Psychodynamic counselling is a talking therapy. Its primary aim is to gain insight into how past experiences affect current difficulties so that positive changes can be made. It can help clients increase understanding of themselves and the way they think, enabling them to better manage life and any problems they are facing.

Sensory integration is the process by which we use sensory information from our body and environment to effectively respond to situations.  Sensory integration provides the foundation for learning and behaviour.  Sometimes individuals have difficulty processing sensory information effectively and this may contribute to stress and anxiety or cause difficulty participating in everyday activities.   

Differences in sensory integration are common in individuals who have experienced Developmental Trauma or neglect, premature birth, Autism Spectrum Condition, ADHD, learning difficulties and some mental health conditions.  For individuals who have experienced developmental trauma, an assessment informed by Sensory Attachment Intervention principles is available. 

Assessment may include questionnaires, interviews, observations and standardised assessments (including the SIPT: Sensory Integration and Praxis Tests).  

If assessment indicates significant differences with sensory integration, then the following interventions may be beneficial:

Ayres Sensory Integration Therapy® (ASI) is an intervention that uses tailored sensory motor activities to provide enhanced sensation in order to improve sensory integration. It is child-led with a focus on play and enjoyment. It aims to provide lasting improvements to our sensory processing which in turn helps an individual to engage more effectively in tasks that are important to them.

Exploring compensatory strategies and environmental adaptions and providing education to those involved in the individual’s care.

Developing a home/ school plan to include helpful sensory strategies.

If partners are having a tough time, a relationship counsellor can help by facilitating communication between them in a non-judgemental way. This allows a couple to explore what is affecting their relationship, how they relate to one another, and how they can work together to bring about positive change. They can begin to view the situation from a different angle and see what changes might improve their relationship.

When people have been impacted by trauma, a trauma-focused CBT approach can be one way to support them. The client’s relationships with themselves, others and the world may feel unpredictable and dangerous, leaving them in a constant state of perceived threat. The therapist focuses first on building a trusted relationship, a thorough understanding of the system around the client and a safety network that can be accessed during the journey. The therapeutic process can take time until an individual feels safe to re-visit the trauma experience and create a coherent narrative that makes sense to them. When the client feels ready, physically re-visiting the circumstances around the traumatic event may be possible, if this is deemed helpful and not re-traumatising. For example, going back to where a car accident happened may support the client’s ability to get into a car without flashbacks of the accident.

The ultimate aim of CBT is for the client to increase levels of functioning in their life, and it is particularly effective with teenagers and adults. It explores how thoughts, feelings and behaviours link with each other, understanding patterns of what triggers reactions. Working with the therapist, clients can start to have more agency over these patterns through new choice-making and problem-solving. Keeping a structured diary between sessions can support this process and give clients more ownership of their progress.

DDP, is an attachment-focused family therapy developed by Dan Hughes, an American psychotherapist. It is used predominantly with families who have fostered and adopted children, where the children have experienced significant trauma in their lives and have problems with attachment. It incorporates the ‘technique of Playfulness, Acceptance, Curiosity and Empathy (PACE). Given the complexities of the families who are supported by DDP, this tends to be a medium-term working relationship, lasting months and sometimes longer.

The aim of DDP is to provide a safe space for learning and communication, without fear or shame, to develop understanding, shared meaning and improved cooperation within the family. The therapist may work with the child and adult(s) together or separately at different times during the therapeutic relationship, and there may be elements of coaching as part of the sessions. For example, the therapist may help a parent use slightly different language with their child to help them respond with empathy. Alternatively, the therapist may help the child communicate more effectively with their parents or carers by asking their permission to talk to their parents on their behalf with all parties in the room to convey the underlying feelings in messages they are giving.

Systemic psychotherapy believes that a problem is best understood within its context, ie within its system or family.

Picture a family making a decision about what to do at the weekend: some may be silent and uncomfortable; some may give lots of ideas; others may argue leading another creating calm. And this repeats every time the family or system makes a decision because they have developed a pattern of relating to each other.

However, systems change – perhaps the peacemaker goes to university - the patterns no longer work and the system becomes stuck.

The aim is to help everyone in a family system understand each other and develop new ways of talking to each other, creating an environment in which everyone supports each other, which promotes health and wellbeing. Systemic therapy sessions usually last 50-minutes and can be with individuals, couples or groups of people. The therapist gives everyone a chance to contribute to discussions and sessions are adapted to the ages, needs, resources and preferences of those present: sessions involving children, for example, often include play and drawing. The therapist is more interested in process, themes, patterns, communication and meanings than the content of conversations, always looking for the difference that will make a positive difference for the system.

EMDR is a therapy for all ages aimed at processing trauma without the client needing to speak about it. The therapist helps the client build their skills to face their trauma, including learning about their emotions, noticing how they feel in different situations and where they feel emotions in their body. Metaphor, stories and art can be used to approach traumatic memories safely, and EMDR uses bilateral stimulation* to process trauma, working through the memory to realise that the trauma has ended and the client is safe. 

* Bilateral stimulation involves the alternate stimulation of each side of body. Thinking about the trauma at the same time merges the logic and creative sides of the brain. With children, a buzzer in each hand can be used to send a message to alternating sides of the brain. However, EMDR is so-called as, with many adult clients, the therapist moves a hand horizontally in front of the client, who follows the fingers with their eyes, right to left and back again, causing the brain to trigger on both sides.

SE helps clients learn about and master their nervous system and reactions in order to complete stuck fight-flight-freeze-fawn responses, both present and past. Fight-flight-freeze-fawn is a response to threat but, rather than riding the wave of it and carrying on – as mammals in the wild do - our emotions get in the way and we can get stuck. SE teaches us to recognise these responses in ourselves so that we can revisit past responses and complete them. In this way, our body learns how to ride the wave of our fight-flight-freeze-fawn response, then carry on. In children’s sessions, we do this with play; in adult sessions, it is through discussion.

Sessions usually last 50-minutes and start by identifying how it feels to be regulated, grounded, oriented and resourced, so the client knows what to look for. They can then gradually begin to revisit the trauma that got stuck in order to process it. Once comfortable with this gradual processing of trauma, the client’s system learns it can cope so that next time there is a reaction to trauma, the system remembers, does not get stuck in its fight-flight-freeze-fawn response, so that the client can cope and carry on.

Art therapy uses art materials to express what is inside, helping clients process challenging emotions without the need for words. It is not about being good at art or making a good image, but freedom of expression, symbolism, imagery, colour and the sensory experience of working with art materials to connect with what is inside. Once expressed on paper on the outside, it may be explored in dialogue between therapist and client, and processed. As sessions progress, a body of work is built up as a physical representation of the therapeutic journey, which can be reviewed and responded to over time.

Art therapy sessions usually last 50 minutes and the therapist keeps time. Many types of art materials are available. The therapist sees how the client responds to them. Some clients dive straight in; others may need to be invited to try something or join a game with the therapist, taking turns to make marks on paper, introducing the idea that a conversation does not have to be verbal. Some work may be diagrammatic or illustrative; some may be shapes, patterns and marks. Time is given at the end of each session to look at the work together and consider what it might represent. 

Music therapy uses musical instruments as tools to express what is inside instead of, or as a compliment to, a verbal dialogue. It is not about being good at music or able to play an instrument. The physicality of playing instruments, exploring their sounds, silences, tempo, dynamics, and the transformative nature of vibrations connect with what is inside. Once outside and in sound, what it represents can explored between therapist and client, and processed.

Music therapy sessions usually last 50 minutes. The therapist keeps time and starts by welcoming the client. There are many instruments available and the client is invited to choose one and explore its sounds. The therapist observes how the client reacts to different instruments and sounds, perhaps asking the client what the experience is like for them. If a client does not want to play, the therapist may sit with the quietness or play something themselves. At the end of a session, the therapist may ask the client to describe the instruments they have played or heard and the feelings they have evoked, considering together what they may represent.

DMP is a creative, relational and body-based form of therapy. It is based on the premise that, through dance, the body can express thoughts, feelings, tensions and experiences through dance, in a conversation without the need for words. As with all conversations, there must be at least two people to enable thoughts and ideas to be shared, with space for imagination, relationship and connection to allow creative and emotional growth. No dance, arts or performance experience is required to engage in a DMP session, and DMP does not correct, teach or force the client to move or dance. The client inspires the session with their movements and unique personal experiences, which support a creative, therapeutic journey. 

Most DMP sessions last 50-minutes and begin with a conversation to check in with how the client has been and connect to the body. Connecting to the body, allows the client and therapist to notice how emotions, thoughts, feelings and experiences have been stored. For example, tension may be held in the head creating headaches, or worry and anxiety creating tightness in the chest. A gentle warm-up is introduced, allowing the heartrate to rise lightly, increasing oxygen supply to the body.  A DMP session may be filled with movement, high energy and choreography; other times, it may be quiet and very still; sometimes props are used to convey emotions and experiences. At the end of each session time is given to talk about the experiences of movement and conversational content. There is space to begin to notice habitual movement patterns, behaviours and responses to specific themes, stimuli or interactions. This check-out bridges body and mind, reducing the heartrate and supporting the client to transition to the next part of their day.

Dramatherapy uses drama as a tool to help clients process challenging emotions rather than needing to express them verbally. A typical session would be creating a story through art, drama, role play or small world play (mini figures). This allows clients, particularly children, to express themselves without having to actually say what may be too painful for words. The therapist may reflect back, curious about what a character might be representing for a client and why. This may result in verbal expression and analysis together about what is happening in the room and what is changing outside of the room for the client. For others, the story continues and is interpreted. Sometimes the story may be a literal expression of their life or, especially with younger clients, the therapist will interpret from what she observes. Through metaphor, healing can happen.

Play therapy is particularly effective for primary school aged children. Its aim is to help relationships improve at home, at school and with themselves so they can be comfortable in their own skin, see their own qualities and feel that fits with society. Play not only helps children develop but also explore and process their experiences, without talking directly about them. Whilst a child may choose to communicate with words, it may feel safer to externalise a thought, feeling or experience through a creative form of expression, possibly through art, music or characters in a role play.

The Play Therapist creates a welcoming, playful, safe, and empathetic space to help children relax, feel special and experience being valued, heard and witnessed. They choose, lead and feel empowered, knowing they have everything they need within them to make whatever they want during the session. They have permission to be however they want and can bring any emotion to the room; for some, it is just a place to play and be happy with someone.

Theraplay®

Sessions do not tend to include parents, but the therapist will feed back about what worked well in the room. However, if appropriate, the therapist may leave time for parents or the whole family to come together and join in children’s natural way of connecting and communicating through play. The therapist may integrate Theraplay® games, which teach parents how to play with their children through the core concepts of structure, nurture, engagement and challenge.

CST is a non-invasive, gentle, hands-on approach that releases tensions deep in the body to relieve pain and dysfunction and improve whole-body health and performance. The practitioner senses tensions in the body and helps to release it in a comfortable way. During or after a session, clients may feel calm and energised, with increased clarity of mind and improved wellbeing.