I use a trauma informed, person centred approach, incorporating elements of Cognitive Behavioural Therapy techniques where clients find them helpful. I work collaboratively with clients, with regular reviews to step back and assess what we might need to tweak in the way we work together. 

Person Centred Approach

My initial training is in person centred counseling. This was pioneered by Carl Rogers, partly in response to psychoanalytical traditions which had gone before. His big idea was that in order to for therapy to be successful you needed three things:

1. Empathy. The therapist must be able to understand and feel what the client has gone through, and the client should be able to feel that from the therapist. 
2. Congruence. This means the therapist should be able to recognise what emotions are arising from them, and what is happening in the therapy room. You can think of congruence as a type of awareness on the part of the therapist.
3. Unconditional positive regard. This means the therapist should be able to offer the client warmth and care. Often in life care is conditional, or feels conditional. You might have felt your parents only liked you if you were quiet, or good, or did well in sports. In the therapy room, clients should feel confident that their therapist’s care doesn’t depend on the choices that they have made. 

The person centred approach is non-directive, which means rather than working through a preset to do list, or what the therapist thinks would be a good thing to talk about today, the client and therapist discuss together what should be the focus. As a therapist I might make offers or suggestions, but a big part of the process is building up your autonomy and confidence in your own decision making. 

Trauma informed 

I have undertaken additional training in working in a trauma informed way with clients. This means being aware that not everything in the past needs to be talked about, or is ready to be talked about right now. In sessions I try to encourage clients to be aware of what’s happening in the body, and look out for clues in their physical feelings and behaviour as to when we might need to slow down. I teach techniques for grounding, breathing and mindfulness that can be used within and outside of sessions. Some clients find it useful to talk about different parts of themselves, sometimes which want contradictory things. We can go slowly, and work with what is here in the present moment.

CBT techniques

I integrate CBT techniques into my work, if it suits clients. I find it can be particularly helpful when clients want something specific to change. These techniques include:

• Identifying automatic thoughts
• Evaluating the evidence for thoughts and beliefs and exploring alternatives
• Behavioural experiments (“could you try this thing, so we can gather some data”)
• Mindfulness
• Grounding and breathing techniques
• Working towards goals and evaluating progress

For some clients who are struggling with avoidance, I offer a technique called behavioural activation. This means:

1.  where we think of all the things the client could do which might make them feel better (routines, things they might find enjoyable, getting outside, exercise).
2. We rate them all in terms of how hard the client will find them.
3. We start with the ones which are easiest, and make a specific goal for them. 
4. We pre-problem any things that might get in the way of that.
5. The client then comes back next week having agreed to attempt the goal, and we discuss what happened. And then look at the next goals.

The idea of behavioural activation is that we are starting very small, focusing on things which are most likely to be enjoyable and starting with goals that are doable. That way we can slowly build up what the client feels capable of.