Presenting Past Psychotherapy is Paolo Imbalzano’s independent practice, offering relational psychotherapy and clinical supervision in Shinfield, Reading, and online, with ILF neurofeedback available in person.

How do I know if therapy is right for me?

There is no single answer to this.

Many people come to therapy when something feels persistently difficult — anxiety that does not settle, patterns that keep repeating, a sense of disconnection, or a feeling that understanding alone has not been enough.

You do not need to be certain before getting in touch. A free 20-minute consultation can help us talk briefly about what feels difficult and whether this way of working may be appropriate.

There is no pressure to continue beyond the consultation.

Do I need a referral?

No. You are welcome to get in touch directly.

I also welcome referrals from GPs, psychiatrists, health insurers, case management organisations, counsellors, psychotherapists, and other professionals, but a referral is not required.

Where do sessions take place?

I offer therapy in person in Shinfield, Reading, Berkshire, and online by video.

In-person sessions may suit you if you are looking for psychotherapy in Reading or the surrounding Berkshire area.

Online sessions are available if you prefer to meet remotely, live further away, travel regularly, or need a more flexible way of attending.

ILF neurofeedback is available in person only, as it uses specialist equipment in the room.

What happens in the first session?

The first session is a chance to begin understanding what has brought you to therapy, what feels most difficult, and what you are hoping for.

I may ask some questions about your history and current situation, but there is no fixed format. The pace is shaped by what feels manageable for you.

You do not need to explain everything perfectly or go into painful material before you feel ready.

The first session is also an opportunity to get a sense of whether working together feels like the right fit.

What if I am not sure what I want from therapy?

That is a very common starting point.

Many people arrive knowing that something feels difficult, stuck, overwhelming, or hard to shift, but without a clear sense of what they are looking for.

That uncertainty is something we can explore together. You do not need to have it worked out before we begin.

Can I try a few sessions before committing?

Yes. There is no requirement to commit to a fixed number of sessions upfront.

Many people find it helpful to begin with a few sessions and then review how the work feels.

If we continue, we can keep reviewing the focus, pace, and whether the work remains useful.

What is the difference between counselling and psychotherapy?

In practice, the boundary between counselling and psychotherapy is often less clear than the terms suggest.

Psychotherapy tends to involve a deeper and often longer exploration of patterns, history, relationships, and underlying experience — including how earlier experiences may shape the way we respond now.

My work is psychotherapeutic in nature, though the pace, depth, and focus always depend on what is clinically appropriate and what feels manageable for you.

What does trauma-informed mean in practice?

Trauma-informed means the work is shaped by an understanding of how trauma, chronic stress, and early relational experience can affect the body, nervous system, emotions, and relationships.

In practice, this means paying attention not only to what you understand consciously, but also to what shows up emotionally, physically, and relationally.

It also means working at a pace that your system can stay with, rather than pushing quickly into material that feels overwhelming.

Do I need to have experienced trauma to work with you?

No. Many people I work with do not identify as having experienced trauma in an obvious sense.

Anxiety, low mood, self-criticism, relationship difficulties, emotional shutdown, overwhelm, or a persistent sense that something is not quite right can all be valid reasons to seek therapy.

What matters is not only what happened, but how your mind, body, and nervous system may have had to adapt in response to experience.

What is the difference between your approach and CBT?

CBT often focuses on identifying and changing unhelpful thoughts and behaviours, usually within a structured and sometimes time-limited framework.

My approach is relational, trauma-informed, body-aware, and often longer-term. It attends not only to thoughts and behaviours, but also to emotional experience, the body, relational patterns, and nervous-system responses.

For some people, a structured short-term approach such as CBT may be the right fit. If that seems more appropriate, I am happy to help you think about what might suit you better.

How do you decide which approach to use?

There is no fixed formula.

The way I work is formulation-led, which means it is shaped around your particular history, patterns, needs, and capacity.

Some people need more stabilisation before deeper work becomes possible. Others are ready to go deeper sooner. The work evolves as we understand more together.

If you would like a clearer sense of the approaches I integrate and how they fit together, you can read more here:

Approaches I integrate in therapy ›

How long does therapy take?

This varies considerably and depends on what you are bringing, what you are hoping for, and how the work unfolds.

Some people find that a focused period of work is enough. Others find that longer-term therapy allows deeper and more lasting change.

I do not work to a fixed number of sessions. We would review the focus, pace, and usefulness of the work as it develops.

Do I have to talk about my past?

No — not in a direct or pressured way.

Understanding the past can be part of therapy, and often is, but the pace and depth of that exploration are shaped by what feels manageable and clinically useful.

Some people begin with earlier experience. Others begin with what is happening now. Both are valid starting points.

Where appropriate, body-aware or nervous-system-informed work can begin without needing a detailed verbal account of everything that happened.

What if I find it hard to talk about certain things?

That is not unusual, and it is not an obstacle.

Difficulty talking about something may reflect protection, shame, fear, or the limits of what currently feels safe to put into words. We would not push past that.

Part of the work is creating enough safety for things to become speakable at their own pace.

What if I have had therapy before and it did not help?

Previous therapy that felt unhelpful — or helped only so far — is worth talking about.

Sometimes a different approach, a different relational dynamic, or work that includes the body and nervous system can reach something earlier therapy did not.

It is not a reason to give up on therapy. It may be useful information about what kind of support you need.

How will I know if therapy is working?

Change in therapy is not always dramatic or immediate.

Early signs are often quieter: a little more space before a familiar reaction takes over, slightly better sleep, feeling less alone with something difficult, or being able to notice what is happening inside rather than simply being overtaken by it.

Change is rarely linear. Some parts of the work may move more quickly than others, and there can be periods that feel slower or more stirred before something settles.

We would talk about how things are going as the work develops, so there is space to reflect on whether therapy feels useful.

What if things feel worse before they feel better?

This can happen, and it is worth knowing about in advance.

Sometimes beginning to look at things that have been pushed aside, or entering into a new relational space, can temporarily stir things up. This does not mean therapy is going wrong.

If things do feel stirred up, we would talk about it, adjust the pace where needed, and make sure the work remains as grounded and manageable as possible.

Can therapy help if I feel emotionally shut down, numb, or collapsed?

Yes, although the work needs to be carefully paced.

Emotional shutdown, numbness, brain fog, or feeling “offline” can be protective responses when the system has had to manage too much for too long.

Therapy is not about forcing feelings open. It is about helping your system feel safe enough to reconnect gradually, with more steadiness, choice, and capacity.

How often will we meet?

Most individual clients meet weekly.

Couple clients also usually meet weekly, although 80-minute fortnightly sessions may sometimes be arranged where clinically appropriate.

Frequency is something we discuss at the start and can revisit as the work develops. Consistency tends to support the process, especially in the earlier stages.

Can I switch between in-person and online?

Occasionally, yes.

In general, I encourage a reasonably consistent format where possible, as the setting forms part of the therapeutic space.

In-person therapy can offer something important through sharing the same physical room. Online therapy can also be effective, especially when a good therapeutic relationship is established.

ILF neurofeedback requires attendance in person.

Where flexibility is needed for practical reasons, we can discuss it together.

What if I need to pause or take a break from therapy?

This is worth talking about openly when it comes up.

Sometimes a break is the right thing. Sometimes the wish to pause appears just as the work is moving closer to something important or difficult. That does not mean a break is wrong, but it is something worth thinking about together.

Either way, it is not something you need to manage alone. We can bring it into the room and think about what is needed.

Is what I say confidential?

Yes. Everything discussed in therapy is treated as confidential.

There are some important limits to confidentiality. The main exceptions are situations where there is a serious concern about safety — yours or someone else’s — or where I am legally required to disclose information.

These situations are rare. Where it is safe and appropriate to do so, I would aim to discuss any concerns with you directly before taking further action.

As part of good clinical practice, I may also discuss aspects of my work in clinical supervision. This is a normal and important part of psychotherapy. Where this happens, only the details necessary to think about the therapeutic work are shared.

Full details are set out in the Administrative Agreement, which I share before we begin.

What is ILF neurofeedback?

ILF stands for Infra-Low Frequency neurofeedback. It is a form of neurofeedback that supports nervous-system regulation using very slow training frequencies.

In my practice, ILF neurofeedback is used carefully and individually, usually alongside psychotherapy or within a wider therapeutic process.

Where does ILF neurofeedback take place?

ILF neurofeedback is available in person only at my practice in Shinfield, Reading, Berkshire.

It cannot be offered online because it uses specialist equipment in the room, including sensors that read brain activity during the session.

Is neurofeedback safe?

Neurofeedback is non-invasive and generally well tolerated.

The sensors read brain activity. They do not put anything into the brain and do not deliver electrical stimulation.

Some people may feel temporarily tired, wired, headachy, emotionally stirred, or unsettled after sessions, especially early in the process. This is why the work is carefully monitored and adjusted according to how your system responds.

What can ILF neurofeedback help with?

ILF neurofeedback may be relevant where difficulties involve nervous-system regulation, including sleep disruption, fatigue, brain fog, anxiety, chronic stress, hypervigilance, trauma-related overwhelm, emotional reactivity, shutdown, dissociation, concentration difficulties, and day-to-day resilience.

These difficulties often overlap. The overall aim is to support improved regulation and quality of life.

Can ILF neurofeedback support trauma therapy?

For some people, yes.

ILF neurofeedback may support stabilisation, including sleep, emotional steadiness, and reduced overwhelm.

This can sometimes make trauma-focused psychotherapy easier to tolerate, especially when the nervous system is highly reactive, easily overwhelmed, or prone to shutdown.

Can I do neurofeedback as a standalone service?

I usually offer ILF neurofeedback within an ongoing psychotherapeutic process.

Where someone is already working with another psychotherapist, psychiatrist, or relevant clinician, I may offer neurofeedback alongside that work if this seems clinically appropriate and there is enough clarity about how the process will be held.

Do I need a diagnosis to do neurofeedback?

No.

Many people come because of symptoms, regulation difficulties, or quality-of-life concerns rather than a formal diagnosis.

How do I get started?

A free 20-minute consultation gives us a chance to clarify what you are hoping for, relevant history, what you have already tried, and whether ILF neurofeedback seems like a suitable place to begin.

There is no pressure to continue beyond the consultation.

Who do you offer clinical supervision to?

I offer supervision to trainee and qualified counsellors and psychotherapists. I also work with small supervision groups where there is a shared professional context and a clearly agreed supervisory frame.

Suitability depends on your professional role, practice setting, client group, supervision requirements, and whether my experience is relevant to the work you undertake.

Is your supervision only for trauma-focused work?

No. My experience in trauma, attachment, dissociation, and nervous-system regulation can inform supervision where relevant, but supervision is not limited to these areas.

We may also consider wider relational work, clinical formulation, boundaries, ethics, safeguarding, endings, professional development, and the therapist’s experience of the work.

What informs your approach to supervision?

My approach is relational, integrative, collaborative, and ethically grounded.

We may consider what is happening for the client, for you as the therapist, within the therapeutic relationship, and in the wider professional or organisational context. My thinking is also informed by multi-layered approaches to supervision, including the Seven-Eyed Model where relevant.

My supervisory stance is also developmental. I take account of your stage of training, clinical experience, professional maturity, scope of practice, and the responsibilities you currently hold. The balance of support, challenge, structure, and space for autonomous clinical judgement is adapted accordingly, while keeping professional responsibilities clear.

Attention may be given to your emotional or bodily responses when they help us understand the clinical work. Supervision remains a professional and clinical process rather than a substitute for personal therapy.

Can supervision complement an existing supervisory arrangement?

Focused case consultation or supplementary supervision may be possible by agreement.

Where another supervisor, training organisation, placement, or employer is already involved, we clarify the purpose and boundaries of the additional supervision, how responsibilities are held, and whether any communication or coordination may be needed.

Can the supervision meet training or professional-body requirements?

This depends on the requirements of your training organisation, placement, employer, accreditation route, or professional body.

Please bring the current requirements to the initial conversation so that we can consider whether the proposed arrangement appears suitable. You remain responsible for confirming that it is formally accepted by the relevant organisation or professional body.

How are supervision sessions arranged?

Supervision is available online by video and in person in Shinfield, Reading, Berkshire. It can be conducted in English or Italian.

Individual sessions are usually 50 minutes, and most supervisees attend weekly or fortnightly. Small-group arrangements are agreed separately according to the size, purpose, frequency, and structure of the group.

Current fees are available on the Fees page.

What happens during the free 20-minute consultation?

We briefly discuss your professional role, practice context, current supervision needs, any relevant organisational or training requirements, and what you are looking for in a supervisor.

The conversation gives us both an opportunity to ask questions and consider whether working together may be appropriate. It does not commit either of us to an ongoing arrangement.

Is urgent or between-session clinical consultation available?

I do not provide an on-call or crisis-supervision service. Any arrangements for contact between scheduled sessions are agreed as part of the supervisory contract.

Urgent clinical, safeguarding, or risk concerns should be managed through the appropriate organisational, safeguarding, clinical-governance, or emergency procedures rather than awaiting a supervision appointment.

For a fuller overview of my supervisory approach:

Clinical supervision ›