Deciding that you want or need psychological help can be a difficult position to arrive at. Choosing the right practitioner to work with can feel like a daunting task with so many different fields of talk therapy, types of therapy and professional bodies overseeing the field. This blog is a guide to helping you find your way to the right psychotherapist for you.
Counselling, psychotherapy or psychology?
Counselling, psychotherapy and psychology all broadly fall under the category of ‘talking therapy’. They have much in common, yet are also very different. I have previously written a piece on the difference between counselling and psychotherapy; the former being largely for shorter-term work and the latter being appropriate for deeper and long-term work on the personality. We also have an in-depth page on psychology here so I shall not go into more detail about that here.
Depth of work
In choosing a psychotherapist, it can be helpful to have a sense of what it is you are seeking to gain from therapy. Generally, psychotherapy is longer term than counselling and rather than working with one specific issue, is instead a relationship through which the client can work through relational patterns (with themselves and others), formed in childhood that they wish to change. Depth relational psychotherapy takes time – months to years – to understand and process relational, or attachment, losses. It is a commitment to a process of therapy and to oneself with sessions being as a minimum weekly, at the same time and on the same day each week.
There are a few professional bodies who offer voluntary registration to counsellors and psychotherapists – the BACP and UKCP. Whilst the BACP includes the ‘P’ for ‘psychotherapist in its acronym, the minimum training requirements of the BACP for someone to call themselves a psychotherapist are quite low. The UKCP, on the other hand requires all registered psychotherapists to undertake a minimum of four years of post-graduate training at an accredited training institution alongside a mental health placement and four years of personal therapy, before permitting applicants to join. At Brighton and Hove Psychotherapy, all of our psychotherapists have trained at least to this standard and many far beyond.
Psychotherapy training is long, challenging and requires the candidate to be in their own personal therapy throughout the training period. Most training institutions are located in London, or further afield, and so a great deal of commitment is required to reach the necessary training standards. One of the main aspects that sets UKCP registered psychotherapists apart from counsellors is that they have been trained to ‘formulate’, which is another work for diagnose, or understand, more complex trauma and mental health issues.
If you have never previously been in therapy, then the prospect of the first appointment can be daunting. It is the job of your psychotherapist to set clear boundaries and create an environment that ‘feels safe, but not too safe’. What does this mean? Psychotherapy is about learning to tolerate difficult feelings and your psychotherapist is there to facilitate this process through their relationship with you. They are not there to be liked, or to be your friend, as this would not be beneficial to you or to your process. If all goes well at the initial consultation then you and your psychotherapist may ‘contract’, or agree, to work together. This means that they have assessed what work is required to facilitate change for you and you have decided that you are going to enter into an intimate relationship unlike one you have perhaps ever had before.
Length of Contract
How long is a piece of string? Most psychotherapy can last for months or years, however little can be inferred from the duration. For example, someone attending a year of therapy is not necessarily ‘healthier’ or ‘saner’ than someone who attends weekly for many years. It is entirely dependent on the work required, how the client wishes to ‘use’ therapy and the relationship formed. Freud famously believed that therapy only begins when the client is no longer in a crisis.
Finding a good psychotherapist begins on paper but ends with a feeling, or a set of feelings. As it is in the relationship that the unravelling of the past takes place, it is critical that as a client, you feel you can build a therapeutic relationship with your psychotherapist. The capacity to do this will hinge on their degree of training, clinical experience and therapeutic boundaries, as well as on it being a relationship that feels ‘safe enough’ – not too safe to not be challenging – within which the therapeutic process can unfold.
Mark Vahrmeyer, UKCP Registered, BHP Co-founder is an integrative psychotherapist with a wide range of clinical experience from both the public and private sectors. He currently sees both individuals and couples, primarily for ongoing psychotherapy. Mark is available at the Lewes and Brighton & Hove Practices.