Choosing a therapist is a big decision because working with the right one can be an important part of reclaiming your life and maintaining wellbeing. When you know what to look for and understand what would best suit your specific concerns, choosing a therapist can be a positive and productive first step on your way to better mental health.
What Makes a Good Therapist?
A therapist isn’t a friend who listens to your woes and tries to give you advice. Instead, the right therapist will help you recognize and change things like negative thought patterns and/or problematic behaviors while simultaneously accepting you for who you are.1 A good therapist helps you improve without judging you for your struggles.
Being selective in your choice will help you get the most out of your time in therapy. It’s important to choose a therapist that possesses strong credentials and effective interpersonal skills that contribute to a feeling of trust and a sense of forward progress.2
When Should I Consider Therapy?
When you’re starting to feel like you’re unsure of your next move or what to do or even confused and overwhelmed about how you feel, consider trying therapy. Therapy is for everyone who wants to do the work it takes to get out of and through a tough situation. Many people consider therapy when they are in a panic, but you don’t have to be at rock bottom to get a lot out of therapy. If you’re dealing with depression, anxiety, relationship issues, family issues, couples issues, mood and stress concerns or any kind of life transition, talking with a therapist can really help you.
Here are some signs that it might be time to find a therapist:
- Uncertainty in yourself
- Avoidance of people, places or situations
- Changes in eating and sleeping
- Feeling overwhelmed
- Low mood
- Hyper mood
- Staying overly busy
“When you feel you need more individualized help and are stuck, it is a great time to consider therapy. Couples often wait an average of 6 years after a problem starts to begin therapy—this is way too long as 6 years is a lot of time to be living in pain. Know that problems can be resolved, even if they’re not fully solved, and therapy can help an individual/couple/family develop a whole new, happier system to deal with a problematic dynamic.” – Nicole Kleiman-Reck, MA, LMHC
“If your daily routines and interactions are being impacted then it may be time for therapy. Whether individuals, couples, or families, if you are feeling that you are stuck or having trouble expressing yourself with others and are feeling heightened levels of stress or anxiety, therapy may help you to reduce those feelings and increase your confidence levels.” – Jaclyn Gulotta, PhD
“If you are feeling alone, isolated and hopeless it is probably a good time to consider therapy. Maybe you’re struggling with managing emotions ‘in the moment’ or running out of communication skills to adequately express yourself to your partner or other loved ones. I see therapy as a ‘tune up’ and a great way to make the time to work on ourselves without the static of the outside world or opinions of others.” – Adria Hagg, LCSW
What to Look For in a Therapist
When deciding on a therapist, there are many factors that go into finding the best fit, including specialty, personality, cost, and scheduling.
Of all the factors in choosing a therapist, finding one that you click with is perhaps the most crucial. Hundreds of studies show that a strong relationship between therapist and client is crucial for the success of therapy.3
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, even when they’re scary or uncomfortable.4
- Authenticity: A good therapist is honest and genuine, demonstrating knowledge but omitting jargon (appearing as an expert but not as a know-it-all).5
- 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. You may also want to find a therapist who is familiar with your identity. This can be especially important for those who identify as LGBTQIA+, BIPOC, or Latinx.
Licensing, Certifications, & Education
There are many types of mental health professionals, all with different levels of education, licensing, and certifications. Having professional credentials means that the therapist 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.
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. For example, some focus on depression, anxiety, or other specific challenges, and some mental health providers work with a particular age group.
Additionally, many different approaches to therapy exist that focus on specific problem areas like thoughts, emotions, or behavior. Some examples of common types of therapy include:
- Cognitive-behavior therapy (CBT): CBT is a helping approach that focuses on teaching people to identify and change unhelpful, negative thought patterns
- Acceptance and commitment therapy (ACT): In ACT, the emphasis is on attitudes and behaviors toward value-driven goals.
- Dialectical behavior therapy (DBT): DBT is useful for managing emotions and distress and involves skills training for effective problem-solving and actions.
- Exposure therapy: Exposure therapy helps people address and reduce anxiety and phobias.
- Person-centered therapy: In person-centered or client-centered therapy, the therapist’s primary role isn’t to teach skills but instead is to listen to the client and engage in discussion that helps the client discover how to move forward.
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.1
Cost & Insurance Coverage
When you’re finding the right therapist, it’s okay to inquire about the cost of therapy.
Ask the therapist’s office or your insurance company about these concerns related to the cost of therapy:
- Their treatment fees (many therapists charge per 50-minute session)
- Whether they accept your mental health 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?)
While 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?
What If I Can’t Afford a Therapist?
If you’ve looked around, checked with your insurance or don’t have insurance and you’re still looking for an affordable therapy option, you should consider:
- Sliding scale therapists
- Pursuing Medicaid
- Working with practices who have student counselors who offer lower rates
- Trying an online platform which may have subscription options at a lower rate
- Contacting local mental health agencies and ask about resources
- Speaking with any university based counseling school to see what options may be available through the school
- Going to a community clinic to ask about resources available through the clinic
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. However, don’t settle for any therapist just because they have a convenient location. 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.
Online vs. In-Person
Many therapists and counselors now offer online therapy where therapist and client meet in a HIPAA compliant video chat (similar to doing a call on FaceTime or Skype, but more secure). Video therapy can make scheduling a session more convenient because it eliminates the need for anyone to commute. Studies are showing that online therapy and in-person therapy are essentially equal in effectiveness.
Specific Life Stages or Cultural Backgrounds
In addition to the above factors, consider your gender, sexual orientation, religion, race and ethnicity, and cultural background. Your age may also play a factor. For example, some therapists specialize in young adults and others work primarily with seniors. 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? This can be especially important for those who identify as LGBTQIA, BIPOC, or Latinx.
How to Review a Therapist’s Profile or Website
Before you make your first call to inquire about a therapist, do some background research. Many therapists or mental health centers have websites with professional profiles. An online therapist directory can be a helpful place to sort through photos, write-ups, and video introductions of the therapists that turn up in your search. Most of those online therapist profiles will let you know if they offer online therapy or are in-person only.
The first thing to look for in a therapist’s profile is the credentials behind their name. These often indicate their level of education and their certification or licensure. Having a string of letters indicates that they’re not just someone who has some mental health advice to impart but are a valid mental health professional who knows how to properly help.
Once you’ve verified that a potential therapist is legitimate and qualified, read their 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.
A profile will also 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 that 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
What Questions to Ask During a First Call
While a therapist’s profile will help you glean basic information, 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. Many people are hesitant to call a therapist’s office and ask questions about the process or the therapist, but it’s perfectly normal to do so. 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.
Here are some questions to ask on a phone consultation with a potential new therapist:2,3,6
- 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 prepare for your first therapy session – it can be helpful to write out a list of the concerns you know you want to cover right away.
What to Consider During Your First Therapy Appointment
Your first appointment is an opportunity to meet a therapist in person and determine if they are 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. Are they someone you could come to trust with your deepest thoughts and feelings?
Watch for these qualities in a therapist during your first appointment:
- They are easy to talk to
- They let you know both verbally and non-verbally (with gestures, expressions, posture, and tone of voice) that they aren’t judging you negatively but are open to your experiences
- They make 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
- They are kind but don’t seem to want to be your casual friend
- They act 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.” However, you should have a feeling of realistic hope by the end of your first appointment. It’s important to choose a therapist who conveys measured optimism and hope.7 A helpful therapist is one that neither acts as if they feel sorry nor makes sweeping promises that 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 or 4 Sessions
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 if they’re not a good fit.
It may be time to search for someone new if your therapist:
- Talks about themselves 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 themselves ultimately useless because the goal is to increase your resilience and self-worth.1 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.
How Long Can I Expect to Be In Therapy?
Timelines can vary for everyone, and usually that timeline depends on your process and journey as the therapist is there to help facilitate that inner work. Typical time frames can be anywhere from 4 to 12 months depending on the types of issues you are dealing with. If you are dealing with anxiety, you likely can expect to be in for at least 6 months. If you go to a CBT therapist you might get a plan with a timeline of 4 months. If you go to a psychodynamic therapist it might be 12 months or longer.
The important thing to remember is that therapy is less about the hours put into it and more about the meaning of those hours of inner work. A therapist will work with you to come up with a treatment plan which will help to inform goals over a timeframe specific to your needs.
“A typical timeline for therapy is anywhere from 3 months to a year, depending on the person’s treatment plans and goals. Therapy can be used for a longer period of time if the person is struggling with more severe symptoms such as intrusive thoughts or depression and thus may create a more in depth treatment plan.” – Jaclyn Gulotta, PhD
“There is no specific timeline for therapy. It really depends on the individual, couple, family and the therapeutic interventions being used. Talk to your therapist and check in with where you are at psychologically and emotionally. It is always good to review progress or discuss where you feel ‘stuck.’ As the saying goes, ‘one size does not fit all.’” – Adria Hagg, LCSW
“On average, therapy starts weekly, and then the gap between sessions expands as growth occurs. Once it is mutually decided that progress can be maintained, a transition out of therapy is ideal. Also, many people and couples attend therapy routinely as a ‘check-up,’ coming once or twice a year—prevention is much easier than treatment and I feel if you are able to do this, mental health checkups are equally important as your physical health checkups!” – Nicole Kleiman-Reck, MA, LMHC
Final Thoughts on Choosing the Right Therapist
Choosing a therapist is a personal decision that involves selecting a mental health professional that will help you overcome your unique obstacles and work toward your own meaningful goals. It may take a bit of research and even some consultations, but the right fit for you does exist. Finding a therapist that is right for you is well worth the effort.