Find a therapist

This is the first of three articles on how to find a therapist. It’s an overview of the principles and first steps.

When you need to find a psychotherapist, there are some things that you should consider, and some that you should ignore.

Overview

There are two stages to finding a psychotherapist. In the first stage, you identify possible therapists, based on things like their qualifications, where they practice, what they charge. This article covers that first stage.

In the second stage, you have an initial session with the therapist. In your initial session, you can establish some things that are difficult to establish in advance. Then you can make your final choice, or go back to the first stage to try again. The next article covers the second stage.

The third article describes a sneaky way to find a very skilled therapist, if you have a condition that seriously disrupts your life.

Diagnosis and symptoms

Psychotherapy does not depend much on diagnosis and symptoms. In general, any therapist can treat anything. Perhaps your diagnosis is unclear, perhaps it is actually wrong, perhaps you have no diagnosis at all — these things do not matter in your choice of therapist.

Gender, race, hairstyle…

Psychotherapy does not depend at all on gender, race, hairstyle or any other characteristics. You might imagine your ideal therapist in a certain way, but you’re probably wrong. Ignore these factors when you choose a therapist.

Language

Language, however, is an important matter. Psychotherapy depends on being able to talk to your therapist without barriers to communication. Choose a therapist who shares your mother tongue (or one of them).

If either of you has a strong accent, then the other must be completely comfortable with it. This might be something you can only find out in the second stage, when you actually meet your therapist.

Recommendation

Sometimes you know someone who can recommend a psychotherapist. If it’s a glowing recommendation from someone you know personally who has recovered from a condition of similar severity to yours, or from a medical professional who knows you and who has referred patients to the therapist, and those patients recovered, then it’s all you need to know.

Specifically, if a therapist has a glowing recommendation like this, ignore the therapist’s orientation and qualifications (the next two sections in this article).

An NHS referral counts as a recommendation.

Orientation

A therapist’s orientation is a general theoretical approach. Some common orientations are: CBT, psychodynamic, person-centred.

As a patient, you should not care too much about the therapist’s orientation. You only care about recovery. You don’t care how you get there.

Do ensure, however, that your therapist has some orientation. A therapist whose approach is unclear might not have any clear idea about how to treat your condition.

Some therapists disguise their lack of clarity about their approach with terms like “integrative”, “eclectic”, or “NLP”. Others advertise a collection of different approaches in their literature and websites. In general, it is better to see a therapist who specialises in one clearly-defined approach.

It’s difficult to know whether CBT is a better choice than other orientations. I would tend to prefer it, but I’m biased.

Qualifications

Qualifications make little difference to a therapist’s effectiveness. Indeed, to some extent qualifications detract from effectiveness. This is because many of the therapists who collect qualifications do so by seeing fewer patients. So a therapist who has many qualifications might be relatively inexperienced.

Even a basic qualification has relatively little value in ensuring effectiveness. There are some well-qualified therapists who are completely ineffective. Equally, there are some unqualified or partly qualified therapists who are very effective. How can you make sense of this?

The best you can do is to understand the probabilities. If you choose a random qualified therapist, then that therapist is probably effective. If you choose a random unqualified therapist, then that therapist is probably not effective. Therefore, when you are choosing a therapist at random, say from a list of therapists in your area, you would do well to choose a qualified therapist. But if your choice is not random — for example, someone recommended the therapist — then qualifications do not matter.

Each therapeutic orientation has an accrediting body in the UK. The accrediting bodies are all (except two) members of the UKCP. You can use the UKCP’s website to identify any registered therapist’s accrediting body, except for CBT therapists, who are on a separate CBT Register.

Be aware that not all the UKCP’s member organizations accredit specific therapeutic orientations. There are some that accredit therapists regardless of orientation. The biggest of these are the BPS (psychologists), BACP (counsellors) and NLP (neuro-linguistic programmers)…and there might be others that I have not spotted.

Make sure that your therapist is registered specifically for an orientation, not just by one of these general-purpose bodies.

In practical terms, using the CBT Register is easier than using the UKCP. This is because you can search the CBT Register for your area, and you know that all the therapists in the list are registered to practice CBT or REBT. When you search the UKCP, you have to check that each therapist is registered for a specific orientation.

Summary

To sum up… Ignore your diagnosis, symptoms, and fantasies about therapy.

If you have a recommendation that you can trust, or an NHS referral, use it first and ignore everything else in this summary.

Use the CBT Register to find therapists in your area.

If you need to expand the list, search adjacent geographical areas and try the UKCP. Check that UKCP-registered therapists are actually registered for a specific orientation.

If you need to expand the list further, check the UKCP’s individual accrediting bodies. They often have lists of qualified therapists who are not in the central UKCP register.

Check for language compatibility, as far as possible.

Rank the therapists by using any practical criteria that matter to you — price, waiting list, distance…

Make an appointment.