Treating Depression

When treating someone with depression it helps to follow a simple process to help you. I think you should start with an initial assessment of the client, as at this stage you can gather information and engage the client in a process with the counsellor to establish the presence or absence of a depressive disorder. You can also determine the client’s readiness for change, be able to identify the client’s strengths or problem areas that may affect the process of treatment and recovery and then you can engage the client in the development of an appropriate relationship with the counsellor for the treatment period.

As the assessment is your chance as the counsellor to learn about the client’s lifestyle, you should think about asking the client questions to build an idea of them, such as,

o How often do you feel tired?

o How often do you feel nervous?

o How often do you feel hopeless?

o Do you often feel restless?

o How often do you feel worthless?

Also, due to the sensitivity of the questioning and how the client may be feeling, the assessment of the client should take place in a quiet room where the chances of being disturbed are minimised. Finally, an outcome of the assessment will be to put together an initial treatment plan for the client.

After this, you will then need to create a contract with your client. This will be a document that will detail what you have spoken about and can include information like:

o An overview of the counselling and what the treatment is that is being offered to the client.

o It will have an outline around the confidentiality of the meetings but also where confidentiality may need to be broken if something of interest is said or done to keep in accordance with the law and to also keep the client safe from any potential harm.

o An outline of how long the treatment is intended to last or how many sessions you and the client have spoken about. You will say what day of the week the session will be on and for how long. The contract should have a treatment end date to give the client a clear end goal.

o The contract will include any information about fees and prices that were discussed with the client, how the client can pay and also what will happen if fees haven’t been paid or can’t be paid.

o Also included could be information about contacting the counsellor outside of the session time and how this is best done whether by phone or email. This should be followed by information about boundaries and if it is appropriate or not to contact the counsellor on a social level.

Based on this, the following is an example of what a put together contract may look like:

Ridgeway Counselling Contract

As part of practising ethically, all counselling sessions that are in line with the British Association of Counselling and Psychotherapy (BACP) Ethical Framework are covered by a contract.

This is a mutually agreed contract between: Rachel Murphy, Counsellor and

........................................................................, client.

It states our responsibilities for the time that you engage in counselling with me.

The aim of your counselling with me: The overall aims of your counselling with me will have been discussed and agreed in our initial meeting. However other issues may emerge as our work together progresses. I will provide a confidential, non-judgemental, safe space for you to explore your thoughts and feelings. I will assist your learning, healing, understanding and growth. I will not tell you what to do but will instead help you to discover your solutions and/or your way forward.

Confidentiality: Our work together is confidential and remains within our counselling room. However there are a couple of exceptions to this. In order for me to provide the best counselling service possible and to comply with the BACP ethical standards, I attend supervision on a regular basis. Also if I felt that you or someone else was in danger or at significant risk I would, wherever possible, discuss with you the possibility of breaking confidentiality to obtain further support for you.

Record keeping: I will keep very brief notes of our sessions, which you are welcome to see at any time. Once your counselling with me has ended I will destroy all these notes.

Our sessions: Our counselling sessions will last one hour and will normally take place at the same time every week. If you need to cancel one of our sessions please give me 48 hours notice. If you are unable let me know 48 hours in advance I will charge for the session. I will also ensure that I give you 48 hours notice if I need to cancel a session.

Holidays: I will give you four weeks’ notice of any holidays I intend to take. I require two weeks’ notice of any holidays you intend to take.

Ethical standards: I am a member of the British Association of Counselling and Psychotherapy and work to their ethical standards. A copy of these standards can be found on their website at www.bacp.co.uk.

Complaints: Should you wish to make a complaint about our work together contact the BACP at www.bacp.co.uk. Insurance I hold both public liability and professionally indemnity insurance.

Feedback: I would welcome feedback on your experience of counselling with me and at the end of our work together I will offer a feedback form for you to complete. This is completely voluntary and you will not be under any pressure to complete it.

I have read, understood and agree with the term and conditions of this contract.

Name:..............................................................................

Signed.............................................................................

Date:...........................................................

Session fee: £.................................................................

Session day and time:.........................................................

Contact telephone number:...........................................

Emergency contact name and number:........................................................

Once the document is compiled the client will then read through it and if they agree with what has been written and