When we think of talking therapies, we very often think of a series of sessions taking place between client and counsellor, face-to-face in a room, over a period of weeks, sometimes months or even years. As those of us who have experienced this work first hand, in either or perhaps both of the ‘chairs’, can attest, amazing things can happen in this therapeutic space.
It’s been proven that talking about our worries is good for us. Speaking about a problem can give us the sense it has moved outside of us somewhat, and that can bring relief. So, too, can the unconditional acceptance of another human, offering a safe space and sometimes by reflecting what we say back to us, providing a mirror to help us see ourselves more clearly.
You could be forgiven for thinking that therapeutic conversations are best over a long period. But as I looked ahead to this year’s Time to Talk Day, I found myself reflecting on a different sort of intervention: the one-off.
I work for SAIF Care, a service that provides helpline support and signposting for the bereaved clients of SAIF member funeral directors, and Grief Chat, an online chat facility that connects bereaved people instantly with a qualified counsellor. In both of these instances, although clients do sometimes return, very often a single call or webchat will be their only contact with the service.
It may even be the only time they’ve talked about what’s worrying them.
The various advantages and challenges of working over the phone or over the internet rather than face-to-face are probably a subject for a later blog, but one of the aspects of a ‘one-off’ intervention that can feel uncomfortable is that the person can just hang up, or leave the chat, and if they haven’t shared their contact details with us, we won’t ever know what happened next. I have colleagues who work for the Samaritans or Childline who report that this is one of the hardest parts of the work, especially when the person is very distressed.
It’s the nature of the work, though, even in longer-term therapy; if we are working in a properly boundaried way, then after sessions come to an end, in most cases we don’t know what happens to our clients when they leave the therapy room. We wouldn’t be human if we didn’t wonder, sometimes, and if we only have one conversation, that wondering can feel more acute.
As Time to Talk Day quite rightly exhorts everybody, not just counsellors and therapists, to open up mental health conversations, I think this might be part of what puts people off; they might wonder, what difference can I really make with one chat? What if I say something wrong / open up a can of worms and make the person somehow worse? I haven’t got the time / energy / skills to support them ongoing, so is it worth me having that one conversation?
My answer would be ‘yes’, with caution. Those are valid concerns. If you are going to support someone in a one-off conversation, whether as a counsellor or as a layperson, here are some suggestions on how best to do it:
- Ask open questions: ‘how are you feeling?’ works better than ‘are you ok?’ because it invites a fuller and often more honest answer (especially when followed, depending on how well you know the person, with ‘how are you really feeling?’). Try not to make assumptions; they may want to talk about a particular issue, but it could be deeper or wider than it at first seems, so it can be worth asking ‘what else?’ What else is worrying you? What else could you try to assist your self-care? What else can I do to support you today?
- …but be clear it is ok not to talk. Knowing that they won’t be pushed, or knowing that if they don’t feel like it today, they can come back another time, can be just the reassurance needed to encourage someone to open up – when they are ready.
- Listen, acknowledge, and offer observations rather than advice. Phrases such as ‘I’ve noticed from what you’ve said that…’ and ‘I wonder whether…’ are a good way of showing you’ve heard what’s been said and can be gentler ways of interacting than telling someone what you think they need to do.
- If possible, try to ‘close’ the chat effectively. One option is to end on something positive, if appropriate, however small, or a next step for today (examples: ‘what do you think you will do for the rest of the afternoon?’ ‘that’s great that you’re going to get out in the garden and have some fresh air’), and of course a wish for them to take care and maybe think about taking another step towards the help they need.
- Look after yourself, too. Hearing and supporting other people is tiring, especially if you do it well. If possible, leave some time for personal reflection after the conversation.
A ‘one-off’ conversation about emotional wellbeing could be the only one someone has. It could be the first step towards accessing longer term support or treatment, or to opening up to a loved one or exercising more self-care.
A talk is never less important for being a ‘one-off’. That one chat might be the one thing that makes a difference.
Written by Joanna Williams, Head of Counselling at Professional Help.