Choosing a therapist

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It can be difficult to choose a therapist, especially if you have never had therapy before. So many people provide services, and it might feel overwhelming when there is so much choice. There may be some agencies local to you, or you can also look online. Here are some things to consider when you are starting your search for therapy.

Your hopes for therapy
Before looking for someone, think about what you’re looking for from therapy. What do you hope to change or be different? Are there specific things you want regular support with or several sessions to learn strategies? Another consideration, especially if this is a long-standing issue, is why now? Has something initiated a need for further exploration of these difficulties, or maybe you feel you now have the time to attend therapy? These are usually things I ask in a consultation or first appointment. Don’t worry if you don’t have clear, defined aims, but have some idea of what you want; this can be worked through with a therapist and is something I have spent some time on with clients in sessions. Having an idea of what you want from therapy helps to be clear on your intentions so that the therapist can have a shared understanding and be better positioned to support you.   

Therapy approaches
Thinking about what you’re looking for from therapy might influence your chosen approach. For example, for trauma, you may have heard of EMDR (eye movement desensitisation and reprocessing) or trauma-focused CBT and are seeking this. This may be from things you’ve seen in the media or heard from peers. Most therapists list what they use in their work in directories or can discuss this with you. You might prefer individual therapy and seeing a therapist one-to-one, or you might prefer sharing the experience with others and instead seek group therapy.

Practical factors
Consider how much time you have for therapy sessions with your other commitments. Usually, sessions can last around 50 minutes, with the minimum being one session a week, or you may be thinking of less frequent sessions, such as fortnightly. Do you feel ready to start therapy? It might feel too difficult to disclose some personal experiences, or maybe things are hectic, and you would find it challenging to maintain attendance.  Think about your availability to meet and where you will be travelling to. If you’re looking for online therapy, will you have a private space for your therapy session? For example, if you are working in a busy office environment or driving in a vehicle, that would not be suitable.

Qualifications and regulation
Once you’re searching for a therapist, you might check online to see who’s available in your area or search by problem or difficulty. Using a reliable directory or checking information on training, qualifications and memberships on their website or social media is important. A critical thing to check is whether the therapist is regulated or a member of a professional association. Unfortunately, anyone can use terms like ‘counsellor’ or ‘psychologist’, meaning they can provide unhelpful support, not properly assess risk, not have appropriate training, or not be aware of the limits to their competency, which could result in harm being done. Training programmes require at least 100 hours of therapy and accompanying clinical supervision during training to qualify as a counsellor. For counselling psychologists, at least 450 hours alongside clinical supervision is necessary to qualify. Furthermore, once qualified, therapists must continue with clinical supervision and engage in continuing professional development activities and stay updated with developments in the field.

Directories such as the Counselling Directory in the UK ensure that all therapists listed are qualified and have full membership with professional associations such as the British Association for Counselling and Psychotherapy (BACP) and the Health and Care Professions Council (HCPC). This means there are accountability and ethical standards to adhere to. Some titles are protected, such as ‘counselling psychologist’, but the therapist must be on the HCPC register to use this. You can check the HCPC register online: https://www.hcpc-uk.org/check-the-register/

Once you’ve met
Your consultation call or first therapy session will allow you to gauge your feelings about working with the therapist. Feeling nervous or worried about meeting with them for the first time and sharing your experiences isn't unusual. There may also be some upset or discomfort as you discuss difficult topics, but your therapist should support you through this.

Good signs are that you feel valued, listened to, respected, comfortable speaking with them, and understood. However, you may not feel too connected with them or think their approach isn’t working for you. The ideal relationship or what people prefer varies, and therapists know this.

Some things I’d be concerned with are experiences being minimised, feeling their attention isn’t on you during the session or having regular interruptions, feeling the therapy room isn’t private in-person or online, not using professional boundaries, oversharing personal information and trying to push their personal views on you. Additionally, trying to force you to ‘open up’ and disclose things you may not feel ready to would also be concerning. You can voice your concerns and discuss this with the therapist if you feel comfortable. If this feels difficult, you might want to inform them via email or text before finding a new therapist.

Ask questions: most therapists welcome being asked about their knowledge or experience in supporting you with your problem or difficulty or if you wish to know about their training or qualifications. You can ask how long they’ve practised and what kinds of treatments they offer. If you have experienced discrimination, you can also ask about their anti-discriminatory and multicultural competencies.

Summary

• Think of the reasons you’re seeking therapy and what you want from it.

• Reflect on your availability and readiness for therapy and the costs if you’re self-funding.

• Check the therapist is qualified and a member or regulated by a professional association.

• It’s okay to ask your therapist questions about your therapy.

Starting therapy and finding a therapist are big steps. Finding a therapist is personal; you might need to meet with more than one to find the one who is right for you.