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Therapy with Liz PSYCHOTHERAPY IN SOUTH MANCHESTER & ONLINE

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I write blog posts and articles which sometimes are featured in psychotherapy and counselling publications. The blogs are shown below.


Recent Blogposts. Steps to Therapy Header Image

Steps to Therapy: Therapeutic Support for Anxiety, Depression, Low Self-Esteem and Migraine

Steps to Therapy is a therapeutic support service based on the stepped model offered by the NHS. There are some differences, however, and the following few paragraphs explains these clearly.

The NHS stepped approach seeks to identify mental health problems and offer pathways to care. It identifies three steps:

Step 1 which is seen as an identification and monitoring stage, with psychoeducation being appropriate

Step 2 is seen as a level at which some support is appropriate, and initially individualised self-help might be offered here

Step 3 is the level at which psychotherapy and combined interventions are deemed to be appropriate.

The key element in all of these steps is that this help is offered as a way of improving mental health. However, it does have limitations in how it defines a ‘mental health problem’ and the kind of support it deems to be appropriate.

What, then, of people who don’t fit this model. Perhaps you:

Don’t match the NHS criteria and aren’t therefore eligible for the solutions offered at Step 1, 2, or 3

Want a different kind of help than that available by the NHS

Don’t want to seek help through the NHS either because of perceived waiting times or just don’t want the fact that you have sought help on your medical record.

Are wanting psychological support for something not offered by the NHS - low self-esteem for example, or psychological aspects of migraine, relationship problems or enduring patterns or themes in life.


Steps to Therapy offers an alternative approach. While based on a ‘steps’ model it has a few differences.

  • You can access these services at any ‘step’ or level and at any time, if you feel you need psychological support.
  • You can progress through the ‘steps’ but don’t have to
  • Accessing these services ensures your privacy and confidentiality. Only you and I will know that you have sought therapeutic support.


  • For easy understanding the steps do match in some ways to the NHS Stepped Care Model.

    Step 1 offers information and self-help strategies through an ebook that you can receive by email

    Step 2 offers self-help via an online course which you work through but with feedback and support. This is a text-based course delivered through an online platform.

    Step 3 is short-term online therapy by video with a fixed period of 6 sessions.

    Step 4 is open-ended or long-term form of psychotherapy. Sessions will take place face-to-face in Chorlton, South Manchester once COVID-19 is under control and it is safe enough for us to meet in person.

    This is a private service, not an NHS one, and so there is a cost associated with the therapeutic support offered by Steps to Therapy. However, there are a range of services to meet a range of budgets and so hopefully there is something for everyone.

    Do visit the Steps to Therapy website to find out more.


    Recent Blogposts. 2 Green Stems

    Online Therapy - Neither New Nor Temporary

    With online working being a familiar discussion topic since the Coronavirus lockdown began, and more recently discussions about returning to normal working, it might seem that online working has been a novel response to the pandemic. This may be true for many types of work and activity but online therapy has been around for a long time. It is neither new nor temporary.

    It has been said that in online therapy there are certain core elements that are missed or lost . These include:

  • Physical presence, being in a shared space,
  • The silences and conversations between two individuals physically present with each other that contribute to ‘feeling felt’.


  • Yet there is an intimacy that can emerge in online therapy, there is an openness in the communication that is sometimes lacking in face-to-face work. There can be a warmness in the relationship that compensates for a lack of physical presence. These can all make online therapy a good choice for working through your difficulties or concerns.


    There are additional elements, too, which are as equally available in online therapy as they are in face-to-face therapy. Factors such as trust, feeling heard and understood, and a human connection with someone who cares. These are all available in online therapy, and form part of the blend of training and experience that an online therapist brings to their particular approach to the process of therapy.

    My particular blend of therapy is underpinned by transactional analysis psychotherapy which looks at how we become who we are, and how we grow and change during the course of life. Also relational psychotherapy, which believes in the centrality of the therapeutic relationship as the significant agent for change and successful therapy.

    There are many reasons to choose online therapy. Coronavirus lockdown is just one. Another might be familiarity with maintaining relationships via social media online. Or there might be personal circumstances such as illnesses, mobility, care arrangements or other accessibility reasons.

    The key thing to bear in mind, whatever your particular reason, is that you are not losing or missing some important and core element if you decide that online therapy is a good choice for you. In the 21st century online therapy is as valid a choice to make as its face-to-face counterpart.



    Recent Blogposts. Identity Mirror

    Identity as Lifelong Exploration and How Psychotherapy Can Help

    As I say on other pages on this website, people come to therapy for many reasons. These can include struggling to work through past issues, focusing on current problems, and wanting to feel better. An increasingly common reason, though, is to get to know yourself better. In essence, to be clear about their identity.

    Identity is a strange thing. For some theorists (e.g. Berne, 1961) identity is a fundamental developmental task, already established by the age of three. For other people, though, identity is a lifelong process of exploration. It can involve a soul-searching process, an exploration of who to be and how to be, and ultimately finding a way to make particular life choices.

    Having a clear identity can give a sense of stability. Conversely, dramatic and disturbing events in life can shake our definition of who we are. Telling our stories (for example in therapy) can help with this. Embedded within our stories are all of our experiences, hopes, fears, excitements and losses. They may impact our identities in significant ways. Often, we can’t just take things in our stride, but rather, how we experience a life event can support or destabilise us.

    We can work through this disturbance though and it is important to do so. Having an ‘identity achieved’ status, according to Marcia, 1966, can help us feel OK about ourselves and our lives. It may not be permanent sense of OKness but it may be enough for the next phase of life. It may help us find new meanings for those past issues or current problems, and help us feel better in the present moment.
    Indeed, if we are able to explore our identities and develop positive self-narratives about who we are then feeling emotionally secure can be an additional positive outcome. Contrast this with negative self-narratives which often lead to low self-esteem and anxiety.

    Beginning psychotherapy and counselling to work through some of these issues can feel like a life-changing or life-saving opportunity. At the other extreme, it may feel self-indulgent and extravagant. However, in times of struggle, our sense of identity can provide purpose, strength and meaning. Take your current area of difficulty, for example. Some change or loss that has happened during COVID-19 perhaps? A relationship difficulty? Or feelings of anxiety or low mood? Whatever you may be struggling with, soul-searching and having a clear self-image can help you know how to respond. As you get to know yourself better, you can, in turn develop greater emotional security, a sense of stability and a new vision for yourself and your life.

    Psychotherapy, then, can provide a safe and secure space for you to explore your identity in the context of your current circumstances or difficulties. If doing this sounds like what you need, then please do email me. Alternatively, feel free to visit the remainder of this website for information about other areas of difficulty which I also work with.



    Recent Blogposts. ACTO New Logo

    Five Reasons to Give Online Therapy a Go

    For people seeking guidance or suffering from mental health problems, the ability to reach out to a professional online is a major boon. As technology has evolved, therapists have made online counselling services a much larger part of their offering.

    In these troubling times, the importance of online therapy has become more apparent than ever. With the ongoing COVID-19 outbreak forcing many people to stay indoors, it might seem like there’s nowhere to turn for help in times of distress. What’s more, studies have shown that staying indoors can amplify the negative effects of mental health disorders, particularly if those affected are trapped in a toxic environment.

    Online therapy can help you if family and friends aren’t close to hand or if you need professional help when face-to-face options aren’t possible. Speaking to someone via a phone call or online can help you explore your feelings and make positive steps without having to leave your comfort zone.

    Below are five reasons why now more than ever would be a good time to give online therapy a go.

    It’s More Accessible
    One of the best things about online therapy is how accessible it is. As long as you have a stable internet connection, you can contact someone no matter where you are. Often online therapists can have greater flexibility on appointments, and you’ll be able to book appointments at a time that suits your schedule. This is helpful during periods of nationwide quarantine.

    It’s Proven to be Effective
    There is evidence that online therapy can be as effective - if not more effective in some cases – than face-to-face therapy. A study published in 2018 declared that computer therapy for anxiety and depression disorders is ‘effective, acceptable and practical health care’. The implication is that online therapy can offer good results and - depending on your preference and circumstances - may be the right option for you. It’s important to note that in some cases – i.e. if you are in a position where you may hurt yourself or others – face-to-face contact might be a better option.

    The Technology is There to Support Online Therapy
    The advent of technology has meant there is now an abundance of ways to talk to people. Free video conferencing platforms such as Zoom are good for one-to-one conversations. Smartphones have also facilitated faster and easier access to therapy on the go. Online therapy app Talkspace recently announced it had seen a large uptick in demand since February, largely as a result of a growing number of people self-isolating. Though it’s important to note that an overdependence/overconsumption of social media can sometimes exacerbate mental health issues, improved connectivity allows people to access a wider variety of therapy to suit their own needs.

    Bypassing the Social Stigma
    You might be uncomfortable with the idea of therapy because of how you might be perceived by peers, family members, or even others in the waiting room. Bringing the experience online limits interaction and allows you to get straight to the person you need to talk to, without having to worry about others. Because online therapy can be carried out alone, without some of the usual social interactions that might otherwise be involved (e.g. getting someone to drive you to an appointment, for example), it can help foster a feeling of independence, as well as help you open up more about certain topics.

    Privacy and anonymity
    In addition to lifting the stigma, communicating via methods that don’t require face-to-face contact (i.e. a telephone call, or a Zoom meeting with video turned off) could help unconscious or consciously held biases about various facets of a person – such as race or gender – from affecting the conversation or your therapist’s diagnosis. Online therapy can feel like a more private affair, making the whole process less intense and formal-feeling than a one-to-one meeting, and allow people to dip their toe into the water. It might help you feel that you can give a more comprehensive picture of yourself when speaking from the comfort of your own home.

    Thanks to Andy Williams of TA Training Organization for his permission to share aspects of his writing here about online therapy



    Recent Blogposts. Coronavirus

    Coronovirus and Safety in Therapy

    The number of events being cancelled because of the coronavirus pandemic continues to grow.


    With this in mind it is important to address safety concerns surrounding your therapy sessions with me.

    Symptoms and Self-Isolation
    If either you or I experience coronavirus symptoms and we need to self-isolate then the therapy can be moved online. I offer video therapy sessions using the Zoom video conferencing application. Zoom offers privacy and confidentiality and is an easy-to-use application. It is, therefore, an ideal platform when therapy in person is not possible or is inadvisable. In addition, if you or I feel too ill to attend by video then the session can be rescheduled. Similarly, if you prefer to have your sessions online to minimise the potential of coming into contact with coronovirus then online zoom sessions can be set up as an alternative for you in this case too.

    Please bear in mind my cancellation policy. This is usually 7 days but for the period of the coronavirus I am reducing this to 48 hours. That is to say that if you give me 48 hours notice of cancellation then the session can be rescheduled without having to pay for the session. However do contact me if you need to cancel a session at short notice because of symptoms or concerns about coronavirus so we can talk through the options.

    Online Therapy
    I am an experienced online therapist and have completed additional training in online therapy. I am registered with the Association for Counselling and Therapy Online (ACTO).

    If you are unfamiliar with online therapy or with using Zoom do let me know. We can, if needed, set up a short session to try out the software so that you can feel comfortable with having sessions in this way.






    Recent Blogposts. Chamomile Small

    How Psychotherapy Helps

    How does psychotherapy help?

    This is a big question of course. Beginning psychotherapy and counselling is a significant and potentially life-changing decision to make.

    However, if you are considering beginning therapy it can be helpful to look at some of the ways in which psychotherapy and counselling is known to have helped, and also some of the components of psychotherapy and counselling that are known to contribute to a successful outcome.

    Ways in Which Psychotherapy and Counselling Are Known to Be Helpful

    First, there are a number of typical ways in which psychotherapy is known to be helpful. Perhaps items in this list are similar to the kinds of help you feel you need?

    Psychotherapy and counselling can help in a number of different ways and on a number of different levels. These include:

  • Help for emotional difficulties including: depression, bereavement, eating problems, anxieties, self-harm, addictions, anxiety, abuse or trauma, relationship conflict or breakdown and migraine and chronic pain.

  • Providing a safe space to talk about experiences and how they are affecting you. A space to work through distressing feelings and think about how they might have arisen. Psychotherapists are professionally trained in helping find the origin of problems, in exploring with you how you might want things to be different and then to help you to create change.

  • Help to bring into awareness those ways of being which have become deeply set and lead to repeating patterns from the past. Such patterns may have caused you to get stuck in a lifestyle, in relationships or in behaviours which may not be what you want for yourself or your life.

  • Help when you may not know precisely what the problem is, or perhaps you know the problem but you want to understand it more clearly

  • Help for when you feel stuck. Psychotherapy and counselling can help to identify the obstacles which are preventing you from changing and moving on. For many this can entail working through blame, shame and various self-sabotaging voices from the past. Learning to identify what is your responsibility and what is not is often a first step.

  • Help for expressing – for sharing – important experiences. Talking about feelings and thoughts that you may not have been able to talk about before can bring a sense of relief. The security of having a space and time with your therapist each week may relieve the sense of being on your own and help to develop the capacity to create change in your life.


  • What Really Works in Therapy

    Next is the issue of how psychotherapy helps. Research on effective therapy has found that there are four common factors in successful therapy. Consideration of these may also help your decision about seeking therapy:

  • First of all, there is you. Your personal resources (hope, optimism, persistence, openness) and your social resources (friends, family, social support). These won’t necessarily all be in place at the beginning of the therapy. Perhaps none of them will be, but your therapist will support you in developing these resources so that the therapy can be effective for you.

  • Next there is the relationship that you have with your therapist. This is called the alliance and really means the strength of rapport or agreement about the purpose of the therapy and how to achieve the goals of the therapy. Choosing the right therapist for you is important, and I have written a separate blog post about this.

  • Next comes expectancy – a commitment or belief that therapy can help.

  • Finally, there are the techniques and the models the therapist uses to help you. My blogpost on diversity in therapy may be useful to read about this.


  • Overall Benefits of Therapy

    So, by taking into account both the ways in which psychotherapy is known to be helpful and how psychotherapy helps, a range of benefits can be experienced:

    • Relief from emotional difficulties
    • Identifying and working towards goals,
    • Creating meanings
    • Understanding lifestyle patterns and behaviours
    • Changing relationships (with yourself and others)

    Furthermore, it can do this with the greatest effect if you have the personal resources, the right therapist (for you) and the expectancy of success.

    To end this post, perhaps the words of Marianne Williamson express why people most often turn to psychotherapy and counselling:

    “Our deepest fear is not that we are inadequate. Our deepest fear is that we are powerful beyond measure. It is our light, not our darkness, that most frightens us.

    Psychotherapy can help with moving into the light. If you feel that it might be beneficial for you, I can be contacted by email or by phone on 07891 613580. We can then arrange an initial session or discuss any queries you might have.

    REFERENCE

    Hubble, M.A., Duncan, BL., and Miller, S.D. (eds.) Heart and Soul of Change: Delivering What Works in Therapy . American Psychological Association: Washington DC


    Recent Blogposts. White Flowers Attached

    Different Kinds of Benefits from Therapy

    An article I was reading recently addressed a myth of psychotherapy and counselling. In essence, whether everyone can receive benefits from psychotherapy.

    The author held a personal belief that most people can benefit in some way or another but I think that whether this is an accurate statement will depend on what “benefit” is taken to mean, and also on what form of therapy an individual experiences.

    The author of the article I read seemed to presume that all therapy is the same. It isn’t.

    There are variations in terms of focus, depth, intensity, duration, as well as in terms of support versus exploration.

    Considering one of these criteria, that of depth, it is often said that psychotherapy is a deeper, longer-lasting, more intense form of therapy, while counselling tends to be more problem-focused, focused on the present and on practicalities and also shorter-term.

    In this blogpost, I will be talking mainly about psychotherapy, so those therapy experiences which are experienced as deeper, more intense and longer-lasting. In these cases, can everyone benefit?

    I think that the answer here will depend on what people are benefiting from? What are the components of therapy? What do people expect from the therapy process?

    There are many answers to these questions but some generalizations can be made. People enter therapy because they want to feel better about something, or to change something (either externally or internally). Often both.

    The therapist helps the person to meet these goals in various ways but the process may be conceptualized as involving several stages:

    1) Initial contact
    2) Evaluation
    3) Early treatment
    4) Deepening
    5)Working through
    6)Termination or Ending.

    In short-term therapy there may not be a deepening stage, but otherwise irrespective of whether feeling better or changing something is the desired outcome from therapy, there tends to be something of a multi-stage process.

    In terms of what happens in therapy, perhaps the words of Jung about when therapy can be effective or ineffective can help here:

    “For psychotherapy to be effective, a close rapport is needed .... The rapport consists ... in a constant comparison and mutual comprehension, in the dialectical confrontation of two opposing psychic realities. If for some reason these mutual impressions do not impinge on each other, the psychotherapeutic process remains ineffective, and no change is produced. ....”(Carl Jung).

    Achieving benefits from psychotherapy, then, comes about from being willing to develop and maintain a rapport with the therapist, a rapport which feels safe enough to be willing to challenge conscious awareness. Of course for this to happen choosing a therapist who is a good fit is fundamental.

    Assuming that you have found the right therapist for you, however, and that you have an enduring and close rapport with your therapist, what can be achieved then? If we return to the main question here, about whether everyone can receive benefits from psychotherapy, it seems that the core issue is about whether everyone is willing to take the step of confronting their internal reality. This can be challenging, scary and unsettling at times. So for some people, different kinds of benefits from therapy might be preferable, or even enough.

    Not everyone may be ready to confront their realities, or feel that it is necessary, but there may be certain other benefits or outcomes of psychotherapy which can be made use of in daily life:

  • The Capacity to Listen – having experienced sitting in a room and being listened to by a therapist, an individual may enhance their
    ability to listen. They know differently how to pay attention.
  • The Capacity for Empathy: Having had time to explore and reflect on relationships, often the way other people are viewed is with
    greater empathy. New insight has been gained about other people’s issues and concerns. There is a different way of understanding and
    making sense of.
  • The Capacity for Deeper Conversation: There may be a new realization that difference kinds of conversation can enhance understandings and make for more fulfilling relationships. So the weather may not be such an attractive topic anymore!


  • So, can everyone benefit from therapy? Well, yes and no. It depends. It depends on the meaning of “benefit”, and the kind of therapy you are seeking.

    As I hope that I have highlighted here, there are different kinds of benefits to be had from psychotherapy.. Exactly which kind you experience, though, will depend on the depth of the process as well as the nature of your desires for change.

    REFERENCES
    Howes, R. (2013) Four Unexpected Benefits of Therapy. Available from http://www.goodtherapy.org/blog/four-unexpected-benefits-of-therapy-0924137. Accessed 28 September 2014.

    Seeman, G. (2005). Getting the Most Out of Psychotherapy. Available from http://drgaryseeman.com/resources/writing/getmost/. Accessed 28 September 2014.

    Answers to Questions about Jungian Psychotherapy. Available from: http://www.thejungiantraining.org.uk/jungian_psychotherapy.html
    Accessed 28 September 2014.


    Recent Blogposts. Internet Image

    Face-to-Face and Online Therapy - How to Know Which To Choose?

    There are a number of factors to consider when deciding on what kind of therapy works for you. When thinking about the mode - whether to visit your therapist in an actual therapy room or to do some kind of online therapy there might be several different things to think about.

    Firstly, are you someone that can easily ‘talk’ over the internet, whether by video or text, or do you feel more comfortable with face-to-face contact. Seeing the person, feeling their presence.

    Or maybe you like to get to know people in-person first and then are comfortable with talking over the internet, but you don’t like using the internet to talk to people before getting to know them first.

    Therapy can work like this too. You can begin by meeting your therapist and having some sessions face-to-face and then move to online therapy if that is more convenient. Sometimes, when you have got to know your therapist by visiting her in person first, online sessions can feel very similar because you have an established relationship.

    You might have a need for online sessions because of your personal circumstances or because the therapist you want to work with does not live local to you, but this might not necessarily make it the right choice for you if you are somebody who needs to see the person they are sharing precious and perhaps anxiety-provoking information with. Psychotherapy is an interpersonal process at its heart and not everyone can re-create the relational aspect of therapy online.

    Alternatively, because sometimes when you haven’t met your therapist in person it may feel more difficult to talk about what is troubling you and what is bringing you to therapy in the first place. That is not to say that online therapy couldn’t work for you but just that this kind of difficulty may mean that getting started may feel a bit on the slow side, while the work is done of forming a connection with your therapist.

    Finally, it is important to consider that while some aspects of online therapy can feel challenging - such as sharing emotions, or not having facial expressions as a guide in text-based work, there can also be aspects of distance which make the therapy feel easier - being in the comfort of your home with the therapist in their office can feel safe and there can still be a sense of presence - being with your therapist that supports the expression of what can feel difficult.

    So, what format of therapy you prefer is a very individual choice. Neither is better than the other. Both can be effective but which is right for you is dependent to some extent on how relationships generally work for you.



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