How To Find the Right Therapist
Finding a good therapist is difficult and can be overwhelming. How are you to know who is effective and who isn’t? The profession is ethically not allowed to pursue testimonials or reviews. Therapist "shopping" is a perfectly acceptable practice. You'll likely need to talk to several potential candidates on the phone or through email to see if they meet your needs. You may decide to meet with several possible therapists before you find the best fit.
Before the Consultation
Most therapists will offer a free 15-minute phone call to help assess if you are a good fit for each other. But before you book the phone call you need to determine what kind of therapist you want to work with. Male or female? What age? Is religious affiliation important to you? Do they need to be experienced in the LGBTQ population or a specific ethnic group? Or since COVID, do you want to see a therapist in person or is online okay?
Therapists have a lot of different initials after their name. Although there are some slight differences in the license, any one of these can have the training and experience needed to be a good fit.
Chances are your first exposure to a therapist is going to be their website. If reading how they describe who they are and how they work doesn't sit well with you that could be a good indicator that it will not be a good fit. Listen to your intuition. If you feel instinctively uncomfortable with a therapist, that will probably inhibit the progress you will make. In contrast, if you feel you ‘click’ with a therapist, that's a good sign that you will be able to build a "therapeutic alliance" with them.
It is also helpful to be able to articulate what it is you want to work on. Where are you stuck? Conflict or dissatisfaction in a relationship? Betrayal? Addiction? Trauma? Depression? Anger? Anxiety? Family conflict?
Therapists who want to specialize in couple therapy must do additional training because in grad school there is only one class in couple therapy. Most therapists don’t like couple therapy and feel it is too difficult. There are several models for advanced training. I'm trained in the Psychobiological Approach to Couple Therapy (PACT). Trainings offer various levels of training (Level 1, 2 3, etc) and certification. Certification could involve logging a certain number of hours using the model and hours of consultation with a well-trained supervisor in the model. Some don’t pursue certification because of the cost. And certification does not necessarily mean the therapist is effective. At the minimum you want your therapist to have a level 1 training in the model they are working with. More training is better. Couple therapy is complicated.
Ideally, I would also recommend that the couple therapist be trained in a trauma therapy. Unresolved trauma is the main issue that prevents couples from successfully achieving their goals. If the couple therapist is trained in trauma, they can do some individual work with one or both partners to calm the reactivity.
For individual therapy I always recommend a therapist who is trained in one of the trauma models. It is my experience that the issues that tend to lead us to get help are influenced by painful events of the past. The most effective way to have deep healing of those experiences is to use a trauma therapy as opposed to traditional talk therapy. Many clients who don’t know about trauma therapy can spend months or even years talking about traumatic experiences without deep healing. They will learn some tools to manage the feelings but won’t actually heal the trauma like a specific trauma therapy will. I'm trained in EMDR, Brainspotting and Internal Family Systems (IFS), which I tend to favor. There are also others like, Somatic Experiencing and Sensorimotor Therapy.
Each of these couple and trauma models has a directory for therapists who are trained in that model. Some therapists may not be on the specific directory but may be on a general directory.
For sex addiction consider interviewing some Certified Sex Addiction Therapists (CSAT).
Before the Consultation
Most therapists will offer a free 15-minute phone call to help assess if you are a good fit for each other. But before you book the phone call you need to determine what kind of therapist you want to work with. Male or female? What age? Is religious affiliation important to you? Do they need to be experienced in the LGBTQ population or a specific ethnic group? Or since COVID, do you want to see a therapist in person or is online okay?
Therapists have a lot of different initials after their name. Although there are some slight differences in the license, any one of these can have the training and experience needed to be a good fit.
- LCSW - Licensed Clinical Social Worker
- LPCC - Licensed Professional Clinical Counselor
- LMFT - Licensed Marriage and Family Therapist
- LCP - Licensed Clinical Psychologist
Chances are your first exposure to a therapist is going to be their website. If reading how they describe who they are and how they work doesn't sit well with you that could be a good indicator that it will not be a good fit. Listen to your intuition. If you feel instinctively uncomfortable with a therapist, that will probably inhibit the progress you will make. In contrast, if you feel you ‘click’ with a therapist, that's a good sign that you will be able to build a "therapeutic alliance" with them.
- The alliance has been shown to be a critical factor in therapy outcomes. In terms of its impact it accounts for seven times more of the variance in outcomes than the therapy model.
- The alliance is made up of three interrelated components: Agreement on therapeutic goals, agreement on the tasks that make up therapy, and the quality of the bond between therapist and client.
- The power of the alliance lies in the creation of hope within the client, faith in the therapist as someone who can help, commitment to the process of therapy, and expectation that the commitment will bring benefit.
It is also helpful to be able to articulate what it is you want to work on. Where are you stuck? Conflict or dissatisfaction in a relationship? Betrayal? Addiction? Trauma? Depression? Anger? Anxiety? Family conflict?
Therapists who want to specialize in couple therapy must do additional training because in grad school there is only one class in couple therapy. Most therapists don’t like couple therapy and feel it is too difficult. There are several models for advanced training. I'm trained in the Psychobiological Approach to Couple Therapy (PACT). Trainings offer various levels of training (Level 1, 2 3, etc) and certification. Certification could involve logging a certain number of hours using the model and hours of consultation with a well-trained supervisor in the model. Some don’t pursue certification because of the cost. And certification does not necessarily mean the therapist is effective. At the minimum you want your therapist to have a level 1 training in the model they are working with. More training is better. Couple therapy is complicated.
Ideally, I would also recommend that the couple therapist be trained in a trauma therapy. Unresolved trauma is the main issue that prevents couples from successfully achieving their goals. If the couple therapist is trained in trauma, they can do some individual work with one or both partners to calm the reactivity.
For individual therapy I always recommend a therapist who is trained in one of the trauma models. It is my experience that the issues that tend to lead us to get help are influenced by painful events of the past. The most effective way to have deep healing of those experiences is to use a trauma therapy as opposed to traditional talk therapy. Many clients who don’t know about trauma therapy can spend months or even years talking about traumatic experiences without deep healing. They will learn some tools to manage the feelings but won’t actually heal the trauma like a specific trauma therapy will. I'm trained in EMDR, Brainspotting and Internal Family Systems (IFS), which I tend to favor. There are also others like, Somatic Experiencing and Sensorimotor Therapy.
Each of these couple and trauma models has a directory for therapists who are trained in that model. Some therapists may not be on the specific directory but may be on a general directory.
For sex addiction consider interviewing some Certified Sex Addiction Therapists (CSAT).
General Directories
PSYCHOLOGY TODAY
More therapists than any other directory. There are pull down menus to add filters to narrow the search, including insurance (if you have in network benefits), issue you want to address and type of therapy.
More therapists than any other directory. There are pull down menus to add filters to narrow the search, including insurance (if you have in network benefits), issue you want to address and type of therapy.
- There are four models of couple therapy listed in the directory -- Imago, Emotionally Focused Therapy (EFT), Gottman and Psychobiological Approach to Couple Therapy (PACT).
- There are three models of trauma therapy listed in the directory -- EMDR, Brainspotting and Internal Family Systems.
- You can use the filter in the search or use the specific therapist directory listed below.
- Some therapists on Psychology Today say they use a specific model when they do not have a Level 1 training. That's why it is important to ask specifically about their training.
Couples Therapist Directories
Psychobiological Approach to Couple Therapy (PACT)
Imago Therapy
The Gottman Method Couples Therapy
Emotionally Focused Couples Therapy (EFT)
The Developmental Model of Couples Therapy
Relational Life Therapy
Psychobiological Approach to Couple Therapy (PACT)
Imago Therapy
The Gottman Method Couples Therapy
Emotionally Focused Couples Therapy (EFT)
The Developmental Model of Couples Therapy
Relational Life Therapy
Trauma Therapist Directories
Internal Family Systems
EMDR
Brainspotting
Somatic Experiencing
Sensorimotor Therapy
Internal Family Systems
EMDR
Brainspotting
Somatic Experiencing
Sensorimotor Therapy
Lower cost therapy options
During the Phone Call
Once you’ve narrowed it down to about 10 therapists who look promising, send multiple emails saying you are shopping for a therapist. It might seem like a lot of therapists, but many therapists are likely to be full and not taking new clients. Include a brief explanation of the issue you want to work on. Ask them to offer some referrals if they are not taking new clients. If you find someone who has time in their schedule, it’s time to ask for a consultation.
These consultations typically last 15 minutes, and you’ll want to share a bit about your background, the specific issues you’re struggling with, and what your goals are with therapy. Studies show a therapist’s ability to show warmth, genuineness, and empathy is key to their ability to form a therapeutic alliance. So consider this your chance to conduct a brief interview with the therapist and see how you feel about their responses.
You can start by asking...
Your First Session
The first session can always be a little awkward especially if you’ve never been to therapy before. During an initial session, your therapist will likely explain how therapy works, provide you with information on confidentiality, and ask you to sign some forms.
From there you may be interviewed about the problems or symptoms you are experiencing and your goals for treatment. The therapist may ask questions about your childhood, your medical history, your family, and any history of past mental health treatment. This can help them gain an overall background. And it will help them work with you on establishing goals at a future appointment. You should feel comfortable and heard as the session progresses.
Even though the relationship will feel friendly, it is not a friendship. The relationship is professional. You are paying for a service. There are various opinions on whether a therapist should “self disclose.” Some therapists won’t even tell you if they are married or have kids. Others will share personal experiences as they feel it would be helpful to your process. The feedback from many clients is that they want to feel that the therapist is a real person who is empathic, respectful, honest and warm. Not surprisingly, clients like therapists who treat them as equals, whose behavior, attitude, and words make them feel safe, comfortable, and valued and who act like a partner in your healing.
At this point, you and your therapist should agree on a treatment plan with specific goals and objectives. The plan should include strategies that your therapist believes will help you reach those goals and might even include a time frame for getting there. Before treatment, your therapist may also ask you to sign an informed-consent document, which includes information about your rights and responsibilities as well as theirs.
If you are using insurance, either in or out of network, the therapist may need to conduct a thorough assessment that helps them identify whether you meet the criteria for a mental health diagnosis, like depression. This is because most insurance companies only cover mental health treatment for people who have been diagnosed with a mental illness.
After a Few Weeks
You should notice that you feel supported and hopeful after your therapy sessions. You should begin to feel at least a small sense of control and change. If you don’t, it may be time to move on. Other red flags that it may be time to change your therapist would include the therapist talking more than you or interrupting you often.
If you aren’t feeling a connection to your therapist or the changes you want to feel, you may want to talk about this with your therapist. This can feel really uncomfortable, but therapists have these conversations often. If there’s an issue that can be addressed, they may want to address it with you.
Once you’ve narrowed it down to about 10 therapists who look promising, send multiple emails saying you are shopping for a therapist. It might seem like a lot of therapists, but many therapists are likely to be full and not taking new clients. Include a brief explanation of the issue you want to work on. Ask them to offer some referrals if they are not taking new clients. If you find someone who has time in their schedule, it’s time to ask for a consultation.
These consultations typically last 15 minutes, and you’ll want to share a bit about your background, the specific issues you’re struggling with, and what your goals are with therapy. Studies show a therapist’s ability to show warmth, genuineness, and empathy is key to their ability to form a therapeutic alliance. So consider this your chance to conduct a brief interview with the therapist and see how you feel about their responses.
You can start by asking...
- Can you tell me about your training and experience in this area?
- If you want a couples therapist, What percentage of your practice is working with couples?
- How much trauma work do you do?
Your First Session
The first session can always be a little awkward especially if you’ve never been to therapy before. During an initial session, your therapist will likely explain how therapy works, provide you with information on confidentiality, and ask you to sign some forms.
From there you may be interviewed about the problems or symptoms you are experiencing and your goals for treatment. The therapist may ask questions about your childhood, your medical history, your family, and any history of past mental health treatment. This can help them gain an overall background. And it will help them work with you on establishing goals at a future appointment. You should feel comfortable and heard as the session progresses.
Even though the relationship will feel friendly, it is not a friendship. The relationship is professional. You are paying for a service. There are various opinions on whether a therapist should “self disclose.” Some therapists won’t even tell you if they are married or have kids. Others will share personal experiences as they feel it would be helpful to your process. The feedback from many clients is that they want to feel that the therapist is a real person who is empathic, respectful, honest and warm. Not surprisingly, clients like therapists who treat them as equals, whose behavior, attitude, and words make them feel safe, comfortable, and valued and who act like a partner in your healing.
At this point, you and your therapist should agree on a treatment plan with specific goals and objectives. The plan should include strategies that your therapist believes will help you reach those goals and might even include a time frame for getting there. Before treatment, your therapist may also ask you to sign an informed-consent document, which includes information about your rights and responsibilities as well as theirs.
If you are using insurance, either in or out of network, the therapist may need to conduct a thorough assessment that helps them identify whether you meet the criteria for a mental health diagnosis, like depression. This is because most insurance companies only cover mental health treatment for people who have been diagnosed with a mental illness.
After a Few Weeks
You should notice that you feel supported and hopeful after your therapy sessions. You should begin to feel at least a small sense of control and change. If you don’t, it may be time to move on. Other red flags that it may be time to change your therapist would include the therapist talking more than you or interrupting you often.
If you aren’t feeling a connection to your therapist or the changes you want to feel, you may want to talk about this with your therapist. This can feel really uncomfortable, but therapists have these conversations often. If there’s an issue that can be addressed, they may want to address it with you.