How to Choose a Therapist

Now that I’ve entitled this blog entry, “How to Choose a Therapist,” I should tell you that no one, including me, can really tell you the right way to choose a therapist. Just like therapeutic work itself, choosing a therapist is both an art and a science. You will need to use your intuition–calling on your deepest instincts as best you are able. You will also need to use some basic knowledge–keeping in mind the essentials to good therapy.

The bottom line is that you should respect your intuition about who is a good fit for you. But it’s also important to know the basics about what to look for, what to expect, what to want, and what not to want.

On the intuitive side of the decision, consider these thoughts:

Different therapists have different styles of working with clients. There is no one right style, but there may be ways of doing therapy that work especially well for you. It’s important to find someone who is a good enough match for you, your temperament, and your particular needs. The therapist should feel to you like an intuitive “good enough fit,” after you’ve had at least one introductory session, and perhaps a few sessions. A good fit does not necessarily mean easy and fun all the time, especially since therapy by its nature ends up dealing with a client’s difficulties. Working through difficulties can be challenging–another reason to find the right therapist.

Coming to therapy involves focusing a special kind of attention on your life and your self. Most people report not having many places (if any) where this kind of attention feels possible. The attention involves a certain kind of care towards, and tending of psychological processes. Some therapists will feel to you like a more natural fit for the job of attending you through these processes. And whatever the initial problem or symptom you brought to therapy, the more complex reality that you’re bringing to therapy is you and your way of being in the world. Things are rarely cut and dry, because we are all quite complex human beings with lots going on at any one time. That’s why therapy (in my view) is as much or more an art than it is a science.

Now for the basic knowledge side of the decision.

First, look for someone with at least these qualifications: a legitimate graduate degree in the field of psychology, counseling, social work, psychiatry, etc. You should also look for someone who is active in the field, who seeks consultation with senior colleagues, who follows the basic ethics of being a therapist, and who has undergone a significant therapy process as a client, as part of training to do this work. This last qualification has a strong basis in the history of modern psychotherapy. Personal therapy has been an important part of training therapists for over a century. Your therapist should also have a personal philosophy and approach to doing therapy and be able to talk to you about it in ways that make sense to you.

In terms of how your therapist should relate to you and the work you are doing together, it is important for a therapist to maintain a real, respectful, and authentic human connection with you, at the same time as maintaining a professional boundary, competence in the field, and commitment to keeping open, curious, careful attention on you, your emotional life, your relationships, dreams, struggles, symptoms, and development as an individual.

When you get to the point of wanting to make some calls, you can explore your options in various ways. You can ask for names of therapists from friends (though you may not want to share a therapist with your best friend or partner), or doctors, or other healing professionals. You can browse the web and read what various therapists have to say on their websites. Sometimes a client finds the right fit quickly. Other times it is good to meet two or more therapists for an initial consultation and then choose one to return to and see for a few sessions. Some therapists charge for a first consultation and some do not. You can ask, and you can also ask what the fee would be for ongoing sessions. Some take insurance, and some do not. Some will reduce the fee if there is a real financial need for a lower fee, and some will not.

These thoughts are not meant to be a complete guide to choosing a therapist, but I hope that they give some readers a good start.