We all want to get the best therapy we can, but how can we know which type of therapy is the best for us? Years ago, when I was looking for a therapist, I didn’t know about all the different approaches of therapy available, so that made my search a bit easier! I looked for therapists who knew about my condition, and I specifically looked for a therapist I could trust. The therapy went very well – it was the best therapy I could have had because we worked well together, and my therapist understood my problem. But even so, after therapy I remember hearing about EMDR therapy (Eye movement desensitization and reprocessing) and wondering if that would have been an even better approach for me? I was hearing EMDR being hyped up, and I was wanting to make sure I was as whole as can be. But I no longer wish I’d had EMDR, I’m confident I had the right approach for me back then, and I’ll come back to this point at the end. So how can we work out which counselling approach is best for us?
Each counselling approach tends to have research to show that their approach is the most effective. But Lester Luborsky found that ‘researchers tend to find that their approach of counselling is the most effective.’ This is called ‘researcher allegiance’ (Luborsky et al. 1999).
Interestingly, research shows one of the most important factors for effective therapy is the relationship between the client and counsellor (BACP 2021). This means that in general the best counselling approach will be the one taken by the counsellor you have a good relationship with. For me, I managed to find a good counsellor I could trust who was available to see me, so this was the ‘best approach’ for me.
Having said that, it’s also worth bearing in mind that some approaches (which we call modalities) do particularly suit specific situations. Cognitive Behaviour Therapy is, in general, a better fit for dealing with phobias, than for dealing with trauma. Trauma requires a counsellor with specific experience and training in helping people with trauma. Exposure Response Prevention (ERP) and Internal Family Systems (IFS) can be helpful with Obsessive Compulsive Disorder; Emotional Focused Therapy (EFT) can be helpful for couples working on their relationship. However, watch out for claims that one modality is much faster than others. Therapy take time, and there are lots of different factors for how long therapy will take.
So, the best counselling approach for you is probably going to involve looking for a combination of two things: 1) A therapist who you can have a good relationship with, and 2) A therapist who knows how to help your problems. If you find such a therapist, they will have an informed opinion about which approach is best for you. Together you can then agree on the best approach to take. And if you have your heart set on a particular modality that your therapist hasn’t mentioned, tell them. If they don’t personally use that approach, they might be able to refer you to someone who does.
So why do I no longer wish I’d had EMDR? Well years later I did get some more therapy but this time with an Internal Family Systems (IFS) approach. This modality worked well for me because of the combination of a therapist I could trust and a therapist who knew how to help my problems. The IFS approach worked well to build on from the previous therapy work I’d done. Furthermore, it was my previous therapist who recommended the new therapist to me. I’m still curious what it would have been like to have EMDR, and I’m sure that would have worked well it had been from a good therapist I could trust who understood my problem. So for me it comes back to finding a therapist you can trust who understands how to help your problem.
By Duncan Forbes