by Tammy Dorff, Psy.D.
When you have decided to seek therapy for yourself or your loved one, how do you find the right person to see?
Most often, people find their therapists based on a referral from someone they know and trust (a doctor, school guidance counselor, friend or relative), by searching online through sites such as Psychology Today, or by looking for therapists participating with their insurance company.
Once you have some therapists’ names, though, how do you decide which one is the best fit for your needs?
Is it based on appearances?
We are often influenced by subtle cues that make us feel more or less comfortable around a new person. How do they seem based on their website photo or when you first meet them? How do they dress? What does their office look like? How comfortable is their couch? Do they look similar to you or remind you of anyone you know? While appearances definitely impact people’s first impressions and can help you to feel comfortable more quickly in therapy, these external characteristics may not accurately predict the long-term successfulness of the therapy because they do not generally reflect the therapist’s empathy, psychological training, skills or abilities. It is therefore important to consider other qualities of the therapist too in determining whether they are a good match for you.
How about geographical proximity and availability?
Being geographically close to your therapist might make it easier to participate consistently. That has to be balanced with your assessment of their skills and training, as well as with how comfortable you feel in talking with them.
Is a good therapist match based on similarities to you?
Do you want someone of the same gender, race, religion, age range, ethnicity or sexual orientation as you so that they might better understand you and relate to your situation? Or would you prefer someone different from you to offer an alternate perspective and be less likely to confuse their issues with your own? Knowing what you prefer will help to guide your selection of a therapist.
What about their education, training and skills?
Ideally, your therapist should have excellent training based both on the graduate school program they attended and on their clinical experiences. You can ask the therapist to describe how they were trained and why they decided to do this work. Often, therapists will also post a resume or CV on their websites for potential clients to review in deciding who to contact for help.
Some types of work require more specialized training—for instance, if you are seeking a play therapist, it is important to find someone who works regularly with young children in this modality. Similarly, if you need a psychologist to do a Custody Neutral Evaluation, hypnosis or EMDR, these are all areas of practice that require specialized training beyond what most graduate schools offer. It is important to let the psychologist know as specifically as possible what type of help you desire and to ask whether or not that person has the expertise you need.
How about their theoretical orientation?
Theoretical orientation is similar to a dialect that each person speaks. Some people feel more comfortable when a therapist speaks the “language” that they understand. Therefore, you may want to talk with a few psychologists over the phone and ask them how they view their role, what they believe helps people to change in therapy, and ask any questions specific to your particular situation in order to get a sense of who they are and how they work. If you especially want a therapist who practices from a particular theoretical orientation, it makes sense to seek out a therapist who is well-versed in that way of conducting psychotherapy.
It is important to realize, though, that factors other than theoretical orientation usually play a more important role in determining positive psychotherapy outcomes. Research shows that different theoretical approaches to intervention are generally equally effective for the vast majority of symptoms, and that the most important variables for effective treatment have to do with the connection you feel to your therapist (see below).
How much are you willing to pay?
While some therapists participate in managed care plans, especially when they are first getting established in the profession, many do not as a result of the ethical, financial and bureaucratic constraints that joining a managed care panel can entail. As a result, you may find that the best psychologist for you needs clinically is not participating in your insurance plan. You will then need to decide whether or not it is worth it to you to see someone who costs more per session but might offer you better services. Consider that it is actually less expensive to see someone out-of-network who is well-skilled and can help you effectively and efficiently than it is to pay less per session to see someone who might lack the expertise to make as much of difference in your life. For people without insurance, community mental health centers offer mental health services, as do some mental health doctoral or post-doctoral programs (where graduate students or training candidates generally act as the therapists and are supervised by more highly skilled and licensed practitioners). Some private practice therapists also offer some degree of a sliding scale or lower-fee services, so it is OK to inquire about this when speaking with them.
Feeling Comfortable Talking to the Therapist
Research has repeatedly demonstrated that the most important factors in finding a therapist who can help you have to do with whether or not you feel comfortable with that therapist, trust the practitioner and feel that he or she understands you, cares about you and can help you effectively. If this sense of connection does not occur immediately, it might be worth returning for another session or two to see whether such a bond might develop—some people take longer to feel safe enough to discuss their private situations than others, and emotional bonds often take some time to foster. However, if after several sessions, you still do not feel this sense of attachment or safety, it might be worth considering other options—speak with your therapist about the sense of disconnection, see whether or not the therapist can do something to change that or else ask for referrals to other therapists who might be a better fit for you.
