How to Choose a Therapist
We live in unprecedented times. Three years in a global pandemic that has claimed millions of lives around the world, government policies that only increase oppression and limit our choices, attacks on our identities and self-expression, wars that devastate our sense of safety. There is a lot going on, and our mental health has a much higher load than usual.
Only after one year of living through the pandemic, National Institute of Mental Health reported a 31% increase in symptoms of anxiety and depression and a 26% increase in stress-related symptoms. We can only imagine what three years have done to our nervous systems.
The truth is - we are all struggling right now and that is absolutely normal given the circumstances we are in. We are experiencing a collective trauma on many levels, and our bodies and minds are naturally on high alert.
But we do not need to go through all of it alone. This is where therapy comes in. Therapy is a good space to bring your worries, fears, anxieties and struggles, and to begin feeling a little bit better, one day at a time.
So now that you are on a hunt for someone to talk to, how do you actually choose a therapist to work with?
To help in that regard, let’s look at the who, how, what and where of finding a therapist.
Who?
A therapist is a mental health professional who has undergone training and education in order to help treat a number of mental health concerns, be it anxiety, depression, trauma, abuse, relationship issues, etc. Therapists come in many shapes and colors, and typically have different credentials, approaches to therapy and ways they work.
The most important part of finding a therapist, in my opinion, is personality fit. We can also call it chemistry.
To use a dating analogy, you may need to go on a few first dates before you feel a genuine connection with someone and want to talk more with them. Therapy is similar in that regard. Look for someone who makes you feel comfortable and heard. Someone you find it easy enough to talk to, and someone who fits your conversation needs (for example, you may want a therapist who talks/engages more, so assess for that when meeting for the first time).
Additionally, some folks find it important to share an identity (or part of) with their therapist in order to feel seen and heard. If it is important for you to find a therapist who identifies as BIPOC or queer, or has experience dealing with chronic pain, for example, make sure you include this in your search criteria.
How?
Arguably, the most important aspect after personality fit is the therapist’s approach to therapy. Do they use cognitive models that focus on modifying behavior? Do they do exposure therapy and go out into the world with you? Do they engage in talk therapy? Are they coming from a trauma-informed lens?
The “how”will be helpful to assess when you have clear goals for your therapy. For example, if your goal is to decrease your anxiety at work, your options may be to work with a behavioral therapist who will focus on identifying the thoughts behind your anxiety and re-framing them to something more helpful. A therapist working through exposure therapy may ask you to slowly engage in situations that cause anxiety with the goal of increasing your ability to manage it. A relationally-focused therapist may begin exploring your story, wondering when your anxiety began, what where the circumstances around it and who was present (or absent) at the time.
The key is to identify what you think may be most helpful approach for you and to look for that.
It is also completely okay to not know what would be most helpful for you. In this case I recommend trying out a few different therapists and a few different approaches in order to see what feels the most helpful to you.
These questions are also frequently answered on therapist’s websites, but not always. Many therapists offer a 15-30 minute free consultation to assess fit. This is a great place to ask what kind of modality they practice and how they think it will benefit your particular circumstances.
What?
The what of therapy is the logistics part. What times is the therapist available? What do they charge and do they take your insurance? Is there a sliding scale available? What are their practice policies and procedures? What is important to them in their work?
Many answers to these questions can be found while perusing a therapist’s website. Spend some time reading what the therapists write about their work, process and logistics. Assess how you feel after reading this information: are you curious to hear more from this person? Is there enough information for you to make a decision to proceed?
Where?
If it is important for you to be able to do therapy online, make sure you are looking for a therapist who offers that. Take your physical location into consideration as well and make sure you search for a practitioner who is licensed in your state (for example, if you are in California and are looking for therapists in Washington, it will be harder to find someone who is licensed to practice in both states).
If you are hoping to be in person, search accordingly. Is their office easy to get to or will you spend two hours in traffic getting there? You will be more likely to cancel sessions if getting to their office is a hassle. Ask about ADA access and gender-neutral bathrooms. If there are five flights of stairs to climb and you experience chronic pain on a daily basis, this will impact your ability and/or desire to attend.
Find out what your preference is for how therapy is delivered, and ask the therapist you are interested in working with how their sessions are conducted.