Feeling at Sea about Choosing a Counsellor or Psychotherapist?

Choosing a therapist, counsellor, psychotherapist, or talking therapist can be daunting. I use these titles interchangeably as there isn’t any agreed distinction in the field between them. There are many therapists, and many different styles of therapy to choose from – four or five major types, and hundreds of sub-types!

One key question you may be asking is:

Is there a specific type of talking therapy that is the most effective treatment for the problem I have?

There are some types of therapy that have been developed for specific problems. These include Counselling for Depression (CfD), which is a largely an adapted humanistic therapy developed by the NHS. Another one is Eye Movement Desensitisation and Reprocessing (EDMR) therapy, primarily developed to treat post-traumatic stress disorder (PTSD).

But when it comes to effectiveness, the research evidence in the field forms a mixed picture, and there are various interpretations of it. One major perspective which the evidence supports is that all talking therapies are just about equally as effective as each other.

Research evidence suggests the most important factors that contribute to successful therapy outcomes is client motivation and the quality of the therapeutic alliance/ relationship (for more on this see The Common Core of Psychotherapy | Psychology Today). What are the implications of this when choosing a therapist?

• Pick a style of therapy you personally feel most drawn towards. For a summary of different types of therapy, see Types of therapy - Counselling Directory.
• Choose a therapist who you feel secure-enough with and feel a connection with.

Good therapists have some room to adapt their approach to meet the needs and preferences of each client. My practice, for example, is grounded in the person-centred approach, and there is diversity in how this can be practiced. I also draw on elements of other major therapeutic approaches where this works for the client.

Another question some clients ask is:

Is it best to choose a therapist who has a lot of experience working with the particular problem(s) I need help with?

A therapist who has specialist knowledge of and a lot of experience working with a particular issue (whether it be grief, anxiety, depression, ADHD, fot instance) is likely to bring this to bear in a positive way to their work with you. But a word of caution. Given that client motivation and the quality of the therapeutic relationship are central to the success of therapy, it’s wise not to narrow your choice of therapist down too much by overly prioritising expertise in a particular issue.

Is it best to choose a therapist who has a similar identity or background to me?

It might be that you feel a greater connection and comfort with a therapist who is overtly like you in some ways. But there may also be more subtle reasons for being drawn to one therapist rather than another.  It’s worth remembering that the aim of therapy isn’t to become more like your therapist, but to become more freely you. So, there are no hard and fast rules. Again, is there a sense of connection and security, and does the therapist have the relational skills and adaptability that will work for you?

In a nutshell, there is no fast and sure way on paper of finding the therapist that is just right for you and your issue(s). The level of your motivation in the therapy will be the big factor in the success of your therapy. Your motivation is likely to be higher if you’re doing a style of therapy that resonates with you, and if you’re working with a therapist with who you have a rapport.

It’s worth having a look through therapist profiles and then seek consultations with those you feel more drawn towards. I offer (as do many therapists) a free 20 minute, no obligation, consultation. Don’t be afraid to ask challenging questions. You may be fortunate to quickly find a therapist and style of therapy that works well for you. But if you don’t, continue with your search. A good therapist will understand that it’s important for a client to find a therapist who is a good-enough fit for them.

Photo by Igor Omilaev on Unsplash