FAQs

General

How do I book an appointment?

To make an initial appointment you can contact me by telephone, email or by completing the contact form the ‘contact’ page of this website. A full clinical assessment of your needs will be undertaken to determine suitability for CBT. Alternatively, if your doctor or another mental healthcare professional (e.g. physiotherapist) is already aware of your difficulties, we are happy to take referrals and liaise with them directly

We also accept referrals from psychiatrists, insurance providers, employers and solicitors, please contact therapy@siobhangraham.com for more information.

At what stage is payment required?

If you are funding the sessions yourself, payment needs to occur (by cash or cheque) at the end of each session. If a session is cancelled with less than 48 hours notice, or you do not attend a session, the full session fee is still payable.

If sessions are being funded through your health insurance policy, it is essential you ensure that full authorisation has been gained from the insurance company. In the unusual event of the insurers refusing to settle the claim, you will be responsible for meeting the costs. If you cancel a session with less than 48 hours notice, or do not attend a session, the fee is still payable and the insurers will be invoiced.

Is everything we discuss confidential?

Confidentiality is an important part of any therapeutic relationship. What you tell the therapist is in confidence. The only exceptions to this are pertaining to whether you are considered to present a danger to yourself, or to other people (this includes issues relating to the safeguarding of children and vulnerable adults). In these circumstances, the therapist is ethically driven to take action, and the most likely disclosure will be to a General Practitioner (GP) or other healthcare professional, to ensure safety is maintained.

That said we encourage our clients to permit us to liaise with other professionals that may be assisting in your care. As therapists, we are not permitted to prescribe medication; therefore it is helpful if we can work together with your GP to ensure that you are getting the best standard of care possible. If you are already working with a physiotherapist or occupational therapist we may want to establish a collaborative working relationship with that person. In all cases this will be discussed with you, wherever possible.

All therapists require regular supervision. When you agree to enter therapy, you also agree for information to be relayed (anonymously) to the therapist’s supervisor and peers within the supervision group. The aim of supervision is to ensure that we provide the most effective therapy for you. If you have any questions about this, please ask your therapist.

How long will treatment take?

Treatment duration is variable and often difficult to predict. However, after the initial assessment, your therapist will offer an estimate of the number of sessions of treatment that will be needed to accomplish your treatment goals.

For most clients, treatment duration ranges between 6 and 25 sessions. However, the therapist’s estimate of the duration of treatment is only an estimate, and no guarantees can be made as to the length of treatment required.

Some clients want or need a time-limited therapy. If this is your situation, please discuss this with your therapist who will work with you to determine whether it is possible to set a target number of sessions required to reach your treatment goals.

The sessions are usually held on a weekly basis (at least in the initial stages) and last for fifty minutes. Occasionally the number and length of sessions required is different as therapy is planned on an individual basis and is dependent upon the nature of your problems/needs.

What happens at the end of therapy?

If therapy has been successful, follow up sessions are offered. These sessions usually occur at one three and six months. The follow up sessions are designed to monitor progress – research has shown that if the progress is, at least, maintained over this time period than relapse is less likely to occur. 

What happens to the information you hold about me?

Your notes will be kept in a secured facility at all times. Where materials are produced electronically they are kept for the duration of your treatment and 6 months thereafter on your therapists’ personal computer (which is password protected) before being deleted. Siobhan Graham Psychotherapy fully complies with the Data Protection Act (1998). Your rights under the Act are available upon written request. 

What do I do if I have complaint?

If you have a complaint about the service you receive, please attempt to discuss it in the first instance, with your therapist.  If you are not able to do so, or are not satisfied with the outcome of the discussion, address your complaint to the British Association of Cognitive and Behavioural Psychotherapies at www.babcp.com

Cognitive Behaviour Therapy

What is CBT?

Cognitive Behaviour Therapy (CBT) is an approach to help people experiencing a wide range of mental health difficulties. Cognitive Behavioural Therapy is a practical, present focused approach to treatment. It is based in the principle that the way people think, feel and behave results from learning processes, therefore it follows that people can unlearn and relearn different ways of coping. It suggests that thoughts, feelings and behaviour(s) are interlinked and that if any aspect of these areas is unhelpful it can affect the others. Click HERE  for more information

Treatment duration is variable and often difficult to predict. However, after the initial assessment, your therapist will offer an estimate of the number of sessions of treatment that will be needed to accomplish your treatment goals.

For most clients, treatment duration ranges between 6 and 25 sessions. However, the therapist’s estimate of the duration of treatment is only an estimate, and no guarantees can be made as to the length of treatment required.

Some clients want or need a time-limited therapy. If this is your situation, please discuss this with your therapist who will work with you to determine whether it is possible to set a target number of sessions required to reach your treatment goals.

The sessions are usually held on a weekly basis (at least in the initial stages) and last for fifty minutes. Occasionally the number and length of sessions required is different as therapy is planned on an individual basis and is dependent upon the nature of your problems/needs.

Will CBT work for me?

This is largely dependent on how much time, effort and hard work you are prepared to put into your treatment. Throughout your treatment programme we will review your progress regularly, if you do not think you are making progress, we can discuss the possible reasons why this may be.

CBT is not for everyone; after your initial assessment, if we think you will benefit more from a different therapeutic approach, this will be discussed and we may provide contact details of an alternative therapist or Service.

Is CBT a quick therapy?

CBT can indeed be quick for some people, depending on the nature of their difficulties and especially for those who have the ability to understand the rationale, develop a close collaboration with the therapist, and are able to work on homework (a form of self-training) outside the therapy session. Moreover, because CBT teaches skills people can take away with them, it can do much to reduce relapse.

However, for some clients this is not the case. There are a range of individual differences that relate to personality, types of problems, early history, mental state and social circumstances that can complicate the therapy and extend its time frame. It is important not to rely on data from research trials to assume, for example, that all depressed people will get better in, say, twenty sessions.

What difficulties can be helped by CBT?

CBT has been shown to help people with various conditions – both mental health conditions and physical conditions. The UK Department Of Health’s National Institute of Clinical Excellence (NICE) has acknowledged CBT as effective in the treatment of the following problems:

As a rule, the more specific the problem, the more likely CBT may help. This is because it is a practical therapy, which focuses on particular problems and aims to overcome them. CBT is sometimes undertaken in addition to medication, depending on the type and severity of the condition being treated.

What are the limitations of CBT?

CBT does not suit everyone and it is not helpful for all conditions. You will need to be committed and persistent in tackling and improving your health problem with the help of the therapist. It can be hard work. If you are feeling low, it can be difficult to concentrate & stay motivated. The ‘homework’ may be difficult and challenging. You may be taken ‘out of your comfort zone’ when tackling situations which cause anxiety or distress. However, many people have greatly benefited from a course of CBT.

However, although CBT can help with most emotional and psychological problems, (though therapists vary in their experience and skill base), it is not suited to those who

  • are in the midst of a psychotic episode
  • are currently engaged in another form of psychological therapy or counselling
  • require hospitalisation
  • drink alcohol to excess
  • have a long term and ongoing dependency on non prescription (illegal) drugs

If you believe that you fall into one or more of these categories we recommend that you speak to your GP about alternative forms of help

EMDR

What is EMDR?

EMDR is an acronym for Eye Movement Desensitization and Reprocessing. It is an innovative clinical treatment that has successfully helped many individuals who have survived trauma, including sexual abuse, domestic violence, combat, crime, and those suffering from a number of other complaints including depressions, addictions, phobias, chronic pain and a variety of self-esteem issues. EMDR is acknowledged as effective in the treatment of PTSD by The UK DOH National Institute of Clinical Excellence (NICE).

Please click HERE for more information

How does it work?

No one knows exactly how EMDR works. However, we do know that when a person is very upset, such as with a trauma or chronic pain, their brain cannot process information as it does ordinarily. Experiences become “frozen in time” and distressing feelings and memories may be re-lived day after day, without ever seeming to get better. Such memories can have a lasting negative effect on the way a person sees the world and how they relate to other people, as well as interfering significantly with his or her ability to live life.

EMDR appears to have a direct effect on the way that the brain functions. It has been suggested that the bilateral stimulation stimulates brain activity normally associated with information processing, such as occurs during REM sleep. Following successful EMDR treatment, normal information processing is resumed. EMDR helps a person see and understand disturbing material in a new and less distressing way.

What is an EMDR session like?

EMDR utilises the natural healing ability of your body. After a thorough assessment, you will be asked specific questions about a particular disturbing memory. Eye movements, similar to those during REM sleep, will be recreated simply by asking you to watch the therapist’s finger moving backwards and forwards across your visual field. The eye movements will last for a short while and then stop. You will then be asked to report back on the experiences you have had during each of these sets of eye movements. Experiences during a session may include changes in thoughts, images and feelings.

With repeated sets of eye movements, the memory tends to change in such a way that it loses its painful intensity and simply becomes a neutral memory of an event in the past. Other associated memories may also heal at the same time. This linking of related memories can lead to a dramatic and rapid improvement in many aspects of your life.

What difficulties can benefit from EMDR?

In addition to its use for the treatment of Post-traumatic Stress Disorder, EMDR has been successfully used to treat:

How long does EMDR take?

An initial assessment period is required for the therapist to understand the nature of the problem and to decide whether EMDR is an appropriate treatment. The therapist will also discuss EMDR more fully and provide an opportunity to answer any questions about the method. Once the therapist and the client have agreed that EMDR is appropriate for a specific problem, the actual EMDR therapy may begin.

A typical EMDR session last approximately 90 minutes – the type of problem, life circumstances, and amount of previous trauma will determine how many treatment sessions are necessary. A typical course of treatment is 3 to 10 sessions, performed weekly or every other week. EMDR may be used within a “talking” therapy, as an adjunctive therapy or as a treatment all by itself.