This guide is for people in the UK wanting to find a counsellor or psychotherapist and not knowing where to start. The first thing you might be asking yourself is: what is the difference between a counsellor and a psychotherapist?
To be perfectly honest, I have never found a difference. There are many myths out there, for example that counselling is short-term and psychotherapy is long-term. This is completely false. Both counselling and psychotherapy can last as long or as short as you would like it to. The main difference I’ve found is perhaps in qualification. For example, a counsellor will have done a counselling qualification (this can be a Level 4 Diploma, or a Postgraduate Diploma), and a psychotherapist will likely have completed some postgraduate study in psychotherapy (this will most likely be a Postgraduate Diploma or an MA/MSc). They are inherently the same, but psychotherapists may have a more specific framework they follow. So where a counsellor may pull together techniques from, for example, cognitive behavioural therapy and psychodynamic theory, a psychotherapist is more likely to have trained specifically in psychodynamic or humanistic, or CBT. This doesn’t make any one type better than the other as you will find that how well you get along with your counsellor/psychotherapist is down to your relationship with them rather than their qualifications.
The next thing to understand is, having basically said qualifications are not that important, it is vital to find an accredited counsellor/psychotherapist. There are two main organisations within the UK: the BACP (British Association for Counselling and Psychotherapy) and UKCP (United Kingdom Council for Psychotherapy). The reason why I stress accreditation is important is because, legally, anyone can be a counsellor in the UK. You can have no GCSEs and no experience in counselling, but you can still provide a counselling service. This can potentially cause an abundance of damage to the client, as they will not have had the training nor the supervision that BACP- and UKCP-accredited counsellors/psychotherapists have.
There are some things you will need to consider when searching. Let’s start with the cost. On BACP, you can find counsellors starting from £40/hour (by hour we mean 50 mins as each session will be 50 mins). Some of these counsellors may have concessionary rates at around £30-£35. I find from experience that UKCP-registered counsellors/psychotherapists tend to charge more, normally starting around £50/hour, but they can charge upwards of £65/hour. You may be lucky enough to find some professionals who charge around £45/hour as a concessionary rate.
Another cost you can expect is the initial assessment. This is the first appointment, where a counsellor or psychotherapist will want to evaluate whether they are able to help you. Initial assessments are often less than 50 mins, and are normally free. However, some professionals may charge for the initial assessment. I would advise against a counsellor/psychotherapist who charges for the initial assessment as you may go through a few before you find someone you can work with. This is unlikely, but possible. However, if this limits your pool of potential counsellors, please do explore professionals who charge for the initial assessment.
Once you have found someone you can afford – and, yes, you really are worth spending that amount of money on on a weekly, fortnightly or monthly basis – the next thing may to find out more about a counsellor/psychotherapist’s modality. Below, I have produced tables with pros and cons about the type of counselling/psychotherapy available. This is just to give an overview, and is by no means exhaustive, so if you have any questions after reading this article, please do feel free to get in contact with me and I will be happy to help answer any queries.
Cognitive-behavioural – this approach basically believes that our thoughts affect our emotions and behaviour. For example, if I think I am bad at my job, this will make me sad and make me feel worthless. The aim of CBT is to modify one’s cognition to help manage their thoughts, which should theoretically help their emotions and behaviour.
|Can be offered intensively or over a longer period of time||Slightly increased likelihood of relapse|
|Effective with short-term problems (e.g. short-term depression)||Not as effective with longer-term problems (e.g. child abuse)|
|Evidence-based – supported widely by research||Does not explore the past and problems in much depth|
|Cost-effective – not too pricey as can be offered short-term|
|Effective in changing behaviour|
Humanistic or person-centred – these terms are sometimes used interchangeably. The idea behind this approach is that anyone is capable of making change if they have the right resources in place, e.g. a warm empathetic environment with someone who believes in them, which would be the therapist. The client is the expert as they know their history, and the therapist presents an environment where the client can explore themselves and their issues.
|Acknowledges the effects of the past on the present||Typically western, individualistic approach to treating wellbeing|
|Treats the client as the expert, rather than the student||Can be short-term but generally longer-term, can be pricey|
|Empowers the client to become independent and free-thinking||Non-directional nature can be overwhelming for some clients|
Psychodynamic or psychoanalytic – you may think of this and think Freud, and you would not be entirely wrong. However, many modern psychotherapists have moved away from Freud’s school of thinking, although some principles may have been initially proposed by Freud. Psychoanalysts may believe that we repeat behaviours from the past in the present, as this is what we are used to. For example, a person who was not used to good things happening to them as a child may recreate these experiences in adulthood as this is what is familiar. Psychoanalysts will help the client make these connections between the past and the present, and will use the analytic relationship to help the client change behaviour
|Gets into the nitty gritty, less likely to relapse||May take time to feel the effects of therapy|
|Can be offered in 6 sessions or 12 sessions||Tends to be longer-term and therefore pricier|
|Client can explore past traumas in therapy|
|Extensively supported by research|
And then there are integrative therapists who may use techniques from any of the three approaches above, and other types of therapy, to help the client reach their goal. You may be thinking ‘why doesn’t everyone go for integrative then?’ For some people, CBT may not be appropriate, whereas for other people, CBT could be perfect alongside humanistic therapy.
There are many other types of therapy, but this is a start. Once you have chosen a price range and a modality, you can reach out to as many therapists as you like, and I always recommend reaching out to more than one. The reason being that many might not have the right availability to coincide with your own, or you might speak to a therapist and decide they are not the right one for you (which is fine, they are used to this).
All the best in your search, may you find a therapist who leaves you wondering why you didn’t start sooner!