What to look for in an online counsellor — and should I become one?

Today I noticed a new mutation of the Hatred-of-Meghan-and-Harry pandemic, which is hating on Meghan and Harry for advocating people spend their time on lockdown training to become volunteer counsellors. A week ago their @sussexroyal instagram drew the attention of their 11.3m followers to @crisistextline @giveusashoutinsta @kidshelpphone and CTL Ireland, and suggested if you’re ‘home and feeling bored, you can digitally train to be a counselor and HELP someone who really needs your support!’. 

Therapists on LinkedIn have been quick to pour scorn on this advice, bemoaning the dangers of flooding the market with poorly-qualified upstarts who lack a lengthy therapy training and accreditation with one of the major organisations: in my country the UKCP or BACP. They say this is dangerous for clients. 

I disagree entirely. 

The type of counselling being suggested by the Sussexes depends on the hard-work and goodwill of volunteers. It is valuable, life-saving work. It requires a willingness to listen, as supportively and non-judgementally as possible. Text-based interventions can be quite challenging: as we all know from messaging, it is easy to misinterpret someone's tone.

I think the majority of people who find themselves wanting to sign up to these sorts of services will already be good listeners. Those who stay the course—the real training in this job is experience with clients—will become great ones. I think for most people, counselling is a calling as much as it is a job. What they need from us is encouragement to stick with it and support when it’s hard. I also think those who are willing to admit their flaws and limitations make the best counsellors. Surely that’s true in many professions. 

During my training with The Site for Contemporary Psychoanalysis I was lucky to be given the freedom to choose my own placements. I worked on a volunteer basis with Islington Mind for five years while building up my private practice, and I worked for three years in hostels as part of the Single Homeless Project. I’m pleased to say I still see some of these clients, and I will always be a better therapist (quite possibly a better person) for the people I worked with during that time. 

I think it is a very good thing for Meghan and Harry to point out that quarantine restrictions during this phase of COVID-19 will be forcing many people in abusive relationships to share space with people who may put them at risk of harm and it takes someone with tact, courage and good basic training, not necessarily a lifetime in psychotherapy, to give a caller the confidence to know when to involve the police, or seek refuge elsewhere. 

There is still shockingly little access to therapy, especially long-term therapy, for people who can’t afford to pay more than even £20 an hour and in a diverse city like London we do well to pause for a moment to notice how the majority of students, those who teach them and their private clients, are white. 

Therapists coming to this period in our history with the expectation of ‘cashing-in’ are in for a rude awakening. Salaries are not generally high and therapists do not earn as much as prescribing psychiatrists or psychologists charging for assessments. 

Volunteer counselling can be hard on those who do it too, and these are people who often (and this is something I do disagree with) don’t have the access to supervision and counselling of their own. This will be especially the case in the coming weeks and months when a lot of people will be seeking help in shock at the loss of jobs and loved ones. 

This is a time when a lot of people will be needing emotional support: some will experience moments of crisis during which they may be at risk of harm, or represent a danger to others. Some will find this is a time when memories or habits from the past start to resurface. We will need more counsellors and the volunteer sector, to a large extent, will be required to provide them. 

I think the problems with this, and with people with few qualifications setting up as counsellors and therapists online are different to what you might think. I think it raises a few interesting questions about why we choose the therapists we do, and the sorts of advice we expect. 

That’s a word that’s been in my head since I read a couple of those critical posts: “they’re going to be giving really bad advice”. But your therapist — should they be giving you advice at all? 

Of course my clients do often bring business problems; problems with relationships. It does seem like they’re saying ‘I should leave this person’, ‘this job isn’t working for me’. Sometimes—a surefire way to get a smile out of me—they say ‘of course, you’re not allowed to tell me what to do’. I like this idea: the therapy police bursting into the room to confiscate my opinions. I often do have opinions; I am free to give them. But I am an experienced therapist, not a financier. I might say ‘but you haven’t come here for business advice’. They’ve come because they believe their anxiety may be the symptom of a psychological problem. Sometimes it isn’t: everyone gets anxious. Sometimes it is. 

One of the main points in the Code of Conduct for my certifying body, the UKCP, is about respecting a patient’s autonomy. I often find that’s a helpful thing to bear in mind here. What is a therapist encouraging in a client — is it autonomy, freedom, thought? Or is it something else? 

Your therapist is not your boss. You aren’t stuck with us — though like any relationship, you may find you get more out of life if you choose to stick around, don’t require it to be all fireworks and revelations, allow for a connection based on listening, profound and unforced. 

So, how do you know if you have a terrible therapist? 

One way is to notice what happens when you try to have that conversation. Perhaps not whether it gets shut down or not: I might be trying, as carefully as I can, to figure out what’s so tender about a particular subject for you. We often find ourselves in a place where one, or both of us, for minutes at a time, is lost for words. I absolutely respect when, in the first session or the 51st, my client has to give me a bumpy ride in order to go where they need to go for changes to happen. 

I’d say give it a few sessions, and the test of a new therapeutic relationship is often said to be whether it survives the first six to ten sessions. But if something can’t be talked about eventually, something that feels pressing to you, as if it is being overlooked, it’s possible you may not have found the right therapist for you at this time in your life.

One of the things that makes therapy so powerful is it is a confidential space in which many things are possible, and I think it’s often a good thing that the rules are adapted to suit you.

While there is always the risk of saying the wrong thing, does your therapist make you feel shameful about your behaviour, your sex life, your attitude to therapy? Is it likely an objective friend might worry your therapist was trying to make you join a cult?

A therapist with any sort of moral compass will never, ever ask you on a date, even after therapy has concluded. The UKCP also requires its members to be in some form of ongoing supervision, where cases are discussed anonymously, in confidence, with another experienced therapist at least once a month. Professional therapists also have insurance.

Naturally I had all sorts of personal criteria for who I went to for therapy when I was training (I’m mystified that some therapists feel able to practice without having had therapy themselves; for me it would be like learning any trade in a classroom or out of a book, but never underestimate people’s ability to learn in different ways), and the same goes for the people I think of when referring clients I’m unable to see myself. 

How do you know if you have a terrible therapist? Try talking to them, you’ll find out. 

ORIGINALLY PUBLISHED ON LINKEDIN, 28 MARCH 2020