I have over 30 years of experience in working as a highly specialised systemic family and couples psychotherapist and organisational psychologist. I focus on helping children and adolescents, adults, couples and families in overcoming mental illness, relationship issues and difficulties in their lives.
I work both in the NHS and privately and am an accredited trainer, lecturer and supervisor. I operate an independent practice as a clinician and clinical supervisor. I treat a wide range of mental health issues, which include eating disorders, depression, anxiety, self-harm, OCD and family and couple issues. I also offer carer and partner support.
I work closely with the Priory in Roehampton, The London Centre in Richmond and The Schoen Clinic in Chelsea. I am a qualified Association of Family Therapy (AFT) supervisor, a Chartered member of the Institute of Family Therapy (IFT) and the United Kingdom Council for Psychotherapy (UKCP). I have a background in organisational psychology, where I have worked with large corporate clients for many years and am a member of the British Psychological Society (BPS).
I work both in the NHS and privately and am an accredited trainer, lecturer and supervisor. I operate an independent practice as a clinician and clinical supervisor. I treat a wide range of mental health issues, which include eating disorders, depression, anxiety, self-harm, OCD and family and couple issues. I also offer carer and partner support.
I work closely with the Priory in Roehampton, The London Centre in Richmond and The Schoen Clinic in Chelsea. I am a qualified Association of Family Therapy (AFT) supervisor, a Chartered member of the Institute of Family Therapy (IFT) and the United Kingdom Council for Psychotherapy (UKCP). I have a background in organisational psychology, where I have worked with large corporate clients for many years and am a member of the British Psychological Society (BPS).
Mental illness and other disorders can feel overwhelming and they can place many demands on individual family members and family life overall. Support, advice, and guidance with navigating around the complexities of such mental heath issues can make a significant difference to the recovery journey. Through
systemic family and couples psychotherapy,
I am able to provide support, help and guidance for individuals, couples and families experiencing such difficulties.
Systemic psychotherapy helps facilitate understanding and collaboration between family members by building on existing strengths. My goal is to work in collaboration with families to encourage change. I am highly-sensitive to complex family structures, nuanced relationships and diverse beliefs and cultures. I am happy also to work in partnership with existing care professionals as part of a total care solution.
Systemic Family Psychotherapy helps people in a close relationship help each other. It also helps those people suffering from mental health issues explore the wider contextual issues within their system that may be contributing to or maintaining their mental health difficulties. Research shows systemic family psychotherapy is useful for families with children, young people and adult families and couples experiencing a very wide range of difficulties and experiences.
Systemic psychotherapy enables family members, couples and others who care about each other to express and explore difficult thoughts and emotions safely, understand each other’s experiences, appreciate each other’s needs, build on strengths and make useful changes in their relationships and their lives. Systemic psychotherapy is inclusive and considerate of the needs of each member of the family and/or other key relationships. It builds on people’s strengths and relational resources and works in partnership with families and others, not on them. Systemic psychotherapy is sensitive to diverse family forms and relationships, beliefs and cultures. It enables people to talk, together or individually, often about difficult or distressing issues, in ways that respect their experiences, invite engagement and support recovery.
Families and couples find systemic psychotherapy provides a safe space to reflect on important relationships and find ways forward.
Systemic psychotherapy enables family members, couples and others who care about each other to express and explore difficult thoughts and emotions safely, understand each other’s experiences, appreciate each other’s needs, build on strengths and make useful changes in their relationships and their lives. Systemic psychotherapy is inclusive and considerate of the needs of each member of the family and/or other key relationships. It builds on people’s strengths and relational resources and works in partnership with families and others, not on them. Systemic psychotherapy is sensitive to diverse family forms and relationships, beliefs and cultures. It enables people to talk, together or individually, often about difficult or distressing issues, in ways that respect their experiences, invite engagement and support recovery.
Families and couples find systemic psychotherapy provides a safe space to reflect on important relationships and find ways forward.
Systemic psychotherapy helps facilitate understanding and collaboration between family members by building on existing strengths. My goal is to work in collaboration with families to encourage change. I am highly-sensitive to complex family structures, nuanced relationships and diverse beliefs and cultures. I am happy also to work in partnership with existing care professionals as part of a total care solution.
- BSc Psychology (University of Manchester)
- MSc in Systemic Practice with Families and Couples (Institute of Family Therapy)
- Postgraduate Diploma in Systemic Supervision (Institute of Family Therapy)
- Qualified Supervisor with AFT (Association of Family Therapy)
- Member of the British Psychological Society
- Chartered Member of the UK Council for Psychotherapy
- Chartered Member of the Institute of Family Therapy
- Chartered Member of the Association of Family Therapy
Services Offered
I operate my private practice from Richmond, Surrey and also offer treatment and therapy through The Schoen Clinic in Chelsea, the Priory Hospital Roehampton, and with The London Centre for Eating Disorders in Richmond. I also offer virtual sessions on Zoom - you can find out more by visiting the virtual sessions section below.
I work with Children & Adolescents, Adults and Couples and also offer Clinical Supervision to qualified and part-qualified clinical professionals. Please click on your relevant group below to find out more about the treatment options I offer.
I work with Children & Adolescents, Adults and Couples and also offer Clinical Supervision to qualified and part-qualified clinical professionals. Please click on your relevant group below to find out more about the treatment options I offer.
Children and adolescents are not immune to emotional hardship and can face difficulties with their behaviour or mood. In such cases, they can benefit greatly from systemic family psychotherapy. I am well versed in helping young people and their families deal with the following problems:
- Eating Disorders and Food IssuesEating Disorders & Food Issues
I have particular experience and expertise in this area, having worked for many years in both in-patient and outpatient settings as a highly experienced systemic family psychotherapist focused on eating disorders.
When it comes to eating disorders in young people, early detection and prevention can be key. The signs are often subtle, as the young person may not verbalise a focus on body image or weight. The young person also may not meet the official NHS criteria for an eating disorder to benefit from intervention.
Most people think of teenagers or young adults when they think of eating disorders, but they can affect young children as well. The rates of eating disorders among young girls and boys under 12 have been growing in recent years, so it is important for parents and anyone who works with young children to recognize the signs. Physical growth is such an important component of childhood, and eating disorders can cause significant damage to a young person’s body. Such disorders include anorexia and food restriction, bulimia and/or associated purging, issues around body, self esteem and relationships as well as non specific issues with eating and weight and shape, including overeating.
Systemic family psychotherapy is a key intervention for eating disorder issues, treatment and recovery. The NICE guidelines highlight this as the most important therapeutic intervention, often alongside psychiatric and dietary support. I work with the young person and the family to explore and understand the eating disorder and underlying anxiety issues. I also help the parents or carers in managing the eating and recovery process. We will work together to consider ways to help the young person and the wider family manage the eating issues and wider systemic issues, often surrounding school, attainment and friendships in more helpful ways and explore best possible support and containment for the young person. - School, College & Behavioural IssuesSchool, College & Behavioural Issues
Conduct and behavioural issues are usually diagnosed in early childhood or adolescence and are characterised by ongoing issues with social conduct, including disruptive and violent actions. The condition is compounded by a general disregard for rules and discipline and can lead to worsening behaviour as the person grows into adulthood.
Working with the family, we can explore how to build understanding and set boundaries, working at both child/adolescent and parental levels to help in managing such difficulties. Systemic family psychotherapy can help a young person and their family to form better relationships and enhance dialogue, as well as support the young person with managing possible anger or anxiety that may be underlying some of their difficulties. We can also explore other possible reasons for the behavioural issues, such as undiagnosed ADHD or school, family conflict or relationship issues. - Obsessive Compulsive Disorder (OCD)Obsessive Compulsive Disorder (OCD)
OCD is an anxiety disorder of two parts – obsessions and compulsions. Obsessions can occur in the form of thoughts, images or urges, while compulsions are the actions that can be taken to get rid of – or cope with – these obsessions. Young people are likely to have different concerns to adults and it is common for them to suffer from just obsessions or compulsions. Sometimes one will be more prominent that the other. As they don’t always appear in equal measure, this can lead to the signs being overlooked.
Systemic family psychotherapy can help the family with exploring and understanding the anxiety issues and reasons for the compulsions or recurring thoughts. We will work together to consider ways to help the young person and the wider family manage the anxiety in more helpful ways and explore best possible support and containment for the young person. - Anxiety, Self-Harm and DepressionAnxiety, Self-Harm & Depression
Just like adults, children and young people feel worried and anxious at times. But if your child's anxiety is starting to affect their wellbeing, they may need help. Children and adolescents can feel anxious about different things at different ages. Many of these worries are a normal part of growing up. Anxiety becomes a problem for young people when it starts to get in the way of their everyday life and can harm a young person’s mental and emotional wellbeing, affecting their self-esteem and confidence. They may become withdrawn and go to great lengths to avoid things or situations that make them feel anxious. Sometimes anxiety can lead to ongoing issues with clinical depression and self harming. It's important to get help early if you think you or your child may be depressed. The longer it goes on, the more likely it is to turn into a longer-term problem.
Self-harm, or self-injury, describes a wide range of things people deliberately do to themselves that appear to cause some kind of physical hurt. It can still be very hard for parents and carers to know about - or witness - self-harming behaviour in their children. Cutting the arms or the back of the legs is the most common form of self-harm, but it can take many forms, including burning, biting, hitting oneself, banging of the head onto walls, and pulling out hair among other behaviours. A young person may self-harm to help them cope with negative feelings and difficult experiences, to feel more in control, or to punish themselves. It can be a way of relieving overwhelming feelings that build up inside.
Systemic family psychotherapy can help the family with exploring and understanding the anxiety and depression issues and possible reasons for the self-harm behaviours when these occur. We will work together to consider ways to help the young person and the wider family manage the anxiety and depression in more helpful ways and explore best possible support and containment for the young person. This can include working with parents and carers and/or siblings. The work involves helping to give a voice to the young person experiencing worries and concerns. Sometimes it can be hard for the young person to discuss such issues and very sensitive handling is important with this in mind. - Grief and BereavementGrief & Bereavement
A young person’s understanding in times of loss will depend on many things, including their age, stage of development, family background and support system, personality and previous experience of death. A young person who is having serious problems with grief and loss may show one or more of these signs: an extended period of depression in which they can lose interest in daily activities and events, difficulties with sleeping, loss of appetite, prolonged fear of being alone or possibly acting much younger for an extended period.
Systemic family psychotherapy can help the young person and the family more widely in discussing and exploring their grief and loss and the impact it is having. We will work together to consider ways to provide support and containment for the young person. This can include working with parents and carers and/or siblings. The work involves helping to give a voice to the young person experiencing such worries and concerns. Sometimes it can be hard for the young person to discuss such issues and very sensitive handling is important with this in mind. - Communication and Family IssuesFamily Issues, Separation, Divorce & Conflict
The way in which young people understood conflicts between their parents and family members can have differing effects and can lead to emotional and behavioural problems. Sometimes parents' fighting or arguing can lead to a young person feeling threatened or fearful that the family will split up. In some cases, the parental couple have already made the decision to split and this can lead to enormous strain and stresses on the family, with young people often getting caught up in the conflict and feeling angry, depressed or anxious. Often families then need to incorporate additional partners and such blended families can place additional pressures on the family system.
Systemic family psychotherapy can help the young person and the family more widely in discussing and exploring these issues and the impact it is having. We will work together to consider ways to provide support and containment for the young persons involved. This can include working at the parental level to guide the parents to work on a coherent narrative in the interests of their children. This can be complex as often there is often distrust and upset at the parental level but forms part of the work together. The work involves also helping to give a voice to the young person experiencing such worries and concerns. Sometimes it can be hard for the young person to discuss such issues and very sensitive handling is important with this in mind.
Systemic family psychotherapy can help a young person and their family form better relationships, communication and enhance understanding as well as support the young person with coping with difficult feelings.
Other Mental Health Issues: I work with families with there may be other mental issues with the young person or within the wider family. This can include ASD, ADHD, bipolar diagnoses, drug and alcohol issues, stage psychosis and emerging personality disorders in young people. Systemic psychotherapeutic support for the young person and family can help in support, building knowledge and understanding and help in managing the issues involved. This can include consideration of relationship issues and trigger factors and how to prevent or manage these.
Other Mental Health Issues: I work with families with there may be other mental issues with the young person or within the wider family. This can include ASD, ADHD, bipolar diagnoses, drug and alcohol issues, stage psychosis and emerging personality disorders in young people. Systemic psychotherapeutic support for the young person and family can help in support, building knowledge and understanding and help in managing the issues involved. This can include consideration of relationship issues and trigger factors and how to prevent or manage these.
Therapy with your partner or family needs to be a safe and private space to come for professional support so you can talk together about yourselves, your lives and any issues that might be causing you difficulty and hardship. The main goal of our sessions will be to help you to discuss and understand your issues, challenges and strengths within the context of your wider relationships, background and culture. We will work together to consider solutions and new possibilities in the ways you approach your lives.
You are reading this because you have taken the first step in acknowledging that something isn’t quite right and that you might benefit from therapy.
In adults, I work with a wide range of clients with differing mental health and relationship problems. These can include:
You are reading this because you have taken the first step in acknowledging that something isn’t quite right and that you might benefit from therapy.
In adults, I work with a wide range of clients with differing mental health and relationship problems. These can include:
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Eating DisordersEating Disorders
Eating disorders are classed as mental illness where your unhealthy relationship with food is used to try to manage feelings. You or your loved one might be eating too much or too little food and you or they can become obsessed with food and eating patterns.
Anyone can develop an eating disorder irrespective of age, gender, cultural or racial background. It is estimated that there are 725,000 people in the UK with an eating disorder.
I have particular experience and expertise in this area, having worked for many years in both in-patient and outpatient settings as a highly experienced systemic family psychotherapist focused on eating disorder issues.
When it comes to eating disorders, early detection and prevention can be key. The signs are often subtle, as the sufferer may not verbalise a focus on body image or weight. The sufferer also may not meet the official NHS criteria for an eating disorder to benefit from intervention.
Most people think of teenagers or young adults when they think of eating disorders, but they can affect adults at any age as well. The rates of eating disorders have been growing in recent years, so it is important to recognize the signs. Healthy eating and maintaining a good weight is essential for both physical and mental health and eating disorders can cause significant damage to a person’s body. Such disorders include anorexia and food restriction, bulimia and/or associated purging, issues around body, self esteem and relationships as well as non specific issues with eating and weight and shape, including overeating.
Systemic family psychotherapy is a key intervention for eating disorder issues, treatment and recovery. The NICE guidelines highlight this as the most important therapeutic intervention for young people and the evidence strongly suggests it is a key therapeutic intervention at any life stage, often alongside psychiatric and dietary support. I work with the person and the family or partner in a couple relationship to help explore and understand the eating disorder and underlying anxiety issues. I also help the parents, partners or carers in managing and supporting the eating and recovery process. We will work together to consider ways to help the sufferer and the partner and/or wider family manage the eating and wider systemic issues, often surrounding university or work, family, relationship and friendship issues in more helpful ways. - Depression, Anxiety & Self-HarmDepression, Anxiety & Self-Harm
Depression is not simply having a bad day or feeling fed-up. Many of us go through periods of feeling low, but when you're depressed or feeling very anxious, this feeling can be persistent and can last weeks and even months. Depression is not a trivial matter, it’s a genuine health condition with pervasive and lasting symptoms. Being depressed doesn’t make you ‘weak’ and it isn’t a mode you can simply switch off and go about your day. Depression affects people differently and symptoms range from lasting feelings of unhappiness and hopelessness, to losing interest in everyday life and the things you used to enjoy. Many people with depression also have symptoms of anxiety and experience a physical impact such as tiredness, insomnia, loss of appetite, loss of sex drive, and various aches and pains.
The symptoms of depression range from mild to severe. The good news is that with ongoing therapy and medication (if needed), you can develop coping strategies and live a good and fulfilling life. Sometimes people can self harm as a way of coping with or expressing overwhelming emotional distress. Often the intention is to self-punish, express distress, relieve unbearable tension, and serves as a cry for help. Sometimes when people self-harm, they are doing so because they feel that their life is not worth living and they want their pain to end. As such, more than half of people who die by suicide have a history of self-harm - so it is a very serious issue that demands urgent attention.
Systemic family psychotherapy can help the family with exploring and understanding the anxiety and depression issues and possible reasons for the self-harm behaviours when these occur. We will work together to consider ways to help the person who is suffering and the wider family or partner manage the anxiety and depression in more helpful ways and explore best possible support and containment. The work involves helping to give a voice to the person who is experiencing worries and concerns. Sometimes it can be hard for the person suffering to discuss such issues and very sensitive handling is important with this in mind. - Obsessive Compulsive Disorder (OCD)Obsessive Compulsive Disorder (OCD)
Obsessive-compulsive disorder (OCD) is a pattern of unwanted thoughts and fears (obsessions) that leads to repetitive behaviors (compulsions). The combination of obsessions and compulsions can heavily interfere with daily activities and cause significant distress. Trying to ignore or stop your or your partner or adult child’s obsessions can increase your or their distress and anxiety and inadvertently encourage the sufferer to perform compulsive acts to try to relieve their symptoms. The result is an increase in more ritualistic behavior — this is the vicious cycle of OCD.
Systemic family psychotherapy can help the sufferer with his/her family or partner with exploring and understanding their anxiety issues and reasons for the compulsions or recurring thoughts. We will work together to consider ways to help the sufferer and their wider family manage the anxiety in more helpful ways to reduce the OCD behaviours and explore best possible support and containment for the person who is suffering. - Early Stage PsychosisEarly Stage Psychosis
Psychosis is a word used to describe a set of conditions that affect the mind, whereby people have trouble distinguishing between reality and fiction - this is known as a psychotic episode. Psychosis usually first appears in young adulthood and it is quite prevalent in society: approximately three out of 100 people will experience a psychotic episode in their lifetime. Psychosis affects men and women equally, irrespective of culture or socioeconomic status.
A first episode of psychosis is often very frightening, confusing and distressing, particularly because it is an unfamiliar experience. Unfortunately, there are also many negative stereotypes and misconceptions associated with psychosis that can further add to one’s distress. With the right therapeutic treatment, many people recover from a first episode of psychosis and never experience another psychotic episode.
Systemic family psychotherapy can help the family or partner with exploring and understanding the issues and possible reasons for the psychotic behaviours when these occur. We will work together to consider ways to help the person who is suffering and help the family or partner to explore ways to manage and provide support. The work involves helping to give a voice to the person who has experienced such worries and challenges. Sometimes it can be hard for the person suffering to discuss such issues and very sensitive handling is important with this in mind. Please note – I can happily work with the person suffering but only once they are deemed ready for therapeutic input. I can, however, still help provide support to the family or partner whilst the person remains very unwell. - Partner & Couple IssuesPartner & Couple Issues
Successful relationships require regular work on all sides. Couples therapy can help make the ‘us’ a more harmonious place for couples. Some of the common reasons why couples seek therapy include:
- You want to improve the way you function as a couple
- Help engaging with each other after experiencing a traumatic event
- One of you wants to end the relationship
- Repetitive cycles of conflict
- You aren’t showing or receiving sufficient care and affection
- Clashing values or cultural backgrounds
- One person feels aggrieved by the other’s behavior.
Systemic family psychotherapy can help the couple with exploring and understanding the issues between them and possible reasons for the arguments or destructive behaviours when these occur. We will work together to consider ways to help you as a couple, explore issues surrounding extended family, work, wider relationship and intimacy issues and explore best possible support and containment and ways to relate well again together, wherever feasible. The work involves helping to give a voice to both members of the couple. Sometimes it can be hard for the people suffering to discuss such issues and very sensitive handling is important with this in mind. I happily work with couples in all forms – whether heterosexual, homosexual, bisexual, transgender and from all cultural backgrounds, nationality, religion or ethnicity. - Carer & Partner SupportCarer & Partner Support
As a carer, you provide support and care for someone who has an illness, disability, mental health problem or addiction - usually unpaid. People often assume that carers tend to be women but research shows that around four in ten carers are men.
Caring for someone is usually only one part of your relationship with that person. You may also be a parent, partner, sister, brother, child, friend or other family member. This relationship can be just as (or more) important to you.
Caring for and supporting others can be mentally and physically exhausting - especially if you also have children or elderly family members to look after. The time you spend caring can vary too – some people look after someone on a short-term basis while others find themselves caring for someone for the long term. Everyone needs support and at times, your role as carer can leave you feeling overwhelmed, unable to cope and potentially impacts your ability to care.
Systemic psychotherapeutic support for the carer and their family or partner can help in support, building knowledge and understanding and help in managing the issues involved. This can include consideration of relationship issues and trigger factors and how to prevent or manage these.
I offer systemic clinical supervision (generally 1-1.5 hours monthly) to those who are either training in or fully qualified as systemic family psychotherapists. This generally takes place through use of technology on-line or in Richmond, Surrey. I have extensive experience in clinical supervision and will work with you on your cases and other clinical issues to help you think about your client and wider issues. I lecture in systemic psychotherapy up to and including MSc level and will help you in applying theory to practice connections as part of this supervision. I particularly like to use narrative, dialogical, post Milan and solution focused ideas. Over the years I have provided supervision to the following disciplines both individually and in groups:
Qualified Systemic Family Psychotherapists
Systemic Practitioners
Social Workers
Clinical Psychologists
Psychiatrists
Nurses
Other Clinical Disciplines Seeking Systemic Input
How I Work
- Initial Consultation
- Your First Session
- Session Duration & Therapy Schedule
- Video Sessions
- Confidentiality
- Cancellation Policy
I offer a free telephone consultation to all prospective patients to get a sense of the challenges you're facing - and if I believe I can help you down the road ahead. In order to book a consultation, please go to the contact section below and be sure to select 'initial consultation' from the drop-down menu.
If you are new to therapy, the run-up to your first session might make you feel a little nervous from fear of the unknown. This is especially true with children but also applies to adults.
My job is to ultimately provide a calm and stress-free environment in which we can talk about your challenges. The first session is all about getting to know each other and to have a frank and open conversation about your illness, disorder, challenges, or carer support needs. It is also the perfect time to set mutual expectations.
My job is to ultimately provide a calm and stress-free environment in which we can talk about your challenges. The first session is all about getting to know each other and to have a frank and open conversation about your illness, disorder, challenges, or carer support needs. It is also the perfect time to set mutual expectations.
- Each session lasts around 60 - 70 minutes and we can decide together on how often and when we meet.
- In terms of duration of therapy, I offer various packages from six, twelve and eighteen sessions.
- Together we constantly assess the need and modify the engagement based on progress and goals being reached.
Due to the COVID-19 pandemic of 2020 and patient ongoing concerns with the potential risks of person-to-person contact, I offer a video service through Zoom and Microsoft Teams to all my client families.
Confidentiality is key within this work. I am bound by implicit trust due to the highly-personal and deeply sensitive nature of the work I do and the patients I deal with.
Everything we discuss is confidential. The exception to this rule is if I believe a client or family member is in immediate danger from themselves or another person. If I believe a client is being harmed or abused in any way or is at risk to themselves or clinically, then I reserve the right to break confidentiality. This will be discussed with the family at that time, as appropriate.
Everything we discuss is confidential. The exception to this rule is if I believe a client or family member is in immediate danger from themselves or another person. If I believe a client is being harmed or abused in any way or is at risk to themselves or clinically, then I reserve the right to break confidentiality. This will be discussed with the family at that time, as appropriate.
Life happens and plans change. So if you need to change or cancel an appointment, I would appreciate at least 48-hours notice and can re-arrange on a no charge basis.
If you cancel within 48-hours, you will be charged in full for the cancelled or missed session. The only exception to this is if there has been a medical emergency and a certificate has been provided.
If you cancel within 48-hours, you will be charged in full for the cancelled or missed session. The only exception to this is if there has been a medical emergency and a certificate has been provided.
Get In Touch
Please email me at: sylvia@metzertherapy.com stating the nature of your inquiry, or click the appropriate button below.
I aim to respond to all enquiries within 1 business day.
I aim to respond to all enquiries within 1 business day.