English Speaking Therapist | Forward Therapy Stockholm

Tag: CBT

Emotional Self Help Books for Expats and English Speakers in Sweden

I need help with Anger Management / Distraction / ADD / Overwhelming Emotions…(strike out what does not apply) …can you recommend any self help books for expats to read?

Clients are often asking me for book recommendations. While self help books for expats aren’t the same as therapy or coaching sessions, they have their place and can sometimes be useful if reading is your thing. If you aren’t quite ready to attend counselling or want to try some things for yourself first, take a look at the categories below and try some of these titles. That’s also an inexpensive alternative. But don’t leave it too late to ask for human help. Often it is easier to recover when frustration or other emotions are not so overwhelming.

Here I’ve collected a few of the titles I’ve found to be useful and effective for dealing with anger, distraction, anxiety and out-of-control emotions. Some of these self help books for expats were recommended to me by English-speakers who have come to live in Sweden. Others I discovered myself in the course of professional development.

(Commissions may be earned on purchases of linked products)

Anxiety, Concentration, ADD and Mindlessness

Researching your condition on the Internet can hazardous! On many occasions I’ve been contacted by expats or other English-speakers who, after surfing around the net, fear they have ‘Adult ADD‘ (aka Attention Deficit Disorder). They talk of being easily distracted, having difficulty staying on task or constant forgetfulness. But neither ADD nor ADHD suddenly begin in adulthood. Unless you had serious problems with your schooling as a child, it’s more likely you are suffering from something associated with anxious states of mind or you just need to tone up your mindfulness.

Books for Improving Concentration and Attention (especially if you are worried about ADD or ADHD)

Your Brain at Work: Strategies for Overcoming Distraction, Regaining Focus, and Working Smarter All Day Long by David Rock.

This book provides, in simple terms, an in depth understanding of how the brain works and how to optimize use of your brain. Rock also discusses how and why the brain gets overwhelmed. If you are interested in getting a scientific understanding that can help you get back in control of your brain, this book could be helpful to you.

We live in a world with ever increasing distractions thanks to the Internet and technological revolution it has brought. This is no less true in Sweden than elsewhere. Modern communication seems to demand we are more accessible. Increasingly we find our attention divided between tasks. Rock exposes the effect of these demands on the brain. This is cognitive neuroscience, fairly detailed stuff, but explained in conjunction with practical tips.

Regaining Focus and Balance through the Strategy of Mindfulness

The Mindful Path to Self-Compassion: Freeing Yourself from Destructive Thoughts and Emotions by Christopher Germer.

Many of us are in jobs that require us to use our intellect all day long. For some, the best way to tackle an overwhelmed mind is not by using our intellect to understand the science of the brain but to live more in the present. That starts with being kind to ourselves and also means listening to the body and allowing it to tell us what it is experiencing and what it needs. When we spend most of the day in our heads, we can lose touch with the rest of our body. Mindfulness involves strategies that can be learned. This book will assist you get back to the present and find a new balance.

Germer’s book is an easier read than Rock’s, and his approach is different. It’s less about understanding neuroscience and more about connecting with and awareness of sensations and emotions. If you see yourself more as a ‘feeling’ type of person than a ‘thinking’ type of person, this is probably the better book for you.

The Chimp Paradox: The Mind Management Programme for Confidence, Success and Happiness by Dr Steve Peters.

The Chimp Paradox is really about managing emotions (a product of our inner ‘chimp’) and using reasoning (our ‘human’ quality). Peters is a psychiatrist who specialises in sports performance and he is concerned with helping people to understand and manage their emotions and thoughts. This is quite a quirky book that lies somewhere between the drier science of Your Brain at Work and the warm, feel-good The Mindful-Path. Peters teaching skills are clear: the book is full of diagrams and metaphors. His models are easy to understand and fun to read.

If you like the idea of being coached, and you are ready to take up a new perspective on your performance, The Chimp Paradox might be one of the best self help books for expats. It has been described as a ‘mind programme’, so be prepared to start reprogramming the way you respond to your emotions!

Self Help Books for Expats for Developing Calmness and Responding to Anger

Wildmind: A Step by Step Guide to Meditation by Bodhipaksa

People often ask me if I do ‘Anger Management’. Well the first step in managing Anger is awareness of it and the emotions which precede it. Meditation provides one of the best ways to develop awareness of emotions. Despite what some people say, anyone can learn to meditate. It doesn’t involve ‘blocking out thoughts’ as such but the practice of focussing. If you are willing to try focussing according to a set procedure, you will find that you are meditating.

I’ve had the pleasure and good fortune to have met Bodhipaksa (a Scotsman and veterinary science graduate formerly named Graeme Stephen) and can vouch he is a very decent chap! He has been practising meditation for over 20 years and teaching for over 10 years. This is one of the simplest and easiest to follow step-by-step guides to meditation by an excellent teacher. It will tell you how to do the fundamental practices that help develop calmness and positive mental states towards others. These are proven techniques to respond to and reduce the influence of Anger and other emotions.

Guided Meditations for Stress Reduction also by Bodhipaksa

This isn’t actually a book but a set of guided meditations on CD. There is also an audio-book version if you prefer that. So if you aren’t much into reading and prefer listening to a voice guiding you, you can use these audio tracks to help reduce your stress response.

Our thoughts affect our bodies both in terms of the sensations we feel and the emotions we experience. And what we feel in turn affects our thoughts. This cycling can leave us in a state of hyper-arousal or acute stress response (aka ‘fight-flight-freeze’). Focussed awareness can reverse this and bring us back to the present-moment experience. If you are struggling with stress, guided meditation could be a way forward for you. Try the CD and consult myself or a meditation teacher if you continue to experience difficulties.

CBT Self Help Books For Expats

Change Your Life with CBT by Corinne Sweet

CBT means Cognitive Behaviour Therapy and it is ‘flavour of the month’ in Sweden right now. It’s not particularly new, having it’s roots in the 1950s and rising to prominence in the 80s and 90s, and is regarded as a ‘2nd wave’ therapy (we’ve experienced 2 more ‘waves’ since!). But psychoanalysis used to be the only talk therapy with credibility in Sweden and CBT is quite easy to justify through research evidence so more people have heard of CBT than Narrative Therapy. That’s not to say Cognitive Behaviour Therapy isn’t effective, because for many people it is. To an extent, CBT is also very favourable to self-help so there are a lot of books on the market to choose from.

I picked up Corinne Sweet’s book a few years ago on my way back to Sweden at the bookstore at Gatwick Airport. It is basic but I think it is one of the most accessible and easy to read texts on CBT. If you are suffering from mild anxiety, ‘catastrophising’ or various negative thoughts, this is a great starter for you to find out how to reduce fear and develop more happiness.

Think Good – Feel Good: A Cognitive Behaviour Therapy Workbook for Children and Young People by Paul Stallard.

I don’t work with children these days but a colleague showed me her copy of this book and I’m not surprised that it is a best-seller. There’s not much around in terms of CBT workbooks for children and this book also provides very helpful guidance to parents and clinicians. I’ve had parents contact me to ask if I will work in English with their kids. I usually send them to a child specialist because I am an adult specialist. If the CBT model interests you, I’d recommend getting a copy of this workbook, reading it yourself and then using it with your children. Sure it costs a bit more than the average book, but it is packed full of helpful activities and will provide you with an excellent grounding in CBT if you decide to see a therapist or counsellor in person. Obviously, if the difficulties are very serious or urgent, it is always best to seek help from a practitioner as soon as possible. In that case, get in touch with a ‘BUP’ (child and youth psychiatry) clinic directly or through a GP at Vårdcentalen.

One last suggestion… This summer, get yourself an Amazon Kindle. Okay, I admit it I am biased. I am a Kindle convert! But it is so much easier than travelling with a stack of books. You can read all of these self help books for expats on Kindle plus novels or other non-fiction books as well and the latest version even works in bed with the lights out! If you don’t have one already you can buy a Kindle at this link.

I hope to post again with some more book recommendations for inspiration, motivation and commencing a new life in Sweden. Just send me an email if you would like to be informed of new articles. I’m also available for consultations online over Skype webcam, by phone or email exchange. In the meantime, happy summer reading!

*As an Amazon Associate, I earn from qualifying purchases.

July 3, 2014
What’s the Purpose of Talk Therapy? 5 Different Reasons to Turn to Online Counselling.

Recently I was reflecting on all the requests I receive for online counselling, coaching and therapy. I’ve been providing therapy consultations over webcam and offering email counselling for several years now, and I’ve heard a diversity of hopes and expectations over that time. Here are some of them.

Strategies and Tools

One of the biggest reasons people contact me is to ask for ‘strategies’ or ‘tools’. The tools or strategies (or methods or approaches) they are seeking could be about improving confidence or happiness, better communication, managing mood (e.g. ‘anger management’) or coping with stress. You might have already tried some approaches you have read about or been told about previously but remain stuck or need some coaching. Or you might be looking to try something new. One size definitely does not fit all (even ‘CBT’ – cognitive behaviour therapy – can be many things to many people and, despite the claims, it doesn’t suit everyone). People sometimes arrive with an expectation that a therapist will fix or treat their mental health problem but generally the approach is collaborative: we treat it together, in cooperation.

Working Through Stuff (or working out stuff)

Life can be complicated. Self-help books only take us so far. But a conversation is dynamic and can take us therapeutically further than reading a book or doing the exercises it contains. When people talk with me about dealing with family relationships, for example, they sometimes need to modify the approach they have been reading about to suit what is happening at the time. Sexuality is another topic that can take some working out. Categories like ‘gay’ or ‘straight’ or ‘bisexual’ can seem very fixed at a time in one’s life when sexual identity is changing. Some dialogue can assist when working through our relationship with our body, desires, public identity and the gender expectations of us. Talking about difficult topics can also make it easier for us to express ourselves. The useful thing about online counselling is that you have the option of requesting some notes from the session or you can exchange therapy emails as a way of holding onto your progress.

Interested in making an appointment to work out something? Click here to send an email.

Letting Go and Acceptance

When something changes, like a relationship or job or even something to do with our bodies such as an illness or disability, the adjustment can take time. We can benefit from some therapeutic conversations. Some people describe this as ‘grieving’ but this word might not fit for everyone. In seeking resolution, counselling can take an interesting turn. For instance, when someone special or close to us passes, we might be thinking of meeting with a counsellor as part of ‘letting go’. However I often find the counselling process leads people to start recovering their relationship with a loved one, and bereavement turns to remembering and holding the deceased close. With death as in life, there are many ways to resolution.

Getting a Sounding Board or Bollplank

When we are looking for answers, having someone experienced to help us ‘bounce around’ ideas, or ‘bollplanka‘ as the Swedes say, can be helpful. Many tell me that they are looking for someone impartial, unlike a friend or relative who might automatically side with them or play ‘devil’s advocate’. In a therapeutic relationship, it’s okay to ask for advice or reassurance. Counselling isn’t always about providing this, but even if it is not possible in a talk therapy appointment, we can explore what you are seeking and how you might get it professionally or on your own. Some people find that one or two webcam consultations are enough to find direction. Others meet with me regularly, like once a fortnight or once a month, simply because they find it helpful to throw around ideas before making decisions.

Making Changes in Life

Speaking of decisions, at certain times of life it can seem like we are at crossroads. Should I remain in the relationship or leave? Should I continue in Sweden or return home? Should I follow my career or take any job, just to earn some money / get into the society? People tell me that making personal changes can be easier when they hear some other perspectives. There are some stories I can share from those who have given me permission. But it is also helpful to explore the subject. Seeing our situations as ‘stay or go’ can produce more stress and often leaves it harder to make a decision about what to do. In this respect, the self-awareness and understanding we get from talking to someone else can open up the possibilities beyond what we had imagined prior to talk therapy.

Meeting for Talk Therapy Online

If you would like to meet online, there are several options available. Webcam conversations over Skype mean we can see and hear each other in real time. If you don’t have access to a computer or prefer not to be seen, you can choose telephone counselling if you don’t mind the additional cost of calling a Stockholm landline (I also have landlines based in London or Sydney, Australia you can call). Instant Message chat provides a slower, more reflective opportunity for meeting in real-time with the added benefit of not being seen or heard. It is entirely text-based conversation. Or, if you prefer to write in your own time, you can choose email counselling where you write me an email and I respond within 72 hours. You then receive an email you can keep referring back to in future.

For more information including my fees and availability, please contact me.

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October 13, 2013
“Tools for Better Living”: 6 English Speaking Coaching Sessions for Expats in Stockholm and across Sweden
This fall I’m offering a flexible course that combines both coaching and counselling in a short series of consultations. These sessions are designed specifically for expats and other English speakers seeking direction. Are you looking for some tools for dealing with change or adjustment? Interested in taking a series of sessions to kick-start your motivation? Read on!

Those of us who have been expats in Stockholm for a number of years know the winters can be tough. Swedes know it too and, although most of them have grown up with the darkness and cold that comes with a Swedish winter, many still struggle. Whether you are in your first few years of living in Scandinavia, or you have lived here all your life, there is good sense in using the autumn to prepare psychologically and emotionally for what is to come.

6 Sessions of Coaching or Counselling, 5 Suggested Themes

This series combines the approaches of Cognitive Behaviour Therapy (CBT), Narrative Therapy, Motivational Interviewing, Life Coaching, Relaxation Strategies, Skills Training (including Stress Management and Communication Training) and Mindfulness. I’ve based it around a presentation of the most common psychological tools I use in my practice but will tailor it to suit your circumstances.

My approach is based on the idea that, through conversation based meetings, we develop ideas and strategies together that neither one of us might have envisaged using before. In this way, you bring your skills and knowledge as a contribution to the sessions and I also introduce theories and tools as possibilities for you to start using. Of course all the sessions and everything you say to me is confidential.

The plan below is a guide only and we can modify it according to your needs.

Want to know more already? Email me!

#1   Who Am I?

Our sense of identity can be quite important to how we manage in new situations or cope with change. Who are you and what has contributed to your sense of yourself, particularly since you moved to Sweden?

The first appointment is a kind of assessment where together we discuss what you would like to cover in the course of sessions and share whatever aspects of your story you would like to tell me. You also have the opportunity to ask me any questions you would like answered. At the end of the session I can give you an interesting identity-based task to take away and complete in your own time, if you like. ‘Homework’ is always optional. Some people want it and some don’t, so you can make the choice.

If you would like to know more about me in advance, read the About Ash Rehn page on this website. And I welcome you to contact me prior to the session if you would like to know anything more about me. It is important that we can work together and for you to feel a sense of comfort during our meetings.

#2   Recovering Energy, Motivation and Establishing Routines

It is not unusual for people to want to meet with a coach or therapist when they are at, or have been at, a low ebb. I’m used to seeing people struggling with motivation, lacking energy or feeling like they have failed. At the same time, it is not always that way. It can be more like chaos that needs sorting out. So part of our work together might be looking at what you want or what you appreciate about your life or what you need. Sometimes this involves considering your ‘vision’ for life. Sometimes people feel stuck, sometimes they feel lost, sometimes they just want me to help them sort through ‘stuff’ or ‘issues’. Whatever the case is, we can discuss it together.

#3   Managing Stress, Coping and Empowerment Strategies

How you deal with change often depends on your past experiences, the techniques you have learned or the resources you have at hand. In our sessions we can consider the skills you are using now as well as what you might need to recover or discover. If you are caught in some Mind Traps (cognitive distortions in thinking) we can identify these and determine alternative psychological strategies to help you escape or re-establish balance. I can also show you some physical practices you can use at any time to reduce anxiety and your stress response.

#4   Career / Relationships / Friendships / Family: Planning and Goal Setting

Would you like to show me what your life looks like now and what your ideal life would be? Often this can be a way of envisaging the future as well. Collaborative consultations can offer the first steps forward to making changes across a number of the aspects of our lives. Together we can explore changes you want to make in any or all of these areas and what might be required for moving forward. It tends to be much easier to do this in collaboration.

#5   Improved Communication for Relationships

Frustration and Anger are two of the most common emotions I discuss with people who meet me in Stockholm or online. If our needs are not being met, we can find our emotions about certain events and incidents spilling into other aspects of our life. And that affects our relationships. Taking an alternative approach to your standard way of communicating is one way to lower the frustration you are experiencing. I can show you some other possibilities and we can practice these in the sessions.

#6   Awareness, Acknowledgement, Acceptance and Building Resilience

It is not generally possible to change everything overnight. Meeting and having a conversation about what concerns you can also be a way of tapping into some other perspectives. Part of this work is about holding onto what you have learned or discovered. Part of the coaching can even include awareness-building techniques like Mindfulness. In these 6 sessions, I offer a start to a process that can take you in new directions. You might decide to continue with something new we discover together during our work or you might even decide to continue with me. With your permission, I will follow up by email at least twice over the 2 months following the series. If you want to continue, we can discuss the possibilities to keep going, what you have achieved and what might remain outstanding.

Pay as You Go or Save with a Package of Sessions

This flexible course is offered as pay as you go or you can receive 6 sessions for the cost of 5 if you pre-pay the series. You can attend just the first session and decide if you want to continue with no obligation to pay for more. You are welcome to decide a few days after the first appointment whether you want to pay for the whole series or pay as you go. I do ask for a deposit of 200 crowns for the first appointment but you have 7 days from the session to pay for the balance. Please contact me for further details of the fee.

No Guarantees or False Promises, but Possibilities, Opportunities and Open Dialogue

It would be quite unethical of me to make false promises about how successful this short series of appointments will be for you, particularly when I have not yet met you. So I don’t offer a guarantee that you will achieve everything you ever hoped for in just 6 sessions. But I do offer to be fully present with you for the sessions and to work collaboratively with you in ways you find comfortable.

It is my professional experience that once people start talking, what they are struggling with often changes or even dissolves. It does not happen at the same pace for everyone, but making a start will give you a better understanding of what might be required. I have chosen a framework of 6 sessions as many people find this is just enough to launch them into self-sufficiency. The relief of talking to a professional in a confidential setting can be influential, as can the possibilities for dialogue, acknowledgement, exploration and even confession.

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Book Now to Secure Appointment Times
- A limited number of these sessions are now available daytimes and evenings during September and October.
- Sessions are available both in-person ‘face to face’ in Stockholm and ‘face to face’ by Skype webcam (or audio-only if you prefer).
- Possibilities for continuing include the option of email counselling once the course is concluded.
Make an enquiry about available times and fees now through my contact page.

I look forward to hearing from you!

Ash Rehn BSocWk, MA, MAASW (acc.)
August 17, 2013
Anxiety Therapy in Stockholm: Walk and Talk or Talk and Tea… You Choose!

Treatment for Anxiety is now attracting the same attention given to Depression over recent years. And it’s no wonder. Many people are unaware that Anxiety is affecting their lives and as a result become confused as to how to better approach their symptoms. Talk therapy can offer new ways of responding to Anxiety, and you don’t even have to do it sitting down!

Expat counselling brings me into contact with a wide range of people and personalities. I meet bankers and barmen, teachers and tradies, researchers, roadies and radio journalists. Some come to Sweden for relationships, some for money and some for recognition. It isn’t easy being an immigrant in Scandinavian culture regardless of how advanced Swedish society seems to be. Relocation, cultural differences and relationships are stressors and how we respond to stress affects how well we adjust and how happy we are.

When people come to me, they have often already researched their symptoms on the Internet and tried to diagnose themselves. So what is actually a stress response has been interpreted as ADHD, or OCD, or Depression, or Aspergers Syndrome, or Bipolar. These are the most common diagnoses people are concerned about. It is quite common for Depression to be preceded by Anxiety. However misdiagnosing yourself with the help of the Internet can mean using an ineffective treatment for the condition or falling into a sense of hopelessness. Some even come to the conclusion they have a genetic fault or biological deficiency that cannot be fixed.

I reckon that most people have come to these understandings because we don’t hear enough about Anxiety and how we can respond more effectively to it. Hopefully that is about to change. However this brings another danger: the idea that there is a ‘quick fix’ to Anxiety. My experience is that those suffering from Anxiety are also susceptible to promises about ‘fast results’ or ‘cures’. Taking medication can sometimes help but some drugs are addictive and only worsen the problem. A promise of complete recovery can be much more appealing than the idea that we might have to work at reducing Anxiety or even learn ways to live with it.

Click Here to Ask a Question or Make an Appointment

How Can I Reduce Anxiety?

Firstly, most people with Anxiety know that it can affect how their physiology works including changing the way they breathe, their heart rate and the feeling of control over their body. But not so many have learned that the reverse is true as well: you can lower physical and psychological Anxiety through consciously changing your breathing, using relaxation techniques and getting back in touch with your physical being. It is much easier to read about these methods than put them into practice. So getting the help of a therapist to try them out can make a huge difference. Let’s talk about the acute stress response of flight / fight / freeze and how important it is to drop out of that if your really want to get a handle on Anxiety.

Secondly, the practice of Mindfulness. Mindfulness is about being right here, right now. Not in the fear of the future or the regret of the past, but physically present in the moment. It is about focussing attention, without judgement, in calmness and clarity. It is not new but at least 2500 years old and it has stood the test of time. Mindfulness offers you a way of observing your feelings and emotions (including Anxiety) without being pushed around by them. It is highly effective but requires work and practice. This is where the therapist or counsellor can support you by explaining the practices of Mindfulness and helping you monitor your progress. If you are interested in reading about Mindfulness and Stress reduction, I recommend A Mindfulness-Based Stress Reduction Workbook available here on Amazon.

Thirdly you can work with your thoughts. This is why Cognitive Behaviour Therapy (CBT or KBT in Swedish) has become so popular. It can be effective but so much depends on how the therapy is undertaken, the relationship between you and the therapist and, most importantly, whether you are outside of the stress response enough for your cognitive capacities to function properly. There are other approaches to working with Thoughts as well. Deconstructing ideas and concepts and working out how the thoughts arose in the first place can be a significant aspect to talk therapy. Again it requires a degree of trust is established between you and your counsellor.

Walking Talk Therapy

I offer a unique approach to working with Anxiety which I call ‘Walking Talk Therapy‘. Of course, you are always welcome to take a comfortable armchair in my consultation room and chat over a cup of tea (including herbal tea), coffee or glass of water. But if you prefer to walk and talk, we can do that and get some exercise at the same time. It is generally well known that exercise helps alleviate many forms of Depression but it can also be effective for Anxiety. This is at least partly because we are using our whole body when we walk and we can work with the breath in different ways as we walk. These are the most effective means to reduce an acute stress response. It can help us to access a more relaxed sense of ourselves, feel more free and clear our thoughts so we have capacity to think differently.

We aren’t all the same and some of us respond better to some Anxiety treatments than others. So apart from face to face appointments in my consultation room and Walking Talk Therapy, I also offer therapy for Anxiety over the Internet through Skype webcam, Instant Message and Email Exchange. So it doesn’t matter where you are in Sweden or anywhere else in the world, through web technology we can communicate and work cooperatively to reduce Anxiety and change your response to stress.

If you are ready to make an appointment or if you want to know more about my availability and fees, contact me now and let’s make a start. There is more information about me and how I work in these pages but if you have any questions I would be happy to answer them directly.

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I look forward to hearing from you!

Ash Rehn.

May 8, 2013
10 Questions to Ask Your Prospective Counsellor or Therapist Who Works In English

Have you reached a turning point in your life and want to find a therapist who works in English? Do you need counselling for relationship issues, stress or a break-up? Or would you like to find an English speaking coach to improve life generally? Here are ten important questions to ask your prospective counsellor or therapist. I’ve provided my own answers to give you a sense of where I fit according to these criteria.

1. How long was your therapy training?

My therapy training commenced when I started training as a counsellor in 1989 and it has not stopped since! Over the last 30+ years I have undertaken Bachelors and Masters degrees in Social Work, specialist narrative psychotherapy training through the Dulwich Centre in Adelaide, Australia and completed many short courses and workshops in a range of therapeutic approaches. These include CBT (Cognitive Behaviour Therapy), DBT (Dialectical Behaviour Therapy) skills training, Mindfulness, Psychoeducation (including Motivational Interviewing), Stress Management, Anger Management, Relaxation Strategies, Problem Solving and therapy for adult survivors of child abuse.

A good therapist does not stop his or her education simply when a qualification is achieved. Professional development must be ongoing. Each year I attend a number of training activities and conferences and regularly share the outcomes of these with my clients.

2. Under which title, ‘coach’, ‘counsellor’ or ‘therapist’ would you be allowed to work in your own country?

In both Australia and England, I am allowed to use all 3 of these titles: coach, counsellor and psychotherapist. In Sweden the title ‘psychotherapist’ (or psykoterapeut in Swedish) is a protected title and only practitioners licensed by the Swedish National Health and Welfare Authority – Socialstyrelsen – can use that title. I have not applied to be licensed as a psychotherapist in Sweden and instead refer to myself as a samtalsterapeut (counsellor) or narrative therapist who works in English. Psychotherapist training in Sweden is limited to certain methods or approaches and applicants for a Swedish license must demonstrate compliance with particularly Swedish requirements. I have found that most of the people who meet with me are far more interested in the benefits of a therapist who speaks their language and understands their culture than they are in meeting with someone who fits precise Swedish requirements or works through the Swedish healthcare system.

3. How often do you have supervision?

I generally attend supervision at least once a month and my commitment to supervision meets the recommendations of the AASW and BACP. Supervision for counsellors and therapists is not the same as supervision in a management situation. It means something completely different. It is about discussing professional issues in a structured way and ensuring the counsellor or therapist is taking care of their own well-being. It helps counsellors, psychotherapists, psychologists and social workers ensure their integrity and ethical practice. Counsellors and therapists in private practice will generally be paying for private supervision from a more or equally experienced person. I have such an arrangement with a more experienced practitioner and also engage in regular peer supervision with colleagues.

4. How long have you been practising?

I began practising as a counsellor in 1989 and have worked across the community, government and private sectors over the years. Since 2005 I have been specialising in mental health counselling and therapy. I commenced private practice as a therapist and mental health counsellor in 2008. I established myself as a therapist who works in English in Stockholm in 2010.

5. As a therapist who works in English, what is your theoretical approach?

My practice is informed by a range of theoretical approaches. When undertaking advanced therapeutic work with people, it tends not to be helpful to be limited to a singular technique or method. In Sweden, counselling and therapy is dominated by Cognitive Behaviour Therapy (CBT or KBT) and Psychoanalysis but there are many other ways of working together if these do not appeal to you. I am particularly drawn to dialogical and narrative practices and the work of a number of well-known therapists including Harlene Anderson, Johnella Bird, Art Fisher, David Epston, Michael White. I enjoy using the Self-Compassion model developed by Kristin Neff. If you would like more information about these approaches, I would be happy to send you some links if you email me for details.

6. Do you offer a 50 or a 60 minute hour?

My standard appointments are 60 minutes. I generally leave at least 15 minutes as a buffer between appointments so that we are not rushed. If I have more time available, I usually don’t mind if we continue a little longer if it is helpful to you.

7. What do the initials behind your name actually mean?

Currently the initials after my name are: BSocWk, MA, MSc, AMHSW. They stand for Bachelor of Social Work, Master of Arts, Master of Science and Accredited Mental Health Social Worker.

8. Are you an accredited member of a professional organisation?

Yes, as above, I am an accreditated member of the AASW in Australia. This accreditation means I have a qualification awarded by a professional association as a specialist mental health provider and can offer focussed psychological services under the Australian government Medicare program when I am meeting with clients in Australia (similar to the services provided by psychologists that are reimbursed by the government there). The AASW supports my practice in Europe and represents my professional interests, however unfortunately Medicare will not reimburse appointment fees unless both myself and my patient are in Australia.

9. Do you need insurance to be a talk therapist who works in English?

Yes, as an accredited social worker and member of the AASW, I hold both professional indemnity and public liability insurance.

10. How much do you charge and do you accept insurance?

You can see my consultation charges on my fees page. It is up to your insurance provider whether they will pay for my services. Many insurers will only pay for psychology providers they work with regularly. If your insurer or company agrees to cover the cost, you will need to pay for your consultation with me upfront and then claim back from them. One benefit of not using insurance is that our consultations will not be on your health record in Sweden or in your home country. If you require your invoice made out to a particular company name, please advise me in advance.

Keep in mind that cost is just one factor to take into account when choosing a coach, counsellor or therapist who works in English. You might find better help from a more experienced practitioner.

You can read more on the About Ash Rehn page. If you are interested in making an appointment, please contact me by email or phone. I’m happy to answer any further questions you might have.

December 11, 2012
Anxiety and Regular Therapy in Stockholm: Temporary and Ongoing Solutions

International relocation to Sweden is a major life change for most people, particularly if it is the first time they have moved somewhere English is not the first language. But for a person with persistent anxiety, the stress of finding accommodation, dealing with visa issues, trying to make friends and maintain relationships can make pre-existing worries feel much worse.

How can regular counselling appointments help Anxiety?

The advantage of building a relationship with a professional therapist or counsellor is that when things go ‘pear-shaped’, you have someone who knows you and can work in ways that suit your background and personality. Uncertainty coupled with the frustration of being in an unfamiliar place can lead to mood swings, irritation and sometimes a sense of despair or hopelessness. It can be reassuring to know there is someone in Stockholm or online who is willing to listen and help you through the transition of settling into life in Sweden or assist to deal with anxiety over the long-term, if that is what you want.

Sometimes I am asked the question: Which is better, brief counselling or ongoing therapy? The straight answer to this is that they can both be helpful in their own ways. It really depends on what you are looking for. ‘Counselling’ is often the term to describe a series of appointments with a particular goal in mind like getting strategies to make it easier to talk to people at parties or ways to manage mood swings after a relationship break up. Sometimes particular methods like CBT (cognitive behaviour therapy) or breathing techniques can be employed to meet specific objectives. Counselling appointments can also be a means to access health education or relaxation techniques. A series of counselling appointments might last 6-12 sessions over 2-3 months.

The word ‘therapy’ is usually used when people describe a process that takes place over a longer period, for example, from several months to a year. Therapy for anxiety can involve talking about previous life experiences and retelling these in ways that reflect new understanding or reveal skills and abilities that may not have been previously acknowledged. Or it can mean developing new approaches to fears or worries, putting these into practice, refining and modifying them over time while checking in with a therapist who helps monitor progress or maintain a sense of achievement. Of course some people choose to continue with their therapist even beyond a year. In this way, a therapeutic relationship can be akin to meeting regularly with a personal trainer, nutritionist or accountant. Ongoing therapy appointments aren’t just about solving problems. They can also be a way of maintaining your overall well being.

These are generalisations of course. You can attend therapeutic appointments with me in Stockholm or have coaching and counselling over Skype webcam for as few or as many sessions as works for you. Both approaches are more than just listening, and ideally are more than just being given skills or techniques by the therapist. Counselling and therapy work best when they are a collaborative process where both you and I work together.

What happens in Anxiety Therapy?

The answer to this question really depends on you, your preferences, experiences, hopes and expectations for the appointments.

I don’t work from a manual because people are not machines. While some of us have common experiences, we also have unique histories that require unique outcomes from therapy consultations. You might be someone who responds well to cognitive strategies and being offered new ways to think about distress and uncertainty. Or you might be looking for tools to modify your behaviour in situations when nervousness takes over. Perhaps you just need a sounding board, to have someone hear what you are going through and ask questions so you can explain and understand your worries. Or maybe you just want to talk and get something off your chest?

I work with anxiety and depression every day. I’m used to meeting with people who feel nervous and don’t know what to expect from the appointment. When you come to see me I will do my best help you to feel comfortable and talk freely. You can talk to me in English and take a break whenever you need. What you say to me is confidential and I am bound by ethics and membership of my professional association to maintain your confidentiality. The only exceptions to this are where there is a high risk to a person’s life, when a child is in danger or if the law orders me to report something in particular. But even in these circumstances I will always try to discuss my concerns with you first.

There isn’t a set time frame for anxiety treatment. Adjustment to living in Sweden and culture-shock tend to require shorter term approaches than fears, hang-ups and suspicions that have been carried around for years. My intention is to provide you with a space where you can put down some of your psychological ‘baggage’, go through it with me, and decide what is useful and what isn’t. Together we can try to make sense of whatever is confusing you or holding you back so you can go forward. Hence ‘Forward Therapy’.

Trust develops as we get to know each other. If you have had difficult or unhappy memories of therapy appointments in the past, I welcome you to share these with me to help me provide you with effective consultations.

A Word about Drinking Alcohol and Stress

It is very common for expats to seek help for problems with drinking too much. Alcohol can enable people to relax and unwind, particularly when they are finding their job (or unemployment) stressful, if they feel they are not meeting the expectations of their partner or having other relationship issues. Unfortunately, drinking can also lead to the other extreme, a total absence of control, anger and more regrets. But even when people are struggling with drinking they don’t always want to stop completely. I will work with what you want to achieve in terms of your alcohol use and what you are aiming for, whether it is just a reduction in how much you drink, changing when or under what circumstances you drink or ceasing drinking completely.

We can meet in-person at my office in Stockholm, for Walking Talk-Therapy on Kungsholmen or over Skype webcam. If you would like to make an appointment, please contact me by email or leave a message on 08-559 22 636 for me to call you back.

April 20, 2012