How many counselling sessions for improvement?

[aquarian]

Hi,

I realise that this question is a bit like "how long is a piece of string?", but I'm getting concerned that, after twelve weeks of counselling for anxiety attacks, I'm not seeing any obvious improvements.

As I wrote in my initial posting in the "Introduce Yourself" section of this forum:

I've been attending weekly counselling sessions for the last three months, but I haven't noticed any improvement -- indeed, my anxiety seems more pronounced now than it was when I started. I trust the counsellor and she seems to be doing the right things, but the sessions don't seem to be getting through to the problem. I'm starting to wonder whether I'm somehow blocking my own progress.

I'm sure that I read somewhere that therapy ought to produce some positive results within six sessions. Although the counselling has helped me to identify some long-term issues, I don't feel that it has yet given me any keys to recovery. Either that, or the keys are there but I'm refusing to grasp them -- a possibility which I'm willing to accept but which feels dispiriting.

I may have complicated matters by going on to medication in the middle of the counselling. My counsellor had previously advised against this approach, but I felt that I had no alternative when I hit a serious low just after Christmas:

In desperation at the New Year, I visited my GP who suggested starting me on Citalopram (20mg per day). I've been taking that for two weeks now and getting side-effects (tiredness, headaches, nausea) but no clear signs of improvement yet (hopefully soon!).

I'm now unsure whether to persevere with the counselling (not least because it's costing me money for each session). I've been tending to regard it as a "lifeline" that I'd be foolish to discard, but I wonder on the other hand whether this attitude is unhelpful in itself.

I'd be very grateful for any thoughts that anyone can offer to help me make a decision on this.

Many thanks.

[margaret jones]

Hi I think you have to make the decision yourself re councelling whether to carry on or not .

I had a lot longer 6 mnths of councelling firstly weekly for 3mnths then every 2 weeks until it was 1 session a mnth i finished in Nov last year i feel it worked for me , i did not take any meds so cant comment on that , it is expensive i had to pay .

Try and think back to when you started and how you felt ?? then think about how you feel now thats how i decieded if it was working or not .

Not a easy one i am sure you will make the right decision .

Take Care Margaret

[nomorepanic]

Are you having counselling or CBT?

Maybe if you aren't having specific CBT you need that instead.

[aquarian]

Thanks, Margaret. I'm glad to hear that a longer course of counselling can achieve lasting results. I'll bear in mind your suggestion about comparing back to how I was feeling before starting the counselling, although that's problematical. During the course of the counselling, I've developed some depressive aspects, presumably due to the longer-term effects of the anxiety, so I actually feel rather worse now than when I started. As you say, it's definitely my decision whether to continue or not, but I appreciate receiving views from other people in helping me to reach it.

Thanks, Nicola. The counselling isn't specifically focussed on CBT, although I believe that the counsellor has been applying some CBT techniques. Most of our attention has been on identifying underlying issues and motivations for my anxiety. Whilst I've made some progress on those, my insights don't seem to have enabled me to change -- hence my suspicion that I'm blocking myself.

[Just.A.Girl.x]

Hello Aquarian,

From my personal experience, I had councelling on the NHS which didnt work for me with the anx..though I did talk about other underlying problems. I then had CBT private and I didnt like the therapist and as I was paying I stopped doing that. I then got on the CBT list with the NHS and it was amazing...it really helped me!!

I really do think CBT is the best way to sort out anxiety as it is very planned and homework based...you actually have to go out and do something about it opposed to sitting talking about problems which are good to be sorted but dont change the anxiety.

As I say this is just my view on the subject and I am now on the waiting list for CBT again after a set back..and have also bought a book on CBT to keep me going while I wait but I do recommend getting yourself on the waiting list even if you change your mind later on

Good luck
Candy xxx

[aquarian]

Hi Candy,

Many thanks for your thoughts. I can imagine that it's very difficult for any form of therapy to work if you don't get on with the therapist.

I'm encouraged by what you say about CBT. I've just signed up for the free online CBT course at http://www.livinglifetothefull.com/. I'm hoping that it will provide me with a more structured approach to coping with the anxiety symptoms while the counselling addresses my underlying issues. I'm aware, though, that I'll need to put in the necessary time and effort in order for it to pay any dividends.

Cheers and all the best.

[Brunette]

Hi Again,

You could try keeping a diary. Since no-one else will ever see it, it might help you get to the bottom of the "blocking" issue.

If you think there are things worrying you that you think might seem silly or trivial for instance it might be that you are reluctant to discuss them, possibly without even realising it.

I'm quite happy to say here that something as stupid as a malfunctioning washing machine, when added to some other stuff, definitely contributed to my anxiety last year. I'm not sure if I'd be be prepared to acknowledge that away from this forum though!

[smudger]

Hi. Im been having CBT on the NHS since the just before christmas and its just recently turning me around. I started a new medication after the first few weeks too which didn't help with the counselling coz of the side effects but they are lessening and I'm eating better and exercising. CBT is good because its proactive. When you leave the sessions that isn't the end of it until your next appointment. You actually put what you discuss into practice and with the help of the CBT therapist, analyse the results the following week.Have you asked your GP to refer you on the NHS?

[smudger]

By the way, at the moment I keep a diary and three times daily I mark my stress levels from 1 to 10 (10 being mega stressed) and identify what Im doing at the time. . I can see a significant improvement over the last few weeks and it has been interesting to see where patterns emerge so that I can come up with coping strategies with the help of the CBT counsellor!For example I always feel worse at the weekends and there is one particular social occasion that rates a 10 on the stress level. Rather than avoid it, Im learning how to cope with it. To come up with a plan etc...You might like to try this, you would be amazed how useful it is. Good luck.

[NoPoet]

Hi, I agree with Nic, if counselling isn't helping you to deal with the anxiety you need specialist treatment. I was referred on to an anxiety specialist by my counsellor when we realised that as helpful as counselling can be, it is not really appropriate when there is a medical issue like an anxiety disorder.

Aquarian, suffering from anxiety in the long term can lead to feelings of being depressed, and I would say it's normal for the anxiety to feel slightly worse with time if you aren't receiving the correct treatment. In cases like yours the depression tends to disappear when the anxiety starts to back down.