Over the years I’ve seen friends asking for recommendations for a therapist and as new year approaches, I see an increase in others reaching out to support services and counselling organisations. Whilst I believe finding the right therapist is a personal choice, I do think there are some general things I like to consider, as well as some resources that make good starting points. I am speaking here as a client who has been in and out of therapy since I was a teenager, as a psychotherapist in training, and most importantly, as myself – these are my opinions on what I ask others to consider when finding a private therapist.
A private therapist! Sounds expensive… Yep. I think we all know therapy is a very middle-class profession and expensive education. I’m sure you also have images of middle-aged white women in pant suits, sitting in spacious rooms, a ficus tree in the corner which you immediately relate to. But this isn’t what all therapy looks like. And going private means you get that control over what your therapy as well as your therapist looks like.
Cost
A huge barrier in accessing support, which is why many of us turn to NHS counselling or going through charities that support mental health. However we don’t always get much of a choice for our therapists, because the waiting lists are so long, we have to take what we are given, and it can be a bit of a lucky dip, despite the reputation of an organisation.
Private therapy doesn’t need to be costly, and ethically I don’t think it should be either. We all have the right to access the support we deserve and to be listened by someone we trust. When researching your therapist, some do offer a sliding scale for their clients. If this isn’t advertised on their website or directory, send them a message anyway. Ask if they have low-cost spaces/student rates available, as not everyone advertises this but some do accommodate.
It’s always worth asking. I was honest with someone that the reason I wasn’t attending as often as I should was because of the cost. Even though when we started working together it was a flat rate, she offered me £5 off future sessions so I could attend more regularly. It was an open honest conversation and I didn’t feel like she was interested in making money, she was more interested in having me there.
Really though, how much does it cost?
For 50 minute sessions (what we call a ‘counselling hour’) I can only tell you what I know from experience. My charity offers counselling on a sliding scale from £5-£20, others £10-£50. For unwaged/students it is usually free. My university require me to have therapy from an approved therapist, which meant I was going to be picking from a very experienced/qualified bunch who all charge a lot, just to make sure it’s expensive all round… My private therapist charges me £55. For those between training and newly qualified, £30-40 would be expected, but it depends on the local market too. Trainees should be charging a reduced rate. Experienced counsellors charge nearer to £50-90. And specialists would charge a lot more…
UPDATE: a very nice experienced therapist friend told me that in London prices are much higher (as expected), her sliding scale is £65-£90. She offers a free telephone consultation, then a flat lower rate for the first session, as there are overheads to pay if you are renting a counselling room for example. It really varies and as she said to me with cuts to mental health provisions, charities are also raising prices to help cover costs and continue running the services.
Either way, the first meeting is usually seen as a consultation and is free of charge. This is where you make a decision on whether they are the right therapist for you, if you can work together. You are letting them in. It’s a big investment for your mental health, but it is necessary to invest in your mental health, just as we try to with our physical health.
Wait, counselling? Psychotherapy? What's the difference?
The main difference is the duration of how long the work is. Short-term therapy (such as NHS or through charities) is counselling. Long-term therapy (such as private therapy) is psychotherapy. You can imagine that the depth and focus of the work is more intense with psychotherapy simply because of the duration of the work, however both counselling and psychotherapy offer space for psychological change.
When it comes to different approaches and types of therapy, well, this is a big one and probably best explained by the experts.
It’s a tough one to cover as there are loads out there but only a few floating around in mainstream vocabulary, because as most things come in and out of fashion, so do types of counselling and psychotherapy. First it was psychoanalysis (Freudian unconscious stuff) then CBT (cognitive changes and behavioural thinking) and now I think people are quite into coaching (solution focused). With NHS, they either offer counselling, groups or CBT through IAPT services. With charities, they offer counselling, which isn’t specified as any particular approach, nor can you really choose what approach you get. Saying that… after speaking to experienced tutors and therapists… after years of therapist work you can’t really tell what someone trained in; the set of skills to hold a therapeutic space and provide conditions for change are the same or they feel the same. Unless it’s a specific issue or trauma you want to focus on or a type of therapy that works with your way of thinking, I wouldn’t worry about it too much. Find a therapist that works for you. On their website they will have a bit about the approach they trained in and how they work – if that sounds good, then just give it a go.
Duration
Unfortunately due to limited resources and funding cuts, counselling within NHS and charities is often time-limited. It’s usually 12 weekly sessions, which can sometimes feel like nowhere near enough to connect, trust and finally open up. It’s okay if it doesn’t feel like enough, and I would say try it anyway if you have that available to you. Sometimes short term counselling can be useful to focus on one issue/event at a time.
However if you know you want someone long term and have a few things going on like I did, then you might want to invest in a private therapist – I wanted to build a long term relationship with one therapist after having so many for 6-12 sessions at a time. Private therapists have the flexibility to offer you counselling for a year or more, because they manage their own referrals and caseload. You can always discuss duration of counselling with your therapist no matter where you see them – you are the client, you are paying/showing up for a service and it should be an agreement between both of you how long you are seeing each other for.
Legitimacy idk but this is an important read
Something not many people know is that you don’t need any qualifications to call yourself a counsellor in the UK. Yes, anyone can set up a website, call themselves a counsellor, start seeing and charging clients. This is why it is so important that you find a therapist through legitimate websites and governing bodies where therapists are qualified, experienced and supported in their practice, as well as being accountable to the ethical guidelines that we train under. All therapists should be in some kind of supervision, and if they are in training they are going to be undergoing their own therapy as well as supervision. I disagree with the legitimacy that comes with academia, putting qualifications and degrees on a superior pedestal however in this context where anyone can call themselves a counsellor, when it comes to mental health, emotional wellbeing, trauma processing, etc, I want you to be safe.
I want to be clear that I’m not dismissing NHS counselling or counselling services provided by charities – I am currently a volunteer counsellor at a charity and I’ve had my fair share of NHS counselling, which was so valuable for me. This is simply to share some alternatives.
Here are a few governing bodies, networks and organisations that have therapist directories, as well as offering memberships, resources and training if you are a therapist interested in joining or furthering your own development.
- UKCP (UK Council for Psychotherapy; leading organisation for the education, training, accreditation and regulation of psychotherapists and psychotherapeutic counsellors)
- BACP (British Association for Counselling and Psychotherapy; a professional association for members of the counselling professions)
- BAATN (The Black, African, and Asian Therapist Network, the largest community of Counsellors and Psychotherapists of Black, African, Asian and Caribbean Heritage)
- BAATN Complementary Therapist Directory
- MCAPN (Muslim Counsellor and Psychotherapist Network)
- Pink Therapy (an online directory of therapists of all sexualities and gender identities who work with gender and sexual diversity clients across the LGBTIQ spectrum)
- Gendered Intelligence Therapists and Counsellors Directory (a listing of members of Gendered Intelligence’s Network for Therapists and Counsellors who offer services to trans people/families/partners – scroll down to download the pdf)
- BPF (British Psychotherapy Foundation; low fee intensive therapy)
- The Free Psychotherapy Network (a group of psychotherapists offering free psychotherapy to people on low incomes)
- List of low cost and free counselling services and organisations in London
If you’re thinking, after reading this therapy actually feels way too scary right now, what can I do instead? THAT’S OKAY. I got you.
Try practicing listening and being listened to with your trusted crew, friends, family or partners. You might have heard about ‘active listening.’ It’s where we show someone we are really listening. It might sound obvious to some, but if you have a read through these resources, you might be surprised at what it takes to make someone feel heard. I used to Skype a friend where we shared how we wanted to be listened to (e.g. don’t ask questions or total silence, just nods) and took it in turns for 30 minutes to just talk. Interested? Click on the lil links below:
- on what active listening is
- on what active listening isn’t
- building active listening into our communities
You could learn about your feelings solo! The wonderful non-binary therapist and academic MJ Barker has written Staying With Our Feelings, an awesome lil zine to help you figure out your own emotional landscape as well as tools to help focus and stay with feelings. Click right here to get to their free zine library and download Staying With Our Feelings from their webs.
If you’re worried about burdening your friends or there are bigger problems in the world, I want to tell you first, there is no hierarchy to emotions. There is always someone worse off than you and there is always someone better off than you. You are allowed to have struggles and you still deserve help.
If you really can’t speak to anyone around you, make use of anonymous helplines (there are loads out there so please have a google). Dedicated and trained volunteers are there for you in any situation, any time of the year. They want to hear from you. Hate talking on the phone like me? Most helplines also have e-mail and webchat, isn’t that great.
If you’re worried about making a big deal out of nothing, well… I can’t convince you it’s not a big deal, but honestly, whatever you are going through, it could be a big deal (whatever that means to you) and that is one hundred per cent okay. It could also not be a big deal but it feels like a big deal which is also okay. You are important and emotions are complicated, weird and wonderful. We react differently to different things and sometimes our responses might not make sense. That’s why we really need space to talk about our feelings freely so we can make sense of it or move through big deals and lil deals.
There is so much more to say on finding the right therapist! This is just a DIY kit I threw together as a starting point. So. That’s all from me. To finish, here is some advice from very nice people I know:
- ‘ask them questions by e-mail beforehand. it’s important to get a good fit. the questions I asked were a mix of things about the issues I knew I’d be bringing to therapy and my life/identity/context as I wanted to make sure that I’d feel comfortable with my therapist and that I wouldn’t be needing to educate them – I’ve heard some horror stories about even the most basic levels of LGBT understanding for example.’
- ‘you are employing them! you are allowed to be choosy <3 you deserve the world’
This is a brilliant, informative and sensitively written article Sabah.