How to Choose a Good Therapist
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Let’s be honest, finding a therapist is a daunting and exhausting task. You have to go through lists, ask your trusted friends for recommendations and then filter potential options by your desired filters – licence, insurance coverage, location, online or in person, fees, areas of expertise, etc. And then comes the final task of selection.
Go to the consultation!
Consultations are hard. They’re annoying, they’re a pain in the neck, and an interruption to your schedule – but go! These days, almost all therapists offer a short consultation to meet and assess “fit.” Fit is therapy talk for what kids these days call vibe check (I know! I am showing my age!) It can get frustrating to do multiple consultations and go over your goals and the issues that bring you to therapy over and over again, but don’t forget that consultations have to be about much more – they are essentially an interview to “hire” a professional to help you.
What should you look for when I consult with a therapist?
This list is not comprehensive, and is definitely missing a lot. If you think I missed something, I would like to here from you.
Competency – this goes without saying. Ask your therapist what gives them the confidence to take your case. Make sure their answer shows that they listened to you and reflected on what your goals are.
Ethics – depending on the therapist’s licencing body/college they need to adhere to certain ethical guidelines. Check that your therapist is not practicing outside of those boundaries. For example, I have heard of therapist saying to their clients that if they choose to work with them, the client cannot work with any other therapist. That is against ethical boundary of client autonomy. Look out for instances like that.
Incompatible politics – for better or worse, we live at a time that political views are at the centre of so many people’s day to day. If you find yourself censoring yourself in social gatherings in which people have different political views, make sure to not walk into the same dynamic with your therapist. You should not feel the need to censor yourself in the therapy room. So, ask about shared values.
Incompatible life views/beliefs – Same thing as above. A good example of this is when my poly/ENM clients come to me after having had negative experiences with their previous therapists “…as soon as the ENM thing came out!” I have heard it more than I’d like to: “Every thing was fine, until (s)he found out we are open/anti-Trump/anti-Zionist, etc.” You deserve to feel safe from judgement in the therapy room.
Therapist’s ego/dominance – this may or may not be accessible in a consult. But I think a good early sign would be if you walked away from your consultation feeling like you did not get a chance to share all you planned to share and ask all you planned to ask. If so, chances are the dynamic was not the right fit. It’s true that the therapist is also interviewing you to assess their willingness to work with you, but this doesn’t mean that they are in charge. In fact, consultation is the first step of a potential therapy work and if it is not balanced then I’d say something needs to be addressed.
Sincerity and honesty – Look for “I don’t know,” or “that’s a good question, I’ve never considered it that way,” or something within these lines. Not saying that you should walk in the session with the intention of trapping the therapist with a blindside. But if you notice your therapist being honest instead of sticking to a sales pitch or a marketing persona, then you have a chance at a sincere and ego-less therapist.
Fit is ongoing
While it would be amazing to find the right fit in the consultation, the truth is, fit (much like consent) is ongoing. The more you get to know each other, the better you can assess if you should continue the therapy work.
Some of the signs that the therapeutic fit is not helpful:
Your therapist talks more than you do. Granted, there is a technique called psycho-education where therapist needs to talk for longer than usual. But if your therapist is taking space that is not justifiable, then I would say get curious about it and maybe bring it up in session. Therapy is not about your therapist’s ego, it’s about you.
Your therapist gives you advice and then gets upset when you don’t follow the advice. Or, your therapist keeps pushing for a certain modality/treatment despite your discomfort or lack of interest. Remember what I said about therapist’s ego? Unfortunately, I hear this type of concerns in consultations as well. A prospective client will say that they have been told by their therapist if they don’t try [insert modality/treatment name here] they won’t get better.
If you want to know why this is red frag, let me know and I will expand on it in another post.
Unethical things keep popping up: from subtle unethical and illegal behaviours, for example unethical payment formats (pay in advance, offering discounts for referral, etc.) to practicing outside of the scope of therapy (for example a RP suggesting medical procedures or pharmaceutical drugs). These are easy to go unnoticed because they are subtle. Familiarize yourself with your rights and if something doesn’t feel right, then get curious.
You cannot feel totally honest in sessions: if you feel that by sharing certain things your therapist will shame or judge you, consider this: is it you, or is it the therapist? as in, “this particular therapist?”
Some topics come up in therapy that feel shameful due to the nature of the topic and/or the society we grow up in. We are not talking about those. If you feel that the therapist you are working with is adding to/creating the judgement and pressure, then we may have a problem. This may not even be specifically named in session. For example, imagine that you KNOW your therapist is an atheist and because of the remarks made in the past, you believe that if you share your religious beliefs, you may be judged. If this happens, notice these moments, and bring them up in session with your therapist. Explore it together and reassess fit all over again.
If you are interested in some suggestions on what to ask in a consultation, let me know.
I hope this was helpful. I am sure I have missed points here that many of you consider before choosing your therapist. I would love to hear from you about those points. If you are curious about any of the claims I have made in this post – or even if I got it wrong – please do reach out. We only learn when we communicate with curiosity and open minds.
