Shopping for a therapist - some clinical considerations

Finding the right therapist for you can be a stressful experience. There are a number of factors you need to consider in making a decision. However, often clients begin to search for a therapist at a point when they are confused, unable to make decisions, anxious or simply overwhelmed by other demands. This can make the process even more difficult.

If you are in this position and finding it difficult to decide who to see, here are some practical tips you might wish to consider:

1. Location

Although it may sound very obvious, the therapist's location is very important. Are they based in an office with a reception area? Would you find it helpful to have a waiting room if you are a little early? Or would you prefer a more discrete entry system where the therapist lets you in themselves without the presence of other people? Do they have parking spaces available? Are there good public transport if you are not a driver? 

A key factor would be how easily you can travel to the therapist. Are you planning to attend after work, during lunchtime, or before work? Is the location relatively quick to get to from where you are travelling from (ie work/home)? The more convenient the location, the less stress you are likely to experience in getting to the therapist, particularly when considering unexpected transport delays and traffic. It is helpful to reduce unnecessary stressors but also balance the accessibility issues with ‘clinical compatibility’. 

2. Gender 

How comfortable do you feel with someone of your own gender? Do you find that you orient towards feeling more emotionally comfortable around men/women or do you have no preference? A good indicator is how comfortable you feel with male versus female colleagues, friends and other health professionals you have previously seen.

A skilled therapist, irrespective of gender, will be able to work sensitively and respond to any emotional resistances, anxiety or biases that are associated with gender. However, if you have significant anxiety for example of being in a room with a woman, you may opt for seeing a male therapist to help you feel ‘safe enough’ to explore what a woman represents for you.

Gender will play a part in the issues that emerge during your therapy. If you see a therapist who in some ways represents something difficult you experienced, it may create an ideal space to explore this and develop a deeper understanding of yourself through the process. For example, you may have unintentionally created ways in your life of avoiding intimacy with men. This may have been through choosing a predominantly female profession, having female only friends, seeing female health professionals and opting for jobs with female managers.

It may be that through the process of seeing a male therapist that your anxieties, biases and expectations of men will emerge thereby allowing you to process any difficult experiences you had with men in your earlier life. You may find that after the initial few sessions, your ability to use the space to explore gender would be less influenced by the therapist's gender but more linked to their ability to attune to your needs. 

3. Ethnicity & Race 

Some clients like to see a therapist who they perceive as being racially or ethnically similar to themselves. The hope may be that the client will not have to 'explain' things, rather that the therapist will already have some understanding about cultural issues within a particular community.

In contrast, some clients actively choose therapists who are completely dissimilar to them in the hope that prejudice/discrimination and negative experiences they may have faced in their own community will not be shared by their therapist. Whatever your personal preference might be, a telephone conversation if not a face-to-face consultation is usually helpful in eliminating any concerns or doubts you may have about the therapist.

You may wish to ask the therapist about their previous experiences of working with others from your community or background. This may help you decide whether a particular therapist is best placed to work with you or whether you need to consider someone else. They may even be able to recommend another therapist who might be able to support you particularly if there are specific cultural issues.

You will often find that the way a therapist responds to your queries about ethnicity in a consultation or telephone inquiry will tell you a great deal about how competent they will be in working with your specific needs. However, it is also important to remember that irrespective of ethnic backgrounds, therapists who are appropriately trained and accredited, will embrace diversity, respect differences and will have a genuine interest in understanding how you see the world - which may be different from the perspectives of others from your own community.

4. Qualifications and Credibility 

A very important part of choosing a therapist is doing some fact-finding and investigating a therapist you may wish to contact. It is vital that they are registered to be providing the service they are offering. You can find out which organisation they are regulated by (e.g. HCPC, BABCP etc) and you may even wish to inquire online about them using their unique registration number or full name.

For example, the Health Care Professionals Council (HCPC) and British Psychological society (BPS) have a system of checking whether a Clinical Psychologist is registered and qualified to be providing a service to the public. 

The actual qualifications of a therapist will vary greatly depending on whether you are considering a Counsellor, Psychotherapist, Psychoanalytic Psychotherapist or a Clinical Psychologist. Although these different titles may seem confusing, ultimately how much you benefit from therapy would depend a great deal on how comfortable and contained you feel with a therapist. Although their qualifications are important to ensure they are fit to be offering a service, it is often the therapist's interpersonal skills and warmth that helps a client feel able to make use of therapy. 

5. Fees

Although there are a number of other factors important in helping you make a decision about the right therapist for you, sometimes it's a pragmatic decision based on your financial situation. Some therapists will charge less on a sliding scale (dependent on your income) whilst some organisations will have the option of you seeing trainees at reduced fees. The fees will also depend on where you are seeing the therapist. For example, Central London on the whole would be more expensive than other parts of London. 

It is worth remembering that therapists are often able to work short-term which may fit with your budget. It may be worth discussing these issues at a consultation or even on the phone, so that if your therapist offers flexibility in their fees or frequency of sessions, they can make this known to you. 

'Gut instinct' and meaningful connections 

On the whole, shopping for a therapist can be difficult. If anything, going with your ‘gut instinct’ during a consultation is the best indicator of whether a therapist will be able to relate to you, connect on your level, understand your world and help you make sense of it. It is ultimately through emotional intimacy and meaningful connections with others and the world around us that we truly find the different parts of ourselves.