How to Choose a Therapist… and How to Know When to Leave One

In the UK, many people seeking therapy are often referred to NHS services through their GP or another healthcare professional. In these services, you are usually assigned a mental health worker or service, limiting your choice of therapist. When searching for a private counsellor or psychotherapist, the sheer volume of options can be overwhelming.

In this article, we will explore the factors to consider when choosing a therapist, and how to determine when it might be time to end that therapeutic relationship.

How Do I Choose the Right Therapist for Me?

Therapist Characteristics

Scrolling through endless lists of therapists can be overwhelming and may not lead to an informed choice. To make the best decision, start by asking yourself: What do I need from a therapist?

While it’s okay to focus on what you want to address (e.g., phobias, abuse, depression), it’s also crucial to consider other aspects of the therapeutic relationship. For instance, you may want to choose a therapist based on their sex, ethnicity, faith, or sexuality if these factors align with your values and comfort level. For instance, abuse victims may prefer a therapist of a specific sex to mitigate trauma triggers. Similarly, cultural background can play a significant role in feeling understood.

What Type of Counselling Would Best Suit Me?

There are various therapeutic approaches, and even therapists using the same model might employ it differently. Consider what type of help you need:

  • Person-Centred Therapy: Ideal if you prefer a non-directive approach where you control the sessions, though the therapist may gently challenge unhealthy thoughts.
  • Cognitive-Based Therapies: These include CBT, DBT, and CAT, and are suited for those who like analyzing thoughts, feelings, and behaviors with a structured approach.
  • Psychodynamic Therapy: Suitable for deeper introspection to uncover unconscious patterns. It focuses on past experiences and behavior patterns.
  • Other Therapies: Explore other methods such as EMDR, which is recommended for PTSD but isn’t the only option.
    Success in therapy depends on a good relationship with your therapist, belief in the process, and commitment to the work.

How Do I Know Who Is Properly Trained?

Therapists listed on PSA-accredited registers meet minimum training standards. Check their membership to ensure they follow an ethical framework. For specific issues, inquire about their expertise:

  • What experience and training do they have in this area?
  • How do they approach this issue?
  • What is their philosophy of recovery?

For example, if you experience dissociation, ask how they will address it. Avoid therapists who use mindfulness for dissociation, as it can be counterproductive.

I Have a Few Possible Counsellors Who Meet My Criteria – How Do I Choose Between Them?

Contacting them is the next step. In-person meetings are preferable if you plan to work face-to-face. Therapists expect you to assess whether they are a good fit for you, so don’t worry about offending them if you choose someone else.

Trust your instincts:

  • Do they make you feel safe?
  • Are they clear and communicative?
  • Have they explained confidentiality?

Feeling safe in therapy might involve the therapist respecting your personal space and allowing you to express yourself without feeling shut down.

A Note for Trauma Survivors: If a therapist reminds you of an abuser, it’s okay to seek someone else. Therapy should not compound your trauma.

How Do I Know When I Need to Leave a Therapist?

This can be challenging, but there are clear signs:

  • Therapeutic Process Understanding: If a therapist doesn’t acknowledge the natural ups and downs of therapy or punishes you for your emotional responses, it may indicate a lack of understanding.
  • Boundaries: Therapeutic boundaries ensure safety and respect. If a therapist seeks your support or overshares, it might signal inappropriate boundaries. Addressing these issues with your therapist can help, but if their response is unsatisfactory or abusive, it’s okay to leave immediately.
    Sexual Boundaries: A therapist should never engage in or encourage sexual activity or arousal. If a therapist suggests or implies such behavior, it is abusive and unethical.

How Do I Leave a Therapist?

You can simply stop attending sessions if the therapy is harmful. While it’s not necessary to provide an explanation, a formal email or letter can provide closure:

Dear [Therapist’s Name], This letter is to formally notify you that I wish to cease counselling sessions with immediate effect. Sincerely, [Your Name]

If you had a good relationship and are not the right fit, consider discussing your decision to move on in a final session. This can help in transitioning smoothly to a new therapist.

If therapy is working well, discuss and plan for an ending that suits both you and your therapist.

Written by Tara Shennan, CTUK

P.S. Many people don’t find the right therapist immediately. Don’t give up – try again.

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