The majority of therapy clients choose their mental health professional based on availability not expertise. That’s backwards. Credentials matter, but the research on therapy outcomes shows that something else is way more important and we’ll explain what it is.
Fit matters more than you think
The connection between the client and the counselor, also known as the therapeutic alliance, predicts whether counseling is effective or not. According to research presented in Hubble, Duncan, and Miller’s “The Heart and Soul of Change”, the alliance is responsible for about 30% of the success, double the effect of the specific technique or model used by the counselor. In simpler words, a great CBT counselor you don’t get along with is likely to help you less than an okay one you trust and are comfortable talking to.
This doesn’t mean the correct training isn’t important. It simply means you must stop considering “licensed and qualified” the goal of your search. It’s the starting point.
Photo by Vitaly Gariev on Unsplash
Name the problem before you name the counselor
Before you check anyone’s bio, be specific about what problem you are addressing. Anxiety, grief, trauma, relationship issues, and depression are not the same and cannot be treated the same. Someone trying to cope with recent grief requires different treatment from someone processing child abuse or dealing with panic disorders.
Modality is related to this. CBT fits well with anxiety and is best used for work with clear goals. DBT is focused on emotional management and is recommended for clients with strong emotional fluctuations or those with a history of self-harm. EMDR is specifically used for trauma. Psychodynamic and person-centered treatment is recommended for people interested in identifying patterns over time and not interested in following a strict program. Once credentials check out, you can turn to vetted platforms like SoulSoothe to discuss the specific cousellors and techniques available that will suit your journey and goals best.
Check the credential, then check what it actually means
After you have an idea of what kind of therapy you’re after, it’s time to confirm the person you’re talking to is actually qualified and experienced enough to help. Designations like RCC (Registered Clinical Counsellor), CCC (Canadian Certified Counsellor), and RP (Registered Psychotherapist) are lengthy and intimidating, but they’re there to help you. They’re tied to a regulatory body, and you can and should check to see if a counsellor’s in good standing with that body before you give them any money. Look the counsellor up on the relevant provincial registry and confirm they’re in good standing – they’ll tell you right up front whether they’re accredited and where.
This will also help you figure out the differences between types of mental health professionals. Counsellors are the folks with these acronyms, but psychologists, for example, are the ones who can actually diagnose mental health stuff. Psychiatrists handle medication in ways a counsellor can’t. Then there are coaches, who can be helpful in a lot of ways but aren’t regulated in terms of ethical or confidentiality standards. Getting this distinction right early saves you from ending up with the wrong kind of support entirely.
Run the logistics filter before you fall in love with a profile
A counselor could have the perfect credentials and experience on paper but it doesn’t mean a thing if you can’t access them. Research if they’re on your insurance provider’s approved list. Look up their rates for sessions. Next, ask if they’re available via a format convenient for you, whether it be video or in-person.
If the commute, hours, frequency, duration, fees, or other boxes on your checklist don’t align, they won’t magically start checking out after you’ve made yourself an appointment. You’ll just keep feeling frustrated and drained trying to make a square peg fit a round hole.
If cultural or religious background, or LGBTQ2S+ experience, matters to how comfortable you’ll feel opening up, filter for that too. A counsellor who’s worked extensively with your specific community will often get you further, faster, than one who hasn’t.
Treat the first call as an interview, not a formality
Most therapists will have a quick chat with you before you sign up for anything. Use it well. Inquire about their work with your particular problem or goal, their usual strategies for the early stage of therapy, and their policies on client privacy and notes. Then see how you feel while you’re on the phone. Overwhelmed? Judged? Okay? This is your gut, giving you helpful information.
There are a handful of red flags to look for during this preliminary call. A therapist who promises you a cure or change in x amount of time is selling you something therapy can’t deliver. A therapist who pushes you to sign on for an extensive, prepaid block of sessions before you’ve even had one session is looking for your wallet. A therapist who tells you all about their still-lingering family drama or bad breakup on the first call is not doing the necessary professional work of keeping their problems out of the room.
Keep checking in after you start
The search is still not over when you have booked in somewhere. You need to check back after three or four sessions and ask yourself if you feel the counselling works. It’s good to change if not – that’s not failure, that’s the same fit-first logic you used to choose in the first place, applied again with more information.
Good counselling support isn’t just about the most credentialed name on a list. It’s about the right issue meeting up with the right approach, it’s about the logistics being right, and it’s about the person across from you actually making it easier to talk.