Starting therapy can be quite a daunting experience for some people, often clients have experienced difficulties for many years and have developed unhelpful thoughts and patterns of behaviour which they recognise cause them problems, but they just don't know how to make the necessary changes or develop new patterns.  

 

When you are considering therapy, finding a suitable therapist can also be tricky, there are so many psychotherapists and counsellors out there who use different approaches, with different levels of skill and experience. It can be hard to know what is going to be right for you. 

 

When a new client contacts me I can offer a brief telephone chat to get an idea of the problems they want to address, some clients are happy to give an idea of this via email, either is okay. I will then offer an initial assessment, this allows me to start to make sense of the problems that you are hoping to resolve, and find out more about you, your background, your current circumstances and your goals. 

Following the initial assessment, if you decide psychotherapy is going to be right for you, and if you feel comfortable with me, we can book in further therapy sessions, either online or at my clinic in Chester. We would discuss the frequency of sessions during the initial assessment.

I provide psychotherapy for clients with a wide range of difficulties. Once we have started to make sense of the problem, then I would suggest what psychotherapy approaches and interventions may be helpful for you. As I am trained in a wide range of approaches, there is usually an approach or number of approaches that we can use to help you to meet your goals. 

The psychotherapy approaches I use and problems I commonly provide treatment for are listed below.

   

Psychosexual therapy involves gradually changing behaviours that are maintaining your sexual difficulties. The main focus of the therapy sessions involves setting and discussing new ideas to try out at home, this may include how your thoughts, emotions and physical sensations have influenced the difficulties that you're experiencing. If you are in an intimate relationship, it is usually preferable that you attend with your partner, as its often helpful to understand how both of you may be contributing to the difficulties. However this is not always necessary, depending on the problem and your individual circumstances. This will be discussed during the initial assessment session.  Therapy tasks are always completed at home, never during therapy.

Psychosexual therapy can be helpful in treating a number of sexual problems, including:

  • Loss of sexual desire

  • Painful intercourse

  • Difficulties with orgasm

  • Erectile problems

  • Premature or delayed ejaculation

  • Vaginismus

  • Problems with intimacy

  • Fear of sex 

  • Problems with sexually compulsive & addictive behaviours

I also work alongside medical colleagues at the Sexual Wellbeing Clinic who can also offer help and support if required.

CBT aims to find solutions that work for you by applying new skills and techniques to patterns of thinking and behaving that have caused you difficulties. The first sessions involve assessing the problems that you want to address and developing some goals which you would like to achieve, these are flexible and constantly under review. The therapist will then work with you to develop a treatment plan. You are encouraged to take an active part in therapy, and will usually be asked to complete some “therapy tasks” between sessions. Therapy can be weekly but will always be tailored to your needs in collaboration with your therapist; sessions are typically 50 minutes.​

CBT is a recommended therapy for a number of problems, including:

  • Anxiety, including social & health anxiety

  • Depression

  • Obsessive compulsive Disorder (OCD)

  • Post-traumatic Stress Disorder (PTSD)

  • Panic

  • Phobias

  • Anger

  • Low Self-esteem  

  • Perfectionism

  • Coping with menopause symptoms

There are a number of steps to EMDR treatment, some of the key stages are to think of a troubling memory, then identify an image of the worst moment of that memory. Identify a negative belief about that worst moment, the therapist may ask “what is the worst thing that moment says about you?”. Identify emotions and bodily feelings linked to that moment.Think about the image & belief while at the same time making left-to-right eye movements, or while paying attention to tapping sensations or sounds that are alternately given from left-to-right. To allow your mind to ‘go with’ whatever comes up and just notice what happens. This process will be repeated until the memory causes less distress, this may happen in one session, or may take more than one session. The side-to-side motion is called bilateral stimulation. It has been found to enhance memory processing. The important thing is to be able to find a form of bilateral stimulation that you are comfortable with.

EMDR is a recommended therapy for PTSD it can also be a helpful treatment for of a number of other problems, including:

  • Anxiety

  • Panic

  • Phobias

  • Anger

  • Low Self-esteem

Relationship therapy involves discussing the issues in your relationship which are causing difficulties, to help you understand and explore how problems may have started, and provide skills in addressing these problems together. This does not involve the therapist "taking sides" or telling you what to do.  Whilst sessions are usually carried out with both partners present, the therapist will often suggest that you have at least one session each on your own, to allow you to discuss issues which may initially be difficult to discuss in front of your partner.  

Relationship therapy can help to address a number of problems within an intimate relationship, including:

  • Problems with trust

  • Communication difficulties

  • Affairs

  • Financial issues

  • Family conflicts

  • Life changes

  • Different parenting styles

  • Different values and goals

Schema Therapy draws its influence from CBT, Attachment Theory, Psychodynamic Theory and Humanistic/Experiential approaches including Gestalt Therapy. Schema therapy has been developed to address chronic psychological problems in which the client's difficulties are entrenched, resistant to change and present with difficult interpersonal styles which can make getting good outcomes from therapy difficult. Problems that Schema Therapy is well suited to treat include long standing difficulties which have not responded well to other types of psychological therapies including; long standing depression, problems resulting from childhood traumatisation, including complex post traumatic stress, as well a range of attachment based difficulties in which the person has developed ways of coping that contribute to their long standing difficulties. 

One of the key theories behind compassion-focused therapy is that within our brain there are interconnecting ‘systems’ that need to be managed in order to improve mental health, the threat system, the drive system and the soothing system. It’s believed that when these systems become unbalanced, it can lead to problems. The aim of compassion-focused therapy therefore is to regain the balance between the systems. The focus is typically on developing the contentment system to help regulate the other two systems. There are lots of different tools and techniques used within compassion-focused therapy, some of which are drawn from other therapies. The primary technique used is called compassionate mind training. This aims to help people experience compassion and develop non-condemning attributes.

Compassion-focused therapy is particularly helpful for those who have the following:

  • Intense feelings of shame or guilt

  • A history of bullying

  • A history or physical or emotional abuse

  • An unrelenting inner critic

  • Difficulties trusting

  • An inability to feel kind towards themselves

Sex and pornography addiction is typically characterised by compulsive sexual thoughts and acts. Like all addictions, as the problem progresses over time the negative impact on a sufferer's personal life is likely to increase and the addictive behaviour will intensify as it begins take more and more to achieve the same results. Research points to the fact that the addiction develops in a similar way to alcohol and drug addiction. During sex the human body releases a cocktail of powerful feel good chemicals, which produce a high that can become addictive. Similar to substance abuse, over time the body will become resistant to these highs and the threshold for what's needed in order to achieve that same high increases.

Sex and pornography can significantly impact on many areas of life including relationships, sexual function, work and finances, the problem can also result in legal difficulties if the addict knowingly or unknowingly accesses illegal images. As internet pornography has been widely accessible for a number of years, many start to access this at an early age and often only recognise they have a problem when they are unable to 'perform' sexually with another person. Support is also available to partners of sex and pornography addicts.  

Some behaviours that may indicate an addiction if they become out of control and repetitive include:

  • Pornography

  • Cyber sex or phone sex

  • Seeking sex with prostitutes

  • Sex clubs or adult bookstores

  • Simultaneous or serial affairs

  • Unsafe sex

  • Partner sexualisation

Treatment is based on a biopsychosocial model, this includes understanding the biology of addiction, the emotional and relational influences, the social context of the problem and cultural factors such as gender, sexual orientation, race, faith and other cultural groups that we may identify with, such as kink, poly and open communities.

For women, and men who have experienced the birth of their child as traumatic, I would initially offer the opportunity to talk through the experience and identify the areas and themes have have been particularly difficult or upsetting for you, known as "hotspots".  If indicated I would assess you for PTSD, postnatal depression and other anxiety problems.  Following assessment, I may offer treatment using trauma focused CBT, EMDR, or a combination of these. Having worked as a midwife for many years I have a great deal of experience in understanding the needs of women during labour and delivery, both in hospital and at home. This experience has been invaluable whilst working in the area of PTSD following childbirth, as I have knowledge and understanding of problems that happen during this process, insight into why some women's labours require medical interventions, and many of the other factors that contribute to the subsequent development of PTSD following childbirth. 

Certain factors can make some women more at risk of developing PTSD, these include:

  • Having anxiety before the birth

  • A previous traumatic experience or experiences

  • Being fearful of childbirth even before it happened

  • Having labour started off (induced)

  • A very long or very short labour

  • Not receiving adequate pain relief

  • Not feeling in control

  • Not feeling listened to or respected

  • Not feeling informed

  • Emergency delivery

  • Problems happening after the birth

Download leaflet "coping with a difficult childbirth experience"

Cognitive behavioural therapy for menopause symptoms can help you to develop coping skills by challenging the negative beliefs associated with the physical and emotional changes you are now faced with and substituting them for more balanced beliefs.

CBT is based on the idea that what you think and what you do affects how you feel. Sometimes people get stuck in vicious cycles and develop behaviours which are not helpful, and what they do to try and solve a problem inadvertently keeps the problem going. CBT helps you to understand how your thoughts, feelings, body sensations and behaviours all interlink, while it’s difficult to change your feelings and body sensations, you can change your behaviours and thoughts to more helpful behaviours and more balanced thoughts, which is the main focus of this therapy, and once you’ve mastered the art of changing your behaviours and challenging your thoughts the changes in how you feel about things will follow.

CBT for menopause symptoms helps you to cope with hot flushes, sleep problems and stress and helps you to gain problem solving skills and challenge unhelpful thoughts. Sometimes women can also experience sexual difficulties during menopause, you can also have the opportunity to discuss these and psychosexual interventions may also be appropriate, if required.

 

I also work alongside medical colleagues at the Sexual Wellbeing Clinic who can also offer help and support if required.