Hiring the right therapist is a crucial first step in ensuring a successful outcome of therapy. A study in Frontiers in Psychology reported that having a good relationship with your therapist is more important than any type of treatment they might offer.
So, how do you find a therapist that’s a perfect fit for you?
Three simple steps.
Step 1: Ask around.
Research shows that the best way to find a good therapist for you is to start by getting a recommendation from someone you trust. According to a study in Consumer Reports, “people who find a therapist through a recommendation from a friend, family member, or doctor have more success than those who pick someone at random from the phone book or their health plan’s provider directory.”
But if you’re hesitant about asking friends or family, or you don’t have a trusted health care professional, you can call a local university with a good psychology department and ask for a recommendation. Or you can get in touch with a professional organization that offers a list of qualified mental health professionals working in your area.
Here’s a list of reputable professional organizations to get you started:
http://locator.apa.org - The American Psychological Association
https://therapists.psychologytoday.com/rms - Psychology Today
http://www.abct.org - The Association for Behavioral and Cognitive Therapies
https://adaa.org - Anxiety and Depression Association of America
Once you have the name of one or two of possible therapists, how do you pick one who’s right for you?
Step 2: Interview the therapist.
Don’t be afraid to ask questions of any prospective therapist. You can learn a lot about how you’re going to work together from a brief conversation.
If you’re not sure what to ask, here are 10 questions to get the conversation started:
1. Are you licensed?
It’s critically important that any therapist you work with is a licensed professional. Having a license means that the therapist has met specific educational and clinical requirements. They’ve had a background check and continue to meet certain educational and professional requirements to keep that license up to date. And, more importantly for you, you have recourse if something goes wrong during treatment.
2. How long have you been in practice?
Having some experience is important in any field, and it’s no different here. Look for someone who’s been in practice awhile – or look for someone who’s working in a multi-therapist practice that offers a newer therapist support and guidance through the therapeutic process.
3. What are your credentials?
There are a lot of different types mental health care professionals, and most of them have a lot of initials after their names. Those initials can be confusing to the layperson. Although licensing requirements and titles can vary from state to state, here’s a breakdown of the different types of providers and what all those initials mean.
Non-Prescribers
The following professionals do not prescribe medication, but, when needed, will refer you to someone who can (see Prescribers list below).
Psychologists: Doctor of Philosophy (Ph.D.) or Doctor of Psychology (Psy.D.)
Master-level clinicians. The following therapists have at least a master’s degree and have met the all the requirements for licensure in their state:
LPC: Licensed Professional Counselor
LMFT: Licensed Marriage Family Therapy
LMHC: Licensed Mental Health Counselor
LICSW: Licensed Independent Social Worker
LCSW: Licensed Clinical Worker
Prescribers
According to the National Alliance on Mental Illness (NAMI) the following health care professionals can prescribe medication as a part of their practice.
Psychiatrist: Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO)
Primary Care Physician: Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO)
Psychiatric or Mental Health Nurse Practitioner: Master of Science (MS) or Doctor of Philosophy (Ph.D.)
Family Nurse Practitioner: Master of Science (MS) or Doctor of Philosophy (Ph.D.)
Psychiatric Pharmacist: Doctor of Pharmacy (Pharm. D.)
4. Do you have a specialty? (Anxiety, depression, OCD)?
Not every good therapist has a specialty, but if you can find one who’s experienced in dealing with your particular mental health issue, the research shows that can have a positive effect on your outcome.
A study in JAMA Psychiatry found that patients who are matched to therapists based on therapists’ strengths often have better results.
5. What is your approach to therapy?
There are all sorts treatment philosophies and therapeutic approaches to helping people heal emotionally. And asking an expert about how they approach the practice of therapy can give you a real idea of their depth of knowledge and their philosophy of what therapy should look like. You may also get a sense of how the therapist will work with you and what your partnership might look like.
A study in Psychotherapy found that when therapists work together with their patients to decide on goals, put together an effective treatment plan, and continue to encourage collaboration throughout therapy, they have better outcomes.
6. How often will we meet? How long will the sessions be? Do you offer online sessions?
The length of therapy sessions varies from therapist to therapist, but generally a session will run between 30 and 60 minutes. How often you meet will depend on your needs and your treatment plan. You can meet once a month, once or even twice a week, depending on what’s going to work best for you.
If you’d rather meet with the therapist by phone, text, or video chat, be sure to ask if they offer those services. And if you choose an online service, the good news is that a 2023 study in Nature Mental Health found that online therapy is just as effective as person-to-person therapy.
7. How long do you think treatment might take?
Again, this is a tough question to answer, because treatment is different for everyone. But opening the discussion with the therapist will give you an idea of what they’re thinking about a possible treatment plan, and what the scope of your work together might look like.
8. What happens if I have a crisis or an emergency?
It’s important to know exactly how the therapist handles emergencies. What happens if you’re in crisis? Can you call the therapist even if you don’t have an appointment? If you call and leave a message how quickly will they respond? Will there be someone covering for your therapist when they’re out of the office? It’s important to know all of that before you’re confronted with an emergency.
9. How much do you charge? Does my insurance cover your services? Will I have a co-payment?
A lot of people hesitate to talk about money with professionals, but it’s an important part of the relationship. It’s really important to have an open and honest conversation about the cost of their service and how they expect to be paid – before you make your decision about what’s going to work for you.
10. If my insurance doesn’t cover your services, or I can’t afford those services, do you offer a sliding scale?
Again, it’s important to be fully informed before you choose a therapist. Some therapists wouldn’t think of offering payment on a sliding scale, while others are happy to offer a lower price to people with limited means.
And let me add, if cost is an issue for you, you may be able to find affordable mental health care through the Substance Abuse and Mental Health Services Administration at http://www.samhsa.gov/treatment or call 1-800-662-HELP (4357).
Step 3: Ask yourself these questions.
If you’re still unsure about whether or not this is the right therapist for you ask yourself these questions:
Did the therapist listen to me with an open mind and without judgement?
Did she seem to be knowledgeable about my issues?
Did she communicate clearly and answer my questions honestly?
Did she make me feel heard, safe, and comfortable?
Did I feel a level of trust and ease talking with her?
Did she treat me like equal partner in the process?
Did she describe a possible treatment plan that made sense to me?
Did she make me feel hopeful that positive change is possible?
If you answered “yes” to all those questions, this might be the therapist for you. If you’re not sure, feel free to get back in touch with the therapist and ask more questions until you’re ready to make the decision that’s right for you.
Therapy Is a Personal Decision
I hope that you find this overview to be helpful. Therapy can be very rewarding – especially if you find the right therapist. It’s important to note that there’s no pressure on making this choice. If you discover after a few sessions that it’s not a good match – it’s very easy to excuse yourself from treatment and find another therapist. It’s a professional relationship with no long-term obligations, so you shouldn’t feel compelled to keep going if it’s not the right hire.
In fact, “trying out” a few therapists may truly give you a sense of who and what is right for you. It’s hard to know this for sure until you have some experience with the process. I have experience from both sides of the equation, and it’s a perfectly natural and expected to take some time to get it right.
More Anxiety Resources
If you’re new to therapy, let me start you off some good reasons for starting the process so that you can make a good decision. Listen to Episode 53 of my monthly podcast, Anxiety Connection:
I also have a segment on this topic in a mini-series I’m calling “Why You're Anxious & What to Do About It,” available on YouTube:
To manage your day-to-day anxiety, I’ve written an “Anxiety Handbook” called, Calm & Sense: A Woman's Guide to Living Anxiety-Free. It’s got 300 pages of practical tools and techniques for helping those quell spikes of anxiety that sneak up on us.
To connect with a great community of women who are managing our anxiety:
My email newsletter, where I notify you of new blog posts like this one and new episodes of the podcast: https://wendyleeds.com/subscribe
And my Facebook page, where we come together to chat about all things anxiety: https://facebook.com/wendyleedskeepingcalm
I’m not just a psychotherapist; I understand the challenges of anxiety first-hand. So please reach out any time. And I sincerely hope that even one of these resources turns out to be helpful to you.
References
Ardito Rita, B., Rabellino Daniela. (October 2011) Therapeutic alliance and outcome of psychotherapy: historical excursus, measurements, and prospects for research. Frontiers in Psychology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3198542/
Consumer Reports. (July 2010) Best Antidepressant for Anxiety According to Our Readers. Consumer Reports. https://www.consumerreports.org/cro/2013/01/depression-and-anxiety/index.htm
National Alliance on Mental Illness (NAMI) (April 2020) Types of Mental Health Professionals. nami.org https://www.nami.org/About-Mental-Illness/Treatments/Types-of-Mental-Health-Professionals
Constantino MJ, Boswell, et Al. (June 2021) Effect of Matching Therapists to Patients vs Assignment as Usual on Adult Psychotherapy Outcomes: A Randomized Clinical Trial. JAMAPsychiatry. https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2780658?resultClick=1
Tryon, G. S., et al. (December 2018). Meta-analyses of the relation of goal consensus and collaboration to psychotherapy outcome. Psychotherapy https://pubmed.ncbi.nlm.nih.gov/30335451/
Catarino, Ana, et Al. (August 2023). Economic evaluation of 27, 540 patients with mood anxiety disorders and the importance of waiting time and clinical effectiveness in mental health care. Nature Mental Health https://www.scientificamerican.com/article/online-talk-therapy-works-as-well-as-an-in-person-session-a-new-study-shows/