Perhaps you’re in a rut. Perhaps a pattern in your life is causing you concern. Do your romantic relationships always end in the same messy way? Perhaps you’ve been diagnosed by your GP with a mental health condition such as anxiety or depression or you feel you may be struggling with one of these illnesses. Maybe, as you get older, you’ve begun to feel less satisfied with your life, but can’t put your finger on why. Maybe you’re just curious.

What you start off focusing on may lead to some surprising detours. In most of my work, particularly with clients I’ve worked with for more than a year, what they started out focusing on has changed over time.

According to Dr Zac Seidler, director of mental health training at Movember, “It’s helpful to have an idea of what you’d like to get out of therapy, your motivation and what’s important to you to understand by the end. This might not always be clear and will likely change session to session, but a good way to think about it is the aspects of your life and the types of behaviours you’d like to improve upon.”

During your initial consultation, the therapist may suggest someone else if they feel your presenting issues would be better helped by another therapist. For instance, I don’t usually work with clients with eating disorders. During the consultation, ask questions about how the therapist works and explain what you are hoping to achieve.

Therapy is a bit like opening a door without knowing what’s on the other side. As I like to say to clients during their initial session, particularly if they’ve not had therapy before, our work has already begun with you making the decision to meet me today. You’re acknowledging that something about yourself needs to change.

Therapy, talking cures, psychotherapy and counselling usually comprise weekly sessions either in person or remotely between someone seeking help from emotional disturbance or mental health problems and a professional who has gone through several years of professionally approved training.

There are several branches of psychotherapy. Gestalt therapy focuses on the client’s immediate thoughts, feelings and behaviour, which leads to a better understanding of how the client relates to other people.

In humanistic therapy, you are encouraged to realise your potential by making more rational choices in your life with the therapist’s support. This form of therapy is closely linked with person-centered therapy, which looks at how you perceive yourself and how you might change this in ways that may be beneficial to you.

For those in existential therapy, the client’s experience of being human is examined philosophically. They are encouraged to look at the givens of life, such as death, meaning, isolation and freedom, which leads to more authentic ways of living.

In the UK, there is no legal definition of psychotherapy or restrictions on who can practise as a therapist or counsellor, which makes doing your due diligence even more important.

If a therapist describes their practice as “psychodynamic”, they work with unconscious processes, which means they’ll be looking at your past, particularly your childhood, to see how your formative years may be effecting you now.

Psychoanalysis works with the unconscious and may require more than weekly sessions and a request for you to lie on a couch, which aids free association or less regulated thoughts being shared with the analyst. You will be referred to as a patient, rather than a client.

Cognitive behavioural therapy (CBT) can be conducted by someone without formal therapy training. Using practical, in-the-present tools, it’s a method of challenging unhelpful thoughts and how they produce difficult feelings such as anger or fear. For instance, if, rather than telling myself I could never speak in public because it’s too terrifying, I tell myself it’s hard to speak in public, I’m giving myself the chance to change with practice.

An integrative therapist is trained in a range of therapeutic approaches, which gives them the flexibility to use the best method for each client.

Research published in the journal Frontiers In Psychology suggests positive outcomes from therapy can be predicted on the strength of the relationship between the client and therapist, rather than one school of therapy over another. This is why the initial meeting with a therapist is so important. If the relationship feels safe and trusted, a good outcome is more likely.

A first good step to finding a therapist, if you don’t have a word-of-mouth recommendation, is via the website for the main professional bodies in the UK. Search for the British Association For Counselling And Psychotherapy, the UK Council for Psychotherapy or the British Psychoanalytic Council and you will find thousands of therapists, their contact details and a summary of their skills or areas of expertise. All the counsellors, psychotherapists and psychoanalysts listed are accredited by their professional body, which means they have reached a minimum standard of training and experience.

Other sites worth checking out are Counselling Directory, Find A Therapist and Mind, which also list accredited therapists. There is also a number of therapy apps, such as BetterHelp, Mindler and TalkSpace, which give you access to online therapists.

“Although it’s no guarantee of brilliance, credentials are essential,” says the UKCP psychotherapist Ms Charlotte Fox Weber. “Someone who claims to be intuitive or naturally therapeutic may offer valuable insights, but it’s not psychotherapy if it’s not with a fully qualified psychotherapist.”

“Most therapists have their own website, so take a good look at how they come across to you,” says psychotherapist Ms Yuko Nippoda. “Do you like the look of a therapist who is smiling in their photo or do you prefer one who looks more serious? I would then recommend calling a shortlist of a few therapists to talk to them directly, as you will get a feeling for who they are and how they like to work over the phone.”

It is vitally important that you are happy with the practicalities of cost and location when it comes to choosing a therapist. If you go for someone out of your price range, or who is two trains and a bus ride away (or someone who won’t do Zoom sessions), you will resent the process before it has begun. Therapy is often conducted via weekly 50-minute sessions, either in person or remotely (this is sometimes called the therapy hour). Many therapists offer a sliding scale of fees depending on your ability to pay, but you will be lucky to find a therapist who charges less than £50 per session.

Discussing fees happens in the initial consultation along with what you are hoping to gain from therapy and sharing some key aspects from your life. This first meeting is an opportunity to gauge if working with this therapist is a good fit for you and whether the therapist feels they are able to help you.

Counselling may be offered through the NHS, but there is often a long waiting list and availability can be patchy.

Like the most important relationships in our lives, successful therapy is built on trust, which can take time.

“Many people make the decision to seek out a psychotherapist when in a crisis,” says psychotherapist Mr Mark Vahrmeyer. “While this is common and the sense of urgency strong, it is important to take the time to find the right fit. This may mean contacting various clinicians and attending more than one initial consultation.”

Short-term therapy of 10 or 12 sessions may be available through the NHS or your health insurance. Valuable work can take place with these time-limited contracts, although more significant change and insights are more likely to happen over a longer period of several months of weekly sessions.

One of the challenging and counter-intuitive aspects of therapy is the perceived weakness or inability of the therapist to “get” the client right away. This is when a client realises they have to dig deeper into understanding themselves or that their therapist isn’t a miracle worker who can magic away their pain or difficulties within weeks.

It is often when the therapy feels stuck that some of the most valuable insights are made. Many of my clients have nothing to say at the start of a session and then look surprised 50 minutes later when they’ve barely come up for breath and discovered something new and important about who they are.