I often get asked to recommend therapists – The requests come from all over the country (in fact all over the world) and with regards to a wide variety of issues, so instead of making a specific recommendation I often suggest things to consider when searching for the right therapist. I thought this might be more generally helpful so I’m sharing these ideas below – if you have any ideas to add, please leave them as a comment.
I appreciate that some people will be limited by geography, cost or NICE guidelines, but hopefully much of this is broadly applicable.
Are you ready to engage in therapy?
The first thing to consider is whether this is something you actually want to do. Be honest with yourself about your motivations for considering therapy. You’ll see the best results when you’re attending because you are ready to work hard for change. Attending therapy to please others or because you feel you should, will generally yield slower results. Conversely, if you find yourself suddenly inspired to seek support for ongoing issues, embrace that motivation.
What are your aims and objectives?
Once you’ve established that the therapeutic process is one that you are motivated to engage in, it’s important to understand what you’re hoping to achieve through the process. This will help you determine the kind of therapy that might be helpful and will help you recognise when you make progress. Ask yourself ‘what would success look like for me?’ This will be different for everyone and is often a gradual process but examples might include:
- Finding safe ways of coping with difficult feelings
- Becoming more comfortable talking about difficult issues
- Understanding and managing feelings related to a specific incident
- Becoming more comfortable in situations you currently find hard
- Developing your confidence and self-esteem
- Learning to manage panic and anxiety
There are many other possibilities, they are different for each person. There is no right and wrong answer but stopping to consider your aims is a hugely helpful process both when initiating therapy and as you engage in the process.
What is the likely cost in terms of money and time?
The therapeutic process can be a long one – how long, how expensive and how intensive depends on a variety of factors including the severity of your condition, how much support is available and / or how much support you can afford. Many people choose to employ a private therapist to jump NHS queues and to give them more freedom to choose a therapist to suit them and continue for as long as they need to (NHS therapy or therapy provided by charities is often time limited). However, if you choose this route, you need to prepared to commit to it financially. The cost varies hugely – anything from about £40 to £150 per session is typical, for one or two sessions a week, for anything from six weeks to two years or more. This can add up and may come at a time when your income is reduced due to illness. For some people, financial stress significantly contributes to their other anxieties and issues so it is worth thinking carefully about how you intend to fund your therapy from the outset. Your GP, school or workplace may be able to refer you for free therapy or make you aware of locally available charities who can support if the cost would otherwise be prohibitive (there are also some options listed below).
The other cost to consider is the time you’ll need to commit. As well as the sessions themselves, you’ll need to factor in travel, time between sessions to complete homework or reflect on what you’ve learnt and you may also find that you need time to wind down and reflect immediately following a session – so it might not be a great idea to sandwich a session in your lunch break from work for instance.
If you can afford it both in terms of time and money then it is one of the best investments you could ever make (in my humble opinion) – but it is worth having a solid plan about your time and monetary investment from the very beginning.
What kind of therapy might be helpful?
Therapy is a very broad term and there are many different types available. Different types of therapy are recommended for different conditions – your GP will be able to advise or you can do your own research. The Mind website is particularly helpful – I’ve included their guide to talking therapies at the foot of this blog post. I also found this Telegraph article which outlines alternatives to Cognitive Behavioural Therapy (CBT) a useful guide.
Some therapists have very specific training and work with one type of therapy, others have a more flexible or eclectic approach. It’s worth understanding what type of therapies your therapist is trained in and how flexible they are. As ever there is no right or wrong answer, but it’s important to ask the question and consider what might work best for you.
It can be hard to wrap your head around what might work well for you if you’ve not engaged in therapy before – this is where friends and family can come in. Asking other people who’ve been or are going through the process what to expect and what’s worked for them can be incredibly helpful and reassuring. Alternatively you could reach out via social networking or online forums to find other people who might offer help or guidance.
What kind of person can you imagine striking up a good relationship with?
Arguably the most important part of therapy is the relationship that you build with your therapist. You need trust, honesty and understanding if you’re to work through difficult issues safely and sensitively in your sessions. As such, it’s really important for you to find someone to work with you can imagine yourself opening up to. If you feel strongly that you have a preference with regards to things like gender or age, then look for a therapist who fits the bill. Think too about whether you want someone who is going to be very gentle, kind and comforting or whether you want someone who will really challenge you and push you hard. As an aside – it’s a good idea to discuss the kind of approach you prefer with your therapist. Mine has known from the outset that I like to be challenged and pushed, that I appreciate humour and that I need not to be allowed to play games. Having that basic understanding from session one has helped us to define a really helpful relationship on which to base our sessions.
You may get the chance to talk to your therapist on the phone ahead of an initial meeting – use this as an opportunity to pre-screen. Ask yourself ‘Can I imagine developing a relationship with this person?’ If you get as far as an initial consultation, view this as your chance to interview the therapist for the job. Many people go to these appointments fearful of being judged by the therapist, but in fact, this is your chance to judge the therapist, to decide whether this is the right person, whether you feel comfortable with them and whether you think that there is a potential for a trusting relationship between you. Don’t feel you have to commit to the first therapist you see, they may well soon know more about you than anyone else, so it’s worth holding out for the right person.
It’s okay to change your mind
If you start sessions with someone but find that their style doesn’t suit you, or the relationship just doesn’t feel comfortable for any reason then it’s okay to change your mind. It’s well worth exploring the issues you’re experiencing with your therapist as they may be able to adapt their style to suit your preferences, but if it’s really not working then it’s okay to look for someone new. Many people work with two or three different therapists before they find someone they really gel with, there is no shame in that.
In the UK, The NHS is working hard to improve access to talking therapies as part of the Improving Access to Psychological Therapises (IAPT) programme. You can search for services available locally to you using this NHS tool. Some services require a GP referral whilst you can self-refer to others.
Visiting your GP (doctor) is a good first step as they will be able to discuss the issues you are facing and help advice on the appropriate next steps. They may also recommend medication in combination with therapy. Your GP can also recommend local private therapists or write a referral letter for you to access paid for support via your medical insurance.
You can approach therapists directly if you are intending to pay the bill. They will ask permission to share some information with your doctor. This is advisable but it ultimately at your discretion.
The following organisations have approved therapists:
- British Psychological Society: psychologists
- British Association for Behavioural and Cognitive Psychotherapies (BABCP): cognitive behavioural therapists
- Association for Family Therapy (AFT): family therapists
- British Association for Counselling and Psychotherapy (BACP): counsellors and therapists
- British Psychoanalytic Council (BPC): psychoanalytic psychotherapists
- UK Council for Psychotherapy (UKCP): psychotherapists
- Association of Cognitive Analytic Therapy: cognitive analytic practitioners and psychotherapists
Some charities offer cheap or free talking therapies. These include:
- Cruse for bereavement care
- Beat for eating disorders
- Mind for mental health problems
- Relate for relationship counselling
Good luck and well done
Well done for getting to the point of considering therapy – it’s a big step and one many of us find terrifying, I know I did. But there is much to gain here. It’s hard work and it’s not all plain sailing but if you find the right person, with an approach that works for you then this could prove to be the best decision you’ve ever made. Good luck.
[n.b. I’m keen to highlight some books in this post but am unaware of anything helpful re entering the therapeutic process – if you have written or read something helpful please let me know – firstname.lastname@example.org ]