The first session is an informal kind of assessment session where I gain an idea of what is going on for you at the moment and an impression of some of your background. It is a two-way process, so it is also an opportunity for you to assess me to see whether you feel I could be useful to you. When you come along to the first session there will be questions in your mind. How do I feel about this person? Could I trust this person? Does this person seem to understand me? Is he likely to be helpful to me? To some extent these questions are always in our mind when we first meet anyone, but they are crucial ones in therapy because of the importance of the relationship. If we chat to someone at a bus stop it is not so important whether we trust them or not, but in therapy trust is much more important.

The honest – if rather unsatisfying – answer is ‘it depends’. There is no set formula. Therapy aims to provide a safe and supportive place to explore your issues. You may know what you want to achieve from therapy, or you may be unclear about this. We can work on establishing some goals for you, we can look at your issues from different perspectives and examine the options open to you. We can look at your underlying feelings and work through these so they are gradually ‘processed’ and understood as opposed to being bottled up. With support it can be a safer journey – and the goals therefore more achievable – than doing it on your own.

What is the difference between counselling and psychotherapy?

Historically there are differences but these days the boundary between the two has become very blurred. There is so much overlap that many counsellors and psychotherapists use the terms interchangeably, which is the practice I also adopt.

Yes, all information is regarded as confidential. There are some exceptional circumstances where this might not apply, for example if I felt you were a risk to yourself or to others when I might be ethically required to inform your GP - but I would try to agree this step with you first. In practice, breaking confidentiality is a rare event

This depends on three main factors: your motivation, what you want to get out of the sessions, and how deep-seated the issues are.

If you want to work mostly on present-day issues (the ‘here and now’ ones), and the issues are not particularly deep-seated then therapy is likely to be relatively short-term. Where there are more disturbing issues from childhood that are still affecting you significantly in the present, and you want to address these, then therapy is going to be longer-term. Bear in mind all of us have some issues from our childhoods but some of us will have deeper wounds than others.

Short-term counselling (or brief therapy) is usually interpreted as anywhere between six weeks and several months. By long-term therapy we usually mean at least a year and often this will be several years. However, it is important not to think along the lines of "This means it will be a long time before I notice any positive changes in me". Therapy is a journey and all along that journey there can be discoveries, insights, and positive steps forward in your relationship with yourself and your view of the world.

You may be anxious about not being understood, or concerned that the therapist might think you – or your problem – are strange or odd. In reality, therapists who have been in practice for twenty-three years (such as myself) will have worked with a whole range of issues, although naturally they may have particular experience or expertise in certain areas.

The only fair answer is that I will have a clearer idea of this after the first session when I know more about your background, your present situation, and your expectations of therapy. After that first session you will also have a clearer idea of how helpful I am likely to be to you.

Trust is an important part of the therapeutic process. It is also a big word to many people (especially if early relationships in our life have been untrustworthy). Learning to trust could then be a useful therapy goal in itself. As trust builds up in therapy you are likely to reveal more about yourself, and discover more. But the therapy sessions are yours and you have a right to take things at a speed with which you can cope.

This is not usually required.