Psychotherapy Referral Process

Introduction

You may have been referred for personal, relationship or family counselling. In each case the psychotherapy referral process is identical.

You can self-refer or be formally referred by a GP or psychiatrist.

The reason a formal referral isn’t needed is because I am a GP.

However, you may prefer to be referred by your GP or psychiatrist. You may want them to be closely involved in your treatment.

Email or phone us in order to make an appointment. We will get back to ASAP usually on the same day.

Our team will have a brief phone discussion with you. We will clarify the reasons you are coming to see me. We will also address your questions before making the first appointment.

Filling out your patient information form

You will complete this form before your first appointment. You will give me an overview of  your medical, mental health, personal and family history. We will also look at your personality style. We will clarify and expand on this during your first session.

The ‘Working Out’ Period

During the ‘working out period’ we will begin to clarify the issues you want to work on in therapy. We will address any questions you have about what to expect in psychotherapy and how we will work together.

I consider the first two or three sessions to be a ‘working out period’. Often this period can be longer.

You may be presenting with a long term condition. Sometimes you might not initially realise that your condition is ‘long term’ (see below). In this  case, your working out period will probably require about 6 weekly sessions. Often it is best if you have two sessions in the first week.

Then it will be easier for you to begin to engage in and understand the process of psychotherapy. This also provides you with  ‘momentum’, continuity and safety.

There is no doubt that this is a big emotional and financial commitment if you have not experienced effective psychotherapy before.

If you have a history of psychiatric illness including hospitalisation this initial working out period will include psychiatric assessment .

The likely duration of psychotherapy will often be agreed on during the working out period. Usually we will agree on a set number of sessions followed by a review to decide how many further sessions are needed.

‘Short’ and ‘Longterm’ Conditions

These are arbitrary definitions. However if your presenting condition or issues have been continuous for more than 1 year I would define it as ‘long term’. If your condition has been episodic for more than 2-3 years I would also define it as ‘long term’.

When we discuss your situation in the working out period this will become clearer. You may realise you have been ‘putting up with’ difficulties and distress for longer than you have previously acknowledged. You may have seen your long term issues or distress as ‘normal’ . It’s all you have ever known.

You may not have prior experience of psychotherapy. Remember, if this is so, you will need a few weekly sessions to engage in the process. If your condition started in childhood it is definitely long term!

Hopefully you will feel a connection with your therapist. Then you will persist for enough sessions to experience, understand and become comfortable with the psychotherapy process!

Severity of your condition

I will take into account the severity of your distress. I will also take into account effects on your everyday functioning.

You may have suicidal ideas or a history of suicide attempts or gestures. You may have other forms of severe distress or effects on your everyday functioning.

If so you will need longer term psychotherapy.

Shared Care

Shared care can be thought of as having a treating team dedicated to your care. Each team member has a specific role.

If you want a shared care approach to your treatment I welcome this. However it is usually only necessary in more complex conditions.

As your psychotherapist I will provide psychotherapy but not medical or psychiatric management. Your GP or psychiatrist will provide these aspects of  your care if needed.

Often, with the agreement of your treatment team I will recommend, prescribe and manage psychotropic medication to help manage sleep, anxiety or depressive symptoms.

Your condition might be complex. In this situation another medical member of your treatment team will manage your medication.  Then you and I can focus all our time and energy on your psychotherapy.

Duration of Psychotherapy

You may have a condition of recent onset such as a crisis with mild or moderate distress. In this case, you will usually benefit from brief therapy. This means up to about twelve sessions.

However if you have a longer-term condition as well, severe distress or suicidal thoughts you will benefit from regular long-term psychotherapy. This could be as frequent as twice a week and could last for a year or longer.

Occasionally, you might need just two or three sessions to sort things out and feel much better. However this is the exception rather than the rule.