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  • Sean Cuthbert

How should you choose a therapist?

Updated: Nov 11, 2018


When you set out in search of a counsellor or therapist, you face an endless array of options. Should you see a counsellor, a psychotherapist, or a Psychologist? Or maybe even a Psychiatrist? What's the difference between all these titles and professions? Should I see someone who is a specialist in the issue that you're trying to address, or maybe you should see a generalist? What about the gender of the therapist? Would you be better off in the professional care of a man or a woman therapist? Would you prefer someone who is passive and gentle, or someone who is more dynamic and directive with an edge? These are just a few of the questions you may need to answer when you start your search. So, here's the bad news - there's no definitive answer to these questions, and it will depend of the individual as to what is going to work. However, having written that, I can offer some guidance towards finding out what is going to work for you!

So, firstly: what is the difference between all these different professions? At a practical level, often not that much. Generally speaking, Counsellors, Psychotherapists, Psychologists, and Psychiatrists may all have generally the same amount of therapeutic training time, but some of these professions have spent longer at university due to other aspects of their training apart from the actual counselling. As a Clinical Psychologist, I spent a lot of time learning how to use standardised psychometric tests (like IQ tests) and becoming familiar with diagnostic categories and systems on top of my therapy training. A Psychiatrist is a medical doctor who goes on to be a specialist in mental health, particularly assessment for diagnosis and prescription of psychiatric medications. What you should be looking for is someone who has solid professional training, a serious ongoing commitment to their professional development, adheres to the ethical guidelines of their registration body, and is a member of their professional association. Secondly, you should always attempt to seek out someone who is a specialist in the specific issue you are wanting to address. It is probably okay to see a generalist for something like mild to moderate depression, but if you are wanting to address an addiction issue, or a traumatic experience in therapy, these are areas in which only a small number of therapists are adequately trained . For me, a telltale sign that you should keep looking is if the therapist profile lists about 10 to 15 areas of "speciality". Would you go to a restaurant that served Thai food, Greek food, Mexican food, and Japanese food? No, because they'd do a mediocre job on all of them. It's the same for therapy. I would treat a limited number of client issues well and I work almost exclusively with men... and the rest I would leave for others. I have an ethical mandate to say that... and I have a problem with others who don't.

Thirdly, and most importantly... what type of person is going to be the best therapist for you? Man or woman? Passive and gentle, or dynamic and edgy? So, here's the big secret about counsellors/therapists... therapy will work well primarily when you have a great relationship with the professional. And by great relationship I mean you trust them pretty quick in the process because they are listening, they have a plan, and you can see that they are as excited about you reaching your goals as you are are. You want a therapist who encourages feedback. And I mean actively seeks it out. "What was that session like? What worked? What could I do different to make this better?" It helps if you like them, but at a minimum, you have to click with them in a way that is going make therapy work. If you don't, the whole endeavour is dead in the water. Think about your life for a minute: have you ever met someone new and you know it's okay, but not that great? If that's the therapeutic relationship, I'd strongly encourage you to say that out loud to your therapist. Because if that's what's happening any professional worth their while is sensing that too, and they should be thinking about a) how to make the experience better, or b) referring you out to someone else. The relationship between therapist and client is like any other relationship you have in your life, it should be amazing, or at least approaching that. You deserve that, and it speeds up the process of getting well.


© 2020 created by Sean Cuthbert, Clinical Psychologist