Picking a therapist

It can be both exciting and somewhat overwhelming picking a therapist. Scrolling through a sea of uncomfortable self-portraits in the counselling directory, flicking through one poorly designed website after another or reading endless descriptions about 'how you are at the centre of the process', and 'non-judgemental, welcoming environment' it easy to feel swamped. And it's easy just to give up and pick the first one that looks halfway-normal.

The problem is if you pick the wrong one, pick someone you can't work with this can be for many clients an expensive, time-consuming and frustrating experience in which you can often feel you are to blame. All the evidence suggests the therapeutic relationship is probably the most import aspect of the process and the key determinant whether therapy will work. Which of course, in many ways feels obvious. If you don't connect or can't trust the person sitting opposite you, you are less likely to share painful, intimate details or talk truthfully about what is going on.

Here are a number of factors that might be worth considering before you make your decision:

1. Location, location, location.

Although for some people having a therapist close to them is beneficial in terms of travelling times there are other considerations. Often clients prefer to see a therapist some distance from where they live, thus removing any chance of bumping into your therapist in the supermarket aisle or seeing them in your local cafe. Or reducing the likelihood of your therapist knowing someone you also know. Additionally picking a therapist far from where you live or work decreases the chance of either you bumping into someone you know before you enter or as you leave therapy. How would you feel if you bumped into a colleague or friend when leaving therapy ? Would you be bothered or not ? This has to be set against how long you are prepared to travel to your therapist. Perhaps it's more important to have somewhere convenient, for example close to where you work. Or somewhere you know you can park easily?

2. Same of different ?

Do you want a therapist who reminds you of a figure from the past, a family member or old colleage ? Some women want women counsellors while others want men, or men want woman therapists, or younger person want an older therapist. So do you want someone similar to you or someone different. Which is more import, that someone will have had similar life experience to yourself, or will challenge your perception.

This can be a very complicated decision. Often we are attracted to familiarity because of a reluctance to be challenged; however challenge may be exactly what is required to shift out of a pattern of negative thinking. Or perhaps you react against challenge, and have a history of finding yourself agreeing with strong opinions of other, for example authorial figures, such as parents, school teachers, etc, and thus you want a therapist that will create a gentle collaborative relationship, allowing you the space and time to come to your own conclusions.

3. How do they work ?

There are three main approaches to therapy, although for the majority of clients, they will only encounter two: CBT and humanistic (if unsure check out entry: What are the different approaches in counselling). Think about how you want to deal with the issue you are bring to therapy. Do you want to explore your feelings or do you just want to work out solutions to get you were you want to be ? Do you want to focus on the past, on behaviour that you struggle to understand ? Do you want homework outside of therapy, for example completing a thought dairy, a common feature of CBT ?

Although most therapists work in a pluralistic manner (meaning they incorporate different approaches depending on the needs of the client) some therapists will feel far more directive than others. Now how do you feel about this ? Again you need to reflect and be totally honest, as often clients will say they would like a more structured approach but actually this triggers a feeling of 'being told what to do', or of 'being at school '. Likewise, how do you feel about exploring the past ? Is that where you believe your problems began, are you happy to talking about dreams, childhood experiences of your parents ?

4. Price & Number Sessions

The standard rate for therapy sessions outside London is around £35 - £60 for individuals, £40 - £75 for couples. But there will be some who change more and some who charge less. For individuals on a low income there might be a low cost service available near you. These are typically staffed by trainee therapists in the last year of training. And before this is dismissed, there is little evidence to suggests that therapists improve with either training or experience !

Often people believe that if you pay more for something you will get a better therapist, but it's more likely to be a reflection on how the therapist views or values themselves. Do you want a therapist with a strong self-worth, or with an possibly over-exaggerated self-image, or would you rather someone more modest, self-effacing. How do you deal with people who are secure and value themselves? Do you feel intimidated or re-assured ?

Pick a price that you are comfortable paying. Although therapist offer short term work, for example 6 sessions, in most cases you should budget for 10 / 12 sessions, around 3 month's worth of therapy. Again this of course varies according to the individual, but the simple reality is that it normally takes 3 / 4 sessions to build a relationship with your the therapist and then another couple of month's to get to the heart of the matter. If it was quick and easy to change painful thoughts and feelings no-one would have them.

5. Free / Reduced Fee Initial Assessment

Wherever possible always try to find a therapist who offers a either free or reduced fee assessment. Therapy is an individual experience, and although you may have explored all the questions above and selected a therapist who ticks all your boxes, you might meet up and feel absolutely nothing. There is always the random element of human dynamics, thus wherever possible find a therapist who offers free initial assessment (typically these are around 30 minutes) or a whole first session for a reduced rate, and ideally face to face. Telephone assessment is better than nothing but still it's difficult to get a reliable handle on how you will feel in the room. Then go along, and if it doesn't feel right, try someone else.

 

Of course there are no hard and fast answers to these questions, but by reading and reflecting on them it hopefully will help give you a clearer idea of what exactly it is that you want.