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Delve into our world as a GP Counsellor describes their typical day

5th January 2024

HomeNewsA day in the life of a GP Counsellor

I work 5 hours per week at a GP practice in Hulme, South Manchester, near to the city centre.

9am:  I arrive after cycling in. I am welcomed by the receptionist and other staff such as the practice nurse. It’s so good to see other people before I start work in a job which, on a day-to-day basis, is just me and the client.

I put the kettle on and set up the room: an easy task – just switching on the computer and rearranging a couple of chairs. With a cup of tea at hand, I check my emails and look at my calendar for the day. If I have any initial assessments or new clients, I read the referral or assessment information. I flag emails I do not have the chance to respond to, hopefully later!  If I have online sessions I check I have a working camera and headset plugged in and if I have telephone sessions, I check the telephone is in place for a handsfree call.

Before I start my first session I read the notes from the previous week’s session – these are brief, with themes that emerge, including coping strategies, unless there have been safeguarding concerns where I do detailed notes. Then, I ‘get in the zone’ for a 50-minute counselling session – this may include a brief body scan to check in with how I am feeling in that moment in the chair, ready for the first client to come in.

10am: If this is a first session, I with check out the person’s understanding of the counselling contract, what confidential counselling means to them and ensure they know the limits of confidentiality. I’ll check out if they know what they want to get out of the therapy and determine their goals. At the beginning of the session, I ask them to complete the GAD7 and PHQ9 (anxiety and mood scores); some people are keen to know their score and to look at changes from previous weeks, others aren’t so interested and just want to talk.

I am a person-centred counsellor, so the focus is on encouraging the person to talk about how they feel, to gain a greater understanding of who they are as a person and make sense of how they feel. Active listening is the key. Some clients are open straight away, eager to talk about what is happening for them and how they feel. I reflect back to them what I have heard, to affirm that what they are saying is important to me. Through this reflection, I may also check out understanding. Also, as sessions progress, I will try to help the client develop a broader and deeper perception of their thoughts and feelings, to help them start to look at themselves in different ways.

In counselling the relationship between the therapist and client is very important. There must be trust and a counsellor must have empathy and treat clients with respect, without judgement. I have found that some clients find it hard to respond to this way of working if it is not familiar to them in past and current relationships.

Some people struggle with this process, find talking about themselves and their situation difficult, and/ or get upset. I will reflect on their emotions, including body language. I work at the pace of the client but when this trust develops it is a powerful way of working to enable clients to explore thoughts, feelings and behaviours.

In some situations, I refer to sources of information, for example when discussing bereavement I have referenced models of grief. I feel it can help some clients understand what is going on with their feelings and behaviours and reinforce that they are not alone in their experiences.

10.40: 10 minutes to go in a session. I would make sure that the client is coming to the end of any disclosure to ensure that they do not leave the room in an emotionally distressed place. I may ask the client what they have got from the session or I may reflect on the session themes. If there has been any acute distress in a session I will introduce a breathing exercise, to introduce the concept of self-soothing and reduce the symptoms of stress and anxiety.

10.50am: End of first session. And time to make notes on the themes of the session. Very little time for a break!

11am: Client number 2. If this is an Initial session I will explain the process to the client. Find out why they need counselling at this time, checking what is on their referral. I complete the assessment document. This takes about a half hour, with a half hour left to write up the notes. If I have time I answer remaining emails.

Midday: I am ready for a break! If it is good weather I eat my lunch in the garden of the practice and then I go for a walk in the park around the corner. If it is wet I eat my lunch in the staff kitchen area and just have a short breather outside. This time is essential for me to unwind after 2 intense hours listening to clients. I am then ready for the afternoon.

1pm: Client number 3

2pm: Client number 4.

3pm: I try to finish promptly. I enjoy the cycle home – thanks to the new cycle path almost all the way from Hulme to Chorlton. I find the fresh air and exercise helps me unwind after the day. I keep a reflective journal which I will complete at home that evening or the next day; this is part of my professional development. I make notes on my feelings about the day’s sessions and highlight anything I need to discuss with my supervisor whom I see monthly. I will not work again for Gaddum until the next Friday, unless I have a monthly team meeting in my diary which I will attend when I can.