North Ayrshire Referrals for Counselling Sessions at Kilmarnock Station Counselling Service

What we offer

  • At Kilmarnock Station Counselling Service we are pleased to offer Cognitive Behaviour Therapy (CBT) and Person Centred Therapy. Both types of therapy are conducted on a 1 to 1 basis either face to face or online whichever suits your individual needs. There is choice to work with a trainee therapist at £15.00 per session or alternatively there is also the option to work with a qualified therapist at a cost of £45.00 per session.

Cognitive Behaviour Therapy (CBT) can assist with:
  • Generalised Anxiety Disorder (GAD)
  • Obsessive Compulsive Disorder (OCD)
  • Panic Disorder
  • Phobia
  • Social Anxiety
  • Low Mood/Depression
  • Low Self Esteem

Person Centred Therapy can assist with:

  • Grief
  • Relationship Issues
  • Loneliness
  • Transitions Through Life
  • Anger
1.Which type of counselling are you looking for?
2.Your full name
3.Your full address including your postcode
4.Your contact  phone number (mobile if possible since sometimes we text information about appointments
5.Your email address (if you have one)
6.Your date of birth
7.Please tell us the name of your GP Surgery & Address 
8.Consent given to contact GP surgery in an emergency?
9.The main issue I am looking for help with is:
Please select only one issue for each row, thank you.
It is not possible for a student counsellor to work with higher risk conditions such as PTSD or for people who are at risk of suicide.(Required.)
Low Mood
Anxiety
Social Anxiety
Panic Attacks
Relationship Issues
Anger
Self Esteem
OCD
Phobia
PTSD
Grief
Main Issue
Secondary Issue
Secondary Issue
Secondary Issue
10.Or any other issue that you'd like to flag to us that you are looking for help with?
11.Are you on medication related to the issue you are seeking help for?
12.If you answered yes to the previous question please provide name of the medication and current dosage.
13.Do you have any contact with psychological/psychiatric services (eg CPN, or psychiatrist) or have you had in the past?
14.Sorry to ask an intrusive question but do you consider yourself to be a risk to yourself and/or others at the current time?(Required.)
15.If you have answered yes to the previous question please answer the following question. Please read each statement below and think how often you have felt like that way in the last week, then mark the box which is closest to this.
Not at all
Only occasionally
Sometimes
Often
Most or all of the time
I have thought of hurting myself
I have made plans to end my life 
I have thought it would be better if i were dead
I have been physically violent to others
I have threatened or intimidated another person
I have hurt myself or taken dangerous risks with my life
16. Can you tell us what slots you might be available for your chosen therapy?  The wider your availability the more timely it is to allocate you to a counsellor. Please tick all that apply.  Mornings are 9am-12pm Afternoons are 12pm- 5pm (last appointment is 4pm).
Yes
No
Monday morning
Monday Afternoon
Tuesday Morning
Tuesday afternoon
Wednesday Morning
Wednesday afternoon
Thursday Morning
Thursday afternoon
Friday Morning
Friday Afternoon
17.Please select which option you would prefer~:
18.We can only hold appointments for 24 hours after we have contacted you as we are extremely busy. Please check your voicemail/text messages regularly to ensure that you do not miss an available appointment(Required.)
19.Is there anything else you think we should be aware of in relation to your enquiry for support
20.Where did you hear about our services
What happens next

If you've requested to work with a Qualified Therapist we should be able to allocate your case based on the information within this enquiry form and they will be in touch by your preferred method (phone or email) to arrange an initial appointment. Occasionally we will require some additional information to support that allocation and we will be in touch if that is the case.

If you have requested to work with a trainee therapist @ £7.50 per session you must commit to 12 sessions of therapy, if you cannot do this then sessions will be charged @ £15.00 per session.

Appointment allocation is based on your availability and we aim to contact you with in 2 weeks of receiving your referral, once we have a therapist available.

Thank you for taking the time to complete this enquiry form.
Current Progress,
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