How can I find a therapist?

November 14, 2007 8:28 PM

I've recently decided that I need a therapist/counsellor. How do I go about finding one? I'm in the UK.

I've recently had some quite severe depressive episodes, which have led me to seeing my GP. He didn't take me seriously, and prescribed me St Johns Wort. So, I can't go back to him and ask for a referral, and I'm not sure I'd want to be dealing with someone that he did refer me to. So, my questions are:

A] How do I go about finding a therapist? I'm quite prepared to pay privately, and I'd probably prefer it. Cost is not a problem, as long as they can help me fix myself.
B] I have great difficulty feeling emotions that I perceive to be negative (anger, ambition, hatred, resentment, etc), until they burst out of me, which obviously isn't good. What kind of therapy might be useful for me? I realise that you are not my therapist, etc. :)
C] I'm in Dudley, West Midlands. Any personal recommendations would be great.

My email is [e-mail]. My thanks go to anyone who helps.

posted by anonymous to health & fitness (7 comments total)

If you're willing to pay privately, the world is your oyster. Treat finding a therapist as seriously as you would finding a mate.

In my experience, the way I present myself makes all the difference. When I was young, and just knew that I wasn't as happy as I could be, didn't know what I wanted out of therapy and didn't realize that good therapists don't come cheap, I wasted a lot of time on crap therapists who shouldn't even have been practicing.

Don't go to the first therapist on your list and ask them to fix you. Come up with a list of three things you'd like to work on, and find a therapist who can work on those three things with you.
posted by freshwater_pr0n at 10:05 PM on November 14, 2007

Counselling on the NHS is actually in much better nick than for many years. I would suggest trying your GP again.
It is highly likely that you down-played the impact this is having on your life.

The reason I believe you should try again is that in many cases both medications and counselling are indicated and it would be good for your GP to be involved at every step. A counsellor in the UK cannot prescribe and would only send you back to your GP should they feel you need a script. Much better for you if the relationship with the GP were a therapeutic one.

The GP is basically looking for three triggers, and any or all of these should result in you being referred for counselling. There is I think a 2 week wait currently.

1. Incapacitating: are you unable to function normally, is it affecting your job, life, are you having difficulties with sleep, appetite, sex?
2 Suicidal ideation: Have you given though to self-harm or made preparations for it in any way. Have you fantasised about ways in which the world would be better without you?
3. Harm to others: Let me stress , even if you would NEVER act on these feelings, have you imagined harm to others? If so give details.

Finding a therapist in the UK is not the same as the USA, you tend to be constrained by geography as the sheer numbers you might see in a US city you simply don't have here. It is very hit and miss.

there's not enough info here to suggest which type of therapy might help - that's up to your therapist. However if they've never heard of CBT or narrative, run!
posted by Wilder at 11:49 PM on November 14, 2007

The BACP is one of the biggest registers for counsellors and psychotherapists and their register includes accreditations from a few other organisations. You can search for a counsellor by geographical area using that link (there are two on the register in Dudley itself), and there's a good explanation of the various accreditations here and a guide to the different therapeutic approaches here. The exact approach you choose is really up to you - there are so many options out there, with a lot of counsellors offering a mixture of disciplines ("integrative counselling"). CBT (cognitive behavioural therapy) has been shown to be a good treatment for depression, often but not always in conjunction with antidepressants, but the most important thing is a good, trusting relationship with your therapist. Any good therapist will be happy to discuss which techniques they use and their application to your situation, along with fees, either over the phone or in an introductory session. Feel free to shop around a bit - you're the one who will be paying, after all.

This GP sounds a bit useless, though. St John's Wort works for some, although the evidence isn't particularly solid, but if you have a history of depression I'd expect him to take it a bit more seriously - at least monitor you or something. You do have the right to change your GP for any reason, without specifying why - don't think you're stuck with this person as your doctor. If it turns out you do need medical treatment in the future, such as antidepressants, it's better to have someone you know will take you seriously to go to.
posted by terrynutkins at 2:20 AM on November 15, 2007

See a different doctor.
posted by fire&wings at 3:28 AM on November 15, 2007

OK, this is going to take some work, but a year from now you'll be so glad you did it.

Set up appointments with 3 therapists. You can pick them out of the phone book if you want, just make sure you're going to see more than 1. Tell them up front that you want to find a therapist who's a good fit, go to a session with each. In my experience, one therapist is going to stand out head and shoulders above the rest. I've wasted a lot of time by going to the first therapist I stumbled upon. Competence varies a LOT.

Also, at least where I am in the USA, it's assumed that if the treatment didn't work, you will go BACK to the doctor. At least, that seems to be what the doctor assumes. Unfortunately I think a lot of people figure, "Oh well, that antidepressant/antibiotic/etc didn't work, guess I have to tough it out." Then they suffer with lingering depression or a sinus infection or whatever for months till it goes away on its own. Not necessary!! A lot of doctors will start out prescribing something fairly mild, and then will reach for something stronger if the first option doesn't work.

The feeling that the doctor didn't take you seriously may be partly the depression talking. It is hard to take yourself seriously and go to the doctor when you are depressed. It is probably tremendously disappointing to have the doctor give you some wimpy herbal thing that may or may not work. Don't give up - St. John's Wort does work for some people. It may just not be working for you. You may need a different medication.
posted by selfmedicating at 7:07 AM on November 15, 2007 [1 favorite has favorites]

In terms of what kind of therapy you might seek out, it's been fairly well scientifically established that, with a few exceptions (none of which you list), all well-established therapy styles are pretty much equally effective. The number-one factor in getting better is having a good working relationship with your therapist, so it's generally going to be more effective to choose a therapist that you like rather than starting out by picking a style and trying to find a therapist who fits it.
posted by occhiblu at 7:18 AM on November 15, 2007

Definitely shop around, as terrynutkins said, the relationship between the two of you is the important thing and that works both ways. A good therapist will first want to find out whether they think they can work well with you and won't offer to take you on without talking to you properly. After all if they are good, they shouldn't be so short of clients they can't be choosy. A no obligation introductory session is a must.
posted by tallus at 9:38 AM on November 15, 2007