If you’re seeking a therapist it’s likely you’re already feeling overwhelmed and vulnerable, so finding the right person is no mean feat. Here are some pointers to help you find a good therapist.

Where to find a therapist

There are various routes to finding a therapist – Google, word of mouth, your insurer or directory sites.

If you have health insurance your insurance company may give you a list of local therapists. This is a great place to start, but it’s worth knowing that if you are doing online therapy you aren’t restricted to local therapists – you just need to make sure they are registered with your insurers.

Online therapy directories are another good option. Examples include Psychology Today, the BPS, Find My Psychologist and Counselling Directory.

How do you know if a therapist is any good?

Once you start looking you’ll probably come across a few people whose profiles/websites resonate with you. But how can you tell if they’re any good? It’s really important to be confident that your therapist has the appropriate skills and experience to offer a good, safe service.  Unfortunately, therapy done badly can cause significant harm.

Here are 3 things that are important to check out, and 4 red flags to be aware of:

3 things to check when choosing a therapist

1. Are they registered with an accredited body?

This is the most important thing to check.  It may surprise you to learn that the therapy field is fairly poorly regulated.  In the UK anyone can call themselves a therapist, psychotherapist, psychologist or counsellor.  However certain titles are protected, meaning that you have to be registered with a professional body to use them.

Being registered with an accredited body means that your therapist:

• meets agreed standards for training and qualification,
• is required to abide by a code of ethics and conduct,
• has to keep their training and professional development up to date,
• is subject to a complaints procedure

If a therapist is not registered with an accredited body you have no way of checking whether they are appropriately trained, or whether they have had complaints made against them. It is possible, and legal, to offer therapy and counselling services even if you have been struck off the register, just as long as you don’t use one of the protected titles. This is crazy, but true.

The HCPC regulates Practitioner Psychologists and Arts Therapists.  This means that you can only use these titles if you are registered with the HCPC, and it is against the law to do so if you are not registered.  The protected titles are: practitioner psychologist, registered psychologist, clinical psychologist, forensic psychologist, counselling psychologist, health psychologist, educational psychologist, occupational psychologist, sports and exercise psychologist, art psychotherapist, art therapist, drama therapist, music therapist.

If your therapist uses one of these titles you can check that they are in fact registered here. If they use a different title be sure to ask them if they are registered with a professional body, and check this out.

Other professional bodies – apart from the HCPC there are a number of other registers for therapists and counsellors.  The easiest way to navigate this is to go through the Professional Standards Authority. You can check a wide range of health practitioners through their site here.  If a therapist says they are registered with a professional body that is not listed on the PSA website, this should be a major red flag.

There are 3 other requirements that are essential to therapists working in private practice – indemnity insurance, a current criminal records check (DBS) and registration with the ICO (Information Commissioner’s Office). Therapists should be easily able to supply you with this information, so do be wary if they don’t when asked or if they seem defensive about this.

2. Are they appropriately qualified?

There are a myriad of therapy qualifications out there, ranging from brief online courses, to doctorate level studies.  As I write this you can buy a CBT course on Udemy that claims to qualify you to be a “certified CBT practitioner” in under 5 hours and for the princely sum of £15.99.

On the other hand it takes most people around 10 years to qualify as a Clinical Psychologist.  Although I also have hundreds of hours of post-qualification training under my belt, there are lots of things I can’t claim to be an expert in. For example, I have very little experience working with children, and don’t see myself as suitably qualified for that kind of work.

Don’t be afraid to ask your therapist about their qualifications to sound them out. Registration with an accredited body is a good sign that their professional qualifications are legitimate, but you may still want to check that they are suitably trained for the service you want.  You don’t need to be an expert on their qualifications to make a judgement call on this – just use your common sense.

If the primary difficulty that brings you to therapy is something other than anxiety or depression do check whether your therapist has experience in this field. For example, if you are struggling with trauma, addiction, psychosis, an eating disorder or psychosexual difficulties it’s worth finding someone with specialist knowledge.

3. Do you have a good rapport with them?

The rapport between therapist and client is one of the most important factors in the success of therapy. In fact, this has more of an impact than the model of therapy or the techniques used.  It may take a session or two for you to be able to make a judgement call on this, but that is an important part of the process. Don’t be afraid to seek an alternative therapist if you don’t feel a good alliance is developing.

Some questions to help you decide this are:

• Are they supportive?
• Do you have a shared understanding of how to work together?
• Do you feel you are working together in partnership?
• Do you have confidence in them and their approach?

4 red flags to look out for when choosing a therapist

Here are some things to look out for when exploring therapy options.  If you come across any of these, be wary.

1. Claims of a cure

Therapy can be transformational but it doesn’t work for everybody, all of the time.  It’s not a miracle cure. Research shows that even the most effective therapists are able to make a significant difference for only 75% of their clients.  We also know that factors outside of the therapy space have a far greater impact on therapy outcome than the therapy or therapist – things such as the client’s support system, resources and readiness for change. Anybody claiming that their approach will help everybody be totally rid of their problems is not being honest.

Pain, sadness and anxiety are unfortunately part of the human condition. They can even be helpful messengers. It’s not possible (or even desirable) to live a life without pain – so be wary of anyone claiming to offer this.

2. Pressure sales

It is not ethical for clients to feel pressurised to engage in therapy, or to be locked in to expensive commitments.  If you are feeling pressured, walk away.  You should feel that the therapist holds your best interests at heart.

All therapists will have terms and conditions related to their business, such as whether they ask for payment before or after a session, their cancellation terms etc.  Just as in any other professional relationship it’s important to be aware of these up front, and to respect the agreement between you. This is distinct, however, from feeling under pressure to pay for a large number of sessions in one go, or being made to feel there might be negative consequences if you don’t go ahead with therapy.

3. Giving advice beyond their competency

Therapists are ethically bound to only offer services that are within their professional competency.  For example, unless they are appropriately qualified, therapists shouldn’t be giving you advice about medication, nutrition, finances etc. They may help to signpost you to other helpful resources, but shouldn’t be offering expertise they don’t have.

This also applies to interventions within the mental health field, for example competencies to offer specialist therapies, or to work with particular clients (e.g. children).  Therapists should be open about the limits of their skills and knowledge and refer on to others if they don’t have the expertise you need.

4. Boundary violations

A therapeutic relationship needs to be held within safe boundaries. People seeking therapy are often in a vulnerable position, and if the therapist doesn’t maintain appropriate boundaries this can leave clients open to getting hurt.

Some boundaries can vary a little bit depending on the type of therapy. For example, there is some variation in therapists’ views on whether self-disclosure (i.e. sharing personal information) is helpful in therapy. Therapists may also have a variety of styles when it comes to contact with clients outside of the therapy session – some may be happy to receive phone calls, or reply to emails, while others will ask for all issues to be brought to sessions.  Therapists should be very open to talking with you about these issues if you are unsure or uncomfortable.

A therapist/client relationship should always be a professional one, and any attempt by the therapist to foster a relationship in any other context is inappropriate.  If you feel uncomfortable about any of your therapist’s behaviour and don’t feel able to discuss it with them (or you aren’t reassured by their response) check in with friends or family to gauge what they think.  If you feel the boundaries aren’t safe or appropriate walk away.

If you are considering therapy I hope these pointers will be useful in helping you navigate this sometimes difficult process, and feel confident in the therapist you choose.

The post How to find a good therapist appeared first on Dr Paula Redmond, Clinical Psychologist.

Talking about mental health isn’t easy though. This seems to be especially true for doctors.

The Medscape UK Doctors’ Burnout & Lifestyle Survey 2020 found that 77% of doctors experiencing burnout and/or depression were not planning to seek professional help. Given the rising numbers of those struggling with mental health issues that equates to a lot of doctors suffering in silence.

The two major reasons for doctors not seeking help were believing they could deal with these difficulties without professional help, and that their symptoms weren’t severe enough. A third of respondents also stated they were too busy to seek help.  However, a significant proportion (nearly 20%) said they weren’t going to seek help because they were concerned about others finding out.

The survey also asked about thoughts of suicide.  The results are devastating: 1 in 5 doctors said they had experienced thoughts of suicide. More than half of these (54%) said they had not told anyone.

The most common reason for not seeking professional support for suicidal thoughts was believing they didn’t need it.  The other common reasons related to stigma, how they might be perceived by colleagues, and the potential impact on their careers.

It is appalling to think of so many doctors (and other health professionals I am sure) suffering on their own and in silence.

If you are struggling right now, and worried about seeking help, please read on as I try to address some of these barriers and concerns.

“I can deal with it on my own”

Maybe, but you don’t need to.

The research shows that about half of those with untreated depression will show some improvement after 12 months.  A year is a long time to wait though, in the hope of some improvement.  There are lots of ways to deal with depression and burnout (e.g. exercise, social support, meaningful activity) but professional support will give you the best chance of recovery.

As health professionals we tend to be pretty bad at recognising our own needs. Please at least seek a second opinion before ruling professional help out completely.

If you are experiencing suicidal thoughts, please, please tell someone.  The stakes are too high for you to be on your own with this.

“My problems aren’t bad enough”

Maybe, but this is just the time to seek help.

We know that prevention is better than cure.  It is much easier to recover from milder symptoms and prevent things from getting worse, than to disentangle yourself from entrenched difficulties. Studies have found that the sooner people seek help, the better the outcomes are likely to be.

Would you ever tell a patient who is suffering that they should wait until things get worse, even when you know there are many effective treatments available that would help right now? I doubt it. Don’t deny yourself help and support that could make a big difference now, and prevent things from getting worse.

“I’m too busy”

Exactly.

At the moment, in the midst of a global pandemic, “busy” probably doesn’t come close to describing the lives of doctors right now. But setting aside your own needs to fulfill your job (or other) demands is only ever going to be effective in the short-term.

You may be feeling so overwhelmed that you can’t find the time or the headspace to reach out for support.  If this is you, please know that there are many different forms of support available out there.  Getting help doesn’t need to mean intensive twice-weekly therapy sessions.  There are a variety of options available to you including text services and free short-term coaching options.  Take the time just to send a text or make a call today – that one small step might make all the difference.

“I’m worried about others finding out”

Know you are not alone.

Next time you are at work look around you – the stats suggest that in a room of 10 colleagues 5 are likely to be experiencing clinically significant levels of psychological distress and 2 are likely to have had suicidal thoughts. Unfortunately, mental health stigma is a reality, particularly within the health professions.  That needs addressing, but more importantly, right now, you need support.

You may be reluctant to access the support available to you through your workplace – you’d be in good company there too. The Medscape survey found that only 30% of doctors were likely to use workplace wellbeing services. There has been great work done over the last year to improve the workplace support on offer to staff, so do check it out. But if concern about your colleagues finding out prevents you from getting support please look elsewhere. There are lots of alternatives (see below).

How to access support

If you are experiencing suicidal thoughts please seek help straight away. You can call 111, the Samaritans (116 123) or text FRONTLINE to 85258.

1. Your workplace

Your workplace will have a variety of support options in place.  One of the positive things to come out of the pandemic is more investment in supporting staff wellbeing. Check out the options available to you, or give Occupational Health a call.  If this worries you, please don’t stop there, as there are many other sources of support.

2. Other sources of free mental health support

I have put together a resource list of free mental health support services specifically for health professionals. The services range from supportive text counselling to individual psychotherapy. Please consider one of these options.

3. Independent psychologists and therapists

If you would prefer to work with an independent psychologist, counsellor or therapist Psychology Today is a good place to start. If you would like to work with me I offer a free initial consultation to discuss whether I’d be a good fit for what you need.

Whatever option you choose please do reach out and talk to someone.

The post It’s Time to Talk – Why doctors are suffering in silence, and why they don’t have to appeared first on Dr Paula Redmond, Clinical Psychologist.