There’s a reason there’s little agreement on standards for treatment or licensure. The only thing we have solid evidence helps in therapy/counselling/psychotherapy is a strong client therapist relationship, the therapeutic alliance. Up until recently the literature suggested cognitive behavioural therapy worked better than other schools but the case for that isn’t looking great lately either.

Therapy is hard and it only works if the client works at it. They can even work at it on their own, but they must work at it. Bibliotherapy, using a CBT workbook, works as well as a therapist if you actually do it but a therapist is an expensive means of ensuring you follow a programme.

> Is Professional Training Worth the Bother? A Review of the Impact of Psychotherapy Training on Client Outcome

> Abstract This article reviews the research literature on the effectiveness of paraprofessional counsellors and the impact of psychotherapy training on client outcome. Methodological and conceptual difficulties that have hampered previous research in this area are noted, and several well‐designed individual studies are highlighted. The existing evidence supports the efficacy of paraprofessional counsellors, although professional training may lead to better outcome in specific areas, such as greater client retention, briefer therapy, and better overall wellbeing for clients. However, methodological limitations of the research prohibit definitive conclusions. Guidelines for future research are offered.