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Self-help guide

Counselling and psychological support following avoidable harm in healthcare

Patients and families

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1. What is counselling and therapy and who might find it helpful?

Counselling is also referred to as therapy, they are the same thing. We have referred to counselling throughout this leaflet, but this could also be read as therapy.

Counselling provides a safe and confidential space for you to talk to a trained professional about your issues and concerns. Your counsellor can help you explore your thoughts, feelings and behaviours so you can develop a better understanding of yourself and of others.

counsellor should not give you their opinion, offer advice or prescribe medication. They should endeavour to help you find your own solutions – whether that is making effective changes in your life or finding ways of coping with issues that you choose to bring to therapy.

Anyone can access counselling and potentially benefit from it although there is likely to be a charge for the service, you should check the cost of the service when you first contact the counsellor.

reputable and experienced counsellor should be used to working with a range of different clients and be trained in using different techniques so they can find an approach which suits you. You can find more about the different approaches at www.counselling-directory.org.uk/counselling.html.

2. Finding a counsellor

The title ‘counsellor’ or ‘therapist’ is not a protected title, this means that anyone can advertise counselling or therapy services. However, trained and reputable counsellors and therapists will be registered with a professional body that is accredited by the Professional Standards Authority (PSA): https://www.professionalstandards.org.uk/about-us . Accreditation should indicate that the professional body is able to assure the public that any counsellor on their voluntary register meets certain criteria for training, continuous professional development, appropriate supervision of practice and working ethically.

Professional Standards Authority (PSA)

Avma recommends choosing a counsellor who is a registered member of a body accredited with the Professional Standards Authority or PSA. The PSA accredits registers so the public can be confident when choosing health and care practitioners. The PSA independently assesses organisations who register practitioners who are not regulated by law, working both within and outside NHS. Any counsellor who is registered with an organisation who is a member of the PSA can be expected to meet standards of proficiency and ethical practice. Organisations registered with PSA include:

All these professional bodies agree standards for education, set criteria for entry on to the register and for counsellors to stay on the register. Some set additional criteria that experienced counsellors can meet to demonstrate their range and length of experience.

Registered members must agree to comply with the terms and conditions of entry to register and to stay on it. These include committing to continuing professional development, working to an ethical framework including having a complaints process in place and being appropriately registered to work with your data via the Information Commissioners Office. These professional bodies ensure that their registrants continue to meet the standards by asking them to commit to these terms and conditions every year when they renew their membership.

There are several directories online that can help you search for a counsellor in your area and consider what kind of counselling you prefer. Two examples of these directories are below.

www.counselling-directory.org.uk/adv-search.html www.bacp.co.uk/search/Therapists Most counsellors can offer face-to-face sessions or online via a reputable platform such as Zoom. We suggest that you review the profiles of the possible counsellors and do not be afraid to contact them to ask further questions if you have them.

Many counsellors have experience of working with trauma, bereavement, loss or disability, but very few counsellors have extensive experience of working with people who have been harmed by health care but a good counsellor will want to learn about your experience and support you in working through it.

3. Who else can offer support?

Support may be offered by your local healthcare provider who may have a bereavement service, or a psychological wellbeing service. These services may include counsellors as well as psychologists. Alternatively, you may want to request support via your GP who could refer you to the local NHS services. However, you may prefer independent support not connected to NHS services.

You may be able to access support via a charity that is focused on a particular issue and who may provide counselling or other kinds of support. A list of these can be found at the end of this leaflet.

If you are employed within an organisation that has an Employee Assistance Programme then you may be able to access counselling free of charge or at a low cost through them, similarly your Occupational Health assessor (if you have one) may be able to help. These services are confidential and your line manager will not be notified that you are attending counselling and no information will be shared with them about your sessions.

4. What might you expect in the first session?

Most counsellors will begin by introducing themselves, establishing some boundaries for the sessions and tell you a little bit about the way that they work. They may ask you to talk about why you are there and what you would like to work on with them. You should feel free to ask your counsellor anything you want to know about how things will work in each session.

5. What might you expect from the counselling?

Most counselling takes place in planned, regular sessions which last for around 50 minutes. How often you see your counsellor and how many appointments you have will depend on your individual circumstances and will be agreed between you and your counsellor.

During a session, your counsellor may take you through specific exercises designed to help with your problem, or you might have more general discussions about how you are feeling. What you talk about will vary depend on what you want help with and the counsellor’s approach.

Your counsellor should be impartial but understanding. They should listen to you without judgment and help you explore your thoughts and emotions. They may offer information, but they will not tell you what you should think or do.

6. The cost of counselling

The cost of counselling varies. Counselling can be accessed free of charge via your NHS services. If you are unable to access counselling on the NHS then private counsellors will charge a fee which you will be responsible for. The cost of counselling varies and can range from £50 – £100 per session, the rate may depend on the area where you live, and the kind of counselling you want to access. With the advent of online sessions, you may have more flexibility in who you decide you would like to work with.

7. Other organisations that can support you.

If you have experienced a bereavement you may find our leaflet on specialist bereavement organisations helpful: www.avma.org.uk/wp-content/uploads/Bereavement.pdf.