Finding the right therapist takes time and can be an overwhelming task, especially if you are in crisis and need help now. If you live in a place like San Francisco, which is teeming with therapists, you will have many to choose from. But how do you know which one is the best for you?
The relationship is the most important factor. The research is very clear on this – the success of therapy depends on the strength of the relationship you have with your therapist. Having a good fit with your therapist is more important than their professional degree or therapeutic approach. What is important is if their approach feels right to you and if you have a good working relationship. Feeling heard, understood and respected are all a part of a good fit. When looking for a therapist I recommend finding a few practitioners for an initial consultation to see how you feel with each one before making your final decision.
How to find a therapist
Finding potential therapists
Word of mouth: The best way to find therapists is to ask people you respect and trust if they can recommend someone. Friends, family, healthcare providers, massage therapists and acupuncturists are good places to start.
Online searches: At goodtherapy.org you can search for therapists by zip code and read their profiles.
Preparation for interviewing therapists and making the call
Before interviewing therapists prepare yourself by thinking about the following:
- Why do I want to be in therapy now?
- What are my concerns or doubts about therapy?
- What do I hope to get out of therapy?
- What experiences have I had with therapy in the past, good and bad?
- What fee can I afford on a weekly basis? What will fit in my monthly budget?
- Is there anything important to me that I need to know about the therapist? (Is it important to you that the therapist has been in their own therapy? Or that they receive ongoing consultation or training?)
I recommend choosing at least three therapists to speak with for a consultation. Use the consultation time to see if you feel comfortable to meet in person, if they have experience with your concerns, and if you can afford their fee.
While talking with the therapist pay attention to how you feel. It is natural to be nervous but notice what else you feel. Do you feel listened to? Does the therapist seem to understand your situation? Do you feel comfortable enough to meet with them for a session?
If the fee is too expensive. If the therapist’s fee is too expensive for you ask if they have a sliding scale or can refer you to someone who does. Therapist training clinics often have generous sliding scales from $25-75. If you work with an intern you get the benefit of their weekly supervision and training with more experienced therapists. Search for therapist training clinics in your city or contact psychology graduate programs and ask if they have training clinics to refer you to.
Your first appointment: does it feel right?
The first session is a continuation of the interview, helping you and the therapist decide if you are a good match and should start working together. In the first few sessions therapists continue to assess if they are a good fit for the client’s needs. Therapists do not work with every client that comes to see them. They discern if they can be of benefit and if they have experience with the client’s concerns.
You should also be assessing: How does the fit feel? Do you feel comfortable talking with them? Do you feel respected? Does it feel like they have your best interests at heart? If you notice any red flags or uncertainties try to be upfront and share these with your therapist early on. This can help clear up misunderstandings and determine if the two of you can collaborate and get back on track. By listening to yourself and expressing your concerns with your therapist you will learn if your therapist can meet you and be receptive to feedback.
It can be so disappointing to have a first session and then realize it’s not going to work out. But it is not wasted energy – it will help clarify what you are looking for. Take the information about what did and didn’t work for you into your next phone call or session with a different therapist.
Once you’ve found the right therapist
As you work with a therapist a good fit should develop into trust that allows for deeper work. This is the strengthening of the therapeutic alliance, and tending to it will support your healing.
It is natural for the alliance to fluctuate, to feel strong and then go through a bumpy patch, and then to come back into alignment. At times your therapist may challenge you in service of your goals or may say or do something that hurts your feelings. These kinds of ruptures are important to any therapy that leads to healing and growth, as long as you and your therapist can explore and repair them. It is important that therapists are receptive to feedback and hearing how they affected you, and that they help you feel understood. This calls on therapists to strive to be non-defensive and it calls on clients to take the risk to express feelings which are typically difficult to express.
Remember, therapy is a microcosm that mirrors your life outside of therapy. What does this mean? Difficulties that arise in the relationship with your therapist often reflect what happens in other relationships and situations. For example, if you are dissatisfied about how therapy is going but feel afraid to talk about it, you might ask yourself where this shows up in the rest of your life. Do you ever feel dissatisfied with your job but are too afraid to make a change? Do you find yourself in relationships in which you are afraid to talk directly about your needs? Exploring these familiar patterns in order to gain insight and transform them is one of the most healing opportunities therapy provides. My hope is that you will find a therapist that can help you create a safe and trusting environment for that exploration to happen.