Choosing a Therapist

Choosing the right therapist can be a challenge. Here are some tips to help!

Therapy is an essential part of wellness and recovery for people living with mental illness, though choosing the right therapist can be a daunting task. How do you know whether someone will be a good fit for you? And how can you tell that this therapist will help you progress in treatment? 

I’ve had to change therapists many times due to moves (I’ve relocated across the country and back multiple times), so I’ve spent a lot of time searching for new therapists. Understandably, different people have different needs, and my criteria will not apply to everyone. Nonetheless, I find that – for me – a therapist with these qualities is most likely to benefit my recovery: 

Trait(s): Compassion, empathy, and genuine warmth

What this looks like: A therapist should be caring and kind, even if they are occasionally blunt. Bluntness should be a choice rather than a default. When working with them, I should get the impression that they are genuinely interested in my life and struggles. This also includes the use of self-disclosure. A therapist who overshares and self-discloses too frequently gives the impression that they have poor boundaries and are not sufficiently focused on my treatment when I come to the sessions. A therapist who can self-disclose only at key moments can sometimes serve the same purpose as peer support. That is, they can make you feel seen, understood, and less isolated. 

Trait: A sense of humor

What this looks like: I have a dry sense of humor, and I have a difficult time with therapists who can’t understand or appreciate sarcasm. That said, even clients who don’t have this problem are likely to do best when a therapist is capable of seeing silliness and lightness in the world. That’s either when a client tells a joke or when (kindly) pointing out an irony. 

Trait: Expert at only a few things (rather than minimal experience with everything)

What this looks like: Have you ever heard the phrase "jack of all trades, master of none"? I do best with a therapist specializing in only one or two types of treatment modalities. This can be tricky because there are many types of therapy, but I'm generally most successful with a therapist who is at least able to clarify a primary theoretical basis behind the work they do. For example, suppose a therapist claims expertise in both cognitive-based and psychodynamic therapies (which are built from psychological theories that contradict each other and don't align in critical ways). In that case, I may be concerned that the therapist has experience with many things but does not actually have proficiency in any one type of treatment. 

Trait: Collaborative (in other words, doesn’t maintain a power differential)

What this looks like: Though some people like therapists who come to treatment situated as "the expert," I find that I do better with providers who meet me as equals. Therapists willing to work together as a team and who value my opinions make me feel like I have agency and resilience. I also do better with therapists who believe me and treat me like a reliable historian. People with mental illness can easily fall into the trap of being considered poor narrators of their stories, and I have more trouble connecting with therapists who accept that without question. Rather, therapists who meet me as I am and are willing to ask respectful, honest questions when they have concerns make me feel like we are working together toward wellness. 

Trait: Answers questions directly

What this looks like: Therapists are often mocked for answering questions with questions, and sometimes – though frustrating – this can be effective. That said, if a therapist never responds concretely, it can be difficult for me to feel grounded in therapy. The therapist and I both come to sessions as people, and when I can't get a good handle on what the person I'm talking to is like, I don't feel comfortable sharing. To clarify, as I said before, an oversharing therapist is not the goal. Instead, someone who tells me their impressions, rather than asking me to always spin my wheels and form my own. 

Trait: Provides good referrals/recommendations

What this looks like: Therapists can’t do everything for you, and hopefully, when something is beyond their scope of practice, they won’t try. Rather, therapists should have some names of providers to whom they can refer you if you have other needs. This includes having names of other therapists available for recommendations if they are out of town or unavailable long enough that you feel you need to see someone in the interim. This is also particularly helpful when looking for psychiatrists, though other types of providers such as neuropsychologists may also be valuable names for your therapist to have available.

One other thing to consider: 

When looking for a new therapist, I often try a few out. This is a normal and valid part of finding a provider, and I strongly recommend that other people try this as well. I used to struggle with this because I was worried about telling therapists I wasn't returning. I've often gotten the advice from peers and people without mental illness alike that I should use opportunities like this to push through anxiety and have an in-depth conversation with this therapist about why they are a poor fit. However, I reject the idea that this is necessary when seeking a new therapist. The goal of treatment is to find someone who helps you work through these things, and if you have difficulty with conversations like that, it should not be a barrier to finding appropriate care. Therapists are providers that you are paying for a service. It is polite to say that you are not returning, but it is unnecessary if it stops you from getting the care you need. I have fired multiple therapists with minimal communication, which has allowed me to find therapists I can work with on issues such as assertiveness and interpersonal anxiety. 

Choosing a therapist can be an overwhelming process, but there is much to be gained by looking for a therapist who fits your criteria. If you’re not sure where to begin, website directories such as Psychology Today and Mental Health Match are a great starting point. Therapy should ultimately lead you on a path toward wellness, and that starts with a good connection with and belief in the capabilities of your therapist. 

It is important to note that this is by no means an exhaustive list, and I always love to hear what other things people look for when seeking a new therapist. Ultimately, no matter what people say, those I've spoken with always return to the importance of the relationship they end up building with their therapists. Though the finer points may differ, the good therapists, the ones people want to stay with, are the ones who make them feel heard and less alone. 

If you’re wondering if online therapy may be an option for you, click here.