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. Fees

Most therapists tend to fall into two camps: professionals and part-timers. It might surprise you but the overwhelming majority, around 80 – 90% of therapists will work part-time. Go on to any therapist directory, such as Psychology Today, and you will see page after page of middle-aged, middle class women. For them therapy is a side hustle; they either have another part-time job or their husband’s income and thus are able to charge quite low fees.

If you want a professional, a person who relies on therapy as their sole income, however you will have to expect to pay more. £100 or upwards of £200 per hour is not unusual and puts therapists in the same bracket as accountants, lawyers, dentists and other graduate white collar professions. Remember even full-time therapists will only see around 15 clients a week so their fees have to reflect these conditions. And of course therapists are self-employed with all the associated costs that go with that.

5. Number Sessions

It is an awkward truth that, partly because of the economic pressures outlined in point 4, most therapists tend to hold on to their clients longer than necessary. In my experience, you should budget for 10 / 12 sessions, around 3 month's worth of therapy. In saying that 90% of my couples and individuals will be completed by 6 sessions yet if I'm totally honest, sometimes I am unsure whether that is a good or bad thing.

Again duration of therapy of course varies according to the individual and the complexity of their back story, but the simple reality is that it can take time to build a relationship, to explore complex or damaged patterns that are locking you in unhappiness. And once this awareness is gained, we have to work on how to shift these patterns and ensure they stay shifted. Remember if it was quick and easy to change painful thoughts and feelings no-one would have them.

 

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.