How to choose a therapist

I have often been asked what to look for when choosing a therapist. It is difficult to say exactly which ingredient is the most important, but rapport is certainly a vital component of a positive alliance between client and therapist. When clients feel understood in an environment of genuine concern, it is easier to expect positive results.

Beyond the therapeutic alliance, there are also three essential points to consider:

1. The therapist’s qualifications and credentials.
2. The therapist’s familiarity with specific topics.
3. The style and/or structure of the therapy.

Qualifications and/or credentials of the therapist

You should be informed and confident in your therapist’s qualifications. Most therapists have a master’s or doctorate degree, with specialized skills in certain areas. A doctorate in clinical psychology is the highest level of training available in psychotherapy, but unless you are dealing with a complex psychological problem, you may not need this level of experience – a good social worker or marriage and family therapist is well suited. in many cases to help clients with certain “life situations” and mild to moderate anxiety or depression. The important thing is to confirm that the person has high-quality training and is prepared to help with your situation. Google the schools and programs listed in your therapist’s online bio to confirm that the schools are accredited by:

• American Psychological Association (APA) for clinical psychologists.
• Council on Social Work Education (CSWE) for social workers.
• Commission on Accreditation for Marriage and Family Therapy Education (COAMFTE) for marriage and family therapists.

The most important thing is that you confirm that your therapist is licensed. I am amazed at the number of people providing therapy, especially online, without a license. Clinical psychologists, social workers, and marriage and family therapists will have verifiable licenses by searching that state’s “professional bureau” website on Google. Feel free to ask any therapist you are interviewing if there is an official state licensing website where you can verify her license. A good therapist will welcome your question and see that you practice good self-care. If the person resists or gets defensive, that could be a red flag.

If you are just looking for training, then no license is legally required. However, many people find that a license in psychotherapy is helpful in a coaching relationship because the therapist’s training in mind and relationships is highly applicable to most coaching goals. I find both therapy and coaching to be extremely important in many situations, and a combination often works best (see my theracoach.me page for more information).

Familiarity with your particular problem

Your needs are unique and it is important that therapists have experience handling similar cases. Here are some guiding questions that may be helpful:

• How often do they deal with cases similar to yours?
• How many clients do you see per week and how many of those clients have problems similar to yours?
• What kind of solutions and therapeutic techniques do you consider useful for situations like yours?
• How many sessions are normally required to obtain results?
• Do you think your situation requires short-term or long-term therapy? How many sessions usually constitute “short term” or “long term”?
• Will they give you homework? If so, will they take the initiative to follow up every week to see if it is doing so, or will it be expected? This one is important: Many therapists expect you to bring up last week’s homework yourself. Personally, I believe that in most cases it should be the therapist who brings up the task, since part of the client’s problem may be avoiding the topic.

These are legitimate questions and should not make the therapist uncomfortable. Reluctance to talk about your experience, qualifications, or vision for your treatment puts early pressure on the potential to build a positive working relationship. If necessary, cite this article to explain why you are asking these key questions.

Style and structure of your approach.

The treatment approach will also be an important consideration. The two main approaches to therapy today are psychodynamic and cognitive-behavioral. The main difference between these two approaches is the role of the unconscious: the unconscious plays a key role in psychodynamic approaches, while the cognitive behavioral approach focuses on thoughts and behaviors that are clearly identifiable.

Psychodynamic therapists often allow the client to begin the session by talking about whatever is on their mind, even if it means the client remains silent for long periods of time. The psychodynamic therapist looks for hidden meanings and unconscious patterns and helps the client become aware of how these patterns affect her daily life.

The cognitive behavioral therapist is more likely to take the client’s statements at face value and then help the client to assess the beliefs and behaviors associated with those statements; and then assign homework to help shape those thoughts and behaviors to produce specific desired results.

Ask your therapist if they take a more psychodynamic or cognitive-behavioral approach. Ask them if they normally assign homework and offer structured therapy sessions, or if the treatment is more “open.” There is no correct answer to these questions, but you, as a client, have a right to know what type of treatment you are potentially starting. If goals or outcomes are important to you, ask your therapist if they typically set goals at the beginning of treatment and how often those goals are reviewed with the client.

If you have been in treatment with your therapist for a period of time, you should feel comfortable asking your therapist to review treatment goals and progress on a regular basis. If the therapist responds to this request in an evasive or confrontational manner or makes you uncomfortable, I encourage you to share this perception with your therapist and then come to an agreement where you feel comfortable discussing goals or consider finding a new therapist.

Going forward

Your choice of therapist is extremely important. Genuine concern in a warm and caring environment where you can express yourself openly is essential. In addition, a qualified therapist will also have the qualifications and experience to develop an approach that fits her needs.

Therapy requires an investment of time and money, as well as emotional effort. You owe it to yourself to make sure your investments are handled carefully. If you’re not sure exactly what type of therapy or therapist you’re looking for, or if you want to better understand your options before committing to any therapist, try to consult with at least three professionals before choosing. Feel free to be open with therapists about the fact that you are “shopping” or “interviewing” to find the right fit. A good therapist will support you in this and may even ask nonjudgmental questions or provide more information to help you explore and define your needs.

Do you have more questions about how to choose? There is a whole chapter on the specific factors of choosing a therapist in my book, Nervous Energy: Harness the Power of Your Anxiety. This chapter discusses choosing a therapist specifically for high-functioning people, but the advice in this article applies more broadly to many situations.

To find a therapist near you, visit the Psychology Today Therapy Directory.