Bret Collins Counsellor and Psychotherapist

I do not normally agree to less frequent sessions at the beginning of the work, though it can be appropriate later on.

For clients who can afford it, having two sessions in a week can sometimes be helpful, but it is usually not necessary. I will not generally suggest extra sessions; clients who want them should ask.

Meeting at the same time each week is generally helpful to the work and minimises diary errors. It is also easier for me. However, I accept that some clients cannot commit to a regular slot and in such cases I am prepared to make appointments around other commitments, so long as we usually manage to meet every week.

Please give me as much notice as possible about the holidays and breaks you plan to take. Even if you only tell me the week before, please tell me at the beginning of the session and not wait until you are walking out of the door.

My eight to nine weeks is an average. Unfortunately some days (e.g. Fridays) are more affected by my commitments than others.

Some therapists are really strict about the 50 minutes and have been known to stop clients mid sentence. (Some American therapists get up and leave the room!) I think this is rude and unnecessary, and prefer a bit of flexibility so that we can finish the thought we are on. However, it is important that we respect the time limits set for the work and I would normally expect a client to be leaving the building no more than 55 minutes from the start time. The idea of containment is important in therapy for a number of reasons. For example, some clients become inhibited if boundaries are not observed.

I am afraid my not having a waiting room may mean sitting in the car, taking an extra walk or using a town centre coffee shop to time your arrival accurately (a brisk 10 minutes!). I am happy for clients to use the toilet on arrival or departure so long as we stay within the overall time boundaries.

I don’t mind whether you pay at the beginning of the session or leave it to the end. If you’re paying by cheque, you waste less of the session if you have it made out ready.

I may be prepared to accept a reduced fee if clients are genuinely unable to pay the full amount but, in order for me to do this, I ask those who can pay full price to do so. (This includes students in training.) If you find yourself in financial difficulties during our work, let me know as soon as possible.

If you pay a reduced fee, you will not get a reduced service.

There are good reasons for asking clients to pay for sessions cancelled at short notice. Some are to benefit the therapist and some are to benefit the client. It helps me maintain a steady income (and keeps my prices down) and it also gives clients an incentive to come when they just don’t feel like it. Last-minute resistance is often a sign that the process is getting somewhere.

“For any reason” can seem harsh and unjust, but I would ask clients to see this in terms of taking responsibility for their own risk. Life is full of accidents, illnesses, childcare problems, and crises at work, and I am not worried whether the cancellation is “justified” or “unavoidable”. I just ask you to accept a financial consequence if these things stop you attending a session at short notice. If I accepted those consequences instead of my clients, I would need to put my session fees up.

On the rare occasions I have been forced to cancel at short notice, or the very rare occasions when I have made a diary error, I have tried to make amends by offering a free session. What is good for the client should be good for me.

If you are a regular client and miss a session without notice, I will generally leave things for a couple of days and, if I have still not heard, I will try to contact you. I will certainly hold the next week’s slot for you but will need you to confirm before making a firm booking in my diary. If you miss two sessions without any sort of contact I am likely to assume that you are terminating therapy, or at least taking a break, and in this case I will stop holding your regular slot open for you.

If you do need to contact me I generally prefer texts or, failing that, emails. You should not assume messages have got through untill I acknowledge them, which I generally try to do. However, I do not always respond to clients who text me to say they are running late for a session. It is often helpful for me to know, but I do not want to delay people further by giving them replies to read.

Please put your name on any texts. It is not considered good practice to put clients’ names and numbers in therapists’ mobile phones (in case of loss) so I won’t know who is texting unless you tell me.

Do not assume that if you ring me at an unscheduled time, I will be able to give my normal, full attention to the call. I cannot operate a 24/7 service. Sometimes I have suicidal clients and I have to warn them that they should never rely on me as their last line of defence when they are feeling low.

Minimal contact between sessions is particularly important in couple counselling and, unless there were very good reason to the contrary, I would expect to be able to talk about any contact outside sessions openly in the next session.

It is not normally appropriate to chat if we meet accidentally in a public place. I am very happy to return a friendly greeting but would not normally go further. It is important that we keep our relationship in the therapy room. It is fine to ignore me altogether if you are with someone who doesn’t know about me. Also, please be aware that I am very poor at recognising faces, so I may not be able to place you if we have only met a couple of times or not for some while. Please don’t take a puzzled look as rudeness!

If a defined need arises, I may offer existing clients telephone or Skype sessions, and I would not rule out other media. I normally need to know clients quite well before remote sessions can be safe and effective. They seem to work better for some people than others.

I generally prefer to work on an open-ended basis and allow the work to take the time it needs. If so, I do not generally have formal reviews along the way, but regard every session as an opportunity to review the process. Sometimes though, usually due to considerations of time or money, we may name a number of sessions at the outset and aim to do what we can within that period. In this case, it is usually desirable to review progress more deliberately and I will aim to set aside time to do so.

Occasionally clients may ask me to give them a nudge when I feel they have made as much progress as they can, and I will do so if I think I know. However, apart from the obvious exceptions listed opposite, I regard it as entirely a matter for the client to decide when to end.

In the event of my needing to change where I practiced or vary the times that I could offer clients, I would offer as much notice as possible of any change and do whatever I could to continue the work.

All reputable counselling regulators require therapists to be in supervision. This means that, from time to time, for your benefit and mine, I may discuss aspects of your story with a qualified, experienced professional. They are be bound by the same rigorous codes of confidentiality as myself, and supervision is always conducted respectfully and with as few identifying details as possible.

Client confidentiality is taken extremely seriously, but most therapists would consider breaking it in the case of likely harm to self or others. Accordingly I will ask you to entrust me with the name and contact details of either your GP or someone who could stand as a next of kin (or both). I would only consider contacting them in an emergency and, ideally, after talking to you first, and even then only in a very limited way.

I only work with people under the age of 18 if they have sufficient maturity to be capable of making up their own minds on the life issues we are likely to cover. However, in the case of minors I might need to break confidentiality if I thought there was a risk of self harm.

Confidentiality in couple counselling becomes a special issue if one of the individuals turns up alone. Generally it is best for couples to attend all sessions together, but sometimes this is not possible or the parties are keen to have separate sessions. In this case it is preferable if anything said to the therapist can be shared with the other party, and if this is not the intention, a new confidentiality agreement needs to be made and its limitations understood.

I am obliged to tell the Police if I believe any client to be involved in terrorist activities.