Mental Health Week is drawing to a close and I’m a very happy bunny. There is a real sense of ‘normal’ taking hold in Ireland and this is incredibly heartening! We are beginning to understand that not always feeling OK is OK, that asking for support is OK. We are fostering a ‘knowing’ that we have worth and that change is possible.
Shame-free, guilt-free change.
Part of this welcome change is that more of us are choosing therapy. What seems to perplex a lot of people though is how to choose a therapist. And so it is important that this ‘how to’ is openly and transparently discussed.
Here are some guidelines if you or a loved one has decided to see a therapist, psychologist or counsellor (there are some important differences and I wrote this piece last year outlining just some of them).
So, you’ve chosen therapy – but where and with whom?
You are about to embark on an intimate journey of healing and self-discovery with someone you don’t know. Your safety is paramount. Hold that in your awareness and allow yourself to consciously put that first before you do anything.
- Your first port of call might be to ask your GP for a referral. Most, although not all, therapists and counsellors will make themselves known to the GPs in their catchment area. If you have a good relationship with your GP they may be able to match you with a suitable person. Bear in mind that your GP may not ever have met the therapist in question and so a referral from a GP is not a guarantee of a fit (nothing is really, you can only decided that yourself).
2. Ask your friends and family if they can recommend someone to you. I’ve noticed that I get personal referrals more and more these days from people who discuss their therapists with their friends. I know that I am not alone in this experience. A friend’s recommendation is very useful because, well, they’re your friend. So they may have an idea of who and what will suit you. Again though I think it’s important to remember that individuals vary, and what worked for you friend may not work for you and vice versa. Think of it as a guide, a good one – but not a guarantee.
3. Shop around. You might get several referrals! If this is the case then please do feel OK about calling a few and seeing how you feel when you speak to them on the phone. It’s a big decision and your comfort is important. I would recommend speaking to them on the phone if you feel up to making that contact. Email doesn’t always give us an accurate sense of a person. Therapists are accustomed to speaking with people who are nervous – there’ll be no judgement. Check out their profile on LinkedIn, their Twitter, website and so on. Bear in mind that not all therapists have an online presence. Regardless, they should be listed on their licensing body’s website – more on that below. Another way to shop in Ireland is through those licensing bodies. The largest are IAHIP, IACP, ICP and the PSI. They will be happy to give you a list of suitable qualified therapists in your area.
4. Interview your therapist. I know this might sound odd but in essence you are about to employ this person. It is a deeply personal piece of work, but it is also a professional arrangement and there are some things you are entitled to know.
- Where did this person train? Was it part-time? Full-time? Online? Was it a certificate? A degree? A postgrad? There are many different levels and types of training.
- Is the person accredited with a reputable organisation? For example are they an accredited member of IAHIP, IACP, ICP or the PSI? Are they listed on the websites of these organisations? (It’s important to check). Some therapists will say they are working towards accreditation – make sure you are clear as to which it is. If they say they abide by the Ethics of ‘X’ association that does not mean they are an accredited member of that association. Nor does being a member necessarily mean they are an accredited or working towards being accredited. It’s OK to ask, and important to clarify. If they are not willing to clarify or if you sense a hesitation, consider hanging up and moving onto the next number on your list.
- What does this person do for CPD? (Continuous professional development – it’s a requirement for re-accreditation, a process that we must engage in every one to five years, depending on the licensing body.)
- Is the person in supervision? It is not considered ethical or safe to work without supervision, but it is not illegal as such. And so if the person doesn’t volunteer this information, it’s important to ask. Be careful of making assumptions – and know that we are more likely to do that when we are in a rush to make a decision.
- Has the person been in therapy? Most modern trainings will insist that the student be a client. It is crucial that your therapist is familiar with self-care and takes steps to look after their own mental health. I’m aware that this might feel like an intrusive question to ask, particularly if you are feeling vulnerable right now yourself. But again, a therapist with integrity will not mind you asking.
- Has the person worked with your particular issue before? What is their area of expertise? Are they comfortable doing professional witness work in court? What is their fee? Is that negotiable? What is their cancellation policy? These are questions that might apply to you and again, it’s OK to ask.
- What is the person’s professional orientation? For example – you may be looking for someone who does couples therapy, or family work. You can read about the various ‘styles’ of therapy online and the styles you will come across most often in Ireland will be Humanistic and Integrative, Psychodynamic, Psychoanalytical, CBT, Gestalt, Reality Therapy to name just a few. The latter three will often be skills or trainings that are incorporated into ‘bigger’ trainings, usually Masters to PhD level. So the therapist may not ‘identify’ as a Gestalt therapist but may have Gestalt training. I know it can be confusing…
- Know that you can change your mind. Your new therapist may suggest a trial of 5 sessions to begin with, but this is your choice. If you feel pressured into attending more often or more frequently than is comfortable or affordable, perhaps go back to your list of phone numbers.
- Listen to your gut when you meet your therapist. You might be particularly vulnerable right now and may not trust your judgement. But ask yourself how often you’ve been wrong about people? Your new therapist is just a person too, and he/she may not be a fit for you. If you feel coerced, directed, pressured, manipulated, sexually compromised or that the boundaries just feel ‘off’, move on. It’s OK.
- If your therapist is engaged in a ‘dual relationship’ with you it is not advisable to continue. For example, if they are a relative, an old school friend, your beautician – you see where I’m going… Healthy boundaries are essential for the process to be safe and to work. Therapists must refer onwards if there is any sense that the work is inappropriate. A refusal to refer is red flag.
- If your therapist tries to sell you a product or directs you to a friend of theirs for extra ‘work’ that you haven’t expressed interest in beware. This is another red flag for boundary issues on the part of your therapist.
Therapists are people too. Even with years and years of training and/or experience, a therapist will bring their own personality to their work. If you find that despite a pile of education and experience you do not feel comfortable with your therapist for ANY reason (their sense of humour bothers you, the scent they wear makes you feel nauseous) – instead of judging yourself or discounting your feelings listen to your own gut. Address minor issues with your therapist if you feel comfortable doing so, but major personality conflicts will just get in the way of making progress in therapy. It’s really okay to look for someone that feels like a better fit.
These are some of the things I have learned to look out for myself along the way. My hope is that they will help you come to as informed a decision as possible so that you can proceed knowing that you are safe. If I have left anything out please do feel free to add in the comment section below. So a super-quick summary:
Good luck on your onward journey!