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I hate finding a car mechanic. I know next to nothing about cars. I often feel like the people I speak to think I know more than I do. So I do my research, try to sound like I do know a bit and do a lot of nodding.
If I let on how little I know, I realise just how vulnerable I am. They could be useless at fixing cars, tell me anything about what my car needs, with any price, and if they’re persuasive enough, or seem honest enough, there’s a good chance I’ll go along.
Many of us can feel the same when we are looking for a counsellor. Most of us don’t have much clue about counselling. So how do we know they won’t rip us off? Or that they know what they’re doing? Or that it will help? Or that we won’t end up spending thousands over years and get nowhere? In short, how do we know we can trust a counsellor?
To make matters more confusing, we might hear stories where therapists have exploited or abused clients (e.g. Mental health: Unqualified therapists exploiting vulnerable patients )
Now, there’s a process I go through with finding a mechanic. I might check reviews, check their prices compared with competitors, check any registered status, and, if I can, talk to someone who has used them. I then might try them for some things I know fixing and see how they relate to me: do they try to push for more, do they get the job done quickly and efficiently, do they seem professional? If so, I might keep using them. If not, I might try elsewhere.
Now, there is no 100% guarantee that the garage I choose won’t exploit me or hurl abuse at me. At the end of the day, there is still trust. But it makes it more likely that the garage I end up using regularly is trustworthy.
So, is there a similar process with finding a counsellor?
I suggest a three-step process, taking into consideration the problems with trust in counselling, and the research about what makes for effective counselling.
Step #1: Registration
Anyone can start up a car repair business. They do not need any level of experience or qualification. It’s the same with therapy; anyone can call themselves a therapist or counsellor with no experience or training. It’s an ‘unregulated’ industry in the UK. This means that, even if someone says they are a therapist or psychotherapist or counsellor, they might have no training or experience.
However, there are accrediting bodies which counsellors can voluntarily register with. In order to register, you need a certain level of training and experience. For example, for the BACP, to become registered you need to have had at least 1 year full-time or equivalent training, 100 hours of clinical work and 50 hours of personal therapy. The training and supervised experience should mean that a counsellor knows how to work in ways that aren’t harmful to clients and that are beneficial. Registration also commits counsellors to an ethical framework (e.g. BACP Ethical Framework for the Counselling Professions), which includes things like: receiving supervision for their work; confidentiality; competency; and a commitment to not causing harm. Of course, a trained, registered counsellor could work in an unethical way still. However, they would then be held accountable to a complaints procedure where an investigation would - if they found to bee behaving unethically - lead to them being deregistered. This gives a level of accountability and security you don’t get from unregistered counsellors.
So, step 1 has to be to check out whether a potential counsellor is registered with a governing body. Here’s a list of Professional bodies. Many of them will also have ways to search for registered counsellors on the website.
Step #2: Narrow down the options
If you start to look for counsellors, you will soon discover there is a huge variety, e.g. in price, in apparent experience, in level of qualification, and in what we call modality. Modality means whether you are person-centred, psychodynamic, CBT, integrative, pluralist, Jungian, compassion-focussed etc. etc. (here’s a whole list if you’re interested: Types of counselling and psychotherapy )They are all ways of doing therapy with different emphases, techniques or language. Unfortunately, it’s like car mechanics having different tools, methods, even different diagnoses of what the issue is; this can quickly get very confusing.
At this point, I think it is helpful to look at the evidence of what has actually been shown to be helpful in counselling for clients? The evidence indicates that the counsellor’s age, experience, professional status, modality all do not have an impact on counselling, rather it is factors about the client, the person of the counsellor and the relationship that determine outcomes (e.g. https://www.whatworksintherapy.com/ ) Now, these can be impacted by the counsellors’ experience or training, which is why registration with governing bodies requires a certain level of this, but it will in the end be idiosyncratic to you, them, and that relationship at that time.
Annoyingly for those of us who like to have it all settled by doing our research first, this means that if we’re going to find a counsellor who will help us, we need to jump in and test out them as a person and the relationship we seem to have when we meet.
So, step 2 for me is to narrow down all the options to a few counsellors you think you could get on with. Perhaps you narrow down initially according to method (online, phone or face-to-face), location and price. Then, consider what you might find helpful in developing a trusting relationship with someone: do you want a certain gender, ethnicity, specialism, religion? Then go onto their websites, check out how they write, how they present themselves, what they seem passionate about, and then choose about three you think you would like to actually try out.
Step #3: Try them out
I don’t get too embarrassed that my car needs fixing. I do a little, feeling I should know more than I do, But, when a mechanic inspects my car, they aren’t going to find any bodies. It’s not the same with counselling. The whole process of counselling is built on the idea of talking about where we’re struggling, weaknesses if you like, vulnerabilities, perhaps things we’re ashamed of or feel compromised by. How do we know the counsellor won’t use this against us? How do we know the counsellor won’t tell others? What power do we have if we find out they do?
In short, counselling requires trust. More, counselling will only be effective if we can trust our counsellor. Now, registration with a governing body often commits counsellors to be trustworthy, and hopefully the training and personal therapy they will have needed to have will have helped them work through all those things that can stop us humans being trustworthy. But, we will only find out if we trust our counsellor by actually going to them. Testing the relationship. Like I will only find out how a garage relates to me, how well they fix my car, if they seem to want to exploit me, how comfortable I feel around them by going and trying them out.
So, I’d finally suggest trying an initial session with the three you’ve narrowed your options down to (some will give this for free, some won’t). Do they seem professional? Do they seem like someone I can trust? Do they seem like they respect me, get me, want to help me? Can they take it if I ask trickier questions about about their training, experience, accountability, complaints procedure? Do they need me to sign up to so many weeks’ work or are they happy seeing how the relationship and work develops? Can we agree collaboratively on the goals of our counselling and how to work best towards them (known as the working alliance).
Once you’ve done all this, you are in the best position to choose which counsellor to go with (at least, provisionally). Basically, trust your instincts here and go with the one you find that you trust the most. If you don’t trust any, you can always go back to step 2 (but be aware that part of this may be you just wanting to avoid counselling!).
And remember, you can always choose to stop after a few sessions and try someone else. I guess this is the end point: as much as it is sensible for me to try out a garage, as I will only then find out how much I can trust them, you’re allowed to try out counsellors. There is no other way in the end to guarantee that you can trust them: there is no other way to guarantee that they are trustworthy, and there is no other way to guarantee that you experience them as trustworthy.
Unfortunately, counsellors and car mechanics - and, indeed, every relationship we are in - have this in common. Yes we can do our homework and take sensible steps to reduce the risk, but in the end, we only find out if we an trust them by trying it.