How to find a counsellor or therapist

You can’t predict what life will throw at us, and sometimes that means unexpected events such as a a bereavement or loss, a relationship break-up, or a trauma — experiences that might result in us needing help with the healing process.

Equally, there are times when nothing dramatic happens at all, but instead of your usual take on things, a rising panic starts, or a continual low mood and deep sense of dissatisfaction doesn’t shift. It is at times like these that many people seek the professional help of a counsellor or therapist to help find a better way forward.

Eugene Farrell, mental health consultancy lead at AXA Health, offers his advice on how to find a counsellor or therapist, and how to know if you're choosing wisely.

How do I find a counsellor or mental health therapist?

When you're in the midst of difficult times or a crisis, your thinking may not be as clear as it usually is, and taking a rational approach to ‘shopping around for a counsellor’ is not going to be all that likely.

But it's important to make sure the practitioner you choose is a member of one of the established self-regulating professional organisations, such as:

• British Association for Counselling and Psychotherapy (www.bacp.co.uk)
• National Counselling and Psychotherapy Society (https://ncps.com/)
• British Association for Behavioural & Cognitive Psychotherapies (www.babcp.com)

and that they have the relevant qualifications.

Referrals

Getting a referral from your GP, a professional body, or a personal recommendation from a friend, is the route most of us take to find support. You can also self-refer to talking therapies through the NHS website.

Something to bear in mind is that you might not initially gel with the first therapist assigned to you or with the one you find yourself. Sitting in front of someone you feel comfortable enough with is important to help you open up and share your thoughts and feelings.

For whatever a therapist’s model of working, research shows that one of the most important factors in a successful talking therapy is the relationship you have with the therapist which is referred to as “therapeutic alliance”.

Therapeutic alliance (TA)

This generally consists of:

• the quality and strength of the affective bond between therapist and client,
• an agreement on therapy goals,
• and a consensus on how to attain those goals.¹

The agreement between therapists’ and clients’ TA estimations plays an important role in determining both therapy process evaluations and therapy outcomes.¹

Making first contact

Once you have been assigned a therapist or you’ve found one yourself, you might wish to have an initial chat. This can be done on the phone or through a video platform, , and if that goes well, to request a further meeting to see how you might get on together.

Helpful areas to cover in your first conversations include:

• Their skills, qualifications and experience in the issue you need support with.
• The approach they take. How might this way of working relate to your problem?
• Your goals and expectations of counselling.
• If individual counselling is the best way forward, or if couple or family therapy would be more appropriate.
• Fees, frequency and estimated duration of your work together.

Do I really need counselling?

For many people the support of family and friends really helps, they can be there to listen, when you simply need to get things off your chest or deliberate a decision, then you might feel this reduces the need for a counsellor.

But for some, friends or family might not be there, or they are part of the problem, being totally entangled in it, and though they may wish to help, they won’t be able to offer the space, objectivity, confidentiality or skills of a counsellor to get to the heart of an entrenched issue.

So, it’s time to get help when...

• You feel overwhelmed by something.
• Your mood is low for a long time and doesn’t lift.
• Emotions are continuously getting the better of you or cause pain and distress.
• Your life is being harmed by a problem you cannot seem to solve.
• You feel you can no longer manage a problem on your own or with the help of your friends.
• You have lost interest in life or think it's not worth living.
• Your relationships with others have a lot of conflict.

What’s worth noting is that modern talk therapies are not always about problems. Sometimes they can be used to enhance life, rather than fixing it.

Ethical considerations

Counsellors must be as neutral and objective as they can be, but of course this has its limits, because we all have our own values, ethics, morals, biases and agendas.

It can be common for a person in a vulnerable situation to view a counsellor as an expert or parent-figure and be overly influenced. A counsellor working ethically will, however, empower you to find emotional health, your own values and ethics and make your own decisions.

All sessions are strictly confidential between you and the counsellor. The main exception to confidentiality is when, through your disclosures, the counsellor believes that there is a serious risk of harm or danger to yourself or others. They would discuss this with you and explain if anything more needs to be done.

If at any time you feel discounted, undermined or manipulated within the session, it is important to discuss these feelings within the session as they arise.

You shouldn’t ask to connect or follow your counsellor on social media, nor should they connect with you. Similarly, it’s not correct to socialise with your counsellor.

If you have any doubts about the counselling you are receiving, discuss them with your counsellor. If you are still uncertain, seek advice from your doctor or the professional body your counsellor belongs to.

References

1. A meta-analysis of client-therapist perspectives on the therapeutic alliance – National Library of Medicine