Interlude #3: finding a counsellor (UK-focussed)

[kaberett]

Previous interludes are under access-lock. As stated elsewhere, in general I grant access very readily, am happy to receive requests regarding same, and use lock so I know to first order who is reading. That's why the numbering looks out-of-order. Additional disclaimer: I have drugged myself to hell and back again and it's all kicking in over the course of writing this post, so like, if it stops making sense halfway through then (1) I apologise and (2) I'll be back in the morning to fix things.

<edit>now more sober, I realise that it would be helpful to state explicitly that I am here talking about finding a private counsellor, which obviously involves a significant amount of financial privilege, even with low-income places. I discuss my reasons for using private counselling in comments.</edit>

There's a number of places I look when I'm trying to find a counsellor. They include:

• PinkTherapy, which is good if you're in London but honestly kind of staggeringly useless everywhere else I've ever looked
  
• The British Association of Counsellors & Psychotherapists' Find-a-Therapist portal
  
• The Association of Cognitive Analytic Therapists' Find-a-Therapist portal

This shortlist arises at least in part because I know what I am looking for. I know that I do my best brain-work when I'm teasing out why I think/feel/believe/do A Thing: the way I approach the world, I find it much easier to address a problem when I know why it is happening. That's why ACAT's on the list above: Cognitive Analytic Therapy is the framework most of my counselling's been in; it combines aspects of Cognitive Behavioural Therapy (e.g. techniques to challenge intrusive thoughts) with a narrative approach (i.e. working out why). (The ways in which CAT works really well for me are... abundantly clear, I think, from my habit of exploring my emotional state and wellbeing and relationship to the world via contextualisation/resonance of song lyrics and poetry.)

BACP is on the list because they've accredited every counsellor I've ever worked with and, for that matter, every counsellor I've ever considered working with. They're more-or-less a gold standard.

And PinkTherapy is included because I'm poly, trans and queer, and I really don't want to have to explain that from scratch to someone I'm paying private rates.


So my process for finding a counsellor goes a bit like this:

1. Work out what style of counselling I probably want (in addition to CAT, I'm currently doing a lot of self-led Mindfulness-Based Cognitive Therapy, and I'm getting on really well with it).
   
2. Find directories of counsellors relevant to my broad geographic region (country-level).
   
3. Filter to local (or willing-to-Skype).
   
4. Filter to types of counselling I'm interested in.
   
5. Run through the list and see if the individual profiles suggest that the person in question has sufficient relevant experience that I won't want to scream before we're ten minutes in to a first session (for me, that means "has heard of queers" and "has worked with trauma"; "knows what an autism is" is a bonus; "will do Skype counselling and is flexible about session regularity" is SUPER-AWESOME but I don't expect to find it).
   
6. No luck? Remove one of the constraints (starting with style-of-counselling - though I note that I have some pretty hard limits about the level of fluff I am willing to tolerate; I fundamentally want counsellors I can trust to tell me I'm talking bullshit, if necessary, in those words).
   
7. Sit with the shortlist for a few days and see who sticks (much like my approach to purchasing Lioness jewelry, entertainingly enough).
   
8. Start sending out e-mails (ideally one at a time) to enquire as to (i) space on their list? (ii) willingness to set up a first session?

And then, of course, there's the issue of the actual first session. How I tend to approach those - and the suggestions I'd make to someone going into a first session, especially if they've not had counselling before - comes in the next Interlude.

Comments

[quirkytizzy]

Wait - you can CHOOSE counselors that will do all this??? I've always had to rely on the state and government funded mental health systems (and here in the US, that usually means interns in the field).

Being able to actually choose people who can work with all the things you mentioned would be AWESOME!

Also, while I understand what Mindfulness therapy is (LOVE CBT and DBT), how do you work it "self-led"?

[kaberett]

The NHS will only (without an enormous fight) give me short-course CBT; my university counselling service will only do me short-course stuff as well, and I need... to do a bit more work than that, really.

So I have a low-income place with a private counsellor who's a genderqueer feminist, at the moment, and it's pretty fucking awesome. (Up until last summer I was seeing someone at my old university counselling service on an as-and-when basis, semi off-the-books, and... this is better.)

[kaberett]

As for self-led MBCT, there's a lot of books available that come with recordings for guided meditations as eight-week courses, and I'm intermittently working with one of those properly and more regularly applying some of the techniques I picked up along the way (body scans, breathing/movement/loving-kindness meditations). Also SuperBetter.com is MASSIVELY based on CBT/MBCT, and I use that on the regular.

[quirkytizzy]

I am reading that site now - omg, thank you for the link!

[shanaqui]

Cognitive Analytic Therapy is the framework most of my counselling's been in; it combines aspects of Cognitive Behavioural Therapy (e.g. techniques to challenge intrusive thoughts) with a narrative approach (i.e. working out why).

That... sounds interesting and like what I tend to do. Thank you.

[kaberett]

Glad it is helpful. ♥

[sfred]

*notes for future reference*

[such_heights]

This is super fab. <3 I'm trying to find a counsellor at the moment and your posts are invaluable.

The one thing I'm a bit stuck on at the moment is how to figure out the style of counselling that might suit me. There are just so many, it's a bit overwhelming! I don't know if you have any suggestions of good resources out there to help narrow it down?

[kaberett]

My first port of call would be the BACP's Types of Therapy page, though that's a bit big & overwhelming. They're short summaries (a paragraph or two each), though, which will hopefully help you narrow things down... I'd start out by looking at:

Behavioural therapy
Cognitive Analytic Therapy
Cognitive Behavioural Therapy
Cognitive Therapy
Dialectical Behavioural Therapy
EMDR (for that, you might also want to check out untonuggan's personal account of EMDR)
Mindfulness (though personally I seem to prefer doing this self-led & can rec resources)
REBT isn't something I'd come across as a distinct thing before, and now want to read up on!

Which still leaves you with "but how do I decide?", so of the ones I pulled out here I'm going to group them into families:

Behavioural therapy: CBT, CAT, DBT, Mindfulness (in many incarnations), REBT
Cognitive therapy: CAT
EMDR

I don't know much about EMDR - as I say, I'm most familiar with it via Liz - but as for the others, it's worth bearing in mind that an individual counsellor is usually familiar with a whole pile of different approaches, and if they're familiar with DBT they'll also know CBT, e.g.

In deciding between behavioural-based and cognitive-based therapy, I think the key question is: do you want to unpick why you do things, or do you just want to replace harmful behaviours/thought patterns with better ones, without exploring how they arose in the first place? If you don't want to do that exploration - which is 100% valid! - then you probably want a "purer" behavioural-based therapy. If you do want the exploration, then you probably want something more cognitive/analytical/narrative.

LMK if more words might be helpful. <3