Choosing a Therapist

It’s tough enough choosing someone to talk to about your deepest darkest on the basis of a grainy photo and a couple of paragraphs. What do all these psycho-labels mean? Which one is better? What the heck do all those letters stand for?

Why can’t this of all things be easy?

Why are they all wearing scarves?

Let me make it as simple as possible for you – because fortunately, it is reasonably simple  (adjusts scarf).

First, the types of professionals available:

Mental health practitioners in NZ typically fall into one of four broad categories: Psychiatrists, psychologists, psychotherapists and counsellors.

So … what’s the difference?

  • Psychiatrists have extensive medical training – basically they gain a medical degree, then go back and study mental health in more detail. In NZ, generally you’ll only see a psychiatrist for assessment, diagnosis and/or medication management.
  • For ongoing talk therapy, you’ll need to see a psychologist, a psychotherapist, or a counsellor.

Broadly, in NZ Psychologists, Psychotherapists and Counsellors differ in a few ways:

  • Psychologists typically provide short-term treatments that are focused on overcoming symptoms and changing behaviour (though this varies between practitioners). They’re trained to at least Masters level, and must be registered with the NZ Psychology board.
  • Psychotherapists usually work long-term, helping resolve deep issues – for example mental distress related to trauma or family dynamics. They’re trained to at least Masters level, must be registered with the NZ Psychotherapy board, and are also required to be in weekly therapy themselves while they study. This makes sure we’re mentally healthy, strong and balanced enough in ourselves to show others the way forward, which is a comforting thought!
  • Counsellors tend to work within a specific area – for example, addictions counselling or relationship counselling. They’re more likely to offer advice and take a more active role in the therapy (hence the name), though this is not always the case. They’re not required to be registered, and therefore may hold any qualification (from nothing official at all through to doctorate level).

Whatever their specific training, mental health practitioners typically have one or more specific frameworks they favour (mine is psychodynamic psychotherapy, for example).

Which brings us to the second confusing bit of choosing a therapist:

What kind of talk therapy is best?

There have been plenty of studies on different kinds of therapy and how effective they are. Screeds. Squillions. Fortunately, researcher Bruce E. Wampold has done a lot of work in examining and summarising what has been found to make a therapist effective. He states that:

“All therapies with structure, given by empathic and caring therapists, and which facilitate the patient’s engagement in behaviors that are salubrious, will have approximately equal effects.”

Translated from academia-ese, this basically means:

  1. Therapy outcomes are better when the therapist is caring and empathic (this should probably go without saying).
  2. Therapy outcomes are best when your therapist assists you to behave in healthy ways (presumably as opposed to unhealthy ways…)
  3. Therapy outcomes are best when there is a strong working alliance between you and your therapist.

This last bit is the really important bit: you’re looking for someone you feel you work well with.

Want someone who’s crazy smart and cerebral? Winner.

Someone who looks kind and wise? Fill your boots.

Sciency and structured?

Chatty and relatable?

Young enough to relate to you?

Old enough to have some life wisdom?

Search for what you feel you need, and you’ll find what’s most likely to work for you.

And if you think I might be a good fit for you, please do give me a call or email to discuss your needs.

Leah Royden