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How to choose a therapist: a guide to help you get it right

Posted by David Wigglesworth on the 6th of September, 2018

As research findings consistently demonstrate, the most significant factor in achieving successful therapeutic outcomes is the quality of the relationship between the client and the counsellor. This being the case, the importance of choosing the right therapist for you cannot be overstated. Getting it right could make a significant difference, saving you a lot of wasted time and money, and increase your chances of successfully achieving your therapeutic goals. But how do I know who the right therapist is? Where to start? What exactly should I be looking for and what questions should I be asking?

This helpful guide will give you a good place to start. Some of these pointers may be more relevant or meaningful to you than others, so pick and choose what feels appropriate for your particular circumstances. If you’re looking to undertake counselling online, the amount of options available may be a little bewildering. I’ve included some additional pointers relevant specifically to this area that should help you narrow things down a bit.

Getting Started

Presently in the UK, counselling and psychotherapy are not state-regulated professions, like they are in the US for example. This means that pretty much anyone can call themselves a counsellor or therapist, even if they have no more training and experience than having looked at a couple of books and fancied that they might be a bit good at it. I’ve heard of a few cases of people encountering these types, with devastating results, and sadly in some cases it’s put individuals off counselling for life.

The good news is that it’s easy to find fully trained, qualified and experienced practitioners through using online counselling directories. Inclusion of a therapist’s profile on one of these lists means they have had their professional qualifications and training credentials checked, and are verified members of independent governing bodies, such as the BACP or CPCAB. In the UK, the main directories are the ‘Counselling Directory’, the ‘BACP’ therapist directory, and ‘Psychology Today’, though there are others. These websites enable you to locate local practitioners by entering your postcode, and a majority of practising therapists are likely to appear on at least one of them. Entering your specific issues, preferred type of therapy and other preferences will help you narrow down your search results further. Individual therapist profiles may contain a link to their own independent website, where you can find out more about them and their counselling practice.

Another way you might come across a therapist is through a referral from someone you know. Those having had successful therapeutic encounters may be eager to recommend their counsellor to others, and a good word-of-mouth reputation may be a positive start. What works for one client may not necessarily work for another though, it’s important to do a little research and rumination on your own about what’s right for you before making any commitments. There may also be counselling agencies in your local area that you could contact, some catering to specific issues or client groups. Have a Google and see what comes up.

At this stage, having established who your local professional practitioners are, you will want to know how to choose between them. The pointers below will help you do just that.

Preparing for contact

Before contacting a counsellor, you might want to consider more precisely what you’re looking for. This will help you to communicate your needs and ask the right questions when approaching potential practitioners. Consider things like:

  • Budget Constraints – Counselling changes lives, and an effective course of therapy sessions with a well-matched practitioner is easily worth the investment. But how much do you want to pay? Are the session fees within your budget range? Are there significant fee disparities between professionals in your area? Maybe the therapist sets their rates along a sliding scale, or offers concessions to certain client groups. Perhaps a local charity offering free or low cost counselling might be adequate for your needs. Consider what you would realistically be happy to pay beforehand.
  • Style of Therapy – Are you looking for a specific style of counselling, say CBT, Person-Centred or Psychodynamic? Would you like a therapist to give you tools and exercises to help you manage symptoms? Maybe you want to work on the underlying psychological issues, or simply have a safe place to express and explore difficult thoughts and feelings. Or maybe all of those things sound good to you. You may have a clear idea about what counselling style you prefer, or you may be unsure and curious about the different options. Either way, be prepared to ask the therapist about their way of working and how that may or may not be appropriate for your needs.
  • Time scale – Time scales for courses of therapy can range from as few as one or two sessions to many years of regular meetings. The amount of time you intend to spend in therapy will make a significant difference in what can be achieved, as well as in the therapy styles that may be most effective. If the amount of sessions you can undertake is limited, you may want to seek out therapists offering ‘brief’ or ‘time-limited’ options. Likewise, if you’re interested in a potential long-term arrangement, you might want to ensure a counsellor would be committed to working with you in that way.
  • Presenting issues – If you are thinking about undertaking counselling, you no doubt have at least some idea of what it is you are seeking therapy for (your presenting issue, e.g. anxiety, depression, bereavement, addiction). Of course you will want your therapist to have some familiarity and knowledge about the types of problems you want to discuss, and you will find a list of the issues they work with on their directory profiles or websites. However, matching yourself with a counsellor that specializes in working with your specific issues may be less important than you think, for reasons I outline below.

Although some professional therapists specialize in specific areas, such as work with young people or couples, or are primarily focused on a specific mental health condition, most counsellors will be experienced in working with a wide range of clients and presenting issues. After all, we are all unique individuals. No one has quite exactly the same problems as us, and the way in which we achieve our therapeutic goals will be equally unique: it is our own individual journey. This is why some counsellors (particularly person-centred practitioners) will be more focused on you as a unique person, with unique experiences, than in fitting you into a ready-made treatment program. The essential point is that you don’t necessarily need to find a therapist offering expertise in exactly the type of issue you are experiencing. It is as, or maybe even more important, to find a counsellor with whom you feel safe and comfortable: someone you feel you could really talk to. It’s all about what feels right for you.

Meeting the therapist

When seeking a therapist, you might be comfortable with the first one you meet and feel like you are ready to get started. Or you might want to shop around a bit and talk to a few therapists before choosing. Some therapists will offer a free (or discounted) preliminary session where you can meet them in person, or chat with you by phone. If not, they may be willing to share a few emails with you to answer some of your questions.
At this stage, having met with a potential counsellor, you may want to assess how you feel about the encounter in order to help you make a decision. The pointers below indicate some of the things you might consider:

  • Did they ask the right questions? Did they seem genuinely interested in who you are and what is happening for you?
  • Did they provide you with opportunity to ask any questions you might have had?
  • Did they show interest in working with you collaboratively to achieve your goals, or in pushing their own agenda?
  • Did they explain, at least briefly, their style of counselling so that you gained some idea of what to expect in the sessions?
  • Did they seem empathetic or insensitive?
  • Did they reassure you that it is normal to experience mental health issues, or make you feel like there is something wrong with you?
  • Did the therapist make you feel safe and comfortable?
  • What is your intuition telling you?

Counselling Online

Counselling online, via email, text chat, or video-call, is becoming increasingly popular. When undertaking therapy this way, over the Internet, we are not limited to selecting from counsellors in our local area, significantly increasing our options. The pointers below should help narrow things down a bit and help you to find qualified, experienced professionals offering their counselling services at-a-distance.

Online counselling has it’s own set of skills, theory and practice, and you will want your therapist to have received specific training and qualifications in this way of working. In the UK, there are several training providers, such as the Online Therapy Institute (OTI), Academy for Online Counselling and Psychotherapy, and Online Counselling Services & Training (OCST).

A good way to ensure you find online-qualified professionals is to visit the website for the Association for Counselling and Therapy Online (ACTO). This is the UK’s leading governing body for practitioners of online counselling and all their members have been fully verified. The ACTO website features a directory listing of professional members with individual biographical profiles, contact information, and links to the practitioner’s independent websites (if they have one): it’s a great place to start.

When you have established contact with an online therapist, you will want to know some more about their policies and procedures. These may be detailed on their website, or they may have an “Informed Consent’ or “Terms of Service’ document that they may ask you to read and sign before sessions commence. Look out for important information such as:

  • What will happen in the case of technological breakdown during sessions?
  • Do the email, chat or video-call services used offer security and protection to keep your interactions private and confidential? (For example, according to ACTO, Skype is inappropriate for online counselling, whereas similar services such as Zoom, VSee and Telebond offer a fully encrypted and secure connection for video calls. Email services such as Hushmail offer greater protection than standard email services).
  • What are the therapist’s policies for interacting with clients on social media and managing the relational boundaries online?
  • What is the practitioners record keeping policy and are they GDPR compliant?

In Therapy

Having started therapy, it’s important to recognise that it may take a couple of sessions or so to start getting into it. If you feel really uncomfortable, you may consider switching counsellors, or giving up altogether. It’s worth a little self-examination before making the decision though: you may be experiencing some resistance due to unconscious defence mechanisms, or may not be quite ready and comfortable with your therapist enough yet to say what you are really thinking and feeling. That’s fine. The feeling of trust and safety in your relationship with your therapist builds over time: resistances can be worked on and overcome. It may well be worth hanging in there until you feel ready to go deeper into what it is you want to work on.

Another common aspect of counselling is that, at first, things may seem to get worse before they get better. As we begin to open up and discuss aspects of our lives that we find hurtful and distressing, we can begin to encounter strong negative emotions and upset. This can be an essential part of the counselling process, and will often pass, or at least recede, as a series of therapeutic sessions continues. It’s important to recognise that the road may be hard at times: keep your therapeutic goals in mind and continue working towards them. Using their skills, empathy, and knowledge, your counsellor will support and guide you along the way. The potential transformative gains of undertaking therapy are worth the journey.

Note: many of the organisations and agencies mentioned in this article can be accessed through the links page on my website.

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