With myriad combinations of types, locations, frequencies and costs for counselling, how do you even begin trying to find a counsellor or therapist? This section helps to answer that question, while the page “Selecting a Counsellor or Therapist” helps in the job of evaluating individual counsellors.
Getting the Right Kind of Help
For anyone in very great distress, and for anyone who believes their distress may have an organic, or physiological, cause, the single most important recommendation is to consult a doctor first.
The degree of medical or psychiatric knowledge which counsellors or psychotherapists can bring to bear on their work varies greatly between individuals and between countries, and in the UK, for instance, most counsellors have either very limited medical or psychiatric knowledge or none at all. So while a competent counsellor will urge you to consult a doctor if he or she suspects your distress may have an organic cause, it is entirely possible that even with the best intentions, he or she won’t recognize the symptoms. If you have any doubts at all, it is best to be safe, and it’s worth repeating: consult a doctor first.
For non-urgent single questions, as distinct from an ongoing therapeutic relationship, you might also consider one of the available question answering services, such as our own Ask the Psychologist.
Medical Referrals to Therapists
Consulting a doctor is also the first step used by many people to find a counsellor. Many medical centres have services affiliated with them which offer various kinds of counselling or psychotherapy, and some which do not can nonetheless offer pointers to local or national charities or to private practitioners who may be suitable.
Beware, however, that there will often be little or no choice as to the theoretical orientation of counselling which can be accessed through medical referrals, and in the UK at least, there may be long waiting lists. In the UK, NHS-affiliated services are also normally time-limited, with 6 or 8 sessions being fairly common. It is also likely that there will be less choice as to the individual characteristics of counsellors (e.g., male vs. female, ethnic group, etc.), and if a client decides against working with a particular counsellor, this may mean returning to the bottom of the waiting list.
Private Individual Counselling or Therapy
For a large and increasing number of people, counselling from private practitioners has become their preferred way forward. Opting for paid services expands the range of options available to clients in terms of theoretical orientation, frequency and scheduling of visits, and overall duration of therapy. At the same time, however, it is even more important to become an informed consumer when one is spending hard-earned cash!
Regulation of the profession varies greatly between and within countries, and in the UK, for instance, there is no statutory regulation of counsellors at all: quite literally, anyone can set up shop, call themselves ‘counsellor’ or ‘psychotherapist’, and start seeing clients. That doesn’t mean, however, that there aren’t many very well-trained, highly ethical practitioners available. (Indeed, it also doesn’t mean that there aren’t some practitioners with very little training who nonetheless offer an effective and ethically sound service.) The challenge is in finding them.
Online Therapist Directories
One approach is to start with national or regional directories. For example, our sister site Psych Tap is now able to bring you a very extensive online directory of psychologists covering every US state, several territories and some Canadian provinces. Our independent UK therapy and counselling directory called Right Therapist is also available, as is our CBT therapist directory, restricted solely to CBT practitioners accredited by the BABCP or AREBT. Some of the professional organizations listed in the section on Web Resources, such as the British Association for Counselling and Psychotherapy, maintain lists of practitioners who have agreed to abide by published ethical guidelines. It is worth keeping in mind, however, that practitioners typically pay to have themselves listed in such directories, and the information provided in the directories is just whatever is reported by the practitioners themselves.
Charities and Other Free or Low-Cost Therapy Services
National charities, some of which are listed in the section on Web Resources, may provide all the help that some people need. These charities and others like them are very well established, and although they are unlikely to be able to provide long term support, they successfully help many thousands of people every year. For example, The Samaritans have played a very important role in the lives of thousands of people whose situations have reached such a point of desperation that they have contemplated suicide.
Other charities operating at the local level, as well as local support groups of various kinds, may also provide valuable services, either individually or commonly in groups. Finally, if you are a student, it is likely your university offers some type of counselling service at little or no cost.
In each case, as with services associated with medical centres, clients should be prepared for a smaller range of choices about what type of counselling they receive, and accessing the services may involve a wait.
Accreditation and Therapist Licensing: Caveat Emptor
It is also worth noting that there is significant debate over the merits of various professional accreditation schemes. While the BACP, for instance, urges clients to consult only those counsellors which they themselves have accredited under their scheme, accreditation is not by any means a guarantee of quality, competence or ability to meet the needs of any particular client. Indeed, there is also no research evidence to indicate that accreditation picks out effective therapists; intriguingly, some evidence even suggests that newly qualified counsellors are more effective than their more experienced colleagues. The section “Types of Counselling and Psychotherapy” includes a page on research comparing counselling effectiveness.
A separate page describes licensing in the US and elsewhere.
Finally, the section on Selecting a Counsellor offers some suggestions and questions to help narrow the field and choose one counsellor, once you have identified some possible candidates.
In This Section
- About Counselling and Psychotherapy
- Counselling, Psychotherapy & Mental Health Bibliography
- Mental Health News
- Online Therapy and Online Counselling
- Self-Help and Overviews
- Symptoms, Diagnostics, and Medications
- Types of Counselling and Psychotherapy
- Web Resources in Counselling, Psychotherapy and Mental Health
All clinical material on this site is peer reviewed by one or more clinical psychologists or other qualified mental health professionals. This specific article was originally published by Dr Greg Mulhauser, Managing Editor on .on and was last reviewed or updated by