On Choosing a Therapist: Part Two
In the first post, we explored levels of qualification and ethical body membership. Now, we turn to the important area of counselling approach. If you’re looking to enter counselling or therapy (remember, these terms are often used interchangeably) for the first time, it can be hard to know what might work for you. As a person‑centred counsellor, it would be easy for me to advocate for my own approach, but I’m going to resist the temptation and offer a little context instead. Please forgive the diversion. If this doesn’t interest you, feel free to skip ahead to part three, where we look more closely at person‑centred and integrative approaches.
The science and art of modern therapy has been developing for many years, and continues to do so. From the early days of the psychodynamic tradition — think Freud, Jung, and Adler, the therapist’s couch, and the role of the unconscious, through the behavioural and cognitive revolutions of Skinner, Beck, and Ellis, who argued that behaviour is shaped by our environment, to the humanist approaches of Maslow and Rogers, who emphasised free will and personal meaning‑making. There are many frameworks for understanding human experience, and the field continues to grow in depth and complexity. Yet even as developments in neuroscience, pharmacology, and biology expand our knowledge, we increasingly find ourselves returning to ancient wisdom traditions for support — yoga, mindfulness, and stoicism, for example, all of which have influenced modern CBT.
You might be wondering where I’m going with this. A fair question. My point, if I have one, is simply that there is no single path to wellness unless we choose it. This idea isn’t new. In therapy literature, it’s reflected in what’s known as the “dodo bird effect”, which suggests that, provided a good therapeutic relationship exists, different therapy models are, on average, similarly effective. More on this later. Back on topic.
For some time now, Cognitive Behaviour Therapy (CBT) has been in the ascendancy, and if you have sought support through your GP, it is likely this was what you were offered.
In brief, CBT takes the view that what we think (our cognitions) strongly influences how we feel and behave. Because CBT can often be delivered relatively quickly (and therefore more cheaply), it has been the darling of the NHS for some time. That is not to say it isn’t effective — it certainly can be. The difficulty, as with many modalities, lies in determining how effective it truly is. Research studies are often conducted by CBT practitioners, and controlling for researcher bias can be challenging. And if efficiency and cost‑saving are major drivers of its adoption, well, that probably won’t surprise any of us.
All that being said, therapists from other orientations, such as person‑centred or integrative (again, more on these later), will often incorporate ideas from CBT, recognising that clients can find them helpful. CBT has been found to be particularly effective for certain issues, such as phobias. But anecdotally, some people find that although CBT explanations make sense to them, they may not be enough on their own.
In the next post, we’ll look at the role of relationship, especially in the context of person-centred and integrative approaches.
