First, let me note how exceptional the person is who seeks counseling. It can be a daunting and frightening thing to do and above all the amazing qualities my clients possess - it is their courage in making that first appointment and coming into my office that I admire most. Knowing, both personally and professionally, how difficult it can be to initiate therapy, I wanted to give a few ideas about how to find a good match in a therapist. This list is by no means complete, but I feel that it is a good start when entering into a therapeutic relationship.
The Initial Preparations:
Identify your needs: It is important to be able to first identify what you are looking for in therapy. To do that, here are a few questions to consider when looking at what you want to gain from therapy.
It is good to consider if there are particular attributes you would like in your therapist. Some people feel more comfortable talking to one gender over the other. Some would like their therapist to share their same religious views or at least be able to converse about religion and/or spirituality. Some are looking for a particular therapeutic technique or approach. Cost, location and availability are also important considerations.
The Office Space:
There are a few things to keep in mind when you arrive at your appointment - do you feel safe in the neighborhood? Is the waiting area neat and orderly? Is the clinician's office comfortable? I check out the books on the shelves to see where their interests are -- I like to see up-to-date psychology journals or a few newer looking books in the office--this makes me feel that they are invested in continuing to build on their skills and keep abreast of changes in the field.
THE IMPORTANT STUFF
1. The RELATIONSHIP between client and therapist
If you look at all the research on what makes therapy effective it all points to the quality of the therapeutic relationship. More than technique or style. More than any therapist attributes. More than cost of treatment or years in practice. This is what makes therapy work or not. The connection you feel with your clinician will be the most important aspect in treatment. Here are some statements that should resonate with you regarding your therapist.
Fallibility: Alas, therapists are not perfect. We mess up. We misread things, we have bad days, we get distracted, we have 'stuff' like anyone else and sometimes we don't do our jobs as well as we can or should. Your therapist may fall victim to being human and it may impact your relationship. That is a good thing! Trust me, having a therapist that messes up can be amazing because you get to practice 'working through the rupture.' You get a chance to talk about the mess-up, how it felt and what you need and how to move forward. So, I invite you to give your very human therapist a chance to make things better -- a good therapist is open to their own humanity and should willingly step into an open conversation about where things went wrong and how it impacted your relationship.
2. Safety
You should feel safe with your therapist - both physically and emotionally. The space you are in should feel comforting, the dynamic with your therapist should feel caring and compassionate. You need to be able to trust your therapist -- that is the only way that you can be vulnerable. Most important, you should feel that your therapist is always working toward your best interests. This is not to say that you should always like your therapist - because sometimes therapy is hard--and it should be. Beware of feeling too comfortable - therapy should present challenges. Challenges to how you think and behave. Challenges to how you view the world and yourself. Challenges that push you out of your comfort zone - where growth happens. A good therapist can help you feel safe; a great therapist helps you feel safe taking risks.
3. Feedback
A good clinician will always ask for feedback regarding your experience, progress and treatment planning. You should feel comfortable asking questions about you treatment and the treatment process and your clinician should be able to answer your questions clearly. A therapist should not get defensive if you speak up about something that you would like to change or address about therapy- it is YOUR therapy and a good therapist knows the benefits of client feedback.
4. Logistics
All of the logistics should be discussed at the initial session or within the first two sessions of treatment. You should know your therapist's policies around after hours contact, how to re-schedule, emergency procedures and attendance policies. You should know what your rights are as a client, what limits to confidentiality are in place, your therapist's theory and approach to treatment, costs and payment practices as well as what the clinician's expectations of his or her clients are. Some clinicians ask that clients do 'homework' between sessions or try different behavioral experiments. I am a big fan of between-session activities because it is very difficult for change to happen when you only devote an hour a week to it. However, it is also very important that you are honest with your clinician about what you are and are not willing to do. For example, I had a client who hated the idea of tracking her feelings every day in a journal but was willing to download an app to help her track her moods. Another client preferred to keep a music journal and downloaded songs to make a playlist of her emotions for the week. Work with your therapist to find what fits for you.
Ethics: A good therapist knows his or her limits. It is unethical to 'practice outside your scope' - so, it is ok to ask your therapist what experience they have working with your types of concerns. You have every right to ask about any part of treatment from a specific intervention to a therapist's training in providing services for a particular disorder. Your therapist should be able to provide you with their reasons for pursuing a particular type of treatment.Your therapist should be licensed - you can check on their license history through your state's board of professions.
5. Humor
This element is often left of the lists of important traits in the therapy room but I think it is vastly important.
It is important to laugh. It is important that your therapist be able to present ideas to you in a way that is engaging. Humor should never be used at the expense of a client or their experience but it can be an excellent tool for finding insight, release and perspective. Tears can be a means of catharsis but so can laughter.
Finding the humor in one's situation is vital - not as a means of invalidating or dismissing the experience - but as a way to see it in its most whole form. I have found that using humor and laughter with my clients is a way to finding peace with difficult things. While holding their experiences with compassion, laughter allows experiences to take on a new form. A form that can be easier to approach, to talk about, to understand and to accept.
So there you have a quick guide for what to look for and look out for when choosing a therapist. Remember, it is YOUR treatment and your comfort is important. Trust your instincts and give therapy a chance to work for you--I absolutely believe that it can.
The Initial Preparations:
Identify your needs: It is important to be able to first identify what you are looking for in therapy. To do that, here are a few questions to consider when looking at what you want to gain from therapy.
- What are three areas in my life that I would like to change?
- How will I know that things are better? - What would I see/feel/experience?
- When did I notice things starting to slip in my life and become more difficult? What was happening at that time?
- What is my push to seek help now?
- Am I willing to give therapy a chance to help? How much effort do I feel I can put into therapy?
- What behavioral changes do I think will be important to make to move toward my goals?
It is good to consider if there are particular attributes you would like in your therapist. Some people feel more comfortable talking to one gender over the other. Some would like their therapist to share their same religious views or at least be able to converse about religion and/or spirituality. Some are looking for a particular therapeutic technique or approach. Cost, location and availability are also important considerations.
The Office Space:
There are a few things to keep in mind when you arrive at your appointment - do you feel safe in the neighborhood? Is the waiting area neat and orderly? Is the clinician's office comfortable? I check out the books on the shelves to see where their interests are -- I like to see up-to-date psychology journals or a few newer looking books in the office--this makes me feel that they are invested in continuing to build on their skills and keep abreast of changes in the field.
THE IMPORTANT STUFF
1. The RELATIONSHIP between client and therapist
If you look at all the research on what makes therapy effective it all points to the quality of the therapeutic relationship. More than technique or style. More than any therapist attributes. More than cost of treatment or years in practice. This is what makes therapy work or not. The connection you feel with your clinician will be the most important aspect in treatment. Here are some statements that should resonate with you regarding your therapist.
- I feel my therapist works hard to understand me
- My therapist is on my side
- I trust my therapist
- I feel that my therapist cares about me and my well-being
- I feel challenged by my therapist
- I feel that my therapist has a plan for my treatment
- My therapist checks in with me about how I feel treatment is progressing
- I feel that I can talk to my therapist about our relationship
Fallibility: Alas, therapists are not perfect. We mess up. We misread things, we have bad days, we get distracted, we have 'stuff' like anyone else and sometimes we don't do our jobs as well as we can or should. Your therapist may fall victim to being human and it may impact your relationship. That is a good thing! Trust me, having a therapist that messes up can be amazing because you get to practice 'working through the rupture.' You get a chance to talk about the mess-up, how it felt and what you need and how to move forward. So, I invite you to give your very human therapist a chance to make things better -- a good therapist is open to their own humanity and should willingly step into an open conversation about where things went wrong and how it impacted your relationship.
2. Safety
You should feel safe with your therapist - both physically and emotionally. The space you are in should feel comforting, the dynamic with your therapist should feel caring and compassionate. You need to be able to trust your therapist -- that is the only way that you can be vulnerable. Most important, you should feel that your therapist is always working toward your best interests. This is not to say that you should always like your therapist - because sometimes therapy is hard--and it should be. Beware of feeling too comfortable - therapy should present challenges. Challenges to how you think and behave. Challenges to how you view the world and yourself. Challenges that push you out of your comfort zone - where growth happens. A good therapist can help you feel safe; a great therapist helps you feel safe taking risks.
3. Feedback
A good clinician will always ask for feedback regarding your experience, progress and treatment planning. You should feel comfortable asking questions about you treatment and the treatment process and your clinician should be able to answer your questions clearly. A therapist should not get defensive if you speak up about something that you would like to change or address about therapy- it is YOUR therapy and a good therapist knows the benefits of client feedback.
4. Logistics
All of the logistics should be discussed at the initial session or within the first two sessions of treatment. You should know your therapist's policies around after hours contact, how to re-schedule, emergency procedures and attendance policies. You should know what your rights are as a client, what limits to confidentiality are in place, your therapist's theory and approach to treatment, costs and payment practices as well as what the clinician's expectations of his or her clients are. Some clinicians ask that clients do 'homework' between sessions or try different behavioral experiments. I am a big fan of between-session activities because it is very difficult for change to happen when you only devote an hour a week to it. However, it is also very important that you are honest with your clinician about what you are and are not willing to do. For example, I had a client who hated the idea of tracking her feelings every day in a journal but was willing to download an app to help her track her moods. Another client preferred to keep a music journal and downloaded songs to make a playlist of her emotions for the week. Work with your therapist to find what fits for you.
Ethics: A good therapist knows his or her limits. It is unethical to 'practice outside your scope' - so, it is ok to ask your therapist what experience they have working with your types of concerns. You have every right to ask about any part of treatment from a specific intervention to a therapist's training in providing services for a particular disorder. Your therapist should be able to provide you with their reasons for pursuing a particular type of treatment.Your therapist should be licensed - you can check on their license history through your state's board of professions.
5. Humor
This element is often left of the lists of important traits in the therapy room but I think it is vastly important.
It is important to laugh. It is important that your therapist be able to present ideas to you in a way that is engaging. Humor should never be used at the expense of a client or their experience but it can be an excellent tool for finding insight, release and perspective. Tears can be a means of catharsis but so can laughter.
Finding the humor in one's situation is vital - not as a means of invalidating or dismissing the experience - but as a way to see it in its most whole form. I have found that using humor and laughter with my clients is a way to finding peace with difficult things. While holding their experiences with compassion, laughter allows experiences to take on a new form. A form that can be easier to approach, to talk about, to understand and to accept.
So there you have a quick guide for what to look for and look out for when choosing a therapist. Remember, it is YOUR treatment and your comfort is important. Trust your instincts and give therapy a chance to work for you--I absolutely believe that it can.
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