Sanjidah This guide is for people in the UK wanting to find a counsellor or psychotherapist and not knowing where to start. I will explore the following: what is a counsellor/psychotherapist, where do you look for one, and what should you bear in mind.
The first thing you might be asking yourself is: what is the difference between a counsellor and a psychotherapist? To be perfectly honest, there is very little difference. I’ll explore some possible differences, but all in all, it appears to depend on what the practitioner prefers to call themselves.
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. However, with counselling, you may have a more imminent goal you would like to achieve, or an issue you would like to overcome (e.g. a divorce, or to stop overthinking), whereas psychotherapy tends to explore a bit deeper than one sole issue, although it can also be goal-oriented.
The main difference I’ve found is 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 or CPD in psychotherapy (e.g. 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 a trained or accredited counsellor/psychotherapist. There are two main organisations within the UK: the BACP (British Association for Counselling and Psychotherapy) and the UKCP (United Kingdom Council for Psychotherapy). The reason why I stress training 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-trained counsellors/psychotherapists have.
You can use the Counselling Directory, BACP register or the UKCP therapist directory to find a counsellor/psychotherapist.
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 a counselling hour is 50 mins). Some of these counsellors may have concessionary rates at around £30-£35, or even free. I find 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 evaluate whether they are able to help you. Initial assessments are often less than 50 mins, either over the phone or face-to-face. However, some professionals may charge for the initial assessment. Whether you have an initial assessment that is paid or not, it is worth bearing in mind that you may go through a few before you find someone you can work with. This is unlikely, but possible.
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.
Cognitive-behavioural – this approach 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, thus making me depressed. The aim of CBT is to modify one’s cognition to help manage their thoughts, which should theoretically help their emotions and behaviour.
| Pros | Cons |
|---|---|
| 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. 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, and may not necessarily mean the same thing for the practitioner you work with. 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. Humanistic practitioners may focus more on your phenomenological experience of an issue and how you experience the world.
| Pros | Cons |
|---|---|
| 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 | Generally longer-term (more than 12+ sessions), can be pricey |
| Empowers the client to become independent and free-thinking | Non-directional nature can be overwhelming for some clients |
| Can be offered short-term |
Psychodynamic, psychoanalytic and psychoanalysis – 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 were initially proposed by Freud. Psychodynamic psychotherapists believe we repeat behaviours from the past. 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. Psychodynamic psychotherapists will work with the client’s unconscious to help understand the client, and maybe to draw connections between the past and the present. The therapeutic relationship is important to help bring about change. Psychoanalytic psychotherapists and psychoanalysts may have a more specific framework they follow, e.g. Freud, Jung, Klein, etc., and are potentially more costly than psychodynamic psychotherapists. Psychoanalysis is often on a twice-weekly or more basis.
| Pros | Cons |
|---|---|
| Gets into the nitty gritty, therefore maybe less likely to relapse | May take time to feel the effects of therapy |
| Can be offered in fewer sessions for people wishing to focus on one problem | Tends to be longer-term and therefore pricier |
| Client can feel free to explore past traumas in therapy, unlike with CBT which tries to focus on the present | Some practitioners may be more interpretative, which might not be suitable for all clients |
| Extensively supported by research and case studies |
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?’ It might be that some clients will not benefit from a CBT/person-centred approach, but are a perfect candidate for psychodynamic psychotherapy which is best carried out by a specialist, rather than an integrative therapist, and vice versa.
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!
Last updated: 4 April 2022
