How to Choose a Therapist

How to Choose a Therapist

No longer reserved for closed-door whispers, therapy is now a topic of everyday conversation, something people mention as casually as going to a general practitioner for a physical check-up. This important shift in public attitudes about therapy means that more people seek therapy when they need it. There are a few downsides to therapy's growing popularity, though. One is that people talk about going to therapy as if every therapist had the same approach when there are almost as many specialties in therapy as there are in physical medicine. Choosing the right therapist and right type of therapy are essential first steps in having a good therapy experience, so we've put this guide together to help you get started.


Questions to Ask When Choosing a Therapist

There are two important first steps to take before you choose a therapist:

  1. Learning more about therapy; and
  2. Learning more about yourself.


The best way to start is by asking questions. Some of the most important questions to ask yourself include: 

  1. Why do I want to go to therapy?
  2. What issues do I want to work on in therapy?
  3. Do I have any specific goals I want to accomplish in therapy?
  4. What kind of philosophy or approach do I want my therapist to have?
  5. Do I have a preference about my therapist's gender, religion, or cultural background?


These and similar questions will help you make important decisions about what kind of therapist you want to see. You don't need to perfectly understand your goals or motivations for therapy—learning about yourself is part of the process. But the more you understand your reasons for going to therapy, the more likely it will be that you'll pick a therapist who's a good match.

Don't forget to keep some practical questions in mind, too: 

  1. How far are you willing to commute to see a therapist?
  2. How will you pay for therapy? Do you want to use insurance?
  3. If you can afford to pay out of pocket, how much can you budget for therapy?

The answer to these questions may depend on how you answer the others. If you want help with a goal most therapists can help you achieve, it wouldn't make as much sense to choose a therapist who was further away or cost more to see. However, if you want to see a therapist with a rare specialization, it might be worth driving further or paying more.


What to Look for When Choosing a Therapist

 There are so many things to consider when you're researching therapists: where they're from, what they believe, what degrees or licenses they have, and how long they've been practicing. How important any of these factors are depends on your personal needs and goals, but in general, these are the most important things to look for:

  1. A therapist with a valid license to practice in your state
  2. A therapist who has experience treating people like you
  3. A therapist whose methods will help you achieve your goals

Whether you're using OpenCounseling, local therapy websites, or another source for your research, you should be able to read a therapist's biography and find out some basic information about them before calling or sending an e-mail. In their bios, therapists usually highlight the type of clients they've done the most work with and how long they've been doing that work.


For example, one therapist's bio might highlight their work with the LGBTQ community, while another's might emphasize their expertise in helping people resolve creative blocks. You'll be more likely to benefit from this kind of information if you know what you most want to address in therapy. What concerns are central for you right now? Do you want to focus on issues of identity, or are questions about creative work what made you want to see a therapist?


If you have or suspect that you have a certain mental health condition and want to address it in therapy, it's a good idea to find a therapist who specializes in treating people with that condition. For example, if you have borderline personality disorder (BPD), you're more likely to be successful if you choose a therapist who has experience working with clients who have BPD and whose vision of BPD recovery is similar to your own. You may have goals that more closely align with desired outcomes for dialectical behavior therapy (DBT), or you may want to focus on trauma work using a method like eye movement desensitization and reprocessing (EMDR).


What Therapeutic Method Is Best?

The answer to that question is simple: there is no therapeutic method that is best for everyone. Which method is best for you depends on your needs and goals. For example, while studies show that cognitive behavioral therapy (CBT) is highly effective in treating a wide range of conditions, even CBT is only effective when it's a good match for what you want to accomplish in therapy.


Understanding the differences between therapeutic methods is one of the least intuitive steps in choosing a therapist. Unless you've already studied styles of therapy, terms like "cognitive" or "psychodynamic" aren't going to be very helpful when you're choosing between two therapists. This is where it's important to do a little bit of research to make sure you have all the information you need to make the best choice.


You could spend years studying the way different therapeutic methods work, but, you don't need to study that much just to be able to choose a therapist with the best approach for you. The following section provides a general overview of the most common methods therapists use.


An Overview of Different Therapeutic Methods

Cognitive or behavioral therapies like CBT, DBT, acceptance and commitment therapy (ACT), rational emotive behavior therapy (REBT), and many other therapies with the word "cognitive" or "behavioral" in the title generally focus on symptom management or control. They work by helping you examine and change your thinking and the emotional and behavioral patterns that are triggered by your thoughts. These methods are particularly effective if you have a mental health condition that is caused or worsened by negative thoughts, such as depression or anxiety.


Trauma-informed therapies like EMDR, neurofeedback, cognitive processing therapy, exposure therapy, and trauma-focused CBT help people heal from trauma. They work by having you learn your triggers and helping you "reprogram" how you respond to them. They are effective methods for treating post-traumatic stress disorder (PTSD) and other trauma-related conditions including BPD. They are a great choice if you know you need to heal from something traumatic that happened in the past, including trauma from childhood.


Psychodynamic therapies include Freudian, Jungian, object relational, and other classic analytic methods. Most modern psychodynamic therapists have updated their approach, so it's unlikely you'll be watching a pocket watch or lying a couch if you go to one. You will, however, be asked to delve into childhood experiences or bring in dreams to examine for subconscious symbolism. Psychodynamic methods help resolve inner conflicts and bring unconscious "complexes" of belief and emotion into conscious awareness so you have more power to change them. Psychodynamic methods are a great choice if you've already done some work to address psychological symptoms or to heal trauma and you want to dig a little deeper into figuring out why you do what you do.


Narrative or existential therapies help you examine and update the stories you tell yourself about your life. We all have an inner narrative built from what we believe, what we've learned from past experiences, and the characteristic thought patterns we use to interpret life events. This story determines how we think and feel about our lives and the meaning we do or don't find in them. Narrative therapies help you examine and change your narrative where it hurts you or holds you back. These methods are a great choice if you are struggling with questions of meaning.


Mindfulness-based therapies are often integrated into other therapies, including cognitive, behavioral, and trauma-informed therapies. Mindfulness-based therapy incorporates meditative practices that help you connect with your immediate experience, counteract negative thinking, and calm down when you're anxious or stressed out. Mindfulness-based methods and tools can also help you become more aware of your reactions, triggers, and inner states. They're a great option if you're feeling disconnected from your body, yourself, or your life in general.


Is a Therapist's Method the Most Important Thing to Consider?

It's good to understand your therapist's method and whether you have any philosophical conflicts with it before you begin, but it's not necessarily the most important factor in choosing a therapist. Sometimes a person who uses a method that you wouldn't normally choose can still be the best match for you. The most important considerations in choosing a therapist are more personal.


Research shows that the relationship you have with your therapist is more important than any other part of therapy. Your therapist's method and philosophy will impact how you feel when you're in session with them, but other elements may affect that connection more, including your therapist's personality and background. Whether your therapist expresses empathy well and is able to make you feel heard and understood goes a long way in helping you heal.


When you have a good therapeutic alliance, you feel like your therapist understands you and where you're coming from. If you are from a minority group, choosing a therapist with a similar background can prevent awkward misunderstandings and facilitate a good alliance. If you want to incorporate spirituality into your therapy, you might prefer working with a therapist who understands and finds value in your spirituality or religion. In the end, you have to decide whether any potential differences between you or your therapist would be an issue for you in therapy and whether you'd work better with someone different from or similar to you.


How Do You Know When a Therapist is a Good Match?

Just because a therapist's bio makes them sound like a good match doesn't mean they will be. A therapist recommended by a friend or family member might not click with you in the same way. It can help to ask the person who recommended a therapist to you more about and why they like them, but there are things you won't know until you've met with your therapist in person.


Personality is an important part of making a good therapeutic match. For example, consider whether you'd be comfortable with a therapist who uses humor in their sessions. Would you prefer to work with someone who was blunt or someone who had a gentler speaking style? In many ways, choosing a therapist isn't that different from choosing a person to date: it's about how you feel while you're with them. This is why it's important to set up an initial trial or "interview" session with a potential therapist before you commit to them. It's okay to meet with several therapists for an initial session before choosing one to continue seeing.


Other factors to consider a therapist's view on essential subjects like psychiatric medication. If you want to use psychiatric medication but your therapist doesn't believe in using it, you're going to have a hard time avoiding conflicts over the topic. It's good to be open to learning and shifting your perspective over the course of therapy, but it's not a good sign if you feel like you and your therapist are on totally different pages from the very beginning. Be sure to ask any questions that could highlight important philosophical differences in your first phone call or interview session.


If your therapist does anything that raises ethical red flags or makes you uncomfortable, you have the right to walk away and find someone who helps you feel safe and heard. Without this basic sense of comfort with a therapist, you won't be able to be vulnerable or do deep work with them. A good therapeutic relationship is one in which you feel safe to be vulnerable. Therapy may confront you with painful memories or unpleasant truths, but it will also empower you to believe in yourself and make the changes you need to make in your life. Good therapy gives you hope.


If you feel ready to start therapy, there are many resources you can use to find a therapist. You can use the search tools on OpenCounseling to find an affordable local therapist, try low-cost online therapy at BetterHelp (a sponsor), or review websites for local clinics. Whatever method you choose, know that you're taking an important step. Even if the first therapist you try isn't a good match, you're that much closer to finding the right one.

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Stephanie Hairston, MSW
Posted on 11/17/2019 by Stephanie Hairston, MSW

Stephanie Hairston is a freelance mental health writer who spent several years in the field of adult mental health before transitioning to professional writing and editing. As a masters-level clinical social worker, she provided group and individual therapy, crisis intervention services, and psychological assessments. She has also worked as a technical writer for a medical software company and as an editor for a company that appeals denials of insurance coverage for behavioral health treatment. As a writer, she is motivated by the same desire to help others that brought her into the field of social work and believes that knowledge is one of the most essential recovery tools. She strongly believes in the mission of OpenCounseling and in making therapy accessible for everyone.