how many sessions can be included and if there are any other restrictions. Some therapists on the team are registered with the major health insurance providers - Cigna, Pruhealth, Aviva, BUPA International, etc. Please ask us first to see which counsellors are registered, as you will be responsible for any payments accrued regardless of the type of insurance cover you have. 

Regularity is important for productive therapeutic work. The standard format of weekly sessions helps you make gradual and steady progress. In some cases, a therapist will agree to two or more sessions per week, if you both deem it beneficial. 

If you proceed with therapy sessions after the first consultation, the therapist will reserve the same time slot (of 50 minutes) for you each week. Any missed sessions or cancellations will be charged at the full fee. This is so that they can set aside the same time for you each week. The cancellation policy applies to holidays, work commitments, illness and other emergencies. Each therapist has a particular set of terms and conditions (including cancellation policy) which will be shared with you prior to your first appointment.

The therapist will take payment in full at the end of each session by cash or cheque. They do not have the facilities to accept credit or debit cards. You will be invoiced for any missed or cancelled sessions. Invoices must be paid upon receipt. Unpaid bills may be passed on to a debt collection agency.

Unfortunately our therapists do not offer concessionary rates, free initial consultations or discounts for block bookings. Rachel Miller, psychotherapist, is available for lower cost therapy. Please call her on 07855 652 938 or email Or read our guide on Free/Low Cost Therapy

Friends, family and colleagues may be very concerned about an individual's well-being and would like to see them have counselling. It is most helpful if the individual in question can make contact themselves, as it is an important step in acknowledging that they may need assistance. We are able to take enquiries from you on behalf of someone else, but you should have their full consent.

Therapists at Harley Therapy are registered and accredited (or eligible for accreditation) to practise by professional organisations which include:
BACP - British Association for Counselling and Psychotherapy
BABCP - British Association of Behavioural and Cognitive Psychotherapy
BPS - British Psychological Society
UKCP - United Kingdom Council for Psychotherapy
UKRC - United Kingdom Register of Counsellors

Complaints should be raised with the therapist directly. If you are still not satisfied that your complaint has been addressed, then you should take this up with the counsellor's accredited body (includes BACP, BABCP, UKCP, UKRC & BPS). Each therapist will have professional indemnity insurance as well as a certificate to practise. If you have a query about the room or administrative service, then you can raise this with the Clinical Director who will endeavour to address your concerns.

Video: What issues can counselling help with?
Video: What happens in a typical counselling session?
Video: Why are cancelled sessions charged?
Video: What are the success rates in therapy?
Video: Are counselling sessions confidential?
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