If you live in a big city, finding a therapist is pretty easy: we’re everywhere. But finding one that’s suitable for you can feel a lot harder: we all say the same sorts of things on our websites, we all use words like “safe” and “non-judgmental” and some of us have the curious habit of referring to our rooms as a “space”. So how can you tell us apart, and how on earth can you really know what you need and what you want?
In this blog - adapted from a three-part blog I wrote in 2019 - I’ll outline some of the key considerations in choosing a therapist: namely location, gender, cost, and commitment.
But first let’s look at the basics:
The Search
Stage 1: The Web is Your Oyster
As well as typing in “Crouch End Therapist” or “Wimbledon Counsellor” into Google and seeing what comes up, there are many specialist websites which have search engines designed to make it easier to look up possible counsellors and therapists.
These include:
UKCP (UK Council for Psychotherapy) - www.psychotherapy.org.uk
(click on ‘Find a Therapist’);
BACP (British Association of Counsellors and Psychotherapists) – www.bacp.co.uk
(click on Therapist Directory);
Psychology Today www.psychologytoday.co.uk (click on Find Counselling);
Counselling Directory - www.counselling-directory.org.uk (click on Find a Counsellor);
Additionally you may find a counsellor whose profile links to the therapy rooms they work from which will have the details of other people who work there (mine is www.onetwofive.me).
.
Stage 2: Narrowing the Search
Location:
The search parameters on these websites will include your postcode (or the postcode you’d like to see someone in, usually near work or home) and an indicator of how far afield you’d like to go. You will then see a load of mini profiles and photos of counsellors who work in that area.
Issue:
You can narrow your search by choosing particular presenting issues which you need help with (say, Anxiety, or Abuse) and the list of possible therapists will narrow to include only those who say they are experienced in working with this.
Stage 3: Making A Choice
Then just flick through the various photos and summaries and see if anyone feels like they might be a good fit.
It might be as cosmetic as them looking nice or the right age, or something in their words which speaks directly to you. You can click on any profile and see what they (we) have to say about themselves in more detail.
Stage 4: Getting In Touch
Once you’ve narrowed it down to a few possible candidates (sometimes it helps to go away and come back a few days later and notice who has stayed in your mind), then you can decide whether to approach him/her.
You can either send them a brief message via the particular site, or phone or email them directly. Many therapists will have their own websites with (hopefully) even more information. Some will even have photographs of their therapy rooms so you can see if you can picture yourself sitting there.
Any contact doesn’t need to be detailed, simply saying you’re looking for a therapist and do they have any slots can be enough for some people; others prefer to write a short paragraph saying “I’ve been having difficulties with x for a while and now feel ready to start exploring it. I wonder if you have any spaces during the day”. It’s completely up to you.
Stage 5: Arranging an Introduction
If the therapist can see you, make sure you agree a session time you can do, as if it’s a slot where you’ll have to race there from work or race out to make it home in time for the school run then this can undermine the process a bit.
Stage 6: Making Payment
The therapist will usually tell you whether you can pay in cash or they’ll invoice you after the session. Some therapists offer discounted first sessions; some even offer free short telephone consultations just to say hello and hear the sound of each other’s voice.
Useful Tip: Shopping Around
It is absolutely normal – sensible, even – to shop around to find someone you feel a connection with. We’re all familiar with clients ‘auditioning’ us by having maybe two or three first sessions just to get a bit of a feel. That’s fine if you feel that would help you. It’s also worth remembering, though, that if a therapist has a busy case load it’s possible they’ll run out of spaces if you wait too long.
It’s Your Choice
There is no right criteria. Some people want to know the therapist’s credentials and working methods; some just want to sense whether they can imagine discussing intimate material with the person in front of them; some just want someone who’s convenient and the right price and beyond that are not too concerned about the therapist’s particulars. In the end, you’re the boss.
So. We’ve examined the terrain. Now here are two of the signposts on your royal road to therapy:
Location
(a) Someone Near
Maybe you have a busy work and family life, and the most important thing for you is finding someone who you can “pop out” to see for an hour and nobody will know you’ve gone. It’s easy: you live in Crouch End, you want a therapist in Crouch End (I say this purely as an example).
This is where the search engines on www.psychologytoday.com and www.BACP.co.uk and others (see previous blog) become your friends. Or just Google “therapist crouch end” or “counsellor crouch end” and you’re away.
On the other hand….
Are you looking for someone local so that therapy doesn't feel like too much of a big deal; you don’t want too much travel time afterwards for any thoughts of feelings to fester? Might part of your motivation be to ‘box it off’: you’ll think about therapy for 50 minutes a week and at no other time? If so, that’s probably something to think about and wonder whether it could change or limit your experience.
(b) Someone Far
Maybe you want to see someone who is nowhere near where you live and work, so that the small chance you might ever see them in Sainsbury’s is reduced to near-zero.
Fine. Pick an area which might be workable for you, or widen your search criteria on your counselling search website to, say 10 miles. Or just look more generally and let the person dictate the location. If you don’t mind driving or getting on a train then you can cast a pretty wide net. Many clients cross big cities to see their therapist. (Although in these Covid times, you may want to factor in what happens if we go back into lockdown.)
On the other hand…
Are you wanting someone further afield for an additional reason? Is there some embarrassment that someone you know might know you’re seeing a therapist? Does distance provide safety? Is that true in other contexts in your life? None of these are problems, but they’re worth wondering about.
(c) Not Important At All
Maybe you don’t care either way. You want a particular kind of person and will go wherever it takes, near or far. Fine. In which case you probably want to search for someone with experience in your particular issue and go from there.
On the other hand…
Will it really make no difference if the person is 10 minutes away or 2 hours? What if there’s a train strike or you move house? If location isn’t a deal-breaker, what is?
Any of these thoughts are perfectly reasonable and very common. Each suggests something about your need: perhaps you want therapy to feel like a special event and so don’t mind travelling, or perhaps you want it to feel like popping to the Post Office with no particular anxiety around it. What is it in your case? Neither are problems; both are worth noticing about how you want to approach therapy.
Gender
(a) Important
Many people will have an instinct that they want to talk to someone of a particular gender, whether their own or the opposite. Victims of sexual abuse might think they don’t want to discuss it with someone of the gender who abused them. Or people with issues with a parent don’t want to talk to someone of the same gender as that parent. Both are understandable and quite common.
On the other hand….
Let’s imagine you’ve been mistreated by men in various ways throughout your life. That might be a good reason not to talk to a man about it, as you fear talking to a man might re-trigger those horrible experiences. That’s completely reasonable. But it also might be a very good reason to see a male therapist, as therapy can be an ideal place to explore such difficult feelings (maybe even including towards the male therapist himself). Therapy is often not about the past, it’s about what’s happening in the present. Within the safety of therapy it can be an ideal place to let that trauma be evoked, if it is, and worked on in safety and at your own pace.
(b) Unimportant
If you don’t have a particular preference, then that’s fine; go with someone you get a good vibe from.
On the other hand…
But it’s also worth asking yourself: would it really be no different talking to a woman or a man about your most private or intimate difficulties? If so then great. But many people know that they feel more comfortable discussing some subjects with some genders more than others. It’s worth being curious about that.
Neither decision is remotely wrong, unreasonable or unusual. Both are worth wondering about.
In Part Three, we get to some nitty gritty: the bits of the relationship that can be the most uncomfortable but also the most important, namely what you give the therapist in return for his or her time and support: money and commitment.
Cost
Cost is unfortunately a factor for most of us, not least as we usually don’t know how long we’ll be in therapy and therefore how much money we need to set aside for it. Where does this factor fall for you?
a) Very Important
If cost is a factor here are some things to think on:
Finding The Slot: Many therapists will have different rates for different times of the day. Evening sessions (particularly the golden hours after work) will be hard to get reductions on than, say, 11am on a Monday. If your work pattern allows an off-peak slot then maybe that’s an option, or perhaps you can find a therapist near enough to work for you to take a long lunch break to go and see them.
Prioritising: Your New “You Thing”: What else do you spend money on for yourself? Do you go out for a night with friends every week? How often do you buy a new outfit? Maybe therapy can become the new You Thing. Maybe it can be as valuable for you as seeing a show or buying a suit or going to dinner. You decide “Previously I did that for myself. Now I’m doing this.”
Asking about Discounts: Many therapists, aware of the costs involved in people coming to therapy, offer some spaces at a reduced rate for people with difficult financial circumstances (particularly students or the unwaged). Ask. If they say no, then at least you asked. These slots will often be in non-peak times (i.e. not evenings) but maybe that’s doable for you. None of us will feel offended to be asked.
Low Cost Services: There are various low-cost therapeutic services to be found, which charge hugely reduced costs. See if there’s a Mind charity near you. Also some particular issues have associated charities which offer low/no cost services.
Better Help is also an increasingly-popular resource for therapy within a budget: www.betterhelp.com
I recommend looking at this website which has a very good list of possible avenues you might explore:
https://freepsychotherapynetwork.com/organisations-offering-low-cost-psychotherapy/
b) Kind of Important
Even if you’re able to commit money to therapy, or adjust your outgoings to allow you to, you don’t want to waste your money. Like shoes or shows or chocolate, useful therapy is worth every penny; useless therapy isn’t worth a bean.
Many areas (nationally or locally) tend to have a trend in rates. Big cities or central locations will often have people charging upwards of £80; in other areas £50 might be a more typical rate. And if you get someone at an earlier stage in their career they may be offering more low-cost places than that.
In North London, where I work, typical prices per session are typically somewhere in the £60-80 range.
c) Unimportant
If the cost isn’t a concern then that frees you up to pick the person you want. Notice, though, that cost is not always an arbiter of quality or experience, but often as much a reflection on the particular therapist’s location or circumstances. Find someone you think is right for you. If you end up with a choice of two who you like equally, then go with your instinct not the price tag.
….A coda on cash……
It’s worth noticing what your relationship with paying fees to a therapist brings up for you.
Does it only feel worth it if you’re paying serious money? Do you begrudge it but would never dream of mentioning it? Does it feel like a block to really connecting with your therapist, as it makes him just an employee? Does it free you up to be as honest and rude and upset and angry as you like because, after all, that is what you’re paying for?
All of these are perfectly reasonable reactions to paying a stranger money to talk about your difficulties at length and depth. But it’s worth wondering which apply to you. And why.
Commitment
Committing to therapy can be the easiest or hardest aspect of the entire experience. You are agreeing to come (usually) every week at the same time for a period or maybe a very extended period to talk about stuff and feel things which you’ve tried to avoid forever.
Surely, some people think, it’s better just to go when you need it? Here’s why that is not as helpful an idea as it may sound.
a) Therapy is a process, not a solution
Although eureka moments can happen in therapy sometimes, the real value is usually cumulative. It’s the building of a relationship, the testing of the boundaries (of the work and oneself), the daunting but crucial business of walking into a dense jungle of emotions with a (hopefully, potentially) trusted safari guide. That kind of work and progress can only usefully happen if it’s consistent. You can cry or rant, be reasonable or objectionable, be fascinating or boring, and you know he or she will be there at the same time next week.
b) The therapist is committing to you, you’re committing to them.
Once you have agreed to work with a therapist they are making a commitment to you: “Every Tuesday at 2pm, for 50 minutes, my entire attention will be on you. Nobody else will ever sit in that chair at that time until our work together has concluded.” That’s both a practical necessity (as discussed above) and an oath of commitment. How you use that is up to you.
That 50 minutes is only yours. If s/he’s made that commitment to you, it’s good to make that commitment to them. Then you can make a commitment to making things better for you. Together.
c) Feel the sting: that’s where the value is.
Any commitment (whether to a partner, a job or a therapist) has its downsides. Sometimes you can’t be bothered. Sometimes you wish you could be anywhere else. Sometimes you need it much more than you’d like. All of those experiences – however lovely or difficult – tell you something about who you are: what you can tolerate, when you become overwhelmed, what makes you bored or frustrated, where your tipping point is.
It’s the difficulty that brings the value. But mention the sting to your therapist when it arises. It’s not irrelevant to the work. It is the work.
Good luck!