STEP 1 – Identify some goals

Think about what you’d like to ACHIEVE as a result of working with a therapist, (i.e. what positive changes you’d like to make by the end of the therapy process). You might not have a clear idea just yet, so to get you started it might be helpful to ask yourself this question and write down everything that comes to mind:

“I’m at the end of the therapy process, feeling delighted with what I’ve achieved… what changes have I made?”

Think about, for example what you’d like to be thinking, feeling and/or doing differently and what you’d like to have (or not have) in your life. Only YOU know the answer to these questions so give them some serious thought.

Then tidy up your thoughts into one or more written goals, making make them as specific and tangible as you can. Some people find it helpful to use some of these formats, filling in the blanks with whatever comes to mind:

“I’ve just completed the therapy process and I have …………… “

“I’ve just completed the therapy process and I am …………… “

“I’ve just completed the therapy process and I no longer …………… “

“I’ve just completed the therapy process and I feel …………… because …………….“ 

Your goals might evolve as the search progresses and during the therapy process, but having an idea of what you’d like to achieve will help you talk to potential therapists and make sure you’re both on the same page. It will also help you with STEP 6 (reviewing progress).

STEP 2 – Make a wish list of the kind of therapist* you might need

*Remember, I’m using the term ‘therapist’ as a short-hand to refer to a therapist, counsellor or psychologist who’s professionally qualified and has plenty of experience using talking therapies in the context of personal growth and relationships

Think about how you’d like to think and feel DURING the therapy process and what kind of therapist might be able to help you to achieve your goals. Again, you might not know at first, especially if you’ve never worked with a therapist before. So, to get you started, you might like to ask yourself these questions and write down everything that comes to mind:

“We’re part way through the therapy process and I’m feeling really good about how well things are going… so what’s happening? For example:

• What would I like to be doing during and between sessions?
• How would I like to feel in the sessions?
• How would I like the therapist to behave towards me?
• What would I like the therapist to be like, as a person?”

Then tidy up your thoughts into a wish list of key requirements that can guide your search. This might include the type of therapy (if you know) and whether you’d prefer face-to-face or online. Take some time to think carefully about the kind of person you’d like to work with and the way you’d like them to behave towards you because, as you know, this can have a significant impact on your experience of therapy. Again, be as specific as you can and really spell out what you’re looking for.

If you’ve never tried therapy before, think about good and not-so-good experiences you may have had with other helping professionals – anything from doctors/ dentists/ nurses/ physiotherapists to gym or yoga instructors and hairdressers – to try to pinpoint what kind of person gives you the most positive experience and leaves you feeling good about the outcome… and what kind of person you’d rather avoid.

You might like to think whether any other requirements are really important to you, (e.g. the gender, ethnicity, sexual orientation or age of your therapist). And if you’re dealing with particular issues, you may prefer to work with a therapist who specialises or at least has experience of working with these issues.

There are obviously no right answers here… it all depends on what’s important to you at the time you’re doing this. The longer your wish list, the more complicated it might be to tick all of the boxes, so try to identify your deal breakers and make them your priority. And again, your ideas will probably evolve as you get more information during the search process and/or after you start working with a therapist. It’s rather like looking for an apartment or choosing an outfit for a special occasion…you might start with a vague idea of what you want and then get clearer as the search progresses.

Don’t worry if you go down a few blind alleys and change your requirements throughout the search… sometimes it’s only when you talk to a therapist who’s wrong for you – or try out a particular therapeutic approach – that you realise what you actually want. And of course, you can’t guarantee that a therapist who ticks every box on your list is available to you or even that you’ll have a choice about who you work with. But…

Having a clear wish list is a great starting point that puts YOU in the driving seat and helps you to ask the right questions. And if things aren’t going so well, going back to the wish list can help you work out what’s missing and look for solutions.

REMEMBER, IF YOU NEED URGENT HELP BECAUSE YOU THINK YOUR SAFETY IS AT RISK OR YOU FEEL REALLY DESPERATE, YOU’LL FIND SOME LINKS AND HELPLINES THAT PROVIDE EMERGENCY HELP AND CRISIS SUPPORT HERE.

STEP 3 – Kick off the search process

Once you’ve completed the first two steps, it’s time to search for one or more therapists who seem to tick the boxes on your wish list. How you go about this depends on how the therapy will be funded and what provision is available in your area. (More about this here: To pay or not to pay? Some factors to bear in mind).

If you’re going down the public health route: You’ll need to find out how the referral process works and whether you fit their criteria. Procedures are different everywhere but a good starting point is usually your local primary health-care provider, (e.g family doctor/ general practitioner).

If you think a voluntary/not for profit organisation might help: You’ll need to contact them or take a look online to find out whether you might be eligible for help and what, if anything, you would be required to contribute financially.

If you think your health insurance might pay: You’ll need to contact your insurance provider to find out what, if anything, is available, whether you fit their criteria and how their procedures work. For example, some insurers provide a list of approved therapy practitioners for certain issues, while others will reimburse a pre-set amount if a therapist meets their guidelines. And a medical referral may be required in some places.If your insurer allows you to select the therapist, read on…

If you’re planning to fund the therapy yourself (or you can select your therapist): This gives you a LOT more options, more flexibility and more choice… but also means you’ll need to dedicate some time to narrowing down the field. This is where the wish list you prepared at STEP 2 will be really helpful.

If you feel comfortable talking about therapy with friends (or family) and there are people in your circle whose judgement you trust, you can ask around for recommendations. Discuss why they would recommend (or caution against) a particular therapist or approach.. and decide whether it makes sense for you.

There are also LOTS of online directories that you can filter using a variety of selection criteria. I have put together a few external links for illustration purposes… and a cautionary word about using them here: Searching for a therapist? A word about online directories.

If you don’t find anyone suitable in your location, many therapists offer sessions online as well as in person. Clients often prefer to meet face-to-face. But if you don’t have that option, remote sessions can work surprisingly well and, with the right therapist, it doesn’t take long to create the necessary rapport.

STEP 4 – Make a shortlist and check credentials

If you can choose a therapist, you might like to make a shortlist of two or three who could possibly be right for you. Then you can do a more thorough check of their qualifications, experience and approach, to find out whether they match the key requirements on your wish list (from STEP 2).

All talking therapists should be professionally qualified but requirements vary depending on the type of therapy they are practising and where they work, (see What are Talking Therapies… and what are the alternatives?)

During a BBC documentary about the value of hypnosis in 2016, Dr Quentin Deeley, Consultant Psychiatrist at the renowned Maudsley Hospital (part of Kings College London) was asked for his view on how to find a suitable practitioner. He suggested that the right practitioner should ideally “have training in a recognised health profession, for example a qualified psychologist, and should be part of a professional, regulatory body to which they’re accountable…”

It’s good practice for any therapist to be a registered member of the professional body that accredits qualifications and sets quality standards for how their members work. You can usually double check this through the membership body’s website and, to help you get started, there are some links to professional bodies here: Searching for a therapist? A word about online directories.

Remember, online directories allow therapists to list their qualifications / accreditation, but only some of them say they have verified this information. Any therapist should be able to explain how you can verify their professional qualifications/ accreditation and I would strongly recommend doing this before meeting up. It doesn’t guarantee that the therapist will do a good job for you but it’s an important part of the checking process.

If a therapist has their own website this might give you a flavour of how they work and the sort of person they are, especially if they provide case studies or examples. Client testimonials can be helpful… IF you feel they’re genuine and written by people whose requirements are similar to yours.

If you’re choosing a therapist yourself, it’s fine to make contact and ask any questions you may have. This might be via message, email or online contact form or ideally via a phone call. How quickly the therapist gets back to you will depend on how busy they are… and perhaps how motivated they are to work with you. Some therapists even offer a free or reduced-price consultation or taster session – by phone or in person – and it makes sense to take advantage of this opportunity if it’s available.

STEP 5 – Your first conversation… and how to weigh it up afterwards

Whether you’re choosing a therapist yourself or a therapist is allocated to you, the first conversation should allow you to get to know the therapist better and to understand how they work and how they might be able to help you.

They should explain the type of therapy they provide and mention their qualifications and which professional body they’re registered with. If not, you should ask. They should also get you to describe why you’re there and what you’d like to get out of the therapy process… and listen to you in a supportive, empathic way. Based on what you tell them, they should be able to give you an initial view about whether your goals seem realistic and this seems to be the right kind of therapy for you. Again, if they don’t offer their initial view, you can ask.

Hopefully they can give examples of how they’ve helped people with similar issues in the past, so you know they’re thinking about you and your needs, not just serving up a ‘one-size-fits-all’ formula. And if you have any questions or concerns, they should be willing to answer them patiently.

In the first session you should also find out the practical details such as how long the therapy might last, how many sessions you might need (or how many your therapist can offer), what work they might ask you to do between sessions (if any), how much they charge (if you are paying) and what happens if either of you need to cancel a session or want to end the therapy process.

While you’re both sharing information, you should try to tune in to how you’re FEELING and whether you’re being your authentic self.

Immediately after the session: take some time to look back at what you wrote in STEPS 1 & 2 and reflect on how it went. Here are some questions you might like to answer

#1 Do I have confidence in this therapist’s approach? Do I feel they can help me achieve my goals?

#2 Do they seem to tick most/all of the boxes on my therapist wish list?

#3 Did they create a safe and supportive space where I felt comfortable and started to open up?

If you’re pretty sure the answer to these questions is “Yes”, then you can go ahead and book in your next session or sessions. But if there are any alarm bells ringing, (for example if you didn’t feel comfortable with the therapist or confident about their approach), then you need to ask yourself:

#4 Is this because it takes me a while to relax and open up? (In which case you might need to give it a few more sessions before making a decision) OR

#5 Is there a fundamental lack of understanding and connection between us as people? (In which case, if the choice of therapist is yours, you should move on and have an initial conversation with the next therapist on your shortlist – with the aim of finding a better connection. If the choice is not yours, you might need to go back to the person who set up the therapy, to express your concerns and see what they suggest).

STEP 6 – Keep reviewing progress

After the first three or four therapy sessions it’s good to step back and reflect on how things are going by asking yourself:

• Am I making progress with the goals I identified at STEP 1?
• Do I need to revise my goals in the light of what I’ve discovered so far?
• Is my therapist ticking most of the boxes I identified at STEP 2?

This should enable you to answer those important questions: Do I like you? Can I trust you? Are we equal partners?

If you have any concerns about how things are going or feel that some adjustment is needed, you should talk it through with your therapist. Explain how you feel and what you need, as calmly and simply as you can, so they can respond. (If you don’t feel totally confident in doing this, it can be helpful to write down your thoughts so you can refer to your notes during the conversation). In the light of your comments, your therapist may adjust their approach or just explain more about where you’re at in the process.

If, after a few more sessions you’re still not satisfied with progress, it might be a good idea to double check whether your concerns are reasonable, by asking yourself:

• Am I being impatient / setting the bar too high / expecting miracles in a short space of time?
• Do I often think there’s something or someone better around the corner (and worry I might be missing out)?
• Do I have a tendency to put people on a pedestal and think they’re wonderful then suddenly change my mind?
• Am I blaming the therapist for things that are outside their control?
• Do I have a tendency to ‘cut and run’ when the going gets tough?

If the answer is YES to any of these and you have generally been feeling comfortable with the therapist and getting some new insights, then maybe take a deep breath, relax into it and give the therapy some more time before doing anything rash. Talking therapy is not a quick fix and clients who commit some serious time and effort tend to get the best rewards.

However, if you answer NO to all of those questions and, a few sessions after discussing your concerns, nothing has changed and you’re still unhappy about the working relationship and a lack of progress, then it’s OK to tell your therapist you’d like to discontinue the sessions. They might ask you to attend a few more sessions in order to round things off… and it’s up to you to decide whether or not you feel that would help you.

Now it’s time to revise the goals and requirements you identified at STEPS 1 and 2 and then start searching for a new therapist who is a closer match for your needs… bearing in mind what you’ve learned so far about what does and doesn’t work for you. Perhaps a different type of therapy might work better for you… or just a different individual.

You should keep reviewing progress in this way throughout the therapy process to ensure you’re moving forward and feeling satisfied with how things are going. A good therapist will help you to do this.

Remember, the therapy process should challenge you to think hard about things you don’t fully understand… and sometimes you need to face up to things that are uncomfortable or even painful. But when the therapy relationship ‘clicks’ because you and your therapist really connect, you’ll feel supported and listened to (almost) all of the time and you’ll know that the therapist has your back… even if things get tense or difficult.

And as you look back each month to review progress, you’ll feel a sense of progression towards your goals and notice how how you’re changing for the better, bit by bit.