How to choose a psychotherapist or counsellor?

To identify and select a psychotherapist or counsellor, you may do best with starting out to identify why you want to have counselling or therapy, and what you hope to get out of it. In some parts of the English countryside your choice may be limited, but in larger city centres, and especially in London, there is a vast range of different therapists, with all kinds of methods of working, different forms of training, different levels of experience, and different professional titles and qualifications.

Psychotherapist and counsellor are not protected designations in the UK, and there is no officially backed system for registration. This may look somewhat unsafe, but is true for many other activities, and officially regulated professions such as lawyers, doctors, teachers, professors, vicars, nurses also have a wide variation in skill level. I won’t say more about it in this blog, but it seems overall safer to restrict yourself to practitioners who do have at least one form of registration or accreditation with one of the major professional bodies, and to check that this accreditation includes a Code of Ethics, and a complaint procedure which you could access if need be. (See under resources for a list of organisations that are major and well-established; which is not to say that all the ones I have not listed there are suspect!).

Questions to ask yourself

  • Are your needs urgent and acute? In that case, have you considered at least consulting the NHS system, starting with your GP?
  • Do you want to be in therapy because you believe it will help you feel better and to be able to talk about and share things  or do you have specific goals for being able to do something that you can’t (e.g. public speaking, flying, leaving your house), or for stopping something that you need to stop (e.g. anger; alcoholism; out-of-control behaviour; panic attacks).
  • Do you have a clear sense yourself about needing help for a short period of time (6, 12 or 18 sessions perhaps)? Or do you believe already that what you need is long-term work stretching out over years?
  • Do you have an insight in the main schools and methods of psychotherapy, and know what you want, or do you only know about yourself?
  • How much money do you have to spend, or do you want to spend? (See another blog for some thoughts about cost)?

A first decision is whether you approach the NHS or not, and whether you try to find a charity, organisation or agency which provides specialised assistance with your particular problem or issue, perhaps at zero or low-fee cost, or at least on a sliding scale adapted to your means. See elsewhere for some thoughts on the options and considerations.

The private sector

If you decide against that, you are talking about the private sector. It makes things easier if you have an idea what kind of psychotherapy you need or would fit your circumstances and wishes, and whether you need short-term or long-term work. With those ideas in hand, you can choose and compare, go to a number of listings or websites, and try to choose a provider. If you don't know exactly what you need, it may be best to find an "insider" to talk with about your situation, who can help direct you to the "right" kind of person. The more that insider is aware of the full range of options and possibilities, is open to the strengths and weaknesses of each, and is not inclined to recommend his or her own school or system, the better it is. It isn't easy to find someone like that, but it definitely would be ideal.

A friend's referral

What many people do in the end is having a chance encounter with a friend or relative who have had a positive experience with therapy, and ask them for the name of their therapist, or at least for the type of therapy that worked for them. This may or may not work out. There is good evidence that many kinds of psychotherapy are almost equivalent in effectiveness (see my blog about this), so that makes it easier to believe this might work. But the choice of therapist is often very personal, and there definitely are issues for which shorter-term or longer-term work is likely to be more effective.

As part of the whole process, my recommendation is to go for a therapist who you feel on first encounter, or in the first one or two meetings, “clicks” with you, is closely attuned to your needs and wishes, and overall convinces you with what they say. And follow to a considerable degree your own conviction as to whether you first want to try short-term work, or want to take the plunge and plan for a long-term series of therapy sessions.

What others have written

These are some of my views. If you like to read a lot, or want to hear some other people's opinions, here are a few links:

As you will have gathered, this is not an easy process. But if you have decided to get psychotherapy, it is your life and your relationships that is at stake. So I'd say: go for it, and take the first step now!