Finding a psychotherapist can feel like a daunting task. For starters, the difference between a counsellor and psychotherapist may not immediately be apparent. Then there are the different modalities, or approaches to therapy. And lastly, there are the different professional bodies to make sense of.
The term ‘psychotherapist’, unlike ‘clinical psychologist’, is not a legally protected term in the UK. This means that there is very little to stop anyone claiming that they are a psychotherapist, without having undergone an accredited psychotherapy training (or indeed any training at all).
There is also, as of yet, no agreement across the different professional bodies as to what exactly constitutes a psychotherapist, which further muddies the water for anyone seeking psychotherapy.
If a client is wishing to go into therapy then my advice would be first and foremost to seek out a professional registered with either the UKCP or BACP and who can evidence significant clinical experience in the field. Both of these professional bodies have helpful websites which enables users to search for clinicians based on location, as well as other criteria.
Once you have a list of accredited psychotherapists, you may wish to consider which approach, or modality, in which the clinicians in question have been trained. Whilst this may seem confusing, it is important to remember that research has shown that it is the quality of the therapeutic relationship combined with the approach, that leads to the most successful outcomes in therapy. Therefore, look for a clinician who is able to explain how they think and work in clear and understandable language – remember, it is their job to help you understand how they can assist you, rather than you needing to figure it out by wading through complex jargon yourself.
Many people make the decision to seek out a psychotherapist when in a crisis. Whilst this is common and the sense of urgency strong, it is important to take the time to find the right ‘fit’ and this may mean contacting various clinicians, as well as attending potentially more than one initial consultation. When new clients come for an initial consultation with me, I always set a goal with them at the start of the session in suggesting that it is their job to work out whether they feel comfortable enough (but not too comfortable) working with me, and my job to work out if I believe that clinically, I can help them. This often comes as a surprise to new clients in that they are there to make a judgement and choice in relation to working with me, however, therapy needs to be a co-created and collaborative process from the outset.
How do I know if my therapist is right for me?
If you find that you are working with a therapist and it does not feel like you are getting what you hoped for or are feeling uncomfortable then raise this. As I stated earlier, psychotherapy is ‘work’ that two people undertake and a big part of the work is in establishing a particular kind of relationship – a therapeutic relationship – or alliance.
If your psychotherapist is unwilling to hear your concerns and to discuss these with you, then that is a strong warning sign that the person you are working with is not a good fit (and arguably not a very good clinician).
I suggested earlier that psychotherapy should be a process that feels supportive and comfortable, but not too comfortable – you have sought out a psychotherapist because you have a problem and want support. Your psychotherapist is not there to be your friend.
They are equally not there to collude with you, but to appropriately and mindfully challenge you.
I previously referenced the different approaches to psychotherapy – the methods. These can seem confusing – and even cause a fair bit of infighting amongst the therapeutic community! One way of thinking about these approaches is to consider them as ways of conceptualising, of thinking, about your inner world. It may be that after a period of time you discover the way your psychotherapist thinks simply does not ‘fit’ with the way you think. Remember, psychotherapy is about understanding the human mind and nobody has veer seen or touched a mind – it is a concept, a construct, and as such is shaped and brought to life by language.
What is ‘good’ psychotherapy?
There are many answers to the question – ‘what is psychotherapy?’ – which is another way of asking the question ‘what is good therapy?’. As there are so many ways of helping people make sense of their inner world, there are an equal number of answers as to the goals of therapy, however, there is commonality.
Rather than ‘good therapy’ being one thing, it can be better expressed as a formula: A solid frame combined with a containing relationship. Let me explain: Us psychotherapists frequently reference ; ‘the frame’ in psychotherapy and this refers to all the elements that enable a solid ‘containing’ relationship to form between the client and their therapist. The frame consists of a regular meeting day and time, a stable and unchanging consulting room, sessions that start and end on time, a therapist who is ready and attentive – these are some examples.
By ‘containing relationship’ we are talking about the very unique role that we, as psychotherapists, must play for our clients. We are there to think about the client every second of the encounter and must not make the relationship or sessions about us.
Therefore, when in psychotherapy, if you ask your psychotherapist a question – something such as ‘how was your weekend?’ – they will likely explore with you what lies behind the question before answering.
A containing psychotherapist is also one who can ‘survive’ their client – in other words, the client is free to express themselves how they wish and the job of the therapist is to be able to hold the boundary no matter what. When the frame and container are solid, that is a good starting point for successful therapy.
Can it be dangerous to see the wrong psychotherapist?
Let us assume that by ‘wrong’ therapist we are assuming a poor fit rather than any kind of abusive relationship, as clearly the latter presents significant risks to the client and would constitute a breach of the psychotherapist’s (BACP or UKCP) code of conduct.
Psychotherapy is, amongst other things, about helping client to understand their wants and needs and to help them put appropriate boundaries in place in relationships. If a client is continuing to see a psychotherapist where they are getting little to nothing from the sessions and feel that they cannot raise this, then this is only going to further undermine their self esteem and confidence which is utterly counter-productive to the process. This would be an example of the client’s experience in their relational world repeating in the therapy.
How important is it that my therapist is accredited and what should I look for?
As I have previously highlighted, psychotherapy remains largely formally unregulated in the UK. Membership of the various professional bodies is voluntary and for clients, it can be hard to distinguish between them.
As a UKCP registered psychotherapist I am acutely aware of the rigorous training standards of my professional body and understand the level of training that other psychotherapists, irrespective of their modality, have received who are fellow members.
Anyone crossing the threshold of a psychotherapist’s consulting room has been on the receiving end of some degree of neglect or abuse in their childhood. This makes them susceptible to further relational injury from working with someone who either is misrepresenting themselves, or has received inadequate training to understand their
Further reading by Mark Vahrmeyer