How to choose a therapist: ‘They don’t need to have a Dr title’

How do I choose a therapist? A recommendation from a GP or a trusted friend or Google can all work. But first, think about your needs. "It's important to be relatively clear about what you need help with," says Dr Damien Lowry, chartered member of the Psychological Society of Ireland and Mater Hospital psychologist. Then check a therapist's experience and specialisms and whether they are accredited to a recognised professional body. A good therapist doesn't have to have a "Dr" title, he says.

Will I have to rehash my childhood? There are different types of therapy, emphasising different things. For example, psychoanalysis explores early life experiences and family dynamics and patterns that have emerged over one's life, says Lowry. Medics and non-psychologists often recommend cognitive behaviour therapy (CBT), he says. "That's much more present-focused and goal orientated. It gives more weight to what has happened more recently to bring about the situation you find yourself in, what can be done to help you understand that and inform your treatment plan." Ask a therapist to explain their approach before choosing.

Location, location, location It's natural to feel trepidation before starting therapy. Working up to sharing intimate worries can be hard. At least make the logistics easy. Is parking a nightmare, is the entrance discreet, what if I bump into someone I know – these are all factors to consider. If a therapist is located above the supermarket and attending will have you darting in and out of doorways, perhaps go elsewhere.

How should it feel? A therapist may have impressive qualifications but rapport counts for a lot when it comes to therapeutic outcomes, says Lowry. "There has to be the ability to get on, to converse, the capacity to trust, to share, to be able to confide and to communicate to and fro," he says. "There should also be the scope to explore challenging or more sensitive things, maybe at times prickly and thorny conversations, to challenge your thoughts or understanding of something."

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What if it's the wrong fit? That happens, and you should switch if it doesn't feel right, says Lowry. "But you don't have to be best mates, you are not looking for a friend, you are looking for a therapist," he says. It's important that "the fit" is a conversation that can be brought up by both sides. "It's my professional duty at times to ask some questions around that – 'how do you think this is going? What's your perception of it and let's pair that up with my perception'. Let's make sure we are not going through the motions and that you are getting value for money and there is a purpose to our contact, because time is valuable too."

How much will it cost? The cost can range from €60 per hour at the lower end to €160 at the higher end, says Lowry. The most expensive therapist isn't always the best. Some therapists may consider a sliding scale of payment or perhaps appointments can be spaced out to fortnightly or monthly to fit your budget. It is reasonable to ask about all of this. Trainee psychologists sometimes offer appointments for €40 or €50 an hour. "I have attended trainee psychologists and you will never find someone more enthusiastic," says Lowry. "They are avid readers, they are studying the latest evidence, but they may lack experience to pick up on certain things quickly. It's a trade-off."

Does it work over Zoom? "I'm doing it in a blended way myself and Zoom is enabling people to attend who otherwise may have not," says Lowry. "Most people tend to have a preference for in-person. You have that in-person exchange, you are not hitting a red button to disconnect, there is that little bit of chat on the way in and out and there is a little bit more maybe added in that sense." In-person appointments entail masks.