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Some Therapeutic Clarity

It can sometimes seem impossible to navigate the many different types of therapies and therapists. So many people try therapy and say that it’s not for them. This may be true for some, but usually when you get into the weeds of it, it boils down to either: they have not had a therapeutic approach that suits their needs; a therapist they connect with; or worse, they have not seen a qualified therapist.  It’s helpful to recognise that there are good and bad professionals in all facets of therapy. The importance is ensuring you know exactly what your therapist is trained to offer, and not on what they propose to offer. Unfortunately, some can be very misleading in how they ‘sell’ themselves. They can provide the pretence of having reputable skills and experience while the small print links to rudimentary training courses often totalling only a few years, or worse days or even hours. Often as the client you are oblivious to the support you are receiving and if this is not to the standard it should be, it can have serious implications to your development as an individual as well as to your mental health. Individuals offering a service they are not properly trained in can be very dangerous for you. ​ With this in mind, we have provided a brief overview of things to look out for when choosing a therapist. We have also included a brief description of what some of the professions do with pros and cons of each. The hope is that this will make you better informed for your future therapy experience. Please note that this is meant as a brief guide to get you going. We suggest that you follow the guidance and search online for a more detailed understanding of therapists that appeal to you.

Therapeutic Guidance

A brief note from Dr Twizell - Founder of Mental Fitness Matters

I made a decision early in my career to become as qualified as I can be in the field of therapy. My reason for this was that it provided me with robust training in the skills required to work across many fields of therapy. Other therapist’s will have their reasons for training but it can be helpful to understand why they took their training journey, as it will likely inform the way they work. So, ask prospective therapists to give you clarity on the points below if their profiles do not paint a clear enough picture.

Robust qualifications should mean that your therapist is training at a bare minimum to a masters level. Their masters should specialise in the field of therapy they are practicing in, for example Cognitive Behavioural Therapy (CBT), or Person-Centred Therapy. People who have done training courses that were a few weeks long are nowhere near long enough to support you effectively, safely, and ethically. I’m sure you can do a crash course on how to fly a plane in a couple of days, you may even be able to sit in a simulator and fly one, but would you trust someone with this training to fly you on your holiday?!

Again, we can’t emphasise this enough, if you are contacting people and don’t have clarity on the above, then don’t be afraid to ask these questions. After all, you are parting with good money and you should want to feel confident that it is being put to good use by someone who can effectively help you. 

The Therapist

There are many different training qualifications out there and hopefully the definitions of job titles below helps you navigate your way through any confusion. One word of caution: there are differences within each role below, so this is only meant as a set of guidelines for understanding who’s who. There will always be exceptions to these general rules. ​ If you are uncertain about a specific therapist we recommend that you research their credentials. The Health and Care Professions Council (HCPC) is the most reputable place to check accredited professionals. You can check their register here by inputting their surname and selecting their profession.

“Counselling psychologists use psychological and psychotherapeutic theory and research. They work to reduce psychological distress and to promote the wellbeing of individuals, groups and families” (NHS definition).

For counselling psychologists, the relationship is considered to be central to understanding particular psychological difficulties and how these apply. They treat a wide range of mental health problems such as depression and anxiety, eating disorders, psychosis, 'personality disorder', negative life events, bereavement, domestic violence, sexual, emotional and physical abuse, trauma and relationship issues. Counselling psychologists work using a range of counselling skills, techniques, and approaches that are informed by psychological knowledge and research. This is usually a self-funded doctorate, but there is also an alternative route to those undertaking a professional doctorate at university known as the Qualification in Counselling Psychology (QCoP) which is the independent route to training as a counselling psychologist, but all will have a thorough robust training. The practical training requirements are in fact more robust than clinical psychologists and focuses on specific therapeutic one-to-one experience with a range of clients. 

A final important aspect for you to consider aside from qualifications and type of therapy, is what we call ‘therapeutic rapport’, which basically means whether you feel there is a fit between you and the therapist. There is nothing wrong with any of the professions above, as long as you understand the merits and pitfalls of the training and the approach of your therapist, if therapeutic rapport is there then you can’t go too far wrong.

The Therapy

Sometimes it can feel like there are as many different types of therapy as there are therapists out there. It's true that there are a lot of different therapeutic approaches, but for simplicity we have distilled them into three: person-centred therapy; Cognitive Behavioural Therapy (CBT); and Integrative or Pluralistic. We've added some detail below on the three with some explanations. We've also added some other types that fit within these three families.

“Person-centred therapy seeks to facilitate a client's self-actualizing tendency, ‘an inbuilt proclivity toward growth and fulfilment’, via acceptance (unconditional positive regard), therapist congruence (genuineness), and empathic understanding.” (Wikipedia Definition)


Person-centred therapy typically guides you rather than leads you. This is a skill typically practiced by a humanistic therapist, more commonly known as a person-centred therapist. Humanistic therapy is more of an umbrella term, with other therapies sitting underneath. Person-centred is the big brother, it’s the biggest and most popular. However, it has siblings who have significant value. These siblings include: gestalt, existential therapy, solution-focused therapy, transactional analysis, positive therapy and schema therapy. There are specific person-centred therapists and there are also some therapists that have person-centred therapy as the cornerstone of their approach while also using other approaches. Therapists who use this approach, as the name suggests, puts you in the centre of the process and works with whatever you wish to address, so you have the autonomy in your therapy sessions. The premise of this is that you are the driver rather than the passenger in therapy. You decide where to go in each therapy session and the therapist simply observes and guides you through this. While person-centred therapy is credible and effective for all mental health struggles, there are some specific areas where you may require specialist direction. Discuss this with your therapist because the approach will be unique to you.

Gestalt therapy is centred on increasing a person's awareness, freedom, and self-direction. It focuses on the present moment rather than past experiences. Gestalt therapy is based on the idea that people are influenced by their present environment.

Existential therapy encourages the client to use their free will to create a life of meaning or to find a meaning in their current life.

Solution focused therapy is future-focused, goal-directed, and focuses on solutions, rather than on the problems that brought the client to therapy.

A final important aspect for you to consider aside from qualifications and type of therapy, is what we call ‘therapeutic rapport’, which basically means whether you feel there is a fit between you and the therapist. There is nothing wrong with any of the therapeutic approaches above, it's what feels most appropriate for you.

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