When we first go for psychology, counselling or therapy, the biggest challenge facing us is how to identify who would be good for us and what sort of therapy might suit us. It might seem that we need to answer each question separately, but research suggests that it is the combination that actually determines what works. The therapist has to be skilled in the modality or modalities they use and this is important for the therapist to be effective. However, the research shows that it is the therapeutic relationship that best determines the outcomes. This suggests that choosing the therapist that you feel comfortable working with is the key measure for you as the client, provided that the chosen therapist has adequate training and skills to be effective.

Some Principles to Apply in Choosing a Therapist

• You need to feel comfortable with the therapist. Within a session or two, you should have a sense that you are being heard, have a sense that the therapist is developing a good understanding of you as a person and that you are comfortable working with this person. The technical term for this is that there is a "therapeutic alliance" between you and the therapist.
• A "comfortable" therapist is not necessarily someone that you never disagree with, or who never disagrees with you. Sometimes the greatest lessons come when the therapist and the client struggle together for mutual understanding. If, however, this does not happen in a "safe" environment, then you are unlikely to be able to make use of this struggle in therapeutic ways. The exchange must always happen in an environment of mutual respect.
• The therapist needs to be skilled in their practice. It is reasonable to ask them how experienced they are, what qualifications they have and what modalities they use. In talking about modalities, a good question might be "so what draws you to working in that way?"
• Psychology, psychotherapy and counselling are skilled professions. While many people can be helpful to talk through an issue, a skilled professional must have more than just a "good ear". Ensure that the qualifications are at a professional level. In Australia, most professionals will have a mix of university and developmental courses to guide them.
• A professional therapist will ensure that their work is subject to review by other professionals. This involves a process in which the therapist regularly meets with another experienced therapist and the work being undertaken is discussed. This process is called "professional supervision" and is done in such a way as to ensure confidentiality is maintained while letting the supervisor explore both the approach being taken and impact of this work on the client and therapist.
• A professional therapist will be a member of one or more professional organisations. This organisation will ensure that the qualifications and ongoing professional development of the therapist is maintained. It will also hold the therapist accountable to a prescribed set of ethics.
• The highest standards of professionalism can be determined by choosing a therapist who is on the Psychotherapy and Counselling Federation of Australia's professional register; the "PACFA Register of Therapists". Psychologistists are required to be registered in the state or territory in which they practice.

If it Does Not Feel Right

If you have been working with a therapist for a while and feel uncomfortable, then it is best, in the first instance to discuss this with that therapist. A good therapist will be willing to work through these issues with you. If despite this, you remain dissatisfied with the outcome, then you should exercise your judgement and either terminate the sessions or seek guidance from another professional.

If you ever have concerns about the ethical behaviour of a therapist, then contact their relevant association, PACFA, or the relevant health monitoring body (in the ACT this is the Health Services Commissioner).