It takes huge strength of mind to seek help for depression, anxiety, stress or any other mental health condition. If you have chosen to seek help in the form of counselling, how do you choose the right one?
Psychotherapy v Psychiatry
Psychotherapeutic counselling is different to psychiatry and psychology. A psychiatrist attends medical school and therefore holds a doctorate, i.e. is an MD. They are trained specifically in medications for treatment. A psychologist holds a doctoral degree i.e. a PhD. Most often this is in clinical psychology but sometimes in counselling psychology. They have often completed clinical internships in diagnosis and will have experienced at least one year of required psychotherapy themselves.
Psychotherapeutic counsellors do not necessarily have a PhD, it is not a requirement, however they will have gone through extensive training, (normally to level 4) before they are accredited by one of the counselling institutions and able to offer clients talking therapy. You should not engage a counsellor who cannot provide evidence they have gained a relevant qualification. In order to obtain liability insurance a counsellor must have relevant qualifications.
Types of talking therapy
Theorists such as Freud or Jung may sound familiar, none of whom are mentioned below as this is not a theory lesson! Different counselling theories or approaches suit different people and different conditions, some call these approaches modalities. Here are some of the main approaches:
Person-centred
As the name suggests, this approach is entirely client led, i.e. centred around the client in the here and now and not the problem, which means that the counsellor is unlikely to direct the counselling session. The client will lead the conversation and the counsellor will use their training to draw out themes and support the client to understand themselves better and be able to cope with current and future problems. This can be useful for clients who are self-aware and can express or describe their emotions. The benefit of person-centred counselling is that the client owns the process and feels capable and able to make their own decisions on change.
Psychodynamic/Psychoanalytic
This type of talking therapy helps client understand the root cause of their problems as well as equip them to cope with further difficulties. The approach stems from the belief that behaviours in the present are born of experiences from childhood, that repressed thoughts and feelings eventually manifest as depression, fears and conflicts. This approach can use a mixture of directive and non-directive methods guiding the client through specific areas of discussion and behavioural patterns. This process can be slow and intensive as it deals with deep rooted feelings, sometimes completely unknown to the client until established in therapy. This type of counselling is beneficial for any type of relationship issues.
Cognitive
This approach explores the link between our thoughts, feelings and behaviours. If we can understand the relationship between these, we can alter our negative behaviours appropriately. The type of therapy focusses on the present, it is solution focussed and not necessarily looking at the root cause of the issue. In order to benefit from cognitive therapy, the client must be able to identify, understand and accept their behaviour(s) and be able to clarify the resulting problems. This type is most beneficial for the support of short-term difficulties.
Integrative or holistic
Many counsellors specialise in one approach, but some may train as an integrative counsellor, which means they have training in several modalities. An integrative counsellor will adapt to the needs of the client and adopt the approach which best suits the circumstances. This can be beneficial for the client as arguably they are getting what is right for them at each step in their therapeutic journey.
Picking the right counsellor for you may not be easy. Many people who say “counselling doesn’t work for me” may not have found the right one. Counselling will not work if you don’t connect with the therapist or understand what they are doing to help you. We are all different and as I’ve shown, the approaches can also be different and suitable for different conditions and personality types. Take time to understand what might work for you and if it isn’t working, tell your counsellor. If they are working to a professional framework they will not only understand but they should either explain the process better or refer your to someone else.
