so, how in the name of mary, joseph and the wee donkey do you choose a therapist?
I would like to say that 'word of mouth' can be a
really good way but honestly I am not convinced that it is! The trouble
is, it may be that the person recommending the counsellor hasn't had that
much experience of being counselled themselves, and may have 'got on ok' with
their therapist but... most therapists are easy to get along
with, and it is perhaps more important that they know a bit about what they
are doing in the counselling room - in relation to what you are there for!
That said, all the evidence points to a good strong
relationship with the therapist being the most important factor linked to
positive outcome. So it's a MUST that you do get along from the off.
I hope that reading the below will help you
understand a bit more about how counselling models can sometimes be 'horses
for courses'. Some models are simply not recommended for some troubles,
whilst others absolutely are. So if you really like your therapist but
they are not used to working in an identified appropriate and helpful model
for your particular issue, then you may be spending a lot of money when you
might not have needed to.
The NHS NICE (National Institute for Health and
Clinical Excellence) have produced guidelines that offer helpful information
about what types of therapy are appropriate for certain types of disorder.
An example would be that a client led, gentle
talking therapy would perhaps not be the first choice necessarily for someone
coming to counselling with a phobia.
For instance, I could sit in the opposite chair to
someone with a dental phobia for ten years of therapy understanding how
difficult things for them are and convincing them how dentistry has come on
and how skilled dentists are now, and how that injection is really not
painful in the scheme of things, and how dentists are really kind old
gentlemen.... but after ten years they would still have to get up and walk
into the surgery and sit in that dentist's chair!
Perhaps a different approach that helped them to
challenge some of the reasons they were frightened in the first place and
moved them into the chair in a supported but much quicker way would be
helpful so the agony was not prolonged and they got the choice to be brave in
the doing of it! They'd discover quicker all that stuff about dentists!
Likewise, it might be no help offering someone with
a deep rooted and long standing psychological problem a short term therapy
that doesn't address the deeper issues concerned.
Am I explaining this ok?
INITIALLY... (SEE WHAT I DID THERE...?)
Well we all have a lot of qualifications and
letters after our names so how can you start to sort out the appropriate
qualifications when choosing a therapist?
The snag is that some of the extremely good and
well run counselling courses out there that are aimed at offering a quicker
route to qualification (so no personal therapy for the counsellor as part
of the training requirement, no personal development groups and the whole
training run over many weekends - rather than a typical University
qualification with a requirement for hundreds of hours of personal therapy, a
weekly personal development group and a much longer time spent studying) some
of these quicker route courses have qualification names as impressive as
longer University diplomas.
Be clear, I am in no way critical of these courses
or the students undertaking them, as they are extremely hard work, and any
student achieving a credible counselling qualification is to be
But perhaps more demanding still are University Degrees
and Post Graduate qualifications.
A typical route through University is a year of
basic skills followed by a year of counselling skills, followed by a year or
two of Diploma followed by a year of Degree followed by a year of PG
certificate followed by a year of PG Diploma followed by a further
dissertation for a Masters Degree.
And then hundreds of hours of personal
therapy, hundreds of hours of 'apprenticeship' often working for nothing for
Then long and arduous routes to Accreditation with
the BACP or UKCP.
It is perhaps then for you to meet some potential
therapists and simply enquire about the depth of their training - especially
in addressing issues such as yours, and just as long as feel safe with them,
TOP TIP! in summary...
So what do you do? You'd be well advised to
find a therapist - who you like, trust and get along with - with a
University Diploma, BSc or BA Degree or Post Graduate Diploma
actually in counselling or psychotherapy; be accredited to
at least one of the main credible professional organisations and
maybe even have years of experience.
So ask if they've completed an accredited
University course that included their own personal therapy as
this can make a vital difference to your therapy journey.
There are many different models of therapy. Some counsellors train in
one core model and believe that this will work for everyone.
Others have experience and training in many and can tailor their
therapeutic interventions to suit not only the person, but as we started to
consider above, the problem itself.
Be advised, the NHS National Institute for Health and Clinical Excellence
(NICE) recommend certain evidence based therapies for certain problems or
disorders and do not recommend others. You may be well advised to check out
what you're worried about and see what approach they advise. Don't forget
that website: www.nice.org.uk
Meanwhile... Back to how you choose a therapist! I think all I might
have done is confuse you further!
POSSIBLE QUESTIONS TO ASK WHEN YOU ARE
INTERROGATING A POTENTIAL THERAPIST! (Warning - if they are not sure about
their answers, try someone else!)
kind of therapy do you offer and what is it trying to achieve?
you had your own personal therapy as part of your training?
long are sessions and how often are they held?
long might therapy last for and how does it end - is there a set number
with regular reviews?
long before I should expect to feel some benefit from therapy?
I contact you between sessions if I need to?
training have you had, and how many years have you been practising?
professional organisations are you accredited with?
you had experience of working with people with similar problems to mine?
therapy confidential and when might confidentiality be broken?
you refer me to, or contact other health professionals involved in my
care - and is this something you are experienced in? Can you discuss my
medication needs for example?
much do I pay per session, and is there a missed session fee?
you work from home or from a professional office or rooms?
you keep notes about me and are they kept confidentially? What will
happen to them if you drop dead!? How will I know?
That said, I will remind you again, research shows
that generally, the most important influencing factor linked to therapeutic
'success' is the strength of the relationship you have with him or her. So
choose someone you like and trust!
If at any time you experience any difficulty with any therapist, if it
cannot be resolved once you have discussed it with them, I would encourage
you to contact their registering body for information and support. The BACP
being my primary registration, at www.bacp.co.uk
If at any time you feel pressured into doing something you don't want to by
your therapist, the chances are it is not right. Your therapist should be
very much 'on your team' and as such NEVER tell you off or be judgemental
about what you tell them! If they do, contact their professional body for
If you have a long standing problem it is not automatically the case that it
will take ages to address - but beware the 'magic' or 'quick fix' for any
upset as it is unlikely to be an effective intervention. (EMDR is
sometimes an exception to this as it can work really quickly on simple
If you are interested, have a look at my sketchy
guide 'a bit about counselling organisations'. It might help
with the letters after the name thing.