Someone recently asked me for advice on how to find a therapist, having left their previous one because the work felt like it had only gone so far.
I’ve been on both sides of the proverbial room having been a psychotherapist for 16 years, and being a client for about the same length of time.
The request for advice reminded me that most people’s initial steps towards a therapist are often made tentatively, even if one has the luxury to afford private therapy. The power dynamics in this are worth mentioning.
Private Therapy vs. Community Services
If you can’t afford private therapy, asking for support comes with a long wait (silence, uncertainty, trying to cope otherwise).
You might get to your first appointment then get told that, actually, you need to access another service for your needs. So you go back to the start again.
If you can’t afford private therapy, your therapist remains nameless until you get offered your first appointment. Your therapist remains faceless until you meet them for the first time. You can’t always have the amount of appointments that you want or need.
For some, these two factors alone can be barriers to accessing the support they desperately need. It means asking someone to trust us as therapists, and have faith in the process, before we even meet. That’s a big ask.
Some ways therapists and organisations can bridge this potential gap in accessibility are:
*Offering a brief initial call or visit to your premises before a client’s first appointment,
*Proactively asking what access needs or preferences a client has that would help them feel more comfortable in sessions – and checking this out at regular intervals whilst working together, and:
*Proactively asking if the client considers there is anything about their personal identity or sense of self that intersects with their mental health and/or ability to access a service safely.
If you can afford private therapy, you get the benefit of browsing profiles and websites to see how you feel before choosing who to approach. And if you do that long enough it can feel like the worst bit of online dating, which is possibly an apt metaphor given the emotional intimacy that can often underpin the therapeutic relationship. It can feel confusing and exhausting quite quickly.
A person’s credentials are of course important when seeking professional support, but most people stay with a therapist because of how safe, comfortable, and positive it feels to work together. For marginalised folks and survivors of sexual abuse, this can be reparative in a world where harm has come from other people.
Power Dynamics
In terms of the power dynamics of it all, a reminder for those trying to access therapy: this should not be a process that you’re subjected to, or makes you feel sidelined or lesser than. It’s not about you being ‘good at therapy’ or behaving in a compliant way.
Getting the right support is important, and you are allowed to have a voice and power in that.
If you feel able to, you can ask as many questions as you want to be sure you’re sitting with the right therapist for you. This can include:
‘What is your level of experience in supporting someone like me?’
‘I need direct questions to open up. Is that something you can offer?’
‘I’m looking for a therapist who will give me structure/direction/advice. Is that how you work?’
‘I don’t find silence helpful. Can you assure me that it’s not always up to me to lead sessions or break a silence?’
‘I can’t always use words to describe what’s going on. Are there any other ways we can communicate or explore what I’m thinking and feeling?’
What have you found helpful in accessing therapy that helped you? And therapists: how do you step forward towards those who need your support?
