Finding the right psychotherapist can seem like a daunting task. For those of us in the throes of mental health difficulties such as anxiety or depression, this worry can be exemplified further when we realise the whole host of options that are out there. The accompanying terminology surrounding all of these options can be overwhelming. If you’re anything like me and are put off by situations that are overly complex or anxiety-provoking, you might even be tempted to give up on the idea of therapy at the first hurdle.
But wait! Please don’t throw the towel in just yet. I believe that there is a therapist out there for everybody. Not just any therapist, but a good therapist, and (providing you don’t live in a hut in the middle of the Sahara Desert), most towns and cities have a decent handful of professionals to choose from.
So – how can you find the right therapist? I hope to be able to provide some thoughts that will be a good starting point to anyone who is thinking of taking the first steps on that fulfilling journey of self discovery and healing. I’ll also do a whistle-stop tour of some of the common terms used, so that some of the mystery surrounding psychotherapy can be lifted.
Therapists are like shoes
That’s right. Therapists are like shoes. They come in all shapes and sizes! Some are more formal than others, some suit certain occasions better than others, and their price ranges can vary enormously (though cost is not necessarily indicative of quality).
The most important point to remember is that my shoes might not fit you, and yours might not fit me. Just because your aunt’s best friend raves about Mr Therapist A (or her Jimmy Choos!) that doesn’t mean you will necessarily feel the same. Therapy is a special journey, unique to you, and although there is great value to be gained from a good recommendation, it’s a highly subjective choice to make. Don’t feel pressured to see a certain therapist just because somebody else does.
A good fitting pair of shoes, and a good fitting therapist, will help you to navigate the bumpy roads of life in a healthy way that is tailored to you.
It’s not always love at first sight
Don’t be disheartened if the first therapist you meet isn’t the one for you. Going back to the shoe analogy – we’re quite confident to walk into a shoe shop and try on a few pairs before committing to a purchase. The difference here is that you are choosing someone that you will entrust with your inner world and your psychological wellbeing. It’s really, really important that you feel you have a choice.
I’d like to reinforce this point by telling you a short story. My first therapist wasn’t right for me. I struggled to build a rapport and I wasn’t overly fond of his formal approach. Being the acutely stubborn human that I am, I became determined to make it work with him, at all costs. I thought that the challenge would make for a better result. I stayed with this therapist for about a year. It turned out, the costs were high. (In short, the therapist was unethical, though that’s another story for another post.) I wish more than anything that I’d listened to my instincts and heeded my initial doubts.
I now have a therapist I feel very comfortable with, and our time together is much more natural and productive. I wish I’d met her before.
Some basics to consider when choosing a therapist
So, onto the meaty bit. You’ve decided to look for a therapist. Where should you start?
You might like to ask yourself some of the following questions:
Do I mind whether the therapist is male or female? (Some people are more comfortable with the same or opposite sex.)
Do I want my therapist to specialise in certain a certain topic? (E.g. trauma, depression, eating disorders, bereavement.)
How much money can I afford to spend on therapy, or are there any health insurance stipulations?
How far can I travel for therapy, and do I have an ideal schedule? (E.g. evenings only.)
Do I want group therapy or individual therapy? (The cost for group therapy is usually less and research shows it can be just as effective. Just something to consider.)
Which type of therapy should I look for?
No one form of therapy is proven to be more effective than another. It really depends on what you are hoping to achieve. For example, some therapies deal with the ‘here and now’, whereas others are more geared towards making sense of the past.
The particular approach a therapist uses depends on the condition being treated and the training and experience of the clinician. The best way to understand a therapist’s approach is to ask them about it. It’s my personal belief that all therapists should offer this information from the start.
The UKCP website contains a list of a whopping twenty-eight different types of therapy, that can be found here. If you find one that you are particularly drawn to, it may be worth utilising the power of Google and seeing if there are any specialists of that type in your local area.
I’ve chosen just a few common approaches, to illustrate how different they can be:
A psychodynamic therapist will help you to make connections between the past and the present. The therapist will often comment on what happens in the sessions as you talk together. This can help to show how some of the things that you feel, do and say are not driven by your conscious thoughts and feelings, but by unconscious feelings from your past. And if it is happening in the therapy sessions, it will also be happening in your day-to-day life. When you understand these connections better, you can make decisions based on what you want or need now, not what your past experiences drive you to do.
Cognitive Behavioural Therapy:
CBT is based on the concept that your thoughts, feelings, physical sensations and actions are interconnected, and that negative thoughts and feelings can trap you in a vicious cycle. CBT aims to help you deal with overwhelming problems in a more positive way by breaking them down into smaller parts. You’re shown how to change these negative patterns to improve the way you feel. Unlike some other talking treatments, CBT deals with your current problems, rather than focusing on issues from your past.
Interpersonal therapy is commonly used to treat depression symptoms by focusing on the interpersonal relationships of the client. The idea of interpersonal therapy is that depression can be treated by improving the communication patterns and how people relate to others. It also focuses on the identification and expression of emotional issues.
A little note on state funding vs private funding
Where I’m writing from (the rainy little island known as the UK) there are generally two ways of obtaining therapy: via state funding (National Health Service) or paying the cost privately. There are marked differences in the two options.
In terms of choosing a therapist, state funded options are often more limited. Although the services are working hard to provide more patient choice here in the UK, there are many of us still experiencing the seemingly random allocation of a therapist.
For example – I was never asked the type of therapy I wanted, and the option I was allocated (psychodynamic) was not explained to me. There was nothing wrong with the psychodynamic approach at all, but now with hindsight and further education I may be inclined to weigh up all the options, or in the very least ask the question about modes of therapy that are available right at the start. Patients should feel empowered to challenge decisions that impact on their health, in the same way that they can with other (physical) medical issues.
Although the choice in private settings is much more flexible, I would argue that all patients have a right to see a different therapist If they choose – whether state funded or not.
Counsellor, Psychotherapist, Psychiatrist, Doctor or Gnome?
Here’s a quick debunk of the above terms:
Counsellors and psychotherapists: Both of these helps clients to work through emotional difficulties and / or life goals. Some experts believe that while areas of the two professions overlap, psychotherapists work on longer-term concerns and have the training to reflect this. Others argue that there is little to no distinction between the professions. Checking a professional’s experience, training and qualifications is always advised. This will give you a better understanding of how they can help support your needs.
Psychiatrists: A psychiatrist is a medical doctor who specialises in preventing, diagnosing, and treating mental illness. A psychiatrist is trained to differentiate mental health problems from other underlying medical conditions that could present with psychiatric symptoms.
Clinical Psychologists: Clinical Psychologists have completed a doctorate in psychology. They use psychological methods and research to make positive changes to their clients’ lives and offer various forms of treatment. They work with clients over a number of sessions to assess and manage their conditions.
Gnomes are not known for their psychotherapeutic skills, although they look cute in some gardens.
Licensure and ethics
Different countries have different processes when it comes to the licensing of therapists. Whatever the law states in your local area, I think that any therapist worth their salt should have taken the time to register to a professional body. This provides some protection to both the therapist and the client, and is necessary for work in most, if not all, professional organisations. Always check your therapist has a license.
As clients, we tend to trust that our therapists are adhering to high ethical standards, such as maintaining appropriate boundaries and respecting patient confidentiality (see my post on boundaries here). Unfortunately there are rare cases where therapists act unprofessionally. I have fallen victim to this and can attest to the psychological damage it can cause. You can read about my story here.
For now, if you are in doubt, please seek advice from a second experienced professional.
So now I’ve chosen my therapist. How will I know if it’s working?
In my experience, I think you’ll know if it’s not working. In general you should feel comfortable with your therapist. Therapy should not be cold and detached, and neither should it be overly friendly. The focus should be on you, not on the therapist. It should feel safe and predictable.
In general you should have a good rapport with your therapist. Please don’t mistake having a rapport with liking your therapist all the time. Sometimes it’s natural to feel distrust or even anger towards your therapist, if this relates to some of the issues you are working through. As long as it is a temporary reaction and your therapist is helping you to makes sense of it, this is okay.
It’s also worth noting that therapy doesn’t always make us feel better (at least, not straight away). Therapy requires hard work and self reflection, as well as the exploration of potentially difficult emotions. Expect good days, expect tough days. Do not expect immediate miracles.
Taking an average of your time in therapy, you should see that it is time well spent. If you have concerns about your therapy, raise it as soon as possible with your therapist. If you don’t feel that this is an option, raise it with another professional that you trust. Lots of concerns can be worked out through simple discussion, and others may require a change in direction.
Good luck in your therapy
I hope that this post has been useful for anyone looking to find the right psychotherapist. In summary, I would say don’t be afraid to explore the options that are out there. Therapy is one of the best investments you can make into your health, so don’t be put off by the process of beginning it.
Think of it as an investment. Ask lots of questions. Put yourself first.
I would love to hear about your experiences. Feel free to share below in the comments. (For anyone using WordPress Reader, the comments box is available through direct link, here.)