Choosing a therapist is primarily a combined function of gut, preference, convenience and available resources around you – whom do you feel most comfortable with, whose style suits you best and whom can you access and afford the easiest.
In India, there is no bar that licenses or certifies therapists. Clinical psychologists can register with the governing medical body in India (RCI), but they are not tested for competence upon entering the field, nor is their continued education monitored. That being said, all is not lost. We still have some excellent therapists. We just have to learn how to apply a filter and make sure that we find whoever is best for us.
I’m listing here some of the factors you could keep in mind when looking for a therapist.
- Training: Your therapist must be trained from credible academic and training institutes. Their desired minimum qualification must be an MPhil in Clinical Psychology or a PsyD (or D.Psych). Students with Masters degrees in clinical/ counselling psychology from noted institutes can also offer their services. Age is not a “legal” criteria, but it does bring experience with it.
However, don’t discount the young therapist. They may be astute, excellent and perhaps very creative in their work. Just make sure you’re aware of what their level of experience is, and what approach they would like to take with you. Extra points if they are under therapy and supervision themselves, which means that a senior professional is helping them help you. It shows their commitment towards you and that they have admirable ethical standards as young professionals.
Certain newer therapies like art and drama therapies might have professionals holding diplomas in their fields. This is acceptable, but make sure that these are not 2 day training courses your prospective mental health professionals attended. A (much) longer certified training program is recommended for someone to become a “professional”. Additionally, it is much preferred if the professionals are trained clinical therapists first, and choose arts like dance or drama as a modality of therapy. This will not always be the case, but is preferred.
Psychiatrists are often MBBS, MD Psychiatry. In India, they are NOT trained to be therapists. They deal with medicine only. So neither should you expect it from them, and neither should they be offering this to you – unless they have sought additional training (like an extra masters or a diploma course) for becoming talk-therapists.
Do not feel shy in asking any mental health professional for their background – your health is at stake, and you have every right to know whom you’re going to trust with it. If they have a problem sharing this information, or take offense to this, you may choose to not engage with them.
- School of thought: Your therapist can come from any of the tens of schools of thought floating around. Some are more known like Cognitive Behavioral Therapy, Existential Therapy, and Psychoanalysis. There are many others too. As a therapist, it is important that they explain to you what school of thought they come from, and how therapy will proceed based on that.
I find that an increasing number of psychologists are adopting something called an eclectic approach. When you hear these words, you should expect that the therapist has training in different therapies, and will use with you the techniques that are best suited to you. It does not refer to a simultaneous combination of therapies – a common error in understanding made more by therapists than clients.
- Distance: There will be times when you will not want to go for therapy. This is a normal part of therapy-induced-healthy-anxiety, and sometimes just simple laziness! So it’s not absolutely necessary but if you can, find a therapist located close enough that distance is never a reason for you to not go.
- Duration of sessions: Sessions can be as short as 30 minutes but tend not to be over 50 minutes. I personally recommend the 50 minute sessions – they always seem more meaningful and deep.
- Number of sessions: Therapists sometimes can tell you how long they predict you will be in therapy for. This is common for CBT based therapies, but not always otherwise. Being in therapy is a voluntary practice and it’s really up to you how long you want to stay in therapy for, which you can decide once you gauge its benefit to you.
- Frequency of sessions: Based on the school of thought and urgency of your situation, you might be required to see your therapist once every two-three weeks for less urgent situations, to twice-thrice a week for more severe conditions. This is tailored to mutual convenience and affordability.
- Fee: There are no standard fee structures or protocols that are mandated of therapists. They can range from INR500 for a session to INR4000. You have to decide what suits your pocket, and what’s worth it – are they experts in their field? Do you feel that they will understand you best? And do you think that they will help you arrive at the answers you’re seeking? This is the same as seeking out medical help from other doctors. The additional factors here are the number, frequency and duration of your sessions which will also play a role in your decision. On an average, you might want to prepare for a range of INR800 – 2500 per session. Fees will vary as a function of, for example, the qualification and experience of the therapist, and even their location of practice (city / area).
- Sharing a world view: You and your therapist must share the same world view, or at least have a tolerance for each other’s world views. You don’t want to visit a therapist who scoffs at your idea of an arranged marriage, or conversely polices you morally when you decide to marry for love, or abort a child. You will likely share extremely sensitive information from your life, and there is almost no exception to the rule that this information should be received in a non-judgmental environment.
- Human connection: All the above factors don’t come close to the importance of this one. Make sure your therapist works with you to make you feel a sense of control and direction in your life. A good therapist will help you find yourself, not tell you who to be. Good therapists are those who can create a safe environment for you. In therapy you will purge some of your problems, if not all. These can get embarrassing or intensely tearful. A good therapist is able to psychologically contain and hold your emotions, giving you space to express and then helping you make sense of them. Somehow, they have the ability to help you while remaining stable themselves. They can take your sadness and worries, and remain calm, while still genuinely feeling your pain. You can feel their lack of judgment fill the room with a sense of support. This can’t be taught. Some people are just gifted. As a client, if the therapist is faking it, you’ll know immediately (and feel free to call them out on it).
Fortunately or not, there is no such thing as a universally good therapist. Therapy is a human connection. Before judging training and patience, you must be able to trust that this therapist, this person, will be able to be there for you. You’ll know when you feel understood. For this, there is only one fool-proof test – your gut.
Evaluate honestly your level of mental distress, and try and give it the same priority as you would a physical illness. We are nothing if not mentally peaceful and happy. Make time and save money for a good therapist.
If you have a particular question about a choice you are considering, feel free to run it by us. If we can, we’ll be happy to help! Writein@theshrinkingcouch.com
Note: This article refers only to individual therapy sessions. I am grateful to Shalini John for pointing this out, as well as reminding me that group and family therapy sessions routinely extend well over an hour. Others, like Lacanian therapy styles, hold sessions for under 15 minutes. (Shalini John is a practicing clinical psychologist in New Delhi, with many years of diverse training and experiences informing her opinion).