Tag: NHS

Shopping for a Therapist

For many people in England, talking therapy is something you have to wait weeks, months, even years to receive on the NHS. For others, however, paying for therapy is an option. But when you go looking for private therapy, how do you find it? What are the potential pitfalls or advantages of shopping for a therapist? I am not claiming to be a great expert in the subject, by any means, but my experiences of receiving therapy and studying to become a therapist have given me some thoughts on the subject, which I hope might be helpful to other people.

When I first needed therapy, I didn’t know anything about it. I had no idea that there were different models to choose from or, more importantly, that therapists vary hugely in their natural competence and their training. I have now had various therapists who have received different training and work very differently to one another. More than one have been genuinely helpful and one in particular has supported me in transforming my life to be richer and more meaningful. The more I have learnt about the field of counselling and psychotherapy, the more I feel that it is a world that needs to be explained to society. There needs to be transparency about how to access therapy and how to choose the type that works for you. If you have the luxury of choosing your therapist, then you need to know how to find a good one.

Key Points:

• Shockingly, there is still no government body that regulates therapists or counsellors. This means that people can set themselves up as a practising therapist without any qualifications. They may not have received any therapy themselves and their motives for helping may be dubious. It is therefore very important when you choose a therapist, that you do it through an accrediting body, such as the BACP (British Association for Counselling and Psychotherapy) or the UKCP (UK Council for Psychotherapy). It is also advisable to ask to see the therapist’s qualifications when you first meet them; any therapist working within the ethical guidelines of these bodies will be happy to show you their qualifications.

• I am going to use the words counselling and psychotherapy interchangeably. Although there is debate in the field as to the differences between these terms, to all intents and purposes they are forms of talking therapy which do similar things. When you choose a therapist, it is more important to look at the therapist’s experience, qualifications and what they say about their own practice, than it is to worry about the terminology they use.

• The therapist themselves and the relationship you develop with them are key to the success of therapy. Choose someone who seems to ‘get you’ and with whom you feel comfortable.

• No therapist can ‘cure’ your mental health problems by themselves: the best results in therapy come when the client works together with the therapist and commits to the process. For this reason, try not to give up straightaway. It can be scary starting with a therapist: after all, you might not have shared your feelings with anyone before, especially not a complete stranger. Plenty of people do give up after one session. But it’s worth giving a new therapist a few sessions to see if you might be able to work together.

• The therapeutic process can be cathartic, reassuring and helpful. Sometimes, however, you might have to feel uncomfortable emotions in order to truly process them and this can be scary. If you have developed a good relationship with a therapist but it starts getting too heavy and painful, you might want to walk away. But try, instead, to share this with the therapist. They are there to provide a safe space for you to explore these difficult thoughts and feelings, so if you’re not ready to do that, it’s ok to say so.

There are many different types of talking therapy- too many to mention here but I will attempt to describe some significant ones.

 

• At the moment, the NHS mostly recommends CBT: Cognitive Behavioural Therapy. This is for a number of reasons. It is partly because it has been shown to be effective in certain clinical trials and partly also because it is a time-limited form of therapy, which is therefore cheaper for the NHS and easier to structure because they know how many sessions each person will get. If you haven’t tried CBT before, it is worth trying it. It is particularly useful if you do not wish to talk about your childhood experiences, but you do want to learn some new strategies for improving your wellbeing. I can only talk for myself but I found CBT really helpful for my OCD and for my anxiety but much less effective when I struggled with severe depression. However, different people respond to different types of talking therapy differently. The key is to be curious, try things and see what works for you.

• Psychodynamic counselling explores the way in which your childhood experiences have formed an unconscious pattern of feeling and behaving that continues to occur throughout your life. Expect a therapist who might be reserved and does not give much away about themselves. Possible positives: if you’ve had enough of advice or had your fill of structured sessions with homework to do, then this might be for you. The therapist is likely to sit back and listen a lot, giving you space to explore your own problems and find your own way out of them, with the goal that this should be an empowering experience. Possible criticism: strictly psychodynamic therapists might seem cold and unfriendly. Sometimes it might feel like there is more of an unhelpful power dynamic in this sort of counselling- with a reserved expert quietly analysing and a patient at the receiving end of a mysterious treatment.

• Humanistic therapy was developed as a backlash against the more deterministic outlook of psychoanalytic and behavioural approaches. It takes an essentially optimistic view of humanity: that every individual has intrinsic self-worth and that every human has the capacity for personal growth and fulfilment in life. Possible criticisms: may take longer to see results than with CBT. Possibly easier to avoid the most difficult bits of your past, which might need dealing with at some point. Possible positives: you are likely to find a warm, welcoming therapist, who treats you as a fellow human, struggling with shared human difficulties. Also, if you develop a good therapeutic relationship with your therapist, then you will feel safer and more able to take risks to explore difficult stuff in your own time and when you’re ready.

• An integrative therapist will draw on lots of different models to offer you therapy that is tailored to your individual needs. Possible criticism- jack of all trades, master of none. Possible advantages: will not make your complicated human situation fit their rigid model. Should not come with a preconceived idea of what exactly will help but work collaboratively with you to help you understand your difficulties and ascertain what you want to achieve through therapy. This is my preferred model and the one that I am studying, since I believe it gives me the best opportunity to treat each person as an equal and an individual.

There are so many other models and they are all interesting but I know that it can be overwhelming to have too much choice. If you need any more information, these pages can be helpful:

https://www.rethink.org/resources/t/talking-therapies-factsheet

https://www.psychotherapy.org.uk/

https://www.bacp.co.uk/

I wish you the very best of luck finding a therapist. Good therapy is out there. When you find it, given time, it might enable you to transform how you feel about your life.

The A&E Merrygoround

There is a fantastic, thought-provoking BBC documentary on the iPlayer in its second series at the moment: Ambulance. It leaves me with enormous respect for the work of paramedics and an overwhelming sense of the human potential for suffering.  However, I am incensed by the treatment of mental health patients in crisis.  

Over and over again, viewers watch these patients being ferried to A&E, which is completely the wrong place for them.  A&E can be a very triggering environment at the best of times, with traumatic injuries coming in, distressed children, angry people waiting, tears, frightening sounds and long delays.  To somebody for whom the basics of daily life are overwhelming, A&E can be a suffocating, frightening space. We must stop sending people to A&E when they are experiencing the intense psychological pain of a mental health crisis.  Those people need specialist care from people who understand their difficulties.  You wouldn’t send someone with a broken leg to the dentist.  You wouldn’t send someone giving birth to an optician. The current system is senseless and broken.  It causes great harm to patients and enormous frustration to the paramedics stuck helpless with patients they don’t understand and can’t help.  

If none of those reasons are enough to convince you to provide proper resources for mental health, then consider the insane expense to the NHS.  Currently we are sending ambulances over and over again to the same people, so we can take them into A and E, where they become frightened or disillusioned and leave, or are offered an endless waiting list for therapy.  The patients go home to continue experiencing the same problems.  They feel unsafe and call again the next day, the next week, month and year at huge public expense.  People who reach out for help and don’t get it are going to look for help elsewhere: perhaps the permanent quiet of suicide, perhaps drugs, alcohol, smoking, food, violent abuse of their loved ones, the list is endless.  The cost to society is endless.  The cost to our humanity is endless.  

We must start taking mental health seriously and treating everyone as we would wish to be treated.  Because the reality is: it could be any of us struggling next time, left running in a hamster wheel of panic and sirens.  It could be any of us.  

Without compassion, society cannot function.