Choosing Counselling

The decision to enter therapy often comes at a time of crisis: either something significant has occurred in your life to bring you to the point of seeking help, or a number of things have been building up, culminating in a burden you can no longer ignore.  For others counselling provides hope in answering life’s questions which may have gently, but persistently been seeking attention.

Choosing a Therapist – Key Questions

One has made the commitment to counselling.  How does one choose a therapist?  Factors which influence this decision, in no particular order, include:

• The issue(s) at hand – Does the therapist have experience with my particular problems?
• The Qualifications of the Therapist – What is the counsellors training?  Did they attend an accredited program of study? Do they belong to a registered professional body?
• The Therapist’s Experience – How long has the counsellor been practising?  What is the counsellor’s work history?
• The Therapist’s Approach – What counselling methods does the therapist use to help me with my problems?
• Measuring Effectiveness –  How will I know that therapy is working?  What does the therapist do to keep track of this?
• Cost – Is the cost of therapy within my budget? Is sliding scale available? Is the cost in line with guidelines set out by the therapist’s professional association?  If I have extended health, is the cost of therapy covered?
• The Therapist’s Personality – On the most basic level: could I get along with this person?  Is the therapist someone I could feel comfortable with? Someone who is accepting of me?
• The Therapist’s Beliefs About Change – What is the counsellor’s theory of how change occurs?  Are these beliefs in line with mine?
• The Therapist’s Gender – Some folks feel more comfortable working with a therapist of a specific gender, or alternatively, a counsellor who is gender fluid, a non-binary, or more.
• The Therapist’s Sexual Orientation – Some clients prefer a counsellor with the same or similar orientation while other clients specifically seek a counsellor with a different orientation than themselves.
• The Therapist’s Age – While important for some, others regard it as a non-issue.
• The Therapist’s Location – Is it convenient to my home or work? Is there parking available?  Transit service? Bicycle parking?
• The Therapist’s Race or Commitment to Antiracism Practice – Would seeing a BIPOC therapist be the best case scenario for your counselling?

Choosing a Therapist – Key Points

• The terms “therapist” and “counsellor” are not regulated; anyone can use these titles.  Choose a therapist who is a member of a professional college or regulatory body.  In British Columbia, look for Registered Social Workers (RSW), Registered Clinical Social Workers (RCSW), Registered Psychologists (R.Psych) or Registered Clinical Counsellors (RCC). These are the most common professional designations; other legitimate options are available, but investigate thoroughly!

• A therapist with experience has had time to develop his or her professional skills and has hopefully worked under clinical supervision for some years before beginning a private practice.  If you are working with a counselling student or new grad, ensure that they are receiving clinical supervision on a regular basis. In fact, I recommend clinical supervision for any therapist, no matter how experienced, and I have my own clinical supervisor whom I see regularly.

• The therapist’s education is important.  Look for someone with a minimum of a master’s degree in social work or counselling psychology.  Those that are registered psychologists have PhDs or PsyDs.

• Research shows repeatedly that the most important factor in successful therapy is not the therapist’s technique but rather the therapeutic fit.  Is there a good rapport between you and your therapist?  Do you feel respected?  Do you respect the therapist?  Do you like the therapist as a person?

• Studies also demonstrate that it is critical that you and the therapist see eye to eye when it comes to your goals, your beliefs about change and the methods for making change happen.  When therapists and clients are at odds about the plan for change, clients are more likely to drop out of counselling and never return to see that therapist. Sometimes the client gets turned off of therapy entirely, saying “it’s not for me.”

• Trust your guts – speak to the counsellor first over the telephone, by video or in person if possible, rather than simply booking online.  Ask questions.  What is your general feeling after speaking with the therapist?  Feeling nervous or apprehensive is normal yet was the counsellor able to allay some of your concerns about the counselling process, answer some of your questions, and generally help you feel comfortable?

• Remember the BMW Rule – As a person I knew once said, steer away from anyone who asks you for your body, unreasonable amounts of money or your will.  Therapy should be a collaborative, non-pathologizing journey.