Finding a good therapist
How do you find a good therapist?
Most people don’t know, if they’ve never been to see one.
And even if you have, you might be in a different place in your life right now, with different issues, than the last time you were in therapy.
So how do you decide? Here is a brief guideline to figure it out.
What problem to do want to work on?
Let’s start with you. What is the main issue that you want to find a good therapist to help you with?
Are you going through a difficult life issue right now? A rough patch in your relationship/s?
What is the main thing causing you stress? Your job, your significant other, an elderly parent or child with health needs, and you are the main caregiver/helper to this person?
One way to narrow it down is to figure out what you DON’T want. Are you up to your ears with people giving you advice and problem-solving? Do you just want an outside person to lend an ear to what you are going through, especially at the start? Then you probably don’t want a person who comes off as pushy or giving you yet more recommendations before hearing you out.
Or is it the opposite? You need to make decisions, you are very anxious about something, and you really could use an objective party to listen and help you lay out your options. In that case, you might want someone directive.
But it’s hard to figure out someone’s personality and treatment approach before you’ve even met them. That’s where it can help to talk to people that you know have done counseling already and find out who they have seen. If it is for a similar issue, that might be a good person for you, too. (Keep in mind some boundaries here, though. You might want to avoid seeing the same therapist that your mom, brother, or close friend has seen, especially if you are having issues with that person.)
Having said that, another good place to look is on therapy directories online, such as Psychology Today. You can look at the professional profiles of many therapists, as well as what insurance they take (if any), where they practice, and what is their area of interest and expertise. This will save you a lot of legwork in trying to find someone who fits your needs. It might be good to jot down the names of three therapists you found this way, and call them to set up an appointment with each of them, before deciding on the one for you.
Keep in mind one thing: No matter what, a therapist is there to listen to your situation and help you come to decisions that work for you. But they will not make the decision for you. At least, they are not supposed to. That will be up to you.
50 warning signs of bad therapy shows a pretty complete list of what to look for and what to avoid in a therapist. And so does 25 signs of a bad therapist: You deserve better.
Even with this, keep in mind that what works for someone else may not work for you, and vice-versa. It doesn’t mean that one of you is right or wrong, just that you are individuals with your own needs and likes.
Another thing: I once had a client who was looking for a marriage counselor for himself and his wife. He had a history of substance abuse (now clean), and was having intimacy issues, along with trauma, which he was actively treating with an individual therapist. So I referred him to an excellent therapist who works with intimacy issues.
He didn’t want to see this person because he wanted someone well-versed in couples work and sexuality, but also someone who worked with trauma and substance abuse. I don’t think he was aware of it, but this was a pretty tall order.
It’s understandable that you would want someone good at what they do, and it’s good to do your homework and find out if this person is well-respected and has experience in your issue. But if you find that you are passing up every therapist you come across, it could mean that, at some level, you are afraid that your problem will not be understood or handled well.
Think of looking for a doctor. The more specialized they are, the fewer specialties you can demand of them. So if you want a cardiologist, you can narrow down what KIND of cardiology they do (adult/child, surgical/non-surgical). But it is unlikely that you will find a cardiologist who is also an orthopedist and a gastro-enterologist. Likewise, you might find a therapist who works with teens on anxiety and does substance abuse, but they might not have too many other specialties than that.
That’s ok. The main thing you want to focus on is, what is the BIGGEST issue for you right now? If it is your relationship with your spouse, and you both want to see a marriage counselor, then that is the top “specialty” you need: Someone who specializes in, and likes to do, couples’ work.
If the next pressing issue is that one of you has trouble focusing, and that impacts your relationship, then that person may need to get screened individually, by a doctor and by an individual therapist, for any underlying conditions, like Attention-Deficit/Hyperactive Disorder
(ADHD). Once you have a diagnosis, they can get individual treatment for the ADHD, and then the two of you can do couples’ work around communication with someone who has some familiarity with ADHD, too, and its impact on relationships.
It isn’t always about their degree, but their passion.
Nowadays, a therapist should have at least a Master’s Level Degree in Counseling, Social Work, or Marriage and Family Therapy. Sometimes they will have a Doctorate (PhD, DSW, or PsyD), which are all varying levels of expertise. Someone with a Doctorate is often able to do or has done research in their area of expertise. They can also provide extensive diagnostic testing, which a Master’s level therapist usually is not trained to do, for example. That’s important if you need your child tested for school accommodations, but maybe not so much if you are looking for talk therapy. And definitely, any mental health professional you see should have a current, active license to practice in the state where you are seeing them.
Beyond that, you’d want someone who has an interest in your particular issue. For instance, it’s much better to get a Masters Level clinician who has a special interest in couples, than a PhD professional who does not particularly like working with couples, if you and your spouse want help together. If you find that therapist who is familiar with and loves working on issues related to ADHD? That person will likely give you more meaningful help than the one who is not all that into ADHD.
The relationship is important.
It took courage for you to come see this person, and to tell them what’s going on with you. Did they seem to be listening to you? That’s important. Did they seem to care? Also big. Are you not quite sure? That’s ok. You also may want to give it about six sessions with someone before deciding that they are or are not for you, unless something they said or did seemed so judgmental or irrelevant to what you are working on, that you really have no desire to come back. Even if that is the case, do you think you could tell this person how you felt when they said that? Therapists are human, too. They might not have realized that what you said hit them that way. And how they handle your upset will be important. Did they dismiss it, or did they at least acknowledge that you got upset? If they did the second part, well, points for them. If not, it may be time to look for someone else.
Make therapy a priority.
I really do get it. Life is busy. There are a million things that need doing, and sometimes it feels like coming in to talk about yourself is the one thing you want to put on the back burner. But trust me: Therapy is like working out. The more you stick to it, the more your chances of success and effective changes. You went to the trouble of coming, so keep it going! Come to your appointments regularly, and only cancel if you really had an emergency, which yes, does happen on occasion. And think about it: If you are not willing or able to prioritize therapy, how can your provider do it for you?
If you have issues that make regular sessions difficult, talk to your therapist. Perhaps you can both agree to postpone sessions until that big exam, trip, or operation is over. Or, if you have chronic health issues or a situation that makes coming into the therapy office difficult, look for a provider who does teletherapy, which is becoming more available. Whatever you do, most providers would prefer that you are honest about your situation than habitually miss sessions or keep cancelling. No shame, no blame.
All this being said, congratulations on thinking about what you are looking for in therapist. It says a lot about you, that you are giving this some thought. So, best of luck, and may you find a good therapist for you!