Billi Silverstein MBACP Snr. Accred Psychotherapy

24/07/2025

18/07/2025

Why We Don’t Pass the Tissue in Psychotherapy (And No, It Is Not Because We Are Mean)

Psychotherapists are taught not to hand out tissues when someone is crying.

I always find myself cringing when a therapist is shown handing a tissue to a client in films or on television. Real life therapy, however, is a little less Hollywood and a little more nuanced.

In training, us psychotherapists are taught not to hand out tissues when someone is crying. Why? Because therapy is not about tidying up emotions like spilled tea or wiping away tears like a polite guest at a funeral. It is about holding space for feelings and letting clients experience them fully on their own terms.

Passing the tissue can unintentionally send the message; don’t feel and move on. That is the last thing the client needs. Often the tearful moments are not just moments of sadness but signals of something deeper, grief, relief, anger or breakthrough. By rushing to fix the emotion, the therapist might close down the very experience the client needs to process.

There is also an unspoken rule of therapy: emotional self-reliance. Clients come to learn how to sit with discomfort and find their own resilience. If the therapist is always the one offering comfort through tissues or soothing words, the client might miss out on building that vital skill.

Of course, therapists are human. We do have tissues on hand, strategically placed. But we wait until the client reaches for one first. It is a small gesture loaded with respect and trust, teaching self-soothing as a way of creating and strengthening independence.

Beyond offering tissues, therapists support clients in cultivating independence by fostering self-awareness, encouraging adaptive coping strategies and building a strong therapeutic alliance. Rather than providing ready-made answers, therapists guide clients toward discovering their own solutions, challenging unhelpful thought patterns, and developing a deeper sense of personal agency.

In psychotherapy, we explore diversity of experience with empathy and without judgement.

Get in touch today to consider your options.

11/07/2025

Why do Psychotherapist need clinical Supervision?

Clinical supervision plays a vital role in the development and sustainability of effective practice. At its core, clinical supervision is designed to create a safe, supportive environment where practitioners can critically reflect on their work. This reflective space allows individuals to not only enhance their clinical skills and knowledge but also to maintain their emotional and psychological well-being amidst the demands of their roles.

The process of clinical supervision serves three interrelated functions: normative, formative, and restorative. The normative function focuses on ensuring professional standards are upheld and that practice remains compliant with organizational and regulatory requirements. This supports accountability and reinforces ethical and professional integrity. The formative function is concerned with learning and development. Through feedback, exploration of practice issues, and shared learning, practitioners are able to grow in confidence and competence. Lastly, the restorative function provides emotional support, recognising the emotional challenges inherent in clinical work. It offers a space where practitioners can process their experiences, manage stress, and prevent burnout.

These functions are not standalone; they are woven together to support a holistic approach to professional supervision. When effectively facilitated, clinical supervision helps practitioners manage the complexities of their roles, fosters resilience, and promotes a culture of continuous improvement. It strengthens the therapeutic relationship between practitioners and their clients by ensuring that those delivering care are themselves supported and ethically grounded.

Ultimately, clinical supervision is not just a managerial requirement but a dynamic and essential component of professional practice, contributing significantly to the quality and safety of care delivered.

If you are an integrative psychotherapist, I am happy to talk to you about your clinical supervision needs. Contact me today.

07/05/2025

Proud to be the winner of this prestigious award:

Billi Silverstein Psychotherapy is one of the 2025 winners of GHP Mental Health Awards.

17/04/2025

Do you know someone calling themselves a mental health therapist without the relevant training?

No psychologist should pretend to understand what he does not understand... Only fools and charlatans know everything and understand nothing.
Anton Chekhov

An essential safeguard in psychotherapy is the ethical framework that licensed professionals are trained to follow. This framework includes principles such as confidentiality, informed consent, professional boundaries, cultural competence, and a duty to do no harm. It guides therapists in navigating complex situations and ensures that the client’s wellbeing is always the central priority. Ethical codes are enforced by regulatory bodies, which hold therapists accountable for misconduct. Untrained individuals posing as therapists operate outside of this framework, often unaware of these critical responsibilities. As a results they may violate boundaries, exploit trust, or mishandle sensitive disclosures, leading to significant emotional and psychological harm. The absence of an ethical framework not only endangers the client but undermines the integrity of the entire therapeutic process.
Harm caused by someone posing as a mental health therapist without any training can be severe and far-reaching. Mental health therapy involves complex emotional processes, including transference and countertransference, which require professional understanding and careful handling. Untrained individuals lack the education and clinical supervision necessary to navigate these dynamics, increasing the risk of emotional damage.
Transference occurs when a client unconsciously projects feelings, expectations, or experiences from past relationships onto the therapist. These projections can be intense, involving parental, romantic, or authority-related dynamics. A trained therapist recognizes this process and uses it therapeutically to explore unresolved issues. An unqualified person may not even be aware it’s happening, and worse, may act on or encourage these projection ;crossing boundaries, creating dependency, or re-enacting past traumas.
Countertransference, the therapist’s emotional response to the client, is equally critical. In therapy, these reactions are monitored carefully, often discussed in clinical supervision, a vital component of ethical practice. Supervision helps therapists reflect on their own responses and ensures they remain grounded and objective. Without it, an impostor might unknowingly act out their own unresolved issues, make the therapy about themselves, or react defensively, all of which can harm the client.
Furthermore, an untrained individual lacks the ethical framework and accountability systems. They may encouraging a client to act on strong emotions without understanding underlying pathology can lead to dangerous outcomes.
Ultimately, pretending to be a therapist without training is not just unethical, it’s reckless. It exposes vulnerable people to emotional manipulation, unresolved trauma, and clinical mismanagement.
In my practice, I am often approached by people who have seen charlatans parading as mental health therapists are worse psychotherapist. I encourage individuals to check credentials by asking to see their license number and approaching their regulatory body to confirm compliance. In psychotherapy we explore diversity of experience with empathy and without judgement. www.billisilverstein.co.uk

04/04/2025

To fascinate or be fascinated? That is the question…..

The distinction between being fascinated and seeking to fascinate others has significant psychological implications, particularly in areas such as emotional well-being, motivation and human connection. In a world where social influence often dominates, understanding why it may be more beneficial to be fascinated rather than to fascinate is crucial. Being fascinated involves engaging deeply with the world and being open to new experiences, whereas trying to fascinate often revolves around seeking external validation or attention.

From a psychological perspective, intrinsic motivation, as outlined in Self-Determination Theory, plays a central role in understanding the value of being fascinated. When individuals focus on being fascinated; immersing themselves in the present moment and exploring new idea, they engage their intrinsic motivation. This intrinsic satisfaction, rather than external validation, contributes to better emotional well-being. Conversely, seeking to fascinate others often stems from extrinsic motivation, which can lead to anxiety, dissatisfaction, and a disconnection from one's authentic self.

Moreover, being fascinated fosters a mindset of openness, curiosity and growth, allowing individuals to embrace challenges and new ideas. In contrast, the desire to fascinate others can limit emotional flexibility by focusing on how one is perceived, leading to anxiety and a fear of rejection. This focus on external approval can stifle creativity and self-expression.

Genuine human connection is built through mutual curiosity and empathy, which are nurtured by fascination. In contrast, trying to fascinate others can result in superficial, transactional relationships. Additionally, being fascinated can serve as a form of emotional regulation, reducing stress and promoting mental well-being, while striving to fascinate often causes performance anxiety and emotional distress.

Ultimately, prioritising being fascinated over seeking to fascinate promotes greater psychological balance, fulfillment and more authentic connections with others.

In psychotherapy, we explore diversity of experience with empathy and without judgement.

Get in touch today to start your journey.



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