Many people ask me this at their initial session. As an experienced therapist, my answer would be ' nearly everyone can benefit from therapy'. I have yet to meet someone who does not have 'issues' that complicate their life when they need not do so. You do not have to be 'mad' or 'ill' to improve the quality of life through therapy. In fact, having the self-awareness that you might be able to live life in a better way is a sign of strength and better health than denial.

If something is troubling you that does not pass with time or you find yourself in the same unsatisfactory situation again, therapy is a good avenue to explore.

By being more self-aware, people establish more fulfilling relationships, make better-informed decisions and generally are able to live life more fully and positively.

Therapy requires commitment and a willingness to challenge yourself.

However, there are a few instances when it is better for a person to keep defences in tact. In these cases cognitive behavioural therapy or a pharmacologically managed treatment may be a better option.

There are no guarantees. However, with a wholesome committment, people often find the changes in their lives far exceed their expectations.

It can be hugely beneficial to understand why unhelpful patterns first made sense to you as a way to decide whether they are still helpful today.

However, it is not necessary to go too deeply into the past just for the sake of it or to recall every detail, unless you feel it is important for you to do so. What is important is to have enough information to reach an understanding of why you experience certain situations in ways that may not be helpful or healthy for you. I see no benefit in reliving pain or trauma for the sake of it. However, sometimes people find it hugely helpful to share a difficult experience. That is always your decision.

Some people do experience a period of dependency during therapy and by working through it, it can prove a valuable part of the process before leaving it behind.

The short answer is: you will know within yourself because the same old problems just no longer seem to be affecting you.

Just how long that will take depends greatly upon the reasons why you are coming for therapy and how open you are to look at and try things in a new way. But please bear in mind that if you have been struggling with something for years or since childhood, time is needed. Even if one could force a long-term issue into a small timeframe, my experience has shown that the results are not integrated and do not last.

Therapy can last from a few months to several years.

Just some of the factors determining how long it will take are:

• how long the issue has been present or troublesome
• how much the client understands the core issue
• what the client wishes to achieve
• the ability of the client to self-reflect
• the complexity of the issues
• the severity of any traumas and age when they occurred
• the ability of the client to let down defences
• the openness of the client to be able to see things from a different perspective
• financial constraints

I usually work on an open-ended basis from a depth perspective. If there you specifically wish to work within a limited timeframe, please mention this at your first session.

It is usual to have counselling or therapy on a regular, weekly basis at the same time and day of the week. During times of crisis or while going through important phases during therapy, you may feel it is helpful to temporarily attend more frequently.

Sometimes people wish to come less than once a week. While I do provide for that, the efficacy of the process is significantly reduced and I question whether the commitment is strong enough to face deep issues.

Sometimes people ask this question. They wonder whether their worries or concerns are not significant enough to warrant attention. Sometimes that might be the issue itself in that they do not think enough of themselves to warrant attention, even if they are hurting, worried, etc. If any of the following are true, counselling is appropriate:

• something is playing on your mind and isn't going away
• you suspect you may be talking about the issue too much with friends or relatives who may be getting bored or feel unable to help
• you have been in a similar situation in the past
• you are at a loss as to why this has happened or what you might have done
• you feel that relationships may be suffering
• you simply do not feel that life is what it should be
• you notice that the same negative situations repeat themselves time and again.

There are, of course, many other reasons for seeking therapy, but the above reasons people often feel are too minor for a counsellor 'to bother with'. A therapist is interested in working with you to improve the quality of your life. If something is bothering you and not resolving itself, it is not considered 'too small' for finding a better way.

Many people have good friends they confide in. This is an important part of life; sharing the roughs and tumbles of life with others who care. And being there for each other.

However, there are times when problems may either place too much of a burden on friends or friends are not equipped to fully understand the complexities of what you are going through. Sometimes this can even make the problem feel worse because it increases feelings of loneliness, alienation or hopelessness.

Friends or family may have their own opinions, wishes or desires about what they think you should do and are not always able to set these aside for your own best interest.

Talking to a therapist is very different. It helps to protect real-life relationships by not over-burdening them and it means you are in an environment specifically designed to help you work through problems. This requires the objective support of someone who is not involved in your day-to-day life.

Therapy does require a financial as well as personal commitment. It is one of the most life-changing things you can do that has potential to affect your long-term quality of life. Sometimes that means, for a period of time, finances need to be prioritised to allow for that. If dining out and expensive holidays are more important, that is not for me to judge, but remember that is a choice. If you really cannot afford therapy, there are various low-cost alternatives such as being a training client at a Psychotherapy Institute, charities and NHS counsellors via your GP.

The answer to this is almost always 'no' because it is not constructive for the client. A therapeutic relationship should be completely clear of any personal needs and emotional expectations by the therapist. Friendships always bring mutual emotional expectations. They interfere with the work, they intrude upon the clear space of therapy and they easily invite misuse or even abuse of the complex emotions a client may experience especially at times of high vulnerability.

Some professional guidelines do allow friendships between clients and therapists, but only after a fixed period of time has passed since the therapy ended.

I do not endorse friendships or personal relationships with clients, entirely for the therapeutic benefit of the client. I have had the good fortune of meeting some very special and delightful people in the course of my work and I am deeply thankful for that. However, in order to uphold optimal therapeutic standards for my clients, it is important that the relationship remains on a professional standing.

Counselling usually concentrates on one aspect of a person's life, such as a bereavement, divorce or other specific event and does not delve into other aspects of the person's life. It is usually time-limited and the counsellor is more active in guiding the work within specific, agreed areas.

Psychotherapy deals with emotional issues and explores more broadly and deeply than counselling. People suitable for psychotherapy are able to maintain responsible roles in life and society. Psychotherapy concentrates on emotional patterns that may be interfering with the quality of life in the individual and provides an opportunity to try things in a new way in a safe environment. It is an opportunity to gain greater self-awareness, especially so that events of the past do not impose upon new situations or present and future relationships. Psychotherapy is generally open-ended and may encompass many facets of a person's life. It requires committment from the client in terms of honesty, time and willingness. However, the benefits can be tremendous. Psychotherapists do not prescribe medication.

Psychiatry treats psychosis, where psychotherapy does not. Psychosis includes delusions, hallucinations, voices, dissociation, uncontrolled behaviour and the inability to distinguish between reality and fantasy. Treatment often includes prescription drugs.

I practice Counselling and Psychotherapy.

The quick answer to that is 'no'. However, I do utilise some CBT techniques for specific issues within therapy.

CBT is becoming a favourite choice of the NHS for quick, inexpensive counselling. It is designed to be a one-size-fits-all approach and ticks boxes in terms of modifying behaviour. There is no doubt, this can be of benefit for specific complaints.

But is it psychotherapy and does it last? My opinion is that for most reasons people come to see me, CBT is not only limited in what it can achieve but can take people further away from their own inherent well being. CBT provides an externalised framework that the client should adapt and modify themselves to. Conversely, depth therapy works quite differently in that it focuses on the individual and is a quest for an enhanced ability of self-agency. Depth therapy works to unravel the root of the problem rather than adjust the symptoms. The work is aimed at the client developing their own sense of well-being with unique meaning for them.

I believe and have seen in my own work that a more comprehensive ability to live a satisfying life comes from the ability to self-regulate. This ability can then be utilised in the broad spectrum of the person's life. This is freedom to trust the self. This is the ability to call upon the wisdom within for healthy and appropriate answers. It allows for a confident and spontaneous approach to life.

I have had a number of clients who have come for therapy with me saying 'I have had short-term CBT counselling and it worked for awhile, but I don't think it really solved the problem'.

I believe CBT is useful as an initial approach to break the negative cycle of depression before we look at underlying issues more carefully. It is good for other issues in dealing with the functional, practical side of substance misuse. But it doesn't help us learn about the misguided intentions of self-sabotaging behaviours.

Much depends upon what the person wants or expects from therapy.

Does CBT bring insight, genuine self-confidence and enhanced ability to live life with spontaneous joy? I struggle to see how it can.... on its own.

As a psychotherapist, I take my work very seriously. To delivery quality therapy, it is essential that I understand each of my clients as an individual. This means I need to understand their childhood, critical events, their family, friends, the way they think, the way they feel and many other dimensions. I also need to enter into a professional relationship with the person. To be able to keep this live and give it the respect it deserves, there is a strictly limited number of cases I can hold open at any one time.

Whether a client attends twice a week or once a month, it makes little difference to the responsibility of keeping the client's profile active, remembered, researched and considered. It is very different to, say, a haircut which is over and done with once the client leaves.