Tag Archives: assessment

A counselling assessment.

I had my counselling assessment on 7th January. Here’s what I posted on twitter straight afterwards.

Twitter 7Jan2013

I’d been referred to my local Mind, but I had a flat bike tyre and it took me 40 minutes to get there. It was an area I’d never been to, in a bleak housing estate. I was buzzed into a courtyard where a group of older men were smoking; I had to ask them for directions to reception. As I walked in, the receptionist signalled for me to wait while she finished a counting task. She finally asked my name, rang up for the counselling coordinator and asked me to wait. I sat down on the one seat available, squashed between a cupboard and a second chair which was taken up with a huge carton of sugar. Several more people came in. The tiny space got crowded and everyone else was standing, so it felt like they were all on top of me. The door was open; the room freezing. I took some notes as I waited:

This feels like a place for people who are sicker than me. It feels like all the places I walk into through my work. I want to walk out now, go to work, find myself a private therapist and ask P to help me pay for it. This doesn’t feel like a place for people who work, it’s a place to go during the day if you have nowhere to be. I feel claustrophobic and like I want to cry.

I’m aware these feelings seem judgemental. What they reflect is my anxiety about being displaced from the position of ‘professional’, with the status that comes with it, into the vulnerable position of ‘service user’. This was part of the reason it took so long for me to seek help, and sitting in that reception, I felt out of control and wanted to run.

Perhaps the receptionist picked up on my discomfort, because she sent everyone else outside to wait and asked if I was cold and needed the door closed.

Eventually Liz* came down to collect me. She looked younger than she sounded on the phone, and seemed friendlier. She took me upstairs to a small but comfortable room. I noted that she positioned herself closest the door. I know that she does that is so she will have an easy escape if I turn violent. Liz told me that the only reason any of my notes would be shared would be if they were subpoenaed, which was a relief given concerns I’ve had about information being on my medical record. She asked detailed, difficult questions, but was gentle and empathic and I trusted her. I disclosed pretty much everything, and I cried a lot.

She asked if I’d been diagnosed in the past and I told her about the Borderline Personality Disorder. She later asked whether I’d been angry at that time. I said yes, and that I suspect that’s why I got the diagnosis: women aren’t supposed to be angry. She laughed and nodded, which I liked, and said, “We don’t do diagnosing here.” She clarified that their counsellors work from an integrative approach, which means they draw on a range of theories in their practice. I’d been worried they would offer cognitive behavioural therapy, which I’ve found unhelpful, so was glad she agreed that CBT wouldn’t be appropriate. As she said, I don’t know why I’m feeling the way I am, so I need therapy that allows me to explore where my feelings are coming from.

The assessment took 35 minutes and Liz offered me 12 sessions of counselling. I need a female counsellor in the evenings or on the weekend; she thought she would be able to allocate me an someone next week, but would call to confirm. I left wishing that Liz could be my counsellor, but feeling hopeful that her approach is reflective of the ethos of the service. She called back this week, but unfortunately can’t offer me a counsellor for another five weeks. I’m going on holiday then, so I won’t start counselling until the first week of March: three months after my first GP appointment.

*not her real name

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Booking an assessment with Mind.

The day after my first GP appointment, I called Mind to arrange counselling. I made the call sitting outside in the cold on my lunch break, trying to find a place where no one would hear me. I was anxious. The first time I saw a GP about my mental health, in 2003, I was also given a number for counselling. Back then, I was similarly sitting on a park bench making the call from my mobile. The receptionist who took my call insisted that I do an assessment over the phone, including the question: “Do you have any suicide plans?” I did. It threw me to be asked it so blatantly. I now know to be prepared for that, but back then it was my first ever contact with mental health services. I didn’t want to discuss my suicide plans over the phone, in a public place, and I was living in a house with 7 other people so there was nowhere I could go to make a private call. I asked her whether I had to answer, she said yes, and I hung up. She hadn’t taken my contact details and I didn’t seek help again for 6 months.

This time, the Mind receptionist put me straight through to the counselling coordinator, but I got her voicemail and left  a message. I was nervous about that because it meant I then couldn’t control when I took the call, but I didn’t want to put it off. Ten days later, I hadn’t been called back so I tried again. Again, it went to voicemail, I left my details again and waited for a callback.

This time, the coordinator responded the following day. Apparently she couldn’t make out my number in the first voicemail, so she was glad I called back. This seems likely: my phone is on its last legs and I’m hanging out for an upgrade. She took some basic contact details and said they can offer out-of-hours appointments if I can “make the time” to come in for an assessment during working hours. Because of the Christmas break, the next available appointment wouldn’t be for three weeks.

So my assessment is booked for 7th January and I received a confirmation letter to my home address, with a leaflet explaining Mind’s counselling services. It will be £15 per session as I’m working full time (significantly cheaper than if I went private), but there’s a limit of 8-12 sessions. I’m hopeful that will be enough, but if it’s not, I’m concerned that I will have built rapport with this counsellor and then have to stop and find someone else. They offer group therapy after individual counselling is finished, but group therapy sounds like my worst nightmare. My other concern about Mind is not being able to choose my counsellor. If I was going private, I would research counsellors beforehand, but here I have to go with what I’m given.

It’s a week now until my assessment. I still don’t know what to expect; the leaflet says it’s to “assess your needs appropriately”, but who knows what that means? I would have liked more specific information, such as what sort of questions I will be asked. The coordinator was also vague about how long I’ll have to wait to see a counsellor, as it depends on how “flexible” I am. I suppose that means I choosing between a short waiting time and seeing a female counsellor in the evening (my minimum requirement).

But I appreciated that the coordinator was kind, and at least she didn’t ask me to be assessed over the phone.

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