Choosing a Therapist or Counsellor
Therapy is not something entered into lightly by most people. By the time you finally come to make that call, things in your life are probably in so much upheaval that it may feel to you as if they are spiralling out of control. Not surprisingly, reaching out for help can leave you feeling as vulnerable as the situations for which you are seeking counselling. After all, you are about to enter into a relationship like no other. One in which you spend all your time together talking about only one person - yourself, divulging all your secrets, purging the contents of your mind, and unleashing the full wrath and volatility of your emotions. All to a person of whom you know very little about. And the strangest part about this relationship is one simple fact. Even though it may be one of the most emotionally intimate experiences you have in your life, this is probably the only relationship you will ever enter into knowing full well at the beginning that one day it will, and should, come to an end.
I'm not trying to be sensationally over-dramatic or scare mongering. After all, it is these very things about therapy that make it work so well.
That being said, it can still feel like walking into a mine field when it comes to choosing a therapist for yourself. But here are a few insider tips on the qualities that make a good therapist, which can translate into an excellent therapy experience. It must be said that different therapy models focus on different ways of 'delivering' therapy – hence, therapists will vary in their approach to therapy and the manner in which they relate to you, according to the modality they follow. I personally operate from a Cognitive-Behavioural model, which is one in which the therapist takes an active role. But in many other therapies, the counsellor may take more of an ‘observer’ role. This too can be an effective approach, but you must decide what fits your personality and suits your needs.
As there are all ready a few hubs written with good tips on how to go about choosing a therapist (i.e. referrals, credentials, etc), I will not cover those issues here, but will stick to covering the less salient characteristics of the therapist herself. I should also note that I refer to the therapist in the feminine form only for the sake of convenience, and point out that gender in no way has any bearing on a therapist's abilities.
Firstly it must be said that, in my opinion as well as many others, the most important characteristics of a good therapist - the ability to develop rapport with the client, empathy, engaging verbal acuity and mannerisms, ability to relate to the client in a way that makes him or her feel understood – are things that cannot be read in a book or taught in a lecture. You either have it or you don't, and to be honest, not all therapists do. Like many other life occupations, therapy is a calling. When you meet with your therapist, you should feel that she gets it, she gets you. Not that she will know everything about you from one session, but you should feel as if she is seeking to understand things clearly from your perspective. A good therapist makes no assumptions about a person – she asks questions and seeks clarification to make sure that she's got the right impression. And you should feel as if you ‘get’ her, not that she is talking down to you or talking above your head. The language she chooses to use, for the most part, should reflect the language that you use. And it should be evident that she cares and wants to help you. As an aside, it should be noted here that a good therapist, while caring and empathetic, is always in control of her own emotions during a session and remains professionally impartial. She will not discuss her own personal feelings or beliefs, or any details of her personal life with you, as it is not relevant to your therapy process.
Rapport - the fellowship, connection, or sympathetic relation between two people - can be one of the most important characteristics in a counselling relationship. But it is important for you to realise that you should not necessarily give up on a therapist if you don’t seem to hit it off right away. Rapport between client and therapist can take a few sessions to build. Usually, the first few sessions of counselling involve an assessment period, in which you will be invited to vent some of your frustrations but you may not be given an ‘open floor’. The therapist will have some specific questions she will need to ask you in order to get a full understanding of the difficulties you are experiencing, to develop a conceptualization of your case, and to formulate an appropriate treatment plan. Hence, she may need to redirect you when your monologue goes off track. This can be off-putting to some people, especially those who have not had a chance to talk to anyone else about what they are experiencing and want a chance to let it out. However, the assessment period is a normal part of many therapeutic processes (including but not limited to counselling), so try not to let this be a barrier to rapport. It is important to note here that in some forms of psychotherapy (such as psychoanalysis and psychodynamic therapies), rapport is not considered to be paramount, and conversely, a seemingly “lack of rapport” can be used as a tool in therapy. This is a difficult phenomena to explain and not the scope of this hub, but useful to know in any case.
A good therapist loves, or at least believes in, what she does. Of course everyone has bad days and goes through periods of burn out, and there are always aspects of the profession that one doesn’t love (i.e. paperwork), but it should never seem to you that the person who is helping you doesn’t like what they do. Let's face it, no one goes into the mental health field to strike it rich or have an easy ride in life. It is hard work and can be emotionally very wearing. At the same time, it is also a very rewarding career and it is usually the love for humanity and the drive to help people that lead clinicians into this career in the first place. If it becomes obvious to you that your therapist is in it for any other reason, then run the other way!
Credentials are important but not everything. Many therapists have a long list of impressive initials behind their name, which mean absolutely nothing to you as a consumer. They tell you that they have gone to school for a long time, but they do not tell you how well they did while they were there (did they excel at it or just slide narrowly by?). Good basic training and an understanding of the therapy process are of course integral, but more schooling does not necessarily equate to better therapy. Going back to the first point, therapy is an art that a person either has the knack for or doesn't. A diploma level counsellor may be as good as a doctorate level therapist, all depending on the specific qualities of that person. Likewise, a highly educated therapist may be impressive in theory but at the same time, it isn’t good enough that a therapist obtains her basic training and does nothing else for the rest of her career. Mental health professionals must be committed to ongoing professional development to expand their skills and keep themselves current. Usually this is done through formal training and ongoing education, but is not limited to it. It also extends to things not usually listed on a resume such as reading, research, writing, etc. It is likely that someone with a high level of training in their field (i.e. Doctorate) is going to have much knowledge and a high degree of commitment to delivering effective therapy, otherwise they likely would not have bothered putting in the amount of work that is required in the realm of higher education. Just don’t assume that this will always be the case.
Lastly, the best way to find a good therapist is via the age old tradition of word-of-mouth. Therapy is not something openly talked about like the weather or the state of the economy, but it is something that may be discussed discretely between close friends. If a friend recommends a therapist to you and you have seen positive changes going on in this friend’s life, it may be worth checking out. What each person derives from therapy will be as different as the problems for which they seek therapy in the first place, but friendship implies a certain amount of similarities that may indicate to you a therapist could be useful to you as well. Just remember, however, that there are two people in the therapy relationship, and you also will need to put the work into it in order for counselling to be successful.
An Example of Therapy (CBT) in Process
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