 We demystify what goes on behind the therapy room door. Join us on this voyage of discovery and co-creative conversations. This is The Therapy Show, behind closed doors podcast, with Bob Cook and Jackie Jones. Welcome back to, I think we're on episode three now. Yes, three. We've done an introduction and this is episode three. This week we're going to be talking about assessments, which sounds like you have to go through a test in order to have therapy. Is that what this is, Bob? No, that's why we laugh in a way because I'm thinking about tests and therapy and some people, of course, set tests psychologically and they find people to fail them. But that's another story. Now, this is really about, you know, once you've decided you want therapists, it's like, how do you find the right therapist for you? Now, 2021 is where we are today and psychotherapy has got a lot more accessible. Yes. I live in Manchester, Ditsbury. So if I wanted to have a therapist, there are quite a lot of them. But the problem is, it's a bit like putting a needle in a map, you know, or a haystack, really. You find someone to suit you because therapy is far better if you actually go on the therapist. Yes, 100%. So there are not many places around that do assessments where you can actually see somebody to talk about what you want from therapy and they can point in the right direction. Very few places around would actually do assessments. There are some places around to do referrals. So for example, well, I can think of a few places, but not many places that do actually half an hour assessments, which point the right direction to a therapist. If you wanted to have a therapist, Jackie, now, for example, what do you think most people do? Google. In near to where you live, I would hazard a guess that's how people go and then they just look at a picture and think, I like the look of them. Is that what you think most people do? That's my fantasy that what people do. Yeah. You just, you Google therapists near me and then those therapists usually have a website or something. You have a look at them, see whether you like the look of them and that's it. That's one way. Obviously not the best way. That's the majority way. I was thinking, if we look at between us, let's just look now. That's one way. Another way is to find somebody, it's by recommendation. Yes. So I was thinking my daughter, when she was looking for a therapist, the age of 20 or 21, even though she was a daughter to psychotherapist, she lived in a shared house and she could have, but she went through us. She could have got recommendations from at least two or three people who had psychotherapy. So you can come by recommendation. It's surprising how many people do actually come by recommendation. That's another way. And they're very popular way actually, though I don't know how many people think it's popular, but it is. They go to the doctors. Yes. No, they say they have anxiety, social anxiety, depression. They often go to the doctors and unfortunately, well, it's a good first port of call, the doctors aren't psychologically trained. No. So they know a little bit about anxiety and maybe a little bit about depression, but they don't really think psychotherapeutically. And even psychiatrists who really, they might end up being heard by, they don't really know much psychotherapeutically in terms of counselling and therapy. So they know a lot about drugs. And some enlightened counselling practices might have a counsellor attached to them. Yeah. So if you go to a counsellor and you say you've got a counsellor then will do two or three, four things. They probably want to send them to a psychotherapist. They might say if they've got a counsellor attached to their venue, they might say, okay, you can go on a list to see a counsellor next, you know, test to RGP. Or they might send them into the NHS maze. Yeah. They might have to wait for quite a long time for CBT or some sort of counselling. But you'd be surprised how many people do go to the doctors first. And then they find out that the route onwards after that isn't that useful. Because they often have to wait ages in the NHS queue. Many GP centres haven't got counsellors aligned to them because they can't afford it. And then they often might get some CBT after waiting a very long time. And then they find out the CBT isn't particularly good for them. But actually, where a lot of them go from a doctor, as I haven't mentioned, it's my last call, is what they call beat the blues website. I don't know if you've heard of it. No, that's a new one. It's a website that a lot of counsellors will send you to if you've got depression or social anxiety. It's basically an online CBT sort of series of questions. And you fill in the, I don't know how many questions there are. And then you go back to the doctor with it and then they may refer you on to a CBT therapy. So a lot of people turn up at my institute having done this beat the blues questionnaire. And they didn't like it at all. So they ended up deciding to go privately. Yeah. See, for a lot of people, the financial side of thing comes into it. And they go to the GP and go in the NHS maze, as you fondly referred to it, because it's free. It's like you say, it's 8 to 12 weeks of CBT. And usually there's no cost to it. That can be the deciding factor for an awful lot of people nowadays. You're absolutely right. And unfortunately, or fortunately, you have to wait quite a long time. Yeah. If you wanted to see a psychotherapist, not a CBT psychotherapist, I don't think CBT is particularly psychotherapy anyway, a psychotherapist or a cancer, you have to wait a damn sight longer. Yeah. I work with, I have worked with a few charities that, you know, particularly connected with the military. That's something that interests me. That, you know, there are funding places where you can access a counsellor for, I think it's six sessions, you know, that is good. You know, if you're a veteran or ex-military. That's really good. So going back to your first point then, you're correct. A lot of people put psychotherapist Manchester. Yeah. For example, an up will come our website, the Manchester Injury for Psychotherapy. That has got over 24 therapists there. And we have an assessment process half an hour with me usually, where I will look at what they want from therapy, and then pass them to a therapist, but their choice was, in other words, match them up. Yeah. So that's that way. And see, just on that topic, that's unique. Yes, it is. You know, one of the, because I made some notes, I'm very good at making notes, so I made some notes that the assessment process for me with a client is as much my skill set, you know, whether I'm a good match for that. It's not that I put them through some sort of a test. I'm also looking at myself, whether I've got the knowledge and the skills in order to, you know, offer support with whatever they're coming with, was you take all that off them. If there's 24 therapists working in your institute, you can sign post them. You know, gender is kind of one thing. You know, if somebody's from the LGBT community, they might want to see a specific, but, you know, ethnicity comes into it. Your cultural beliefs and everything, it's all of it as a bearing in the therapy room. Yeah. And that's why people like the idea of an assessment. Yeah. So they can get matched up by somebody who knows what they're doing. So I've been doing this perception process for about over 20 years, I would think. Yeah. And present time, I would average about five or six assessments for psychotherapists who are fully qualified or people who are graduated. And also, at the Manchester Institute, there's a low-cost therapy system where you can get therapy for 26 weeks of 15 pounds a therapeutic hour. So I might have three or four low-cost assessments as well a week, which might take me up to about, I don't know, nine, 10 a week if it's a good week. Last week, I think it was six or seven. I've just come back and I've had three assessments, two of them were low-cost and one was for fully qualified therapist. But of course, I'm not there five days a week because I do various other things as well. So it is quite busy, though, for people who like the idea of an assessment particularly. So that's the sort of major way that we get people. And the assessments half an hour for a low cost is 15 pounds. For fully qualified therapists, it's 30 pounds. But if you go the low-cost route, it's for low-income people. So it's for students or people under 15,000 pounds. So it's low income. Which is a brilliant resource that you're offering to people in the locality. I did the low-cost clinic. That was part of our training when we were doing it. And I thoroughly enjoyed it. It was good that I was still within the Institute and had the comfort of knowing that I was still part of something while I was training. It's invaluable. It is and there aren't many places around to do assessments for either of those pathways. And I'm very proud of that fact. So many people come through assessments. An assessment is quite a skilled job that I do really. I know I've developed it over 20-yard years. But you have really 20 minutes to get to find out what they want from therapy. And often they don't know what they want, but they're just there. Many come with social anxiety and depression and stress. So then you need to find out what stops them actually getting to the place they want to get to themselves. And there's other things you need to check. You need to check up things like if they've had counselling with therapy before. So that'll give you a big clue into whether they've been down that path or in fact whether they've been in the psychiatric system. Because if they've been in the psychiatric system, they're going to probably have a psychiatrist or they will have, you know, psychotherapy might not be suitable for them because they're fairly disturbed. And psychotherapy isn't necessarily the right venue. So I deal with people from that frame as well that might be quite disturbed. And then I need to, it's a different sort of intake process. But I would think a majority of the people I see are what I call the neurotic well category or the worried well category. And mostly it's things like self-esteem, confidence, social anxiety, depression, stress, the fire. Yeah. I can remember there was a period where I was getting a lot of people that were kind of becoming aware of replaying the same behaviour over and over, you know, keep moving jobs and then getting unhappy and then moving to another job and it not being what they thought and then moving to another job. So sometimes it's kind of when they start to become aware of behaviour patterns. Absolutely. And when they have a large discomfort in life. And the other thing to really remember if we talk about what happens behind closed doors, is this, A, this is a confidential system. The other thing to really remember is especially if they've never come to therapy before, or even if they have to a certain extent, they're pretty scared. So, you know, they're pretty, they're sharing their vulnerabilities, takes a lot of courage to do this. And so part of my job is to enable them to feel safe and secure and somebody who's pretty accessible to talk to and can help them point in the right direction. Which is really what I'm doing, but I've had a lot of wealth of experience. And the other thing, I've got the Manchester Supercycle Therapy, but across the road, I've got the Manchester Wellbeing Centre with another 10 therapists. So I've got a lot of therapists that I can point them to. And matching them up exactly where you started right at the beginning is crucial. Yeah. Because there's so many differences of what people want. You named a few of them from gender to cultural differences to, you know, you're correct. And that's another, oh, that's bad. I have to know my psychotherapists well, or the psychotherapists who work through my Institute and the Wellbeing Centre, because I then can match them up really. It's a very, there is nowhere like it, I know actually. No, I've never heard it being that way. As somebody that went through the training process, it's a very nurturing environment to be in. You know, yeah, I'm always talking about Manchester Institute Psychotherapy. There's so many courses that I think the psychotherapist, psychotherapist counsellors go on where you're in a kind of a bubble and then suddenly released to go and see clients. And as much as it's nerve wracking for the clients to come on their first session as a psychotherapist, I can remember my first session. Yeah. Seeing your client, he was in the mall. Yeah. But yeah, your mind is working overtime. You're just trying to get everything just right before you ease into the process. I used to say to trainees, and I still do, I think, is that when you have your first session as a trainee, psychotherapist, throat counsellor, to remember that the client in front of you who's just come through the door is usually more scared than you. Slightly, only a little bit. I always like that because I try to remember that it's very important for me to help the person feel at ease. Yeah. In that assessment process before we send them off to psychotherapy, because most of them don't know what psychotherapy really entails or what it's about. So talking therapy, use these about how the past effects are present, but it's an hour where people can actually talk about their vulnerabilities. And that's so new for people, even though they know they need to be there for many different reasons, perhaps it's still a pretty daunting prospect. Yeah. Yeah. And I think when you're doing the job day in, day out, it's important to remember that when you see a new client. I only work online at the moment. I'm not seeing clients face to face, but I always offer a 30 minute, similar to, I would imagine, your assessment where they come to me free for 30 minutes just so that we can meet each other and see whether we can work together, whether we can be in a room together. Yeah, that's wonderful, Jackie, because I think it's a really interesting area you've now gone into. So somebody wants therapy. Another thing that may appeal to people, so I'll be really interested in this since you've brought this up, is the people who offer free consultancies, like you've just said there. So if you came for an assessment with us, it costs £30 for the half hour, or if it's low cost, it costs £15. But you do go to therapists, and there's quite a lot of people for different reasons, which offer half an hour free consultation free. And that's, there's lots of discussion about that. In other words, is it, does it actually, for example, what does it model? Is it actually a good space for somebody because they don't have much money? Is it a place where they can learn what therapy is for the first time? And I'll be interested from your perspective, your thinking behind having it free. Very valid point that, usually because I'm only on Zoom at the moment, it's about whether they can access it for a start. Okay, okay. You know what I mean? If there's somebody, I don't want to disrespect elderly people, but you know, they can phone me up and be fine on the phone, but then when they try to get, so the first thing. It's not so accessible, is it? It's making sure that they know how this would be in a therapist. I understand. I mean, there's a lot of reasons that I like the idea of that free consultation half an hour. And that's because people often have a lack of money. Secondly, they've not had therapy and counselling before, so it's like a taster into that world. Thirdly, I think it's a very generous process, unbehold of the therapist or counsellor. So there's lots of reasons I can see for doing it. And the other one you just mentioned in terms of accessibility and Zoom. So it's an interesting one. Again, about when you look for a therapist, some people might be attracted by the fact that it's a free consultation and that might appeal to them and get them into dealing with their mental health. Get them in the right avenue, if you like. Yeah. See, I just shot myself in the foot because it's not something that I advertise. What normally happens is somebody will form me up and contact me and I book a session. And what I then say when they've already made contact with me is, you know, I can send you a link. We'll have a quick 20 minute, 30 minute chat on Zoom and then we'll see how you feel from there. So it's not. Yeah, I don't advertise that. So maybe I've just shot myself in the foot now. I think it's only generosity of soul. And I've said before, there's many therapists and counsellors that offer that. If you go on to one of the biggest directories for finding counsellors and therapists, there is on the net, which is cancellingdirectoryco.uk. There's far too many. I mean, if you zoom through all those, it'll take you bloody ages, by the way. But if you go through the first time down to six or seven pages, you'll find that quite a lot of people give half an hour consultancy free as a way of, I think, you know, supporting people coming into psychotherapy or counselling for the first time. So you're not alone in that. No. And like I said, for me, it's more the fact that I can assess, you know, their needs and whether I have the right skill set in order to work with them. That's that's my, you know, reason for. Good. So in terms of finding a therapist, let's go on. The directories, counsellingdirectoryco.uk is very good for finding a psychotherapist in your area. And what I particularly like about it is that you'll be able to see a picture of the person, you'll be able to see their CV, and you'll be able to hear what they offer. I really like that. Another really good online sort of directory, if you want to put that ways, psychologytoday.com. Now that's that's a really good one. It has the same process as counselling directory, but there's not so many, there's so many on counselling directory, be there for a long time, trying to, you know, searching through them. I think what you've got with, you know, psychologytoday is that it's it's it's more there's more information about the therapist and counsellor on that psychologytoday website. And then of course, there's other directories as well. So people often, if they know about them, or they'll be sent to them when they put their name, you know, looking for a therapist through Google, they'll go to these directories. That's another way people often. I think I can remember when I was at the Law Cross Clinic, one of the things that we had to do when we were working in the Institute was have a business card. Have a business card, yes. And I can, I can remember, I put my picture on my business card and I don't know whether you still feel the same way now, but you said to me that you didn't think having a photograph was a good idea on a business card. No, I still hold by that. And the reason why is because people will project onto that photograph. 100%. Whatever they want to project onto it. So we're talking about the counselling directory and everybody's got the picture on that. I don't know why, but my head went to Tinder, you know, the dating app. Well, I do know about it. It's kind of like that for therapists, isn't it? It's like I like the look of them. I don't like the look of them. They remind me of my dad. That's cool. It's as happy as it is in terms of projections. Yeah. So I'm not really one that likes the idea of photographs. Having said that, I haven't been on counselling directory for a long, long time to look at how many people have photographs on it. But I know there is quite a few of them. And it's the same in PsychologyToday.com. They do as well. So there's directories. There's not that many Institute centres like ours, but there are some places. Now, I know another couple of centres but they do referrals instead of assessments. So they might get a 10 minute phone call with somebody who refers them to a therapist at their centre without a sort of detailed assessment. So there are some referral systems around. I don't know another assessment one. So those other avenues recommended, as I said, is a high one. But the really important thing is that I think is somehow it's important to get to a therapist that will suit them. So the next thing I'm going to say is really, really vital and unfortunately not followed. And that is for the people that don't go through assessments systems. They don't go through referrals. They don't go through directories. Or even if they do, they go to a therapist. It's very, very important they get on with them. Too many people just stay in the therapy or counselling, hoping it will get better or think it's their fault. My tip is that if you don't get on with that therapist, leave them. Now, people watching, listening or watching to this might say, oh, you've got to give them a chance. Okay, give them a chance, but not forever. Not for, you know, have a certain bounded amount of time where you can see if you can get on with them. Don't just stay there because you could re-applicate your history. Yeah, 100%. I completely agree. And I think that's why I like doing that initial assessment because you get a vibe. You get a feeling, do you know what to mean? And it's both sides as well. I remember, I had somebody who came in last week or a week before and she said she had some counselling or therapy. I said about a year ago, I said, did you get on with them? Oh, I stayed with them for six months. I endured it. It was not a good experience. I said, well, how come you stayed? Oh, because I didn't know I could leave. Oh, bless. I said, I basically thought, I've basically worked out I could. I said, well, thank goodness you've come here at last so we can get you to somebody who suits you. And sometimes that experience can be enough to put people off therapy altogether. Fortunately, that's true. Yeah. Yeah. Absolutely, too. I saw someone I got about a month ago and she said, oh, I said, I always ask that question, see, have you been in counselling there before? She said, yes. I said, when? 15 years ago. I said 15 years. She said, yes. I didn't get on with the therapist. I did leave after about six or seven sessions, but it put me off so much. I said, well, thank goodness you've been brave enough to come here. She said, yeah, that's why I've come to somebody with an assessment system. So I'm going to be appointed to somebody who'll suit me because I don't want to have that type of experience again. But you are right. Some may never come back. And it's a big step. It's a daunting step for somebody to reach out and then to feel like they have to endure therapy. That's not meant to be. Not meant to be that. No. It's a sad, indictment dog profession. But on another and on another level, not everybody gets on with everybody. Not. You don't have to. The question is, do you have to go with your therapist for therapy to work? Not necessarily. But I still think if therapy has a better chance of working, at least you have a certain amount of rapport with the person that you go to. Yes, which is a very valid point. I need to say or interject in this that as a therapist, I can challenge my clients sometimes and they don't always like that. But in my eyes, that is part of the therapy. But you will only do that after a certain amount of sessions. 100% on the first session. Yeah, no, no, no, no, no, not at all. We've already got in the relationship at that point. But yeah, I don't always collude with my clients. No. And I think a professional therapist will not do that. They're not in the business of just a cosy sort of two years of therapy or something. It's difficult. I think that's the other thing. People think you just sit in a room and chat for a therapeutic hour. I can remember after my weekend training, I was shattered just having that one hour of get together at the end of it and feedback and all that sort of stuff. It was exhausting. It is. And I think it's exhausting both ways around. So yeah, we're going around, I hope to the listeners to say, look, assessment places do assessments, places do referrals are extraordinarily useful. 100%. I do think therapy directors are useful because at least you get to read about the therapist that you're going to. And you have some accountability and assessment centres like mine, you have some scans of accountability and with referral places, which is a good thing. And you know, I really hope people listen to this will think about if they all go down this road and I really applaud you to do this a lot of discomfort in your life and you need to reach out, find somebody who will suit you. And I think the best places are the places that offer referrals and assessment processes or at least a directory or best of all, a recommendation. Yeah. Yeah. I do think it, you know, like your institute, there's a certain amount of safety and security walking into that building, knowing that that is the job 100% of the time that you do. Do you know what I mean? The experience that is in that building is, yeah, it's second to none. So yeah, go to Bob's. If you're anywhere near Manchester, check out. Or at least somewhere that's got a referral system, or you've got a recommendation. Now, the recommendation might come from the doctors. Yeah. There's nothing wrong with that either. So don't just look in the map. From insurance companies, you know, the, well, yes, if there's been quite a serious accident and the person is struggling, you know, the insurance companies have got in touch, you know, see, but yeah, it's not a pin in the map. It's not the worst thing to do. Yeah. Yeah. That's absolutely the worst thing to do. And please don't stay in therapy because you think you can't leave. Or please don't stay in therapy because you think that something wrong with you and the therapist by some God divine right can, you know, treat you in the ways which you don't feel respectful as a human being. Yeah, 100%. Yeah. And, you know, we, every relationship, which I'm sure we will talk about in the many, many weeks to come of us doing the therapy show, we co-create relationships. And there's a dynamic that, you know, an energy that goes backwards and forwards in that it's not one person is wholly responsible for it, but you've got to be comfortable enough to share some stuff in that room. And if you're feeling criticised or judged or shame or any of that stuff, won't talk about it. You are right. And maybe we'll love to go into this on another podcast. And I like, as I said off air before we started, I could talk forever about these things. And there is the nether points. I know after sensing that there is another point that I may have to disagree with you. I don't have to, but at least I'd like to have another viewpoint. I think it is the, I know enough about co-creation. And I understand and I agree with you in the way that you're talking. However, stroke and I think it is the duty of the professional therapist and counsellor to be the one that actually goes out of the way to make sure the environment, et cetera, is a safe, secure environment in the first sessions for the people who have reached out to be able to talk. Yeah, yeah, 100%. Yeah. And, you know, when we're not just talking about the therapeutic environment, it's the physical environments as well, you know, that the room is at a certain temperature that there's somewhere nice to sit that, you know, it's quiet and it's not over there. There's not a lot of background. There's an awful lot of stuff that you need to be mindful of. Absolutely. So it isn't just about a co-creation but needs to be led by the therapist at the beginning. Protection, permission, importance, that always sticks in my head. Those are the three pieces. Three pieces of the psychotherapy to a lexicon. That's absolutely right. So, really... Holding them in a safe space and that they can trust that you're going to be there holding them in that safe space because it is no fracking. Yes. And I know we'll come to the end of the podcast. So I really do hope listeners bear this in mind that it's important to spend some time finding the right therapist for yourselves. Yeah, yeah. And don't give up after the first one. If it doesn't work out, it's not personal. Try again. Yeah. So what we're doing on the next episode, Bob, have we decided? Are we going to surprise people? Are we moving on? I think it's logical we do that we're moving on to the first session. Okay. Sounds good. The initial session. Yeah. I'm not talking about the assessment. The assessment is the pathway or the paving to the right therapist. So we're going to assume that Joe Blogg's now has got the right therapist, has been matched up or at least recommended or at least gone through the directory or whatever, all the things we would talk. So now they've arranged a first session. What happens in that first session? Now there is so much to this. I think we're waiting baited anticipation, but I would enjoy talking about this. So until the next episode, Bob, thank you so much. Thank you. I shall speak to you soon. You certainly will. 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