Bristol Positive

How do I choose a good therapist and what is the best therapy approach? - here are some tips.

Psychological change is most likely to happen if we can build an exceptional relationship with a therapist. Without this, lots of things simply will not happen. Trust and respect will not form, nor enjoyment or satisfaction from the process. Therapy can actually be fun, as well as painful at times. Although 'laughter' can be a 'defence' to feeling, my sessions are good humoured, when appropriate, and I spend time building the relationship with clients. Without a good relationship, motivation flags, deeper aspects of ourself are never reached, self belief decreases and interest is lost.

Life and time are precious, so it's sensible to find a therapist who is effective and good value. Below I list qualities for a successful therapeutic relationship. It would maybe take a few sessions to answer these questions in your own mind. If you are feeling unsure about a new therapist, do discuss what you feel with them. They may learn something. You may be challenged as being 'resistant' or as having what's called a negative transference (old feelings about someone you don't like being transferred to the therapist). In reality, this may be true. Negative transference is useful exploration in longer term dialogic, inter-subjective or analytic psychotherapy. However, if you do not have an over-riding sense of the genuineness or 'good-enough-ness' or likeability of your therapist, is this going to support and motivate you to change? 

It is amazing that growing research points to the fact that for good treatment outcome, it mostly does not really matter what therapeutic approach is used, yes you read that right! Any well practised, credible therapeutic approach appears as be as good, as any other, in terms of potential to bring a positive outcome. Research shows, it is the intrinsic quality of the therapist and the 'relationship' you have that really supports change. The NHS NICE guidelines list the best approaches for mental health disorders, evidence comes from funded mainstream research, so there is bias.

Six Qualities of Successful Therapy

1) Is the therapist self aware, smart? so there is a sense that they can collaborate with you 'at' or 'ahead' of your own level of awareness - a good counsellor or psychotherapist will have done a great deal of therapeutic work on themselves to look at areas where they are negatively limited and restricted in their own thinking, feeling and awareness. This helps them to open your awareness to better choices and to offer you a more genuine, connected relationship.
2) Can the therapist 'know you', experience you? - empathy is extraordinarily important in all good therapy - a feeling of really being listened to.
3) Can the therapist succesfully challenge your resistances and denial? We all have the capacity to hoodwink therapists. Perhaps we over-concentrate on others instead of 'owning' our own part in what feels wrong - especially if there is a some aspect of our thinking or behaviour that is a blindspot or we do not want to admit to. An experienced therapist would gently confront you where appropriate - but at the same time leave you feeling cared for with dignity and respect.
4) Is the therapist warm, real, on your wavelength, engaging or humorous? - I think at least the first 3 are important, for we tend to build relationships with people we like. Ideally all of these qualities need to be present. Warmth is a sign of love and I believe that 'the best therapy is a work of love'. So some warmth very important, yes!
5) Do you feel you can respect the therapist for what she/he demonstrates experientially, can observe or feel about you or underpin with a theoretical base? The first two are very important, ideally all three. As for theory, I really do believe that a good theoretical understanding helps make a great therapist.
6) Do you 'get a feeling' that this therapist has overcome some big life struggles courageously and succesfully? (a therapist may not always tell you this). If you sense or know this, the therapist can act as 'a model of excellence' (NLP). If a therapist has processed and overcome various (and maybe major) life issues of their own, they will better understand how to explore and support you in resolving yours.