29 Jan 2021

Counselling in 2021, Embracing New Approaches and Constantly Evolving

The last year or so has seen some dramatic changes for counsellors. From the way counselling is delivered to embracing new technologies, these have all had an impact on the way counselling services are delivered. We recently chatted with Dr Susan Lawlor lecturer, psychotherapist & co-founder of State of Mind Ireland and she reflected on how the profession has evolved in the last year, the role technology has played and also the development of counselling in 2021

How has Counselling Evolved?

There have been a lot of changes, the way that we work has been disrupted and it has been changed to different degrees. There has been an impact on everybody’s state of mind, the way that people have responded to the lockdown and the restrictions do vary, and that includes us as therapists.

In a lot of instances, their work has halted. Even since last year and bleeding into this year, we have found ourselves dealing with multiple challenges. We are most certainly trying to find new or alternative ways to delivery therapy while also negotiating what the clients also bring to the table.

On top of that, there is a concern for our own self-care and that of our loved ones. There is also the obvious threat of financial security.

It is new territory for everybody, with that being said on a professional capacity all therapists and psychotherapists are willing to adapt to change to evolve and I think it’s really about having that client/person-centred approach and then putting the client at the forefront of everything. Then asking yourself the question:

“How are you best going to serve the client in this new climate?”

It can go back to something such as do we actually recontract with a client? For example, if they were originally dealing with financial troubles/stress do we reconstruct the client’s contract then to deal with some kind of anxiety or stress that could have happened because of the onset of COVID as opposed to their initial reason that they came to see us which was financial troubles

There are definitely a lot of unknowns but for us, as therapists, it’s important not to get caught up in that. There is a lot of anticipation for the challenges ahead, it is our job to ensure that the situation does remain calm, that we are there to listen to the clients and that we don’t add uncertainty.

It is important to point out though that whilst all of us are anticipating what will come next and trying to face those in a personal and professional capacity it’s important that we understand that we need to have a normal reaction to an extraordinary situation.

It’s normal to feel a level of stress, that’s a normal/typical reaction to an extraordinary situation. It’s important for us to strike a balance and to reassure the clients that what they’re feeling is typical, what they’re feeling is normal and that we do understand them.

A lot of clients if they’re going through a journey of health anxiety or depression before COVID in a lot of ways will feel that they are being understood now. Their inner world is almost matching the external world. It’s very important as a therapist to ascertain the dynamics within the session.

Young people are also beginning to question the real meaning of life. We are learning about the impacts and side effects of COVID on the news and it’s important as a therapist to understand what’s happening in the external world. Once again remember to strike that balance and reassure the client that what they’re feeling is normal.

It’s also important to consider when people went into lockdown and are restricted and in a lot of cases they may lose their job or their jobs may be halted. It is important to focus on the positive. It’s almost like setting alternative goals with them as a therapist. It’s about giving clients that balanced approach and explaining to them that they can set goals. For example adhering to their fitness regime, learning a new language, doing some gardening, repainting a room, getting in touch with a skillset they had before. So make sure to provide clients with that space to process those challenging feelings and thoughts and help them to adapt to the new world in a positive capacity.

 

How have Counsellors Utilised Technology?

When councillors are faced with this type of challenge there is an expectation of an organic transition into working online. I find that quite interesting as a lot of therapists may not be skilled in using IT. As well as that face to face sessions have that natural interaction. The therapeutic relationship is also different when using technology. When you have someone on a one to one capacity and with that person-centred approach it is quite different than how that transcends through telephone or text message or through online.

For a therapist, it is most definitely an adjustment period for them. How much training is being provided to therapists on all of these kinds of different approaches? Even the most obvious and practical of things such as their location need to be taken into account.

Questions can arise such as:

  • Are they at home?
  • Are they homeschooling?
  • Are there others around you working from home?

It’s mindful to keep that in place. There’s also the practical side of things. Simply think of WiFi, is it good or are you in an area where it can be very patchy?

With some clients, there has been a mutual agreement to pause the sessions because there is that question of are they in a safe space, a space of confidentiality? You need to make sure they are comfortable. It’s about putting the client first.

One of the areas that have come to light as of late when doing counselling through the telephone and online is the degree of working with silences. In a therapeutic setting, it’s quite natural to have silences so that you can let the client process information. I have heard that issues with WiFi etc, outsides noises etc has resulted in interjecting a little sooner than normal. It’s requiring therapists to adapt their approach to counselling sessions.

Zoom Counselling 2021

 

What are Some of Your Recommendations to Counsellors to Help Overcome these Challenges?

It’s important to just be yourself, remember that you are the professional and that they are there seeking help. It’s not a situation where you are offering advice to them, that’s not what counselling is. You are there to hold them in a safe space and help them on their journey.

Also, be aware at the beginning to embrace the fact that you could be faced with difficulty (WiFi will drop!!). So stay cool calm and collected and also introduce this to the client. Here is a WiFi speed test tool you can use to check yours.

If you’re transitioning from face to face to online or the telephone remember to bring the clients on the journey with you. So from the initial phone call I let them know that we are transitioning, we both could be faced with obstacles that we both have to overcome.

I also say to them that we can do the alternative, call them. Remember it is the counsellors’ job to stay calm, it is our job to hold them in a safe space.

 

What developments do you see for Counselling in 2021?

I think that one of the most important things to remember first is that in this field you need to be evolving FULL STOP. It’s imperative for every therapist to consistently learn and also to learn about themselves.

I think it’s key for therapists especially at the moment to also practice self-care, first and foremost. Ensure that you are OK, practice what you preach. We can tend to take a humanitarian approach of we will take care of others but we can’t pour from an empty cup.

So make sure to practice self-care. Whether that’s:

  • Getting out into the fresh air
  • Mindfulness
  • Reading
  • Art
  • Yoga

As I always say:

“It’s important for every human being to feed the mind, body and soul every day”

If you’re not doing this there’s going to be a disconnection. As you evolve as a therapist this is key to the role we play. So keep reading, learn who you are as a person and how you’re adapting to this situation so that you can then help others.

 

There will be a lot of upskilling for therapists where they become more comfortable with the new types of technology and become more comfortable with doing sessions by these channels because these are not the same as an in-person counselling session. Our role in a lot of cases is not only listening to the client but also seeing the client and reading in a lot of circumstances their body language, eye contact & facial expressions. Things like this need to be considered alongside their sleeping patterns, food habits etc. In certain circumstances where people are behind a keyboard or a telephone it is almost like a barrier for the therapist and also for the client. They may not be comfortable showing the camera.

There are existing challenges but I do think that therapists are open to change and that we are here to help people as much as we can to bring them on their journey and to keep them safe as they move along that process.

Things will evolve but I don’t think it is something that will act as an obstacle.

 

About Susan Lawlor

Susan launched the State of Mind Ireland Mental Health Clinic which is located in the Therapy Rooms, Victoria Cross, Cork (alongside CUH) which offers a range of psychotherapy, psychiatry and psychological mental- health services for the Munster region.

To avail of these services please contact: stateofmindireland@yahoo.ie or alternatively at (085) 7360994.