In order to get the full benefits of therapy, you have to put your mental health in the right person’s hands. There’s no one-size-fits-all approach to therapy and the professional that works well for someone else might not work as well for you. There are important considerations to keep in mind through every step of the therapy process.
Before the Consultation
If you’re new to the world of psychotherapy, you’ll probably start by asking friends for referrals, discuss a referral with your physician, or search online. When researching possible candidates, you want to make sure they have the tools to solve your issues. At the very minimum, a therapist’s website should include information about their education, certifications, and specializations. There are different kinds of mental health accreditations, and a counselor’s certifications will be different than, say, a psychiatrist who prescribes medication. The specific credentials you should look for include: a licensed professional counselor (LPC) who has a master’s degree in counseling, a licensed clinical social worker (LCSW), a licensed marriage and family therapist (LMFT), or a licensed clinical psychologist who has a PhD or PsyD in psychology. Therapists typically specialize in specific areas, like substance abuse, trauma, family therapy, couples counseling, or even career issues. These areas should be listed on the therapist’s website.
A therapist should also communicate what kind of approach they take to therapy. Perhaps there are researchers or scientists whose work they follow or specific techniques they use in their work. Many therapists will include this information on their website, which can give you an idea of what to expect once you’re in a session. At this stage, keep an open mind: there are many different approaches to therapy, and there is little evidence that any one therapy is better than another. For example, there’s cognitive-based therapy, mindfulness-based stress reduction, acceptance and commitment therapy, and so many more.
Online reviews can help you find a good therapist, but they can also be problematic. Therapy is more subjective than, say, bad service at a restaurant and a certain treatment might help one person but not another. Also, because of confidentiality issues, therapists cannot illicit reviews from clients. Still, negative reviews can help you look for red flags, like a therapist watching the clock or pushing their own agenda. Be discerning when you comb through them and understand that what works for one patient at a particular point in therapy may not work later when their needs change.
The Phone Consult
Once you’ve narrowed it down to a few therapists who look promising, it’s time for a quick consultation call. Before committing to an actual appointment, reach out and ask to chat on the phone or send some questions via email. These consultations typically last 10-15 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.
During the consultation, you also have the opportunity to ask the therapist questions that are important for you to know about that therapist. Some people are interested in knowing where the person went to school or what certifications or licenses they have. For others, knowing about their experience with their particular issue are more important. This is probably a good point to ask about fees and availability, too.
Your therapist should be a good listener, and you can get an idea of this during your phone consultation. A good therapist is also compassionate and nonjudgmental when listening to your concerns. Remember that “good” listening is somewhat subjective. Some people prefer a therapist who does a lot of listening while they vent and process, while other people prefer a more active therapist who teaches coping skills and offers more feedback. You can tell if a therapist is a good listener if you feel heard and understood when talking with them.
Beyond feeling understood, the therapist should be able to communicate that they’re knowledgeable about your issue through training and experience. You can simply ask, “Can you tell me about your training and experience in this area?” Their answer should make you feel confident they can handle your issue, but it is recommended that people focus more on how it feels talking to the therapist. Research has shown that the relationship between the therapist and the client plays a big role in the success of the therapy.
If you don’t like what you get in your initial consultation, be willing to shop around. The research is clear about this: good rapport with the therapist is vital to success, so make sure you find one with whom you are comfortable.
During Your First Session
Especially if you’ve never been to therapy before, the first session can always be a little awkward. You don’t exactly storm into the office, plop down on the couch, and declare, “Okay, doc, fix my intimacy issues!” The conversation typically emerges more organically. Your therapist might ask how your week has been, then dig into the issues from there. Either way, you should feel comfortable and heard as the session progresses.
Good therapists demonstrate good boundaries. They keep the relationship professional by limiting the personal information they share about themselves. They stay awake and alert throughout the session and do not answer their phone or check their text messages. During your session, you should never feel that your therapist is pushing his or her own agenda or professional goals, like selling a book. Therapists should work to support the goals of the client. Part of establishing solid boundaries means referring clients who are experiencing issues outside the therapist’s area of expertise.
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 should also ask you to sign an informed-consent document, which includes information about your rights and responsibilities as well as theirs.
Initial Progress and Cautions
You should notice that you feel supported and hopeful after your therapy sessions.
After a few weeks of therapy, 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.
That isn’t the only red flag, of course. If your therapist constantly watches the clock, makes you feel guilty for quitting, or threatens that you’ll “plunge into depression” if you stop going to therapy: those are surefire signs that you might not be getting the help you need.
A few other red flags that it may be time to consider another therapist:
- The therapist is talking more than you.
- The therapist is interrupting you often.
- Any inappropriate behaviors from the therapist (sexual or otherwise).
- The therapist has violated your confidentiality.
It’s worth pointing out that the last two red flags are also reportable offenses. You can file a complaint with DSPS for ethical (and, potentially legal) violations.
How long therapy lasts varies depending on the person. It may take months or years until you feel that your therapy is complete and you’ve reached your goals. Ultimately, therapy is successful when you decide that you’ve developed the skills and tools to cope with the emotional challenges that brought you to therapy. Some people also value longer-term ongoing care to further maintain progress, growth, and optimal functioning. At the beginning of therapy, it is important to develop a clear treatment plan with your therapist and monitor this over time to assure that you are receiving the value that you desire. After all, therapy can be expensive and you want to make sure you’re getting your money’s worth.
Five Key Reminders in Finding Your Optimal Therapist
1. Research, research, research.
2. Look for experience that matches what you need.
3. Make an early connection.
4. Check licensing and credentials.
5. Never settle and find your best fit.