What factors influence a client’s choice of counsellor or psychotherapist in a private practice setting?

  • Julie May

Student thesis: Doctoral Thesis


This study considered how a client chooses a psychotherapist/counsellor working in
private practice. It emerged from a desire to know whether clients made informed
choices, which factors influenced their selection and the extent to which they were
aware of the regulatory status of the profession. 22 participants including ten
psychotherapist/counsellors, ten clients and two other professionals were
interviewed using semi-structured interviews. This qualitative study was underpinned
by pragmatism, and data was analysed using thematic analysis.
The findings suggested that the primary selection factor was third-party
recommendation, and where this option was either absent or undesired, selection
was made based on internet searching using location, experience of the presenting
issues and the perceived ability to relate to the client. Clients assessed these factors
using the photograph and rhetoric on the therapist’s website or directory entry, as
well as during the first face-to-face meeting, largely relying upon unconscious
projection and ‘gut instinct’. Factors of limited importance in the selection process
included qualifications, professional standing and modality. There was an
assumption that the profession was already statutorily regulated and that these
factors would be obligatorily in situ, before a therapist could practise privately. The
findings suggested little awareness that the responsibility to validate a therapist’s
professional standing or credibility rests, with the client. A lack of information for both
clients and recommenders was highlighted, together with an increased risk for
exploitation affecting private practice clients, because of unprotected titles and an
absence of minimum education standards for the profession. Recommendations
from the research included an increase in public education, urgent debate within the
profession of the issues highlighted and support for statutory regulation.
Date of Award2018
Original languageEnglish
Awarding Institution
  • University of Brighton
SupervisorDiane Waller (Supervisor)

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