Finding a Psychotherapist
Here I outline the necessary criteria for practitioners trained in a psychotherapy framework. I include this so you can understand the rigorous training that a psychotherapist must undertake in order to practice.
Prior qualification in a related field
It is an expectation that your practitioner has a qualification – degree or similar – in a field related to mental health. This qualification may include but is not restricted to social work, social science, counselling, psychology, sociology, psychiatry or even occupational therapy.
Psychotherapy training – beyond prior qualification
Following is a broad description of the training process for a psychotherapist proper. This should help you when interviewing a potential mental health practitioner for yourself. For too long the trusting public have assumed the skill of the person they visit.
Let us be clear that psychotherapy training is not obtained online or in a speedy one or two years. The very nature of the training is that the practitioner must develop, grow and evolve into the role over the course of time. Any psychotherapy training worthy of the title will have been run over a minimum of four years (even with prior qualifications, and that includes medicine).
Once the four-year training is completed, the trainee prepares for assessment, which takes two avenues. The first is a written dissertation in which the trainee shows their understanding of the theory by writing about client casework and overlaying the theory. This is done with recorded live casework, transcripts and intense supervision. It is in effect a thesis.
The written work consists of several components.
- It includes information about the practitioner and how that practitioner works,
- how the theory informs their work and their own relationship with the theoretical biases.
There is a personal account of the practitioner’s journey that reflects deep understanding of the Self as a result of their training and, more importantly, of their own journey in the psychotherapy chair as the client (a prerequisite of the training).
While the greater part of the written exam is a deep and thorough thesis, the case study is of a client over a long period in psychotherapy. It includes all levels of understanding of the practitioner’s own thinking, interventions, treatment planning and diagnosis, using the theory and more.
The assessment of this thesis is done by two different professionals. Much care is taken that it is not assessed by someone local or someone who perhaps is known to the trainee. Certainly not someone who has been a part of the training body through which the practitioner is training.
As Transactional Analysis is taught worldwide under the same specifications and guidelines, the assessment of papers (for this modality) is frequently done in other countries.
After the joyous news of a pass for the thesis, the trainee embarks on the second segment of the assessment process. This is usually referred to as the oral exam.
Preparation for the oral exam takes no less than one year and usually much longer.
Here the trainee presents verbal narratives (through transcriptions) of sections of client sessions to the exam board. Members of the exam board can ask any questions regarding theory, treatment planning, the psychotherapist’s thinking or even the psychotherapist’s life. It is a time to show the board your thinking on all levels. The board panel would usually be made up of three to four examiners. Again using Transactional Analysis as our example, these exams are scheduled for the days before an international conference, so the panel is often comprised of international examiners.
Concurrent requirements during the training process
Many of the parallel mental health professions have a high burnout rate. It is a relatively simple equation to avoid this crisis. When asked how I work all day with clients’ sad and traumatic stories, I reply that there are four requirements to prevent burnout:
- Proper and specific training in long-term psychotherapy proper
- Being in one’s own psychotherapy (as a guideline for a minimum of ten consecutive years, although usually much longer for any practising psychotherapist)
- Regular, ongoing clinical supervision – supervision by someone trained to supervise, not someone with seniority as a practitioner
- Ongoing professional development (workshops, conferences, residential meetings and so on related to the field. This does not include reading or online professional development.)
As an adjunct, probably the single most important aspect of any training is the requirement to be in one’s own psychotherapy. To quote Carl Jung: ‘We are only able to take our clients as deep as we have been ourselves.’
It is important here to add that your psychotherapist does not have to have had the same life experience or trauma as you to do this work. In fact, it is the thinking of many that sometimes this may be contraindicated. I say this because, as humans, our own material can be triggered when working with a client with parallel issues. Herein lies one of the crucial reasons for the psychotherapist to have done their own personal work. Perhaps this could be described as clearing out the ‘ghosts’, leaving us emotionally available to be entirely there for our clients.
Serious questions are raised if a trainee is reluctant to go into their own psychotherapy. What does it say about their capacity to expect another to do so?
Finding the right psychotherapist
When you are looking for a mental health professional to work with, it is important to find someone who is not only appropriately qualified but also is appropriate for you. Here are a few points you might want to look out for.
Not just any ‘therapy’
If someone refers to themselves as a ‘therapist’ it might be a hint they are not a psychotherapist.
From my description of the training, to become a psychotherapist is long and protracted. A practising psychotherapist would not discount that level of training and work by using a word that has little specific meaning.
The word ‘therapy’ is from a Greek word meaning to service or to wait on, hence its use in occupations such as physiotherapist, hypnotherapist, beauty therapist, occupational therapist. It is only when the word has the descriptive addition that it gives clarity, informing of the occupation.
The word ‘psycho’ is also from a Greek word, meaning the mind, and is used in terms of ‘relating to the mind’. To use a crude form, which perhaps the ancient Greeks might flinch at, ‘psychotherapy’ means to service the mind.
Corsini’s Dictionary of Psychology refers to psychotherapy as ‘a systemic methodology based on theory of personality intended to achieve desirable changes in thinking, feelings and behaviour’.
What type of mental health practitioner are they?
If someone’s business card, advertising or website uses several titles, please ask them to clarify their discipline. Titles may vary from coach to counsellor, psychotherapist, psychologist, hypnotherapist and more.
The issue of concern for the public here is that, if the practitioner is confused about their occupation, you can be darn sure you will be as well.
This is often the result of people achieving one type of training, then engaging in other types of training or courses and tagging on the titles. Having said this, they may well have done full and complete training in one, two or all of the titles. It is your prerogative to ask about which of those titles or ‘skills’ will provide your treatment plan.
Questions to ask of a psychotherapist
A counsellor is a counsellor, a psychologist is a psychologist, a coach is a coach, and a psychiatrist is a psychiatrist. They are not psychotherapists unless they have done a training similar to what I have described above. Having done a medical degree and one year of training in psychodynamic psychotherapy does not make a practitioner a psychotherapist. Again, the simplest thing to do here is ask three questions:
- How many years of their own personal psychotherapy have they done? (Remember, you will accept nothing less than a consecutive ten years if you are to work with them.)
- What training of four to six years did they do specifically in psychotherapy after their initial qualification?
- How often do they attend clinical supervision with a trained psychotherapy supervisor to manage their caseload? Please remember, if you are looking at doing long-term work, you have the right to ask these questions. We, as practitioners, are answerable to you, the public. Let’s educate everyone!
The importance of a psychotherapist’s personal analysis
The reason it is important for a trainee to undergo their own psychotherapy before working long term with clients is that it assists the trainee in developing areas of their character that are paramount in long-term work. It will allow an openness (as opposed to a defensive approach), stability, maturity and flexibility while working deeply with their clients. Personal analysis for the trainee fosters an ability to better reflect and observe their own thoughts and feelings when working with clients, without contaminating the client’s space with their own world.
Without this, many of our own psychological issues, vulnerabilities, character traits and family histories will most often interfere with the work we are doing with that other person. These often stem from our own biases, defences, trauma and relatedness. A trainee’s own work is designed to assist in removing these conscious and unconscious feedback loops.
As a result of this personal development, the trainee is able to understand the value of analysis, thereby having the conviction of the work done in the frame of psychotherapy. This is never more important than in working in the areas of a client’s childhood experience.
Personal analysis for a trainee (and eventual fully fledged psychotherapist) forms the core of all that goes into working deeply with a client. Without such it is uncategorically impossible to assist another person through their journey of pain, loss, trauma, depression, anxiety and more.