Choosing a therapist

This might help…

You might be feeling anxious about something, or depressed and feeling sad, alone and at a loss. You’ve been thinking that counselling or psychotherapy might help but you don’t know where to start. You’ve read that mental health is more accepted these days but you still feel it’s harder to confront and deal with than a physical illness so where do you start? Who should you go to for help?

There are so many counsellors and psychotherapists to choose from but their qualifications sound confusing, you have no idea how to make the right choice. Do you need a counsellor or a psychotherapist? Do you need a course of CBT or would you be better off with a person centered counsellor or a psychodynamic psychotherapist? But what do these terms mean and what’s the difference? What is best for you?

Research evidence has consistently shown that no one approach to treating anxiety or depression is more or less effective than another and that it is the ‘therapeutic alliance’ that you make with your counsellor or psychotherapist that will help you to feel better. Research also shows that counselling and psychotherapy are as effective as taking anti-depressants. However, making that difficult first step in phoning up or contacting a potential therapist is so much harder than visiting your GP, how do you make this impossible first step towards confronting and dealing with your mental health?

Start here…

Counselling usually offers shorter term (from a few weeks to maybe 6 months or so) help in coping with immediate problems like bereavement, difficulties at work, physical health problems or relationship issues. Counsellors often work in schools, charities or with Employee Assistance Providers (EAP’s) but also in private practice in your local area.

Psychotherapy provides the same support but often working over longer periods of time (over 6 months and sometimes for unlimited open-ended therapy). Therapists usually help clients find a deeper meaning and understanding of the reasons why they feel like they do. Psychotherapy is generally regarded as an exploratory approach to uncovering deep seated feelings and behaviours whereas counselling might be regarded as a supportive means of helping a person through a difficult period.

However, in practice whether someone decides to call themselves a counsellor or psychotherapist will not affect the attention they give you and their skills in helping you to feel better. Counsellors and psychotherapists will have had similar training and will be registered with either the BACP (British Association for Counsellors and Psychotherapists) or the UKCP (United Kingdom Council for Psychotherapists). Counsellors and psychotherapists charge similar fees.

Psychoanalysis and Psychodynamic Counselling and Psychotherapy:  Psychoanalysis was developed by Sigmund Freud over 100 years ago and was traditionally an intense and extensive examination of a person’s life, usually involving daily therapy for many years. In the modern world, this is rarely delivered because of the expense and inaccessibility of the treatment to most ordinary people. Psychodynamic Counselling and Psychotherapy evolved out of psychoanalytic theory but has been adapted for use in a wide range of mental health care settings, including the NHS and in private practice. Research shows that neither person centered counselling or psychodynamic psychotherapy are more or less effective in treating anxiety and depression and it is the matching of client with therapist in developing a healing therapeutic alliance that will bring about change in the client’s life. Psychodynamic counselling and psychotherapy (either short term or longer term) looks at finding meaning in a person’s life history and relationships and finding ways to understand how their past influences how they feel in the present. In working with the therapeutic alliance, relational patterns and ways of behaving are examined and how these affect thoughts and feelings in the here and now.

Cognitive Behavioural Therapy (CBT): CBT is the most researched approach to dealing with low to medium levels of anxiety and depression and is most often seen in the NHS where it is delivered over short fixed periods. CBT is shown to be helpful in many cases but certainly not all but it is the most likely treatment to be offered within the NHS. CBT focuses on examining how certain events trigger behaviours and looks to provide alternative ways of reacting that help you feel better. It is particularly helpful in managing phobias and certain anxiety related difficulties, as well as low to medium levels of depression.

Person Centered Therapy (PCA): A large number of counsellors are trained in what is known as the “Person Centered Approach’ and is based on theory developed by Carl Rogers in the 1950’s and humanist philosophy. Therapists use their personal skills in showing empathy and unconditional positive regard (being non-judgemental) and being genuine or congruent with their client in their therapeutic relationship. Research shows that when provided with a relationship based on these core values, that clients experience significant improvement and relief from their symptoms.

So how do you go about choosing what type of counsellor or psychotherapist is right for you and which theoretical approach is most likely to work for you?

I am happy to discuss your feelings about all of these approaches in our pre-assessment phone call and I will provide unbiased feedback on your thoughts, including any previous experience of therapy you have had with different theoretical approaches.

Contact me to get things moving…