Choosing a therapist is a big decision because working with the right therapist can be an important part of reclaiming your life and maintaining wellbeing. When you understand what factors influence the success of therapy and know what to look for, choosing a therapist can be a positive and productive first step on your way to better mental health.
The Process at a Glance
When beginning the process of finding a therapist, here are the basic steps:1
- Know what you want
- Generate a list of names
- Learn about potential therapists
- Make an initial appointment or consultation
When you are new to therapy, knowing what you want can be daunting, as can even knowing where to look. Here, we’ll briefly explore where to find a therapist before diving into helpful information on deciding what you want. You’ll also gain insights into just what information you need to know, how to evaluate a potential therapist even before calling, what questions to ask when you make that first call, and how to evaluate a therapist after you’ve begun working with him or her.
What Is a Therapist, and What Makes One Successful?
Knowing what therapists do can help you choose the right one for you. According to the National Institute of Mental Health (NIMH), therapists do many things, including helping people develop awareness and insight into bothersome thoughts, emotions, and behaviors; further, therapists also can help with stress management, relationship difficulties, the effects of living with a mental illness, and more.2
Think of a therapist as an expert guide on your journey to wellbeing. You already have within you what it takes to overcome obstacles and thrive, and a successful therapist recognizes that. Ideally, your therapist will help you recognize and use your strengths as you work to make improvements that are meaningful to you. Approach choosing a therapist as if you’re selecting a working partner in your journey to enhance and maintain wellness.
Being selective in your choice will help you get the most out of your time in therapy. The American Psychological Association (APA) emphasizes that it’s important to choose a therapist that possesses strong credentials and effective interpersonal skills3 that contribute to a feeling of trust and a sense of forward progress.
A therapist isn’t a friend who listens to your woes and tries to give you advice. Instead, look for an informed professional who will help you recognize and change things like negative thought patterns and/or problematic behaviors while simultaneously accepting you for who you are.4 A good therapist helps you improve without judging you for your struggles.
Where to Find Therapists
The first step in choosing a therapist is knowing where to look. This list of sources can get you started. A helpful tip: Begin anywhere on the list, and use more than one resource. If you notice a name appear in multiple places, that could indicate someone reputable and worth looking into. However, appearing in only one source doesn’t mean a therapist should be dismissed from your consideration.
To discover potential therapists:
- Talk with people you know and trust (friends, family members, or coworkers who are in therapy themselves or who may know of good therapists in your area)
- Ask your regular doctor for a referral
- If you live near a university with a graduate program in counseling or psychology, check their website for services offered
- Visit local mental health organizations such as the National Alliance on Mental Illness (NAMI), Depression and Bipolar Support Alliance (DBSA), or others (a simple online search will reveal organizations in your area)—these resource centers often have contact information for local therapists
- Stop by community centers, your library, clinics, and hospitals, as many have brochures or business cards of people providing mental health services
- If you belong to a religious organization, ask your faith leader if he or she has recommendations
- Go to your state or county government website and search for the health department; often, there are listings of mental health providers or organizations
- Call your insurance company or visit their website (find contact information on the back of your card) for a list of approved mental health service providers
- Use online directories to conduct a search for therapists in your area
As you search, create a list of therapists you’d like to learn more about. That way, you can compare and contrast professionals using the information in this article. Then, rank your choices and call for consultations. If one doesn’t work out, you don’t have to feel discouraged and start over from the beginning. Simply return to your list and keep going.
Now that you know where to look, the next step is determining who you’d like to investigate further. To do that, decide what’s important to you.
Deciding What’s Important to You
Therapy isn’t a one-size-fits-all endeavor. Each person is unique with distinct needs and personalities. Likewise, no two therapists are identical; therapists, too, have their own personalities and particular approaches to helping people. To help make therapy a positive, productive experience, consider these factors to help you choose who you want to work with.
Know Your Purpose
Why do you want to seek mental health therapy? The more specific you can be in your answer to this question, the better equipped you will be to figure out what you want from your therapist.
Know what you want out of therapy by reflecting on these questions:1
- What difficulties are you currently experiencing?
- How are they affecting you? Consider your emotions and thoughts as well as the negative impact they’re having on your life.
- What do you hope to gain from therapy? What do you hope will be better as a result?
Many times, people just know that things in their life aren’t right but find it hard to describe in words. Know that this is normal and okay. One purpose for therapy is to help you make sense of what you’re experiencing. Therefore, you don’t have to develop lengthy and detailed responses to these questions. Just let them guide you in developing a rough goal so you can ask a potential therapist if he or she addresses what you need.
Licensing, Certifications, and Education
There are many types of mental health professionals, all with different levels of education, licensing, and certifications. Working with someone with an advanced degree—a master’s or doctorate degree—and who is certified and/or licensed by a professional board and approved to practice in his or her state can increase your confidence in the process.
Having professional credentials means that he or she has completed years of specific training to help people with mental health concerns. This communicates a level of understanding and competence required to not only help people but also to avoid harming them.
Dr. Susan Krauss Whitborne recommends finding a therapist who is both confident and competent, with credentials that are current to indicate that he or she engages in continuing professional education to stay up-to-date with emerging mental health research and practice.5
The use of credentials with their name tells you their level of education as well as their certification and licensing status. You can also ask about their credentials when you contact their office.
While most therapists see a variety of clients for various reasons, many specialize in certain areas. Some, for example, focus on depression, anxiety, or other specific challenges. Some mental health providers work with a particular age group.
Additionally, therapists have specialized approaches to people and problems. Many different approaches to therapy exist that focus on specific problem areas like thoughts, emotions, or behavior. For example, cognitive-behavior therapy (CBT) is a helping approach that focuses on teaching people to identify and change unhelpful, negative thought patterns, while acceptance and commitment therapy emphasizes attitudes and behaviors toward value-driven goals.
Each therapeutic approach has merit in its own right. What’s important is that a therapist’s approach is evidence-based and goal-directed while remaining flexible and open to your individual needs and experiences.4
As you choose a therapist, do a bit of research into the approaches your potential therapist uses. If their information indicates that they use CBT and motivational interviewing, for example, read a couple of articles about each to see if they resonate with you. You can look in the “Therapy Techniques” tab on Choosing Therapy to learn about many common therapies.
Cost & Insurance Coverage
You have the right to learn, from the therapist’s office or your insurance company:
- Their treatment fees (many therapists charge per 50-minute session)
- Whether they accept your insurance (you might have to contact your insurance company or look at a list of approved providers on their website)
- How much is covered by your insurance and how much you will pay out-of-pocket
- If your insurance limits the number of sessions you may have and how the therapist honors the limit (for example, if your insurance only covers six weeks of therapy, can your therapist create a six-week plan for you or provide alternative payment options beyond six weeks?)
- If the therapist takes Medicaid or Medicare
- If they offer a sliding fee scale based on income
While mental health therapy shouldn’t increase your life stressors by causing financial hardship, think in terms of long-term benefits when weighing the costs of therapy. Working with a therapist is an investment in your mental health and quality of life. To you, is this worth forgoing spending in other areas of your life?
Practical considerations like office location and scheduling flexibility are important when selecting a therapist. The therapist you choose must see clients at the times when you’re available, and it’s helpful if his or her office is in a convenient location.
That said, licensed marriage and family therapist Tracey Cleantis advises against settling for a therapist who is convenient.6 It might be worth adjusting your schedule or driving a bit out of the way if it means working with a therapist you trust and helps you move forward.
“Generally the best predictor of success in therapy is rapport—feelings of trust and respect between the participants; a therapeutic alliance. When there’s no rapport, there’s no therapy.” -Dr. Noam Shpancer4
Of all the factors in choosing a therapist, finding one that you click with is perhaps the most crucial. In a special question and answer publication by the APA, psychologist Bruce Wampold informs us that hundreds of studies show that the therapeutic alliance, the relationship between therapist and client, is crucial for the success of therapy.7
A positive, supportive relationship is based on several factors, including:
- Personalities: A positive connection (but not a friendship) with your therapist is vital. This is often referred to as a sense of rapport.2
- Trust: You should trust your therapist enough to discuss your thoughts, feelings, and behaviors.2
- Authenticity: A good therapist is honest and genuine, demonstrating knowledge but omitting jargon (appearing as an expert but not as a know-it-all).8
- Unconditional positive regard: A therapist worthy of your choice values you and believes in your ability to progress (rather than viewing you as broken or dependent).
- Positive communication: Therapists should communicate openly and warmly even when pointing out areas for your growth.
- Your own preferences and comfort level: The best healing work happens when you feel connected to and comfortable with your therapist.
In addition to the above factors, consider your gender, sexual orientation, religion, race and ethnicity, and cultural background. How important is it to you to work with someone similar to you in any or all of these areas? Would you be comfortable talking about private matters with someone of a different background?
Considering each of these facets will help you decide what’s important to you. How, though, do you determine if a therapist meets your criteria? A look at their website or other professional profile can help, as can your initial phone call and first few therapy sessions.
How to Review a Profile or Website
Before you make your first call to inquire about a therapist, do some background research. Many therapists or mental health centers employing therapists have websites with professional profiles. Some online therapist finders provide photos and/or write-ups of the therapists that turn up in your search.
Some mental health professionals even create informational brochures and place them in community centers and local mental health organizations. While these profiles can’t tell you what someone is like to interact with in person, you can learn quite a bit of basic information about a potential therapist.
The first thing to look for in a therapist’s profile is the credentials behind his or her name. These often indicate their level of education and their certification or licensure (Decode what they stand for here). Having a string of letters indicates that they’re not just someone who has some mental health advice to impart but instead are a valid mental health professional who knows how to properly help.
Once you’ve verified that a potential therapist is, indeed, legitimate and qualified, read the bio. It will reveal if a therapist has expertise in a specific area such as depression or relationships. Lack of this information typically means that the therapist addresses a broad range of mental health challenges.
Likewise, a profile will reveal whether the therapist sees people in a certain age group. Some profiles mention the use of a particular therapeutic approach like cognitive behavioral therapy. This means that the professional is highly trained in using the given approach. If there’s no mention, quite likely the therapist draws from multiple techniques and tailors his or her approach to what each individual client needs.
While the profile will help you glean basic information (often including accepted insurance plans), you won’t learn the most important component—the chemistry between the two of you—until you talk with the therapist on the phone or in person.
What Questions to Ask During a First Call
Many people are hesitant to call a therapist’s office and ask questions about the process or the therapist. Know that doing so is perfectly okay. Therapists expect people to be unsure about many things, and they welcome inquiries.
To make a call less intimidating and ensure you remember to gather the information you need, prepare a list ahead of time.
The NIMH and APA provide similar recommendations that include such questions as:9,7,3
- What are your fees?
- Do you accept my insurance? (Have your insurance card handy)
- What do your credentials mean for me?
- Do you have experience working with people who have concerns like mine?
- How do you approach helping people?
- Do you make treatment plans? If so, will you share mine with me?
- How do the sessions work with you? (How long is each appointment? What will we do?)
- How long might I be working with you? (How many sessions do people have with you?)
If you have a positive conversation, feel that the therapist is open and easy to talk to, and the rates are affordable for you, it’s time to make your first appointment.
What to Consider During the First Appointment
Your first appointment is an opportunity to meet a therapist in person and determine if he or she is someone you’d feel comfortable working with. Rapport between you and your therapist begins to develop immediately, although it’s natural to feel a bit hesitant during the first few sessions. Pay attention to whether your therapist welcomes you warmly and puts you at ease. Is he or she someone you could come to trust with your deepest thoughts and feelings?
Watch for these qualities in a therapist that foster trust and are evident from the very first appointment. The therapist:
- Makes a point of discussing confidentiality so you know what will be kept private and anything that might be shared and why it would be shared
- Is easy to talk to
- Lets you know both verbally and nonverbally (with gestures, expressions, posture, and tone of voice) that he or she isn’t judging you negatively but is open to your experiences
- Is kind but doesn’t seem to want to be your casual friend
- Acts as if the two of you are a team (the therapist indicates that they have insights to help you but doesn’t act condescending or like a know-it-all).
Both the positive working relationship and forward progress are part of a process that occurs over time; therefore, you might not leave your first appointment feeling “cured.” You should, though, have a feeling of realistic hope by the end of your first appointment.
It’s important to choose a therapist who conveys realistic optimism and hope.5
A helpful therapist is one that neither acts as if they feel sorry for you because you are incapable of helping yourself nor makes sweeping promises that, if you keep working with them, you’ll never experience problems again in your entire life.
If you have a positive first session, make a few more appointments. It can take a few sessions to fully determine if you’re making progress with a therapist. Then, after three or four weeks, it’s okay to re-evaluate to determine if you wish to continue.
What to Consider after 3-4 Weeks
Therapy isn’t a quick-fix or a miracle cure, but it is a relationship and set of actions that leads to positive change and empowerment. How have your first few sessions been? Are you starting to feel or think differently? Have you learned new behaviors, even small changes, to implement in your life? Do you feel you have a healthy working relationship with your therapist?
Your answers to these questions can inform your decision to continue with this therapist or seek someone else to work with.
It may be time to search for someone new if your therapist:
- Talks about themself a lot, beyond occasional examples from their own life
- Is too friendly, treating you more like a buddy than a client
- Gives advice or tells you what you should or shouldn’t do
- Doesn’t give you their undivided attention during your sessions
- Uses a lot of technical jargon or grows impatient if you ask for clarification
- Doesn’t provide feedback
On the other hand, if you feel that you can trust this therapist and that you are deeply heard, you are likely in the right place. It can be difficult to express complex thoughts and feelings, and the right therapist for you will read between the lines to interpret your communication and then reflect it back to you to help you understand yourself more deeply.
Also, after a few sessions, if you feel that your therapist is helping you move forward to eventually end therapy, you’ve likely made a good choice. A good therapist seeks to make themself ultimately useless because the goal is to increase your resilience and independence.4
As much as you may like this therapist, you don’t want to feel that you’ll need him or her forever. Choosing a therapist is about selecting someone who will set you free, confidently and competently.