How to choose a Therapist

So, you’ve thought about it, and now you’re almost ready to see a therapist. The next question that arises in your mind is: “How do I choose a therapist and what should I be looking for?” This article will attempt to give you some pointers as you consider choosing a therapist.

The task of psychotherapy

The first thing to think about is what you hope to get from your therapy. This is because there are different kinds of therapy, and each one has a different focus. For example, with Cognitive Behavioural Therapy (CBT), the focus will be working on helping you to correct unhelpful thinking patterns, and find new ways of tackling your worries. In psychodynamic work, the focus will be working on what causes your difficulties, including things you may not be aware of that may be contributing to your difficulties, so you can develop and change in your personality.

This said, whilst different kinds of therapy will work differently, they aim to help you gain more knowledge about yourself, and to help bring changes in your life.

So, ask yourself: What would I like to get from my therapist and my therapy? Do I want a therapist who acts more like a coach and help me change my thoughts and behaviour, or do I prefer a therapist who would give me thoughtful space and help me with understanding why I behave the way I do? If the former, a CBT therapist may be more suited to you. If the latter, a psychodynamic therapist may be more suited to you.

Of course, the next question after this is how do I know my therapist is good at what they do and can really help me? To answer this question, I would like to turn the question around to see what an inadequate therapist looks like in practice. 

Signs of an inadequate therapist

--- The Comfort Blanket Therapist

This is a therapist who will agree with your version of problems you are facing and say comforting and friendly things to you but ultimately does not help you to change. For example, they will side with you in blaming others rather than helping you to see the problem which may be in fact, be inside of you. It is very difficult to pick out the comfort blanket therapist because they would reflect what you are saying and their words would feel relaxing. However, the clues to the comfort blanket therapist is that you may end up feeling empty at the end of sessions. You may also find that you are never annoyed, angry or upset in your sessions with the therapist (which ironically is a bad sign because you are not addressing your difficulties).

With a comfort blanket therapist, you may end up feeling nice and relaxed but you have not learnt anything new about yourself and so cannot change. It is easy to be seduced by ‘niceness’ in a therapist but this is not the most important quality. So, the questions to ask yourself about your therapy are these: Are you learning new things about yourself? Do you have a greater understanding of yourself at the end of your sessions?Are you ‘shocked’ into new ways of thinking and feeling? If you find that none of the above is happening, you may want to think about looking for a different therapist.

--- The Magic Wand Therapist

This is a therapist who promises and attempts to take away your problems, difficulties and negative feelings. They will tell you the solutions immediately when you describe what troubles you. Instead of helping you to think about your pain, they will give you an ‘absolution’. The magic wand therapist finds it hard to sit with your complex feelings and works hard to eliminate them for you by telling you what to do.

It is hard to pick out the Magic Wand therapist because when you are in need, it is tempting to have a therapist who tells you everything is OK, or you will be OK. It may be a temporary relief to not have to think or feel too much and simply follow the therapist’s ‘solutions’, rather than find out about the part of yourself that doesn’t want to change or finds it hard to change. So, like the Comfort Blanket therapist, the Magic Wand therapist will give you a lovely feeling but they will ultimately lead to disappointment. This is because lasting psychological change happens only when you have worked something out for yourself.

So, ask yourself: Is my therapist challenging me in my thinking and feelings? Are they helping me to find my own solutions to the difficulties I have? Are they only focused on giving their answers and solutions rather than thinking with me about my problems? If your therapist is not helping you to find your own way through your difficulties, consider changing your therapist.

--- The No Boundaries Therapist

This is the therapist who is not aware of how they are affecting you. They are very good with theories, but does not pay attention to the kind of impact they have on you. For example, the no boundaries therapist may start telling you about their own problems in your sessions. They may pay very little attention to what would be in your best interest. For example, I have heard of a therapist whose consulting room is on the top floor of a building which houses other businesses open to the public. When the appointment time was due, instead of walking down to collect her patient, the therapist hollered the patient’s name at the top of the stairs. When the patient got up to the third floor, she found the therapist there with her cat in the room.

This therapist is not aware of how she is affecting her patient – the fact that confidentiality may be compromised, or that the patient may have an allergy to pet hair, or the distraction of a third presence (cat) in the room. So, questions to ask yourself: Does my therapist pay attention to what would be in my best interest? Do they provide a safe environment for me? Do they protect my confidentiality? Are they punctual and thoughtful about time? Are they deeply aware of how their words and behaviour affect me? If not, this therapist is a no boundaries therapist, and you should consider changing therapist.

Signs of a Helpful Therapist

 
So far, we have been looking at the inadequate therapist. You may wonder at this point: What are the signs of a good and helpful therapist?

You would have gathered so far from this article that the internal qualities of the therapist matters. Their capacity to understand your difficulties and help you think about what is unthinkable or difficult for you, to challenge your way of thinking and feeling, to be able to understand your pain and anxiety without resorting to either giving you temporary relaxing comfort or to wash away your painful feelings magically.

The sign of a good therapist is that they have good knowledge and understanding of how the mind works and show empathy because they have spent time working through their own difficulties. When you see a good therapist, they should help you understand something you may not have understood before. So, after you have seen your therapist for an initial consultation, ask yourself: Have I learnt something new that I didn’t know before? Does the therapist “see through” me, including the parts of me that I don’t yet understand? Do I experience any change in my mood or feelings after seeing them? This does not mean your problems are sorted out, simply that the therapist has begun to help you think and feel about yourself and your situation in a new way.

Alongside these, it is useful to think about external qualities. This includes:

• Are they accredited or registered with a professional body? (For example, In the UK, they should be accredited by BACP or UKCP, or registered with the BPC or HCPC). You can find out if your therapist is accredited or registered through the public registers of these professional bodies which can be accessed online or by calling the professional bodies.
• Have they had psychotherapy themselves? How long was their training? Have their training been purely academic or does it have actual patient contact hours?These practical questions are important in giving you an indication of the therapist’s standing and experience in providing psychotherapy for you. You should be able to ask your therapist this at your initial consultation.

Christian therapists VS therapists who are Christian

Lastly, I often get asked: Should I pick a Christian therapist and what would be the difference? This is an important question about the place of Faith in therapy. In the UK, they are broadly divided into two sections:

1. there are therapists who offer “Christian Counselling” or “Biblical Counselling”. This means that they use a specifically Christian worldview in their counselling and may use the Bible or Prayer as part of their work with you.
2. there are therapists who offer “Counselling or Psychotherapy” who are Christians. These are therapists who have trained in secular psychological institutions but are also Christians in their workplace.

It is your decision which you feel would be most helpful for you. Either way, it would be useful to sound this out with your therapist. Does your therapist take your faith and Christian worldview seriously? You may want to say to your therapist that your Christian faith is really important to you and that you do not want your faith to be pathologised in the therapy. You can also ask your therapist if they have experience in working with someone with a strong Christian Faith. A good therapist will be able to think of that together with you, be respectful of your Christian Faith and even help you to utilise the resources of your Faith as part of your therapeutic journey.

National lists of acredited counsellors and therapists

 

1. Christian Counselling: http://www.acc-uk.org
2. General Counselling: http://www.itsgoodtotalk.org.uk/therapists/
3. Psychotherapy: http://www.bpc.org.uk and http://www.psychotherapy.org.uk (UKCP)
4. CBT: http://www.cbtregisteruk.com

[All counsellors are overseen by the Professional Standards Authority who maintain many other lists that could not be included above.]

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I am grateful and indebted to Neville Symington, psychoanalyst for his inspiring book with the same title in my writing of this piece.

Thomas Yap is a Psychodynamic Psychotherapist (BPC) and founder of Talbot Court Psychotherapy, a private practice in the City of London offering individual psychotherapy. Email: thomas@talbotcourttherapy.com Tel: 07502 126754