Is therapy right for me? And… what therapy, anyway? Tips to choose therapy and therapist
‘Can ‘therapy’ help me?’ is a legit question for everyone going through a difficult time, navigating a tricky relational, work or personal situation or who needs to make an important choice.
Therapy aims to offer a safe place where one can gain an understanding of our current difficulties, how we’ve kept going despite our efforts, and learn and practice new techniques that could help us move forward. However, there are several aspects to consider when seeking therapy: a therapeutic orientation that suits our goals and learning style, a regulated therapist who ‘clicks’ with us, to say a couple. All this can turn seeking suitable therapy (and therapist!) into a minefield. Here are some ideas you may want to consider to narrow down the wide choice available:
Your therapy goals. Sometimes we approach therapy without a clear sense of what we expect. And it doesn’t make sense, as it’ll be an investment (not only financial, but also time and emotion-wise), so you may want to have a way of measuring its success. Thinking of what would change as a result would be helpful for both you and your therapist. So, what would you like to be different as therapy progresses? What would you do more or less of? What would you stop doing altogether? What changes would people around you notice in you? It’s helpful here to move from dead person’s goals (i.e., what I would like not to do or feel, which dead people would be better at than us, like not feeling anxious) to living person’s goals (i.e., what I would like to do and how I’d like to interact with the world despite feeling X). How would you be able to manage the next time you feel Y or someone does Z? How would your relationships be different? Think of this as short, medium and long-term goals, as that’d be a good map to where you are going.
Your therapist’s therapeutic orientation and experience. Different therapeutic models will be more or less suitable to your goals. Whether you want to focus on learning techniques and changing the way you respond to specific situations or need to ‘make sense’ of how a past experience has affected you, there will be different orientations that will help you address that. This is sometimes a difficult call to make: whilst one model may fully address the difficulties you seek help for, it’s often the case that several ‘tools’ are required for the job. You will find therapists that are more ‘purist’, having trained in depth in one model, and others more ‘integrative’, who bring together learning and tools from different ‘toolboxes’. You may also know that different models have demonstrated evidence of effectiveness for certain presentations and are, therefore, recommended ways of addressing those difficulties. You may want to check if your therapist offers evidence-based therapies. Also bear in mind that different models will involve different ways of working: some will focus on what happens in the session, whilst others, more focused on learning and practising techniques, may place emphasis on between-sessions tasks. Apart from regular attendance, you may need to think if you can accommodate this key element in your day-to-day life.
Your therapist’s training. There are different professionals that offer therapy, from clinical and counselling psychologists to psychiatrists, psychotherapists or counsellors. Each of them have completed training varying in duration (e.g., clinical psychology is a doctorate level qualification whilst counselling or psychotherapy can be a postgraduate or masters-level training) and specificity (e.g., whilst clinical psychologists have a breadth of knowledge, encompassing different models, psychotherapists may specialise in one or two of them). Psychiatrists have a core medical training, specialising on mental health and often focusing on a specific therapeutic approach.
Your therapist personal characteristics. This and the point above are very connected, as their therapeutic approach may dictate how they conduct themselves in the session. However, it goes a little further: how do they explain important points? Do you feel understood by them? Do they assume too much? Do they invite or impose? Do they give a rationale for what’s going to happen? Do you feel you have a chance to disagree? Is that taken into account? Their age, gender, sexual orientation and other characteristics may also be something to consider depending on the difficulties you intend to work on, although it’s all about how you feel about it, as it can work either way (e.g., working with a male therapist on sexual abuse perpetrated by a male may prove a corrective experience).
Your therapist’s registration. It follows from the above. All therapists are regulated by different bodies which are meant to protect the public from unethical and unsafe practice by people without the necessary skills, training, supervisory structure and continuous professional development. However, even with this in place, you may come across (not-that-) professionals you may want to keep away from. As a health profession, therapy is regulated by the Health and Care Professions Council (HCPC) in the UK. So, as a minimum, you may want to find out whether your therapist is registered with the HCPC. Depending on what their main approach it is, they may also be registered with or accredited by other bodies, such as the British Association or Counselling and Psychotherapy (BACP), EMDR UK, the British Association of Behavioural and Cognitive Psychotherapies (BABCP), the British Psychological Association (BPS) and so on. Make sure you ask for their registration/accreditation credentials or search on their respective websites.
Other practicalities. And you may also need to think about other not less important aspects, such as whether your respective availabilities fit or the frequency of the sessions (it’s often the case that therapy sessions take place weekly, but there should be some flexibility allowing for unexpected events). The format of therapy (i.e., online vs. face-to-face) seems an important aspect to consider for some. However, recent research suggests that therapy can be equally effective, provided that one has a private space and good enough technology enabling seamless communication. Finally, the money side: some therapeutic work is time-limited and the therapist may give you a pretty accurate estimate of its predicted duration. Other times, you may embark on open-ended therapy (back to your goals again!). In either case, you may need to consider the fees-side, as they may limit your access to therapy. Some health insurers include therapy as part of their policies. However, there are limitations (in terms of the type of therapy, professionals and duration of input you can get). You might also want to consider what use they will make of the confidential information you will be disclosing to them, by checking what their data protection policy is.
And one last thing… Probably by now you can say I’ve failed to reassure you that this is a simple process, but hopefully this has given you some pointers to consider. With this in mind, you may narrow down your search to a few therapists that seem suitable. Then is when you may approach them and have a free, brief and non-committal conversation with them, where they can give you a sense of how they may be able to help you.
If, after reading this, you think I may be able to help you with the difficulties that you, your relationship or someone close are experiencing, just let me know and we can discuss it further.
By Dr Jose Lopez, Clinical psychologist, Accredited CBT and EMDR therapist