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I’d like to get some help, what are the first steps?
Read this page if you are seeking face-to-face support, along with my Online Therapy FAQs if you’re seeking therapy via the internet. You can then write to me at mark@marksnelling.co.uk and I will get back to you within two working days to arrange an initial meeting, either online or face-to-face. (If I am on leave or travelling with work, you will receive a message confirming when I will be back.) If you would like to proceed, we’ll agree on a contract clearly setting out the terms of our work together, including a regular time each week for your sessions. If another form of support would be more helpful, I’ll do my best to help you with an appropriate referral.
What issues can you help with?
Over the years, I have worked with a wide variety of clients who have brought a broad range of difficulties. In organisational settings, I work a lot with stress, anxiety, depression, relationship difficulties and burnout. In my NHS work, I have also supported clients with complex and enduring mental illnesses. I strongly believe that counsellors should never work beyond their realm of expertise, so if I feel you would be better served by seeing another kind of therapist, I will certainly let you know.
In my trauma work, my clients bring a broad range of experiences, including childhood abuse, sexual violence, armed conflict, mugging, kidnapping and traumatic bereavement. Some have a formal diagnosis of Post-Traumatic Stress Disorder (PTSD), but many do not.
How long does it take before I feel better?
I do not think that people should be in therapy for longer than is necessary, so I undertake to be as focussed as possible in our work together and as clear as possible in helping you decide how much you need.
Many people find that talking openly and honestly makes an immediate difference to how they feel. Just knowing that there is an opportunity each week to be listened to carefully and non-judgmentally can quickly shift one’s attitude to the world. In terms of fully resolving the problem that brings you to counselling, it really depends on how deeply entrenched it is. A current issue that you feel a bit stuck with can normally be worked through in a matter of weeks. Difficulties arising from more longstanding patterns of behaviour and feeling can take longer to address.
In terms of trauma support, some overwhelming experiences are relatively straightforward to deal with. But if what has happened has been particularly severe, has gone on for a long time, or follows previous experiences of trauma or mental illness, you may need more sustained support in order to move on with your life.
During our initial meeting, we will take some time to consider whether we will take a time-limited or open-ended approach to our sessions. We can always adjust later on. Ending well is very important in successful therapy, so if and when you choose to stop seeing me, I would encourage you to give me at least 2-3 weeks’ notice so that we can bring our work to a satisfactory close.
How long do sessions last?
All sessions last 50 minutes. For those seeking trauma support, we may agree for a period of time to extend our sessions to 90 minutes in order to give you plenty of time and space for processing what has happened.
Are counselling and psychotherapy confidential?
Everything that is discussed in our sessions is confidential. I am bound by the Data Protection Act 1998 as well as the BACP’s code of ethics to actively protect all information about my clients from unauthorised access or disclosure. Respecting your privacy and confidentiality is a fundamental requirement for establishing trust and maintaining your autonomy.
In line with legal and ethical requirements, I will only break confidentiality if I believe you are at risk of harming yourself or others. Under the terms of the Children Act (1989) and the Safeguarding Vulnerable Groups Act (2006), I am also required to alert Social Services or Police if you disclose that a child or vulnerable adult is at risk of significant harm. This applies no matter where in the world those concerned are located. I have a statutory obligation to report any disclosure of activities related to terrorism or drug trafficking. I will always endeavour to discuss confidentiality issues with you first, although this may not always be possible.
Finally, I am required by the BACP to receive regular clinical supervision of my work. I may discuss aspects of your therapy in supervision, but without identifying details. You can read the BACP’s full Ethical Framework for the Counselling Professions here.
How secure is my information?
Many people are now increasingly concerned – with good reason – about the security of their personal information, which I take very seriously. In accordance with the Data Protection Act 1998, I am a registered Data Controller with the Information Commissioner’s Office (Registration Number ZA183635). In compliance with the General Data Protection Regulation (GDPR), I store all confidential client data on a secure cloud network with device encryption, next-generation anti-virus and advanced security enabled.
I need help right now, what should I do?
I do not provide emergency clinical support. If you feel you are in severe crisis right now and need immediate assistance, I urge you not to keep it to yourself. If you are in the UK, you can call the Samaritans on 116 123, 24 hours a day for emotional support. You can also go to your nearest Accident and Emergency department or book an appointment to see your GP. In England, you can also contact your local NHS urgent mental health helpline. Internationally, you can contact Befrienders Worldwide. Helpline numbers are listed country by country on their website at www.befrienders.org. You can also contact your insurance company, if you are covered for medical evacuation or psychological support, or your embassy’s nearest consulate.
What issues can I get support for with online counselling?
Online counselling can be very helpful with a range of issues including stress, burnout, anxiety, depression and relationship problems. It is most useful for people who have access to adequate resources where they are, but feel they would like some additional support.
In some more complex cases, I may recommend longer term face-to-face support. For individuals who have experienced a traumatic event but have the resources locally to remain where they are, I can provide supportive stabilization, continuing assessment and guidance.
Is online counselling any different from face-to-face therapy?
Research shows that the success of any counselling process rests largely on the quality of the relationship between the client and counsellor. This applies regardless of whether your sessions are online or face-to-face. In both settings, then, it is vital that we both work to establish a sense of honesty and trust. In online counselling, there can be a greater potential for misunderstanding, especially when it comes to e-mail sessions. It is important to acknowledge this when it happens and take time to clarify what was really meant. Online counselling clearly has certain advantages over face-to-face work. It offers greater flexibility in terms of geographical location, especially if you travel a lot or live somewhere with few mental health resources. Some people feel nervous of going outside or inhibited by the idea of meeting someone face-to-face. If that is something you recognize, online counselling might feel more comfortable. Clients who choose to have their therapy via e-mail appreciate the opportunity to work with the written word and to reflect at greater length on what they want to say.
How secure is online counselling?
For video conferencing, I use Zoom and Microsoft Teams. Both use end-to-end 256-bit AES encryption, so you can be sure that all data transferred between us is safe.
For those wishing to conduct their therapy by e-mail, I use Protonmail, a fully encrypted webmail service.
What kind of technology do I need?
You do not need to have any specialist equipment. For online video, you need to ensure you have an adequate broadband signal and a working webcam. It is important that your computer is protected by good anti-virus software. It is also vital that you ensure that others do not have access to your computer or can see your screen while you are in a session. I encourage clients to keep any written records in password-protected files.
Can we maintain contact through social media?
In face-to-face counselling, it is accepted that it is unethical and potentially harmful for any therapist to engage in social contact with a client outside the consulting room. Similarly, online counsellors are advised not to accept invitations from clients to connect on social media. Please do not be offended that I decline such requests.