Reflection

How to Find a Psychotherapist in London

London has more therapists per square mile than almost any city in the world. It also has almost no barrier to entry. Finding a therapist here is easy; finding the right one takes some knowledge of what you are looking at.

The thing most people do not know

In the United Kingdom, “psychotherapist”, “counsellor” and “therapist” are not protected titles. There is no law preventing anyone from using them, whatever their training or lack of it.

The titles that are protected, and regulated by statute through the Health and Care Professions Council, include practitioner psychologist, clinical psychologist and art psychotherapist. “Psychiatrist” is protected because psychiatrists are medical doctors on the GMC register.

Everything below follows from that single fact. In most countries the state has already filtered the field for you. Here, you do it yourself.

Check the register, not the website

Professional body logos on a website are just images. The registers are free, public and searchable by name, and checking takes about a minute:

• UKCP, psychotherapy.org.uk. Registration generally requires four or more years of postgraduate training, personal therapy, ongoing clinical supervision and continuing professional development.
• BACP, bacp.co.uk. A larger body covering counsellors as well as psychotherapists.
• HCPC, hcpc-uk.org. Statutory regulator for practitioner psychologists, art psychotherapists and related professions.
• BPC, bpc.org.uk. For psychoanalytic and psychodynamic practitioners.

Registration does not tell you whether someone is right for you. It tells you they met a training standard, are supervised, carry insurance, and can be complained about to somebody other than themselves. That last point matters more than it sounds.

A therapist who cannot say which body they are registered with, or whose name does not appear when you search it, is a therapist to leave.

Who does what

The words are used loosely, including by practitioners, so it is worth being precise:

A counsellor usually works shorter-term and more practically, with a defined difficulty.

A psychotherapist typically trains longer and works with patterns that are older and less conscious, why the same thing keeps happening rather than only what is happening now.

A practitioner or clinical psychologist holds a doctorate in psychology, is HCPC-regulated, and often works with formal assessment alongside therapy.

A psychiatrist is a medical doctor. Only a psychiatrist, or in some cases a specialist nurse, can diagnose formally and prescribe.

Many people need one of these and are sold another.

Match the person to the problem

This is where most poor matches happen, and it is the part accreditation cannot help you with.

Specialist presentations need specialist training. For eating disorders, look for someone whose clinical practice is genuinely in that field rather than someone who attended a workshop. For addiction, specialist training such as the Hazelden model, and ideally experience inside treatment settings, is relevant. For trauma, EMDR accreditation is the recognised standard.

The most useful first question is not “what modality do you practise?” It is: have you worked extensively with people presenting like me, and what was your training for this specific territory?

An honest answer to that question is worth more than a page of qualifications.

What it costs

Roughly, in London:

• £60, £120 with a counsellor or newly qualified therapist
• £90, £150 with an experienced psychotherapist
• More with senior specialists, consultant-level clinicians and Harley Street practices

Online is often somewhat less. Many practitioners hold a small number of reduced-fee places; it is reasonable to ask, and no reasonable therapist will be offended.

A higher fee is not evidence of better work. It usually reflects experience, seniority and premises. Premises are the part you may not need at all.

The NHS route

NHS Talking Therapies is free and self-referring in England. You do not need a GP letter. It is generally CBT-led and shorter-term, waiting times vary widely by borough, and it is often a good fit for anxiety and depression.

It is less suited to long-standing patterns, complex trauma, eating disorders or addiction, where the work is longer than the service is designed to provide. Many people use both routes at different times, and there is no contradiction in that.

Online or in person

Outcome research finds the two broadly comparable for most common presentations.

The real argument for online is choice: you are no longer limited to practitioners within travelling distance, which matters enormously if you need a specialist rather than a generalist. The arguments against are specific, medical instability, immediate risk, or a home with no privacy.

Red flags

• Cannot or will not name a registering body
• Guarantees a cure, or a number of sessions in advance
• Discourages you from seeing anyone else, or from ending
• Vague about fees, cancellations or what happens between sessions
• Offers a diagnosis in a first conversation, before knowing you
• Reacts badly to direct questions about training and experience

“The single most important thing I would tell anyone looking for a therapist: ask the questions that feel difficult to ask. Ask about their experience with your specific presentation. Ask what they think is happening for you. A therapist who deflects these questions is telling you something important.”

Philippe Jacquet

A note on Harley Street

Harley Street carries a reasonable association with senior specialist practice, and many excellent clinicians work there. But the address is rented, not awarded. It is an indicator, not due diligence. Ask the same questions regardless of the postcode.

What a first session is actually for

A first session is a mutual assessment, not a commitment to treatment.

You are assessing whether you can imagine speaking honestly to this person. They are assessing whether they are the right clinician for what you have brought, and a good one will say so if they are not, and refer you elsewhere.

If you leave with no sense of having been seen or understood, that is information rather than failure. Seeing two or three people before choosing is normal.

Dr Philippe Jacquet is a UKCP-registered psychotherapist and Jungian analyst, HCPC-registered art psychotherapist, and Hazelden-trained in addiction, with twenty-five years of practice. He works at Harley Street, in Fitzrovia and in Colchester, and online in English and French. Specialisms: addiction, eating disorders, trauma and EMDR. Arrange a first conversation.