How Should I Choose a Therapist?

When you choose a therapist you are making a hugely important decision. You are asking someone for help where you may be most vulnerable, and entrusting that person with some of the most private and confidential matters in your life. It’s therefore wise to put some thought into how you choose a therapist, though there are practical considerations that may need to be taken into account too.

One of the frustrating things about choosing a therapist may be that it can take a few sessions to get a sense of whether or not you will feel comfortable working with a certain person. Often you have to go on first impressions, especially if your insurance limits the number of therapy sessions it will pay for in a given year. There are a few things that you can ask yourself and any therapist you might contact, before you have your first session.

First, you might ask yourself if you will feel greater comfort working with a person of a certain gender. Both men and women may feel that they would be better able to talk about difficult issues with a person of the same or opposite gender. Don’t worry about being sexist here; simply go with gender preference when you consider what you’ll be discussing. Therapy works best when a person can talk about complex feelings, emotions and situations without embarrassment. If opposite or same gender appears to make you more embarrassed, eliminate the therapists you feel you won’t be able to speak with fully and openly.

Second you should consider how to choose a therapist based on type of therapists: psychiatrists, psychologists, Licensed Clinical Social Worker (LCSW) and Marriage and Family Therapists (MFTs). If you think your problem may not be resolved without psychiatric medication, the logical choice is a medical doctor — a psychiatrist — since he or she can both prescribe medications and conduct therapy sessions. Not all psychiatrists do both. Some function primarily to manage and prescribe medications, and will only see you for half-hour sessions. In this case you may need both a psychiatrist and a therapist of another type.

Probably more important than degree or titles is level of experience, especially in dealing with your specific issues. This is a question that can be asked prior to therapy. If you’re trying to choose a therapist to work on issues in your marriage, you want a therapist that has in depth experience with couples’ counseling. Before heading to your first session, make sure the therapist you choose has some experience or expertise in the area you need. A therapist who hasn’t worked with kids before wouldn’t, for example, be the best choice for your child. A good question to ask here in an initial phone interview with a therapist is: “How many people have you treated with concerns like mine and how successful was your treatment?”

Another question to ask is whether the therapist will take your insurance, which can definitely help with payment. When you are uninsured or have limited resources, look to charitable organizations within your community that can help provide therapy at minimal costs or on a sliding scale fee. Note that sometimes this therapy is done by people working toward fulfilling their hours requirements to get licensure, but that licensed counselors will supervise them.

It also makes good sense to create some goals. What do you want out of therapy? What are you trying to resolve? In a first session after you choose a therapist, or even in a pre-session phone conversation, you may want to state your goals and ask the therapist if he feels he can help with them. When a therapist states plainly that he can’t help you achieve these goals it’s time to choose a different therapist who can.

Other things to consider include state licensing and theoretical orientation (different types of therapy offered). The most important thing, though, is comfort. If you feel distinctly uncomfortable, it’s time to choose a therapist that may set you more at ease. Don’t expect that therapy is automatically a comfortable process; it certainly can be very difficult. However, listen to yourself and if you find the manner, actions, or ideas of a therapist in great conflict with your own, look elsewhere for someone who will fit you better.