The terms "counsellor" and "therapist" are often used interchangeably. "Counsellor" is also a term that is used a lot outside of a mental health setting where just about anyone giving advice can be called a "counsellor".

In a mental health context a "counsellor" is someone who has been trained to work alongside people to help them identify some of the following things: where they are, how they got where they are, where they want to be, and how they are going to get where they want to be. Counsellors in this context rarely (if ever) give advice. They are more concerned to work with clients to help them identify and achieve solutions to their problems. "Counselling" is often used to describe brief work that it targeted at particular problems or situations, with an emphasis on change, especially of behaviour.

"Therapy" is another word that is used in a variety of different contexts where people provide a helping service for someone. In a mental health context "therapy" tends to mean longer term work where the client is encouraged more to focus on underlying thoughts and feelings and motivations. Therapists stand back more from the present behaviour and encourage the client to dig deeper. They are concerned with change, but also with a particular greater self-awareness and understanding.

Because "therapist" can mean anything, in a mental health context people working at this deeper level with clients often distinguish themselves by calling themselves "psychotherapists" - though in practice, in a mental health context, "therapy" and "psychotherapy" are often used interchangeably and can mean the same thing.

In reality there is no clear dividing line between "counselling" and "psychotherapy" and there is considerable overlap between the two. At Connections we provide both, though we firmly believe that sometimes (not always) the answer to immediate issues is found by helping people to dig a bit deeper.

The issue for most clients is not "What do you call it?" but "Is it working for me?"

Of course, you don't HAVE to come at all. In one sense, you can come for as little or as long as you want to. At Connections we firmly believe that you are the adult paying customer and that you will make you own decisions about your own therapy (hopefully using discussion with us as part of that decision making process).

Behind that question is often a fear that people will get trapped in therapy and have to stay longer than they want to or need. We want to emphasise that we are professional practioners who abide by a code of professional ethics. We will not encourage you to stay longer than we feel is necessary, and you are free to stop the process at any time. We are committed to having regular reviews with clients to check that the process is working for you and to discuss with you what (if anything) still needs to be done.

Some people come for a few sessions, some for much longer. Initially we encourage clients to think in terms of committing for six sessions because it often takes that long to understand the problem, build a therapeutic relationship, and to achieve any change. You will have a sense of whether or not what you want to talk about can be helped in the short or longer term. We once told a couple at at initial session to think in terms of six sessions to begin with, and were greeted with: "Only six! It is going to take a lot longer than that!"

We also find that some people occasionally want to come back for a short period of time after a break. For example you may spend 15 sessions doing some really important work, but then find that two years on, you want to come back for one or two more, to reinforce that change and adapt it to new circumstances. We are happy to offer that facility.

It is perfectly ok for you to come and explore things. We often have clients who either are unsure why they have come or who have so many reasons that they cannot pin it down specifically. Part of our work would be to explore and help you clarify and understand, as well as to address any specific issues that arise. We try to have a no risk policy for the first session - we reduce our charge for the first session anyway, and if at the end of it you felt you had wasted your time, say so, and there would be no charge. Similarly, if we felt that it would be inappropriate for you to have counselling with us (for whatever reason), we would say so at the end of the first session and there would be no charge.

Phone counselling is a good option for people who either cannot travel to us, or who can only travel to us occasionally but who want to maintain the counselling, despite the distances involved. So, for example, we have individuals and couples who may travel some distance to see us once or twice, and then continue the counselling via phone. (We are happy to work with couples via phone provided that they are happy to use our conference call facilities (calling in from separate locations) or provided that they have access to two handsets or a speakerphone if they are in the same room.)

We treat phone counselling appointments in the same way that we do face-to-face appointments. You have to book a time for an appointment, and we will provide you with a UK geographic (normal) number to phone us on at the appointment time. Please note that we are happy for you to call (day or evening) to book an appointment or to discuss whether counselling is appropriate for you. However, we will not do counselling work with you without a booking. In other words, we do NOT provide an emergency crisis drop-in (or call-in) service where we are expected to drop everything and respond immediately to you (yes, we are human too, and do have a life to live apart from work). If you want counselling via the telephone, phone or email us and book an appointment.

If we do not know you, and have not worked with you before, we would expect a payment prior to the first session (in addition to you paying your own call charges). You can pay by cheque but the simplest way to do this is via debit or credit card using our secure card payment facilities which we will be happy to explain to you. If you were unhappy with the call, we would gladly make a refund to you in order to protect your consumer rights.

If we agree to counsel you and if you have an appointment, then, yes, we do charge for our work. Our heating bills are getting bigger just like yours, and our children want trainers too!

If you live within a 20 mile radius of King's Lynn and want face-to-face counselling and have a condition that prevents you from travelling to us, we may be willing (at our discretion) to travel to you for appointments. However, you would be expected to pay for travelling time and travelling expenses. Phone counselling would be a cheaper option.

Yes. We offer a professional service, and as part of that professionalism we promise confidentiality. However, there may be very rare occasions when we may wish to talk to another trusted adult about what happens between us - if we felt that your life was at risk, for example. We will explain our confidentiality policy, and the difference between confidentiality and secrecy before we work with you.

Qualifications
Millions of years ago you might have gone to any dentist who felt they had a gift for removing teeth, but these days you are only likely to go to someone who has had several years of professional training at university. Ask your counsellor what level of training he or she has had, and ask to see the certificates. There are hundreds of small organisations offering certificates in counselling skills, based on a relatively short period of superficial study. Personally we would be skeptical of anyone who had not had several years of study at a reputable university - and diplomas and degrees are preferable to certificates.

Professional Membership
In the UK, at the moment (there are slow moves to get it changed), any one can claim to be a therapist or counsellor. However, the reputable ones are all accredited members of respectable national bodies such as the British Association of Counselling and Psychotherapy (BACP). This means that in addition to their years of academic study, they have also had to gain several hundred hours of supervised practice demonstrating competency. Watch out for 'accredited' membership. As a student, for example, you can be a member of BACP, but only accredited members have demonstrated (amongst other things) both training and practical competency. Ask your counsellor about membership of professional bodies, about the level of membership he or she has, and about the criteria for determining that level of membership. Ask to see proof of membership.

Model of Therapy
Ask what kind of counsellor he or she is, and try to do some research once you are given the answer. For example, Person Centred Counsellors are very different to Cognitive Behavioural Therapists, and Gestalt Counsellors are very different to Rational Emotive Behavioural Therapists. Each 'school' has a different set of underlying core assumptions and will encourage practitioners to work with clients in a particular way. More and more counsellors these days are describing themselves as 'eclectic' or 'integrative' meaning that in addition to their initial training, they have picked up ideas and skills from other counselling models and try to integrate these into their practice for the benefit of the client. Rather than sticking rigidly to one model, they tend to go with whatever suits the particular client best. For most clients, the model used is not a big issue - the therapeutic relationship they form with the practitioner is far more important. However, for some, knowing the kind of way the counsellor is likely to work is important.

Area of Expertise
Ask about any particular area of expertise a counsellor may have. Some clients are not initially able to identify their problems and value the chance to explore with a trained professional. However, others are well aware of particular areas they want to work on and they are looking for specific and skilful help. If you and your partner are attending, you may wish to see someone who has both training in and experience of working with couples. If you are struggling with an addiction, or with obsessive compulsive disorder (OCD), for example, you may wish to assure yourself that the counsellor you are seeing has experience of working with clients in these areas.

Record Keeping
Ask your counsellor what records are kept, how they are stored, and for how long they are stored. If records are kept on a computer, ask about whether or not they are encrypted. If the answer is 'No' then any technician at the local computer shop is likely to be able to read your records every time the computer is taken in for a memory upgrade or to fix a hard drive failure. If they are kept in a filing cabinet, is it one which is securely locked?

Professionalism
How professional is the counsellor in terms of his or her honesty in advertising, openness about charges, willingness to offer receipts for payment, making and keeping appointments, and time keeping? Does your counsellor have professional insurance to operate? If boundaries are crossed here, they may also be crossed in therapy.

Confidentiality
If you are not told, ask about what confidentiality policy is in operation. Confidentiality is not the same as absolute secrecy. There may be occasions when any professional counsellor may need to talk to other trusted professionals about something that takes place in any session. Find out what these occasions are and assure yourself that you understand and are comfortable with them.

Code of Ethical Practice
Find out whether or not your counsellor follows a code of ethical practice which spells out his or her requirement to work in your best interests at all times, and which often advises on acceptable practice in situations which may initially appear ambiguous. Any counsellor who is also a member of a national professional body will almost certainly be required to agree to a code of professional conduct before becoming a member.

Accountability
There are two ways in which any reputable counsellor operating in private practice is accountable for his or her practice. Membership of a professional body means that clients can complain and, if the complaint is upheld, gain some form of redress. In the UK the ultimate sanction is removal from membership of the professional body. Readers of newsletters and journals produced by the professional bodies will know that this does, in fact, happen on a regular basis.

The second, more immediate, form of accountability, is through regular supervision. Reputable counsellors are required to meet regularly with experienced practitioners who will question and support ways of working with particular clients and monitor practice. For example, BACP members are required to have at least one and a half hours supervision a month.