How to Choose the Right Psychotherapist or Counsellor?

Marta Ciesla, Counselling, Psychotherapy in Manchester June 25, 2012

Firstly: Shop around! 

There are many different psychotherapists and counsellors using different approaches. This can be quite confusing. One of the first questions you might have is: What’s the difference between counselling and psychotherapy or is there any difference at all?  And if there is, which of the two is the most useful for me? 

Counselling or Psychotherapy?

Well, some say that there is no difference, but according to the United Kingdom Council for Psychotherapy (UKCP)  there is a “widely agreed understanding that psychotherapy can deal with a wider range of clients and work can be more in-depth if that is appropriate”.  Psychotherapists are required to study to Masters level and are required to have 160 hours of personal therapy themselves during their training. The British Association for Counselling and Psychotherapy (BACP) on the other hand does not make any distinction. The Health Professions Council (HPC) proposes differentiating standards emphasizing that psychotherapists need also to be trained in understanding severe mental disorders, their diagnosis and theoretical approaches for treatment, whilst counsellors need to have an understanding of mental health and well-being and life problems.

Shopping around

The safest way to find a counsellor or psychotherapist is by recommendation or referral from someone you know and trust. 

You can also look online via search engines or online directories. When reading someone’s website or directory entry go with your gut feeling. Does what the therapist or counsellor write speak to you? Are there any red flags? Once you have a few names of therapist you would like to meet, give them a call or email and arrange appointments. Some counsellors and psychotherapists offer a free initial session or at least offer a reduced rate. 

Making contact

When calling or emailing you can give a short description of the reasons why you are seeking counselling or therapy. Always leave your contact details and if leaving a voicemail or sending an email indicates whether it is safe to contact you back at a certain phone number. This is to ensure your confidentiality in case someone else uses the same phone. 

Here are some questions you might want to ask during the initial phone call:

What are your fees?

What openings are available?

What theories are you using? (Gestalt, CBT, Transactional Analysis, Person-Centred, etc.)

What are your qualifications and training? 

Do you specialize in anything particular?

How long have you practiced?

Are you a member of a professional body and are you insured?

What is your professional and personal goal when working with clients?

Although you could ask all these questions over the phone, you might want to book an initial session to find out how comfortable you are with the practitioner. This is especially important, as research suggests that the therapeutic alliance (relationship) is one of the most important factors in counselling and psychotherapy. 

Once you meet you can also ask the practitioner other questions and test their honesty and integrity. 

You might want to ask about confidentiality and what happens to your notes, how the counsellor or psychotherapist thinks about certain issues (do they accept mental health diagnoses, are they open to different religious faiths and sexual orientation, etc.). Another important questions is about their views on professional boundaries (this is important for your safety). 

If it does not feel right, then keep shopping around.

Red flags

Some things to look out for:

If you feel uneasy (go with your gut feeling)

If you have the impression that the counsellor or therapist is giving you a sales talk rather than being interested in your experience

If some of your questions are being avoided and not answered 

If the psychotherapist or counsellor is not a member of a professional body

If the counsellor or psychotherapist expresses any views or opinions that fundamentally go against your own (e.g. try to talk about god whilst you are atheist or of a non-theist faith, express racists or discriminatory views)

If you have the impression that you are being assessed rather than it being a mutual assessment

If the counsellor or psychotherapist wants you to commit long-term straight away

Important points to keep in mind:

When you meet a counsellor or therapist for the first time you might feel like you want to book the next session straight away. This is fine if you feel very comfortable and not pushed to do so. 

However, always remember that the first assessment is for both of you. The practitioner will assess whether they feel they are competent enough to work with you and you assess whether you feel comfortable enough to work with them. See it as a two-way job interview with you in the power seat. 

Some misconceptions:

The more expensive the better: In an ideal world a counsellors or psychotherapists fee will be dependent on their experience and expertise, but this is not always the case. Some practitioner’s need to charge high fees depending on their location, whilst others work from home and don’t have to pay office rent.  Or some might have a sliding scale or offer low cost therapy for people on a low or no income. 

The more specialisations the better: Not necessarily. The effectiveness of some techniques is not proven and in some cases people might end up trying a lot of different things before something works for them. 

Qualified is best: Yes, there is an advantaged to seeing someone who has qualified already, as compared to seeing someone who is in the midst of their training. However, it is more important to feel safe and comfortable. 

Choosing the right one

You will know that you have found the right counsellor or psychotherapist if you feel safe and comfortable and have a sense of trust. After all, you will be sharing some very personal things about yourself and your life. 

Embarking on counselling or psychotherapy can be a life changing, positive and healing experience in which you chose to be the writer of your own life’s story. It can be a rollercoaster at times, but if you are working with the right person it will be a rewarding and inspiring journey.