Counsellor & Psychotherapist (BA Hons, MBACP)
rumena@rumenapervin.com +44 (0)207 1013249 Location: East London, UK
Frequently Asked Questions
If you would like to explore the possibility of us working together, I would be delighted to arrange a free no-obligation 'Pre-assessment' as detailed under the 'Process' option on this website's menu.
In the meantime, here are the most common questions as they apply to my own private practice. If I am helping you through another organisation such as a charity, I will align to their approach.
Are there any restrictions on who you will accept as a client?
If you are in an immediate mental health crisis, for example if you feel you are about to harm yourself or others, then I'm afraid my service is not right for you. Instead, I urge you to get help via this page.
Also, in extremely rare cases, it is not possible to proceed due to a conflict of interest. For example, I would not be able to help a prospective client that is already personally known to me. In these situations, I may be able to provide a referral to another practitioner. We can establish whether there are any conflicts of interest during a free no-obligation pre-assessment session as detailed here.
Otherwise, I will (and already do) work with people of different locations, ages, faiths, genders, etc.
Will there be some form of 'Therapy Contract' to sign at the outset?
Yes.
For my private practice, I use a short standard agreement which you will need to sign.
This is standard practise and is not meant to catch anyone out. It is just to set expectations around how we will work together and deals with basic matters like fees and the Cancellation Policy.
If you are seeing me as an individual but an organisation is funding you (e.g. your insurer or your employer), you will still need to sign the standard contract, albeit with the recognition that the funding is coming from elsewhere.
If I am helping you via another organisation such as a charity, it is probable that they will have something similar that you will need to sign instead (if you have not already done so).
Must your discussions with Muslim clients stay within Islamic norms?
No.
My approach is centred on connection, respect, empathy and humanity in general.
My Muslim clients say they find value in me being able to empathise with their lives and the cultural context in which they operate.
This informs their therapy, but never needs to be a limit upon where that therapy leads.
Will you work with clients outside the UK?
Absolutely and I already have some non-UK clients.
Time zone considerations including the clocks change for British Summer Time complicate scheduling and there are also some countries where I cannot provide help due to local licensing restrictions for practitioners.
If you take the opportunity of a free no-obligation pre-assessment, we will use that opportunity to discuss these aspects.
Can I have a 'hot line' to you for use in between sessions?
I do not offer this option for my own private practice.
This is in order to enable robust diary management and to maintain both personal and professional boundaries.
Do you speak any other languages?
Yes, I speak Bengali (Sylheti) but I only conduct therapy sessions in English.
Can you prescribe medication such as anti-depressants?
Can I bring someone with me, at least to the first session?
No.
In the UK, psychotherapists are not authorised to prescribe medication; this would be a decision for your doctor.
Within therapy, we can discuss anything around an actual consultation with your doctor. For example, we can discuss whether you feel you might benefit from medication. If you start taking medication, we can discuss whether it's working and, in time, whether you feel you still need it.
This is a very understandable question but ultimately this is likely to inhibit our discussions and I am confident that I will be able to make you feel comfortable without the need for a companion.
What control and visibility do I get if I am paying for someone else's therapy?
In this situation, the normal confidentiality rules apply.
The role of any referring relative/employer/friend/insurer/etc will be limited to:
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Articulating their own wishes for what the therapy will achieve AND
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Clinical admin (e.g. settling invoices if that is applicable to the arrangements in place).
I will:
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Listen to any input from the referring party
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Confirm patient attendance (if the patent is not funding the therapy)
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Confirm suitable patient co-operation (if the patient is not funding the therapy).
In fact any referring party (e.g. relative, insurer, employer, etc) will be similarly restricted and I would advise you that any ethical practitioner would apply these same constraints.
What are the limits of client confidentiality?
Under UK law, there are some very specific and truly exceptional circumstances in which client confidentiality can be broken, namely:
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Your disclosing of a serious or life-threatening risk of harm to yourself or others
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Your disclosing of involvement in (or knowledge of) an act of terrorism or its funding
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My receipt of either a Coroner’s request or a Disclosure Order from a competent court.
A good overview of matters relating to client confidentiality can be found here.
Do sessions have a standard length and/or frequency?
Yes, the default approach is to hold 50 minute sessions (or 90 minutes for couples) at a weekly frequency.
That said, sessions often go slightly over the allotted time to get to a logical stopping point.
The weekly frequency is to allow me to get to know the client/couple over time rather than in one or two marathon (and therefore tiring and expensive) sessions. It also provides regular opportunities to gauge whether suitable progress is being made so that we can change the approach if required.
Can sessions be longer and/or more frequent, or even less frequent?
What does it mean for a therapist to have a 'Supervisor'?
My professional body (the British Association of Counselling and Psychotherapy) mandates that I must regularly meet an independent and specially-trained Supervisor who oversees my client work.
The supervision appointments get longer and more frequent as I acquire more clients and they are there to ensure that:
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Ethical and safety guidelines are being adhered to
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The therapy is being conducted in the best way for my clients
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The therapist gets challenged with fresh perspectives.
Clients remain anonymous and if I am helping you via another entity (e.g. a charity), I will discuss your case with their Supervisor, not my own. This means that at any one time, I may be engaging with multiple Supervisors.
Why is a session 50 minutes long when the diary slot allocated is for 60 minutes?
Will you travel to clients?
I will (and do) travel when working for an organisation, but I do not travel to the homes of individual clients.
Subject to diary capacity, sessions can be longer and/or more frequent than the '50 minutes per week' default if I feel the client will genuinely benefit clinically from the additional intensity. This is something I have done before to positive effect, but it needs to be assessed on a case-by-case basis because although giving therapy is my livelihood, acting ethically must always come before income.
A significant minority of my individual clients have their sessions fortnightly. This is usually due to budget constraints but some new clients use fortnightly sessions to ease themselves into therapy and then move to weekly. Some clients go from weekly to fortnightly if they feel better, but want to phase out my support in a gradual manner. Please note that fortnightly sessions for couples are offered, but not recommended for clinical reasons.
Do you offer evening and weekend appointments?
Yes but demand from, for example, full-time workers who cannot work from home or couples who cannot otherwise make their diaries work, combined with the fact that all of my clients are in long-term therapy, means that my evening and weekend slots are usually (but not always) fully and continuously booked.
Each standard session for individuals is one 'clinical hour' long, with 50 minutes of that being spent with the client. A quick Google search will confirm that this is standard practise.
The 50 minute period with the client is sized to:
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Maintain focus on the discussion as the time is precious
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Give me time to write up my notes while they are still fresh in my mind
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Give both the client and myself an opportunity to mentally reset before the top of the hour, when we are likely to have to context-switch into another activity that needs our focus.
How many sessions will I need?
Is there a car parking space for your therapy room?
Unfortunately there is no off-road parking space available.
Evening and weekend on-road parking is available without a permit providing it is not an event day at the nearby stadium.
Can I have a therapy session when I'm out and about?
Good therapeutic practise requires therapy sessions to be conducted when the client is alone in a static and quiet location.
This is something that I insist on even though I understand that life can be hectic. Ultimately, this is for the client's benefit.
Can my regular appointment slot flex from time to time?
Maintaining a regular slot is mutually beneficial for both myself and the client and so changes should be minimal and infrequent, but inevitably there will be times when life gets in the way (e.g. having to attend parents' evening at school).
In such cases, I always try to re-schedule the session within the same week and historically I have been able to be very flexible. However, as my practice has continued to grow, my diary has become more congested and so re-scheduling sessions has become more difficult over time.
Sometimes re-scheduling just isn't an option and in those cases, a session can be cancelled free of charge so long as at least 24 hours' notice was given in respect of the original need to change the appointment's time.
Therapy is not a linear journey of a predictable length and nor is it usually a quick fix. Processing and making sense of our experiences, doing the work to re-wire our nervous system and learning new tools and practises will take a period of time that can vary greatly between individuals, with some needing weeks and others needing months or even years. There may also be frustrating moments or pauses in progress along the way.
Consequently, it is not possible for me to say how many sessions you will need, or to quote you an average that has any meaning.
That said, the aim is to work together for no longer than is, from your own perspective, necessary or valuable.
Will you automatically tell my doctor that I am in therapy?
Are there specific things I should consider for video calls?
No.
I may request your doctor's details at the outset just in case there is a medical emergency during a therapy session, but even in that scenario I will, if iit's physically possible, ask your permission before contacting your doctor.
Yes.
To make sure you get the most out of using video calls for our sessions, you should review my Video Call FAQ which you can read here.
What is your Cancellation Policy?
A session can be cancelled free of charge providing at least 24 hours' notice has been given. Most of my peers require 48 hours' notice to avoid being charged for a cancelled session.
Before we get to that point, I always try to re-schedule the session within the same week that it was originally due to occur.
Do you conduct the first session for free?
What are you fees?
I do not offer that option but I do provide a free no-obligation pre-assessment session as detailed here.
This is not a free therapy session as such, but more a chance for us to meet, discuss in detail what you would like help with and to determine whether we are a good for to work together.
The pre-assessment session should give you a clear sense of whether you want to proceed to full-length paid sessions with me.
Are telephone or video sessions cheaper than those held in-person?
I'm afraid not.
This is so that:
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Clients who are too far away to attend my therapy room do not feel that they are at a potential disadvantage in getting into my diary, on the basis that they appear less financially attractive.
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Clients can make their decision on how we should speak based solely on what works best for them both therapeutically and practically, without that judgement being influenced by costs.
Ultimately, this approach is about ensuring fairness to all clients and prioritising clinical outcomes over financial considerations.
The relevant information on fees is set out here.
If I book longer or more frequent sessions, does the hourly rate drop?
I'm afraid not since cash-handling fees on a business bank account are relatively high.
I'm afraid not.
To clarify, for individuals:
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A 90 minute booking will cost 50% more than a 60 minute booking
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Two 60 minute bookings in a given week would cost twice as much as a single 60 minute booking
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Two 90 minute bookings in a given week would be triple the cost of a single 60 minute booking.
The same logic applies to couples therapy, but the starting point in that scenario is a 90 minute session.
Do you give discounts for payments in cash?
Will you give a discount in return for a review?
No.
A financial incentive of this type would undermine the integrity of my practice's published reviews which can be found here.
In principle, do you accept client referrals from insurance companies?
Yes and I have done this in the past.