Your Therapist and You

Following an article in the Irish national press recently that highlighted the lack of Government regulation in Ireland around counselling and psychology, I believe it would be helpful to talk about engaging in therapy in a way that is best for the client – YOU.  Sometimes the biggest barrier to recovering from a dysfunctional relationship with food and breaking that negative cycle, is being unable, for whatever reason, to reach out and ask for help.  I hope this blog will help.

Qualifications

1. Although in Ireland there are no Government guidelines or legislation in place currently on the qualification of Counsellors, Psychotherapists or Psychologists, there are several Accrediting bodies within these professions, including but not limited to, for Counsellors & Psychotherapists: IACP , IAHIP, ICP, NCII, IAAAC, and Psychologists: PSI. (Acronyms explained below).  Do you know who the various licensing or accrediting bodies are in  your state or country?

2. Each accrediting body has its own guidelines and criteria for accreditation, so although a Counsellor may be accredited by one body, that doesn’t necessarily mean they would be accepted by another.  Other Therapists are accredited by two or three bodies and this doesn’t mean they are more qualified than anyone else, just that they’ve gone to the trouble of registering with several bodies. However, it may indicate that they have a strong, recognised qualification and that can be reassuring.

3.  Even if a Therapist is accredited by a body, it doesn’t mean they have the necessary specialist knowledge or qualification to work in a specific area of care.  So for example, my accrediting body of choice is the IACP, but they would not list me as a Specialist in Eating Disorders unless I have completed specialist training in that area.

4. Finally, any Therapist can complete training and get qualifications in counselling/psychotherapy, but it is their ability to understand their clients, empathise with their situation and offer the right sort of support for each client that matters.  Qualifications vs skill as a therapist are not necessarily the same thing.

Do you know whether the Counselling, Psychotherapy and Psychology areas of work are legislated for by Government in your country?  If not, how do you go about choosing a Therapist?  In over three years of working with clients both individually and in a group, I have only been asked twice for my credentials, which is surprising.  Although they are listed on our website not all clients come to us via finding our website.  So I can only assume that clients assume I know what I’m doing, simply because I say I am a Therapist and I specialise in Eating Disorders.  I would suggest anyone thinking of attending a Therapist for the first time, to check their credentials.

I picked up a copy of the Wall Street Journal in the US recently (18 October to be exact) and in the Personal Journal section there was an article on how to choose a therapist.  There was a short list of questions to ask, which I fully support:

– What are your credentials and are you licensed/accredited?  By Who?

– Based on my symptoms/issue, what kind of treatment do you suggest?

– Have you experience of dealing with this problem? What has been the outcome for your clients in the past?

– How long do you expect treatment to take?

Choosing a Therapist

First, you might want to look for a referral to someone rather than choosing yourself.  So ask your GP/Physician, contact one of the accrediting/licensing organisations, or go online and ask for recommendations from others in your area.  Don’t be afraid to ask – if someone emailed me asking for a recommendation, I would do my best to find someone for them.

In our Centre, we have a policy of offering a free, no obligation consultation to all new clients.  This gives each new client the opportunity to meet a Therapist, have a chat, ask questions and decide if they feel comfortable working with that person.  If you are asking someone to engage in therapy for anything from 6 weeks to a year or more, then it seems reasonable to allow them to “try before they buy”.  However this is not common practice with Therapists, but I would urge you to ask if it is available.

Equally, once you start therapy, you might feel more comfortable if you set a couple of goals with the Therapist, or you might not want any goals, or ‘homework’.  These are questions to raise in your initial consultation, such as:

“What type of theoretical model do you use?” or “What is your style of working with clients?”

“I would like to try and set some goals initially and work on those together” or “I don’t want to feel under pressure to meet goals, how will that work if I come to you?”

Dr. Stone a Psychologist at Stanford and featured in the Wall Street Journal article, gave a very good summary of what therapy is essentially all about:

Effective therapy can be difficult at times – particularly when the [client] is exploring painful thoughts or fears.  A good therapist should give you comfort and discomfort at the same time.  They should make you feel understood but challenged”.

Your Therapist is not your friend, but they are certainly not your enemy.  If, overall, you are not feeling any better after several sessions or you come out of each session feeling frustrated or annoyed with your Therapist, and not just because they have held up a mirror to something that you are trying to avoid looking at, then you might want to consider shopping around for someone else.  Therapy can only work when there is a relationship of mutual trust and respect in place.  And when this is in place, you should be able to tell your Therapist when you are feeling uncomfortable with what they are doing, and why.  A good Therapist will take this constructive feedback on board and respond appropriately to it.

Lastly, and the most important aspect of therapy that I try to tell all my clients, is that it is not the Therapist’s job to change you.  It is our job to bring into awareness the choices you are making and the unhelpful behaviours you are engaging in.  This gives you the opportunity to make different, better choices which you explore within therapy.  The Therapist’s work is done when the client understands the choices they are making, and realise that it is they who have to live with the consequences.  This is the crux of change.  Whether the client chooses to change or not is entirely up to them.

Questions:

Have you had a bad experience with a Therapist? Did it stop you from trying to find someone else to work with?  What is stopping you from looking for a Therapist to help you?  Has this article helped?  Your feedback is welcome!

Irish Accrediting Bodies:

IACP – Irish Association of Counselling and Psychotherapy

IAHIP – Irish Association of Humanistic and Intergrative Psychotherapy

NCII – National Counselling Institute of Ireland

ICP – Irish Council for Psychotherapy

IAAAC – Irish Association of Alcohol and Addiction Counsellors

PSI – Psychological Society of Ireland – Psychologists only