Mr Williams Reflection

The psychological service where I met Mr Williams (identifiable information have been changed/omitted to maintain anonymity) is an IAPT service in South-East London. It delivers step 3 primary care, offering short-term therapy to clients who are often referred by their GP or may have self-referred. Treatment duration is limited to 8, although this may be extended up to 24 session based on client’s needs/recovery.

Mr Williams had self-referred and following two telephone assessments (step 2 and 3), was given the option of having CBT, bereavement counselling, or counselling (he had chosen the latter and was offered 8 sessions of counselling. This was reviewed at session 6, but could not be extended as his scores had improved and were ‘in the
While sitting in the waiting room, he had hunched and was looking down on a book with a tight facial expression. He had grey hair and was wearing a long black coat, glasses, and marks of many years’ experience across his face. In the first session, policies around confidentiality, risk and session arrangements were discussed and agreed upon. Mr Williams also consented to audio-recordings, being made aware of his ethical rights (e.g. that this is optional and he can withdraw) and that his anonymised information and recording could potentially be used to write a ‘case study’. Mr Williams was very articulate, confident, and socially skilled, but initially made little eye contact. He was able to be highly reflective and engaging in the sessions; however his mode seemed to be intellectualising rather than staying with the feelings. Mr Williams was also always around 20 to 40 minutes early, something that I never managed to explore with him, perhaps because of my own relationship to