So, you’ve decided you would like to see a counsellor or psychotherapist, how do you choose who might be best for you and your needs? If this is the first time you are looking for mental health support, it might feel a little daunting. You may be wondering where to start. I felt the same when I started looking for my first therapist several years ago. This is what led me to write this article. I hope this will help you in this process, by outlining what I see as the essential five questions to ask a potential counsellor or psychotherapist during your initial session with them.
How much experience do you have working with my issue or concern?
Many counsellors and psychotherapists work with a wide range of issues and clients, initially during training, and then as they build experience over the years.
However, you may want to address a very specific aspect of your life. Some examples include couple or family therapy, exploring gender or sexuality, or support with addictions or phobias. In this case, you may prefer a counsellor or psychotherapist who specialises in this area. When you ask this question, an ethical and professional counsellor or psychotherapist should be honest with you and their limits of competence or practice. If it is something they feel unqualified to help with, they should signpost you to other organisations or professionals who may better meet your needs.
How does therapy work? How many sessions will I need? What do you charge? Do you charge for missed sessions?
These are some of the practical questions about therapy you might have. How therapy works really depends on various factors including what you want to focus on, the counsellor or psychotherapist’s training, and how your therapeutic journey evolves over time.
The number of sessions depends on the nature of the issue or problem you want to address. I suggest a minimum of six sessions to my clients. This allows time for the therapeutic relationship to build, for clients to explore what is troubling them, and to start to work collaboratively to find a way forward. As I wrote in my last blog, what we struggle with now is very often related to earlier experiences. As awareness of these deeply held parts of self emerges, a client may choose to extend the number of sessions. There is no definitive number, no right or wrong with therapy. It is always about what you, the client, want and need at that moment.
The cost of private therapy varies depending on experience and qualifications. In the therapist directories listed above, the average range for a 50-minute session with a qualified counsellor or psychotherapist is anywhere between £50 and over £100. Some counsellors or psychotherapists offer a sliding scale or concessions based on the ability to pay. It is always worth asking, even if they don’t state it on their directory profile.
Each counsellor or psychotherapist has their own way of dealing with missed or cancelled sessions. Most will ask for a minimum of 24 or 48 hours notice for any cancellations. The policy around missed sessions, cancellations, or any planned breaks should be clearly stated in the written therapeutic contract.
How much of your own therapy have you done?
Has the person you are considering as your counsellor or psychotherapist been a client in their own therapy? Bento & Sousa (2022) found that in having their own therapy, counsellors and psychotherapists become better therapists. They suggest this is because personal therapy encourages looking inward to gain greater self-knowledge, advance personal development and process internal issues. This article by Dr Jonathan Shedler makes a similar point.
According to Dr Gabor Maté (2020), to be an accurate mirror for clients, counsellors and therapists need to be ‘clear’ about themselves to work ethically and professionally with clients. As he writes: “no one can see in a dirty mirror”. Simply put, counsellors and psychotherapists need to have done the work on themselves before starting to work with their clients. And ideally, they should be having personal therapy on an ongoing basis.
Ultimately, I suppose it boils down to this question: How can your counsellor or psychotherapist be offering something to you of which they have no personal experience or insight as a client?
Do you belong to a professional organisation? What training have you done? What qualifications and CPD do you have?
Counsellors and psychotherapists should be registered members of a professional body. First and foremost, this means they are bound by the code of ethics of that organisation, which is important for you, the client.
For the organisations listed below, registration tells you the counsellor or psychotherapist has completed a minimum level of training. As a broad rule of thumb, qualified counsellors and psychotherapists should have undertaken training which provides a minimum of 400 hours of in-person, experiential hours with tutors and peers. and at least 100 hours of supervised client hours.
Practising counsellors and psychotherapists should also undertake continuing professional development (CPD) each year. This is to maintain and build their therapeutic skills to stay abreast of research, updates and changes within the field.
Additionally, ethical, and professional counsellors and psychotherapists have supervision. This involves meeting regularly with a more experienced colleague to discuss client work for support, reflection, and best practice.
The following are links to therapist directories for the most common membership bodies in the UK: British Association for Counselling and Psychotherapy (BACP),UK Council for Psychotherapy (UKCP), National Counselling and Psychotherapy Society (NCPS), British Association for Behavioural and Cognitive Psychotherapies (BABCP).
Do I trust this person?
This is the final and probably the most important question relating to whether you want to work with one counsellor/psychotherapist or another.
What is your instinct or gut telling you? Can you trust this person with your inner world? Do you feel safe with them? Do you feel you can share intimate parts of yourself and your life with them? Do you think they will really hear you and understand you? Do you think they can tolerate whatever you bring with acceptance and judgement?
Therapy is most effective when you, the client, feel you can be fully yourself, and fully open with your counsellor or psychotherapist.
When working with my clients, I am inspired by the words of Hedy Schleifer (2010). She describes the invisible “relational space” which exists between therapist and client as a bridge. The therapist must “cross the bridge between the worlds” for a true “encounter – human essence to human essence.” To “listen with an open heart and new eyes” therapists must cross the bridge with a “clear plastic bag with only a passport and a visa”. As therapists, we metaphorically leave our baggage behind, to enter the world of the other.
Taking the time to find a counsellor or psychotherapist who can help you with whatever you want to bring, is an investment in yourself. It is where your own therapeutic journey, of self-understanding, acceptance and ultimately change, begins.
Bento, F. & Sousa, D. (2022). The therapist’s personal therapy: What influence does it have on their clinical practice? European Journal for Qualitative Research in Psychotherapy, 12, 113-124.
Maté, G. (2020). ‘Healing the wounds of trauma’, Therapy Today, 31(7), 28-31.
Schleifer, H. (2010, July). The Power of Connection [Video]. TEDxTelAviv.ny