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How to choose a therapist

 How to choose a therapist: You have made an important choice, a potentially life-changing choice: to begin therapy (sex therapy, marriage counseling, couples counseling, individual therapy, or family therapy). But how do you find a good therapist?

Do Your Homework: You can learn a great deal about a therapist’s training,  experience, services, specializations, personality style and biases before meeting him/her by doing a little homework.   By reading a therapist’s website, brochure, or blog you can get a sense of whether or not you’d like to work with him/her.  If you would like a personal recommendation, ask someone you trust such as your physician, family member or friend for a recommendation.  Doing your homework can save you time and money by helping you determine your compatibility with a therapist before attending and paying for a first appointment.

Personality Match: The personality match between you and your therapist is critical. Research has shown that the quality of the relationship between the client(s) and therapist greatly influences the success of treatment.  A good personality match (or good chemistry, a trusting relationship, “a good fit”, compatibility or “clicking”) can help clients feel comfortable enough and safe enough to let go of their fears and risk trying new behaviors. If you’re in crisis and need to begin treatment immediately, do not worry if you do not have the time to do your research.  Most therapists will be good enough.

If you’re currently in therapy and the relationship doesn’t feel right to you, or if you’re hiding important information from your therapist, bring it up in your sessions and try to work through it.  That in itself, can be very therapeutic.  If that really isn’t possible, do not be afraid to schedule an appointment with another therapist.

Defining a Good Fit: You will work best with someone around whom you feel comfortable, safe and respected. You will work hardest when you like your therapist, respect him/her, and believe in his/her ability to help you. In the end, finding a good fit with a therapist is much like dating. You need to trust your intuition…if it doesn’t feel right, it probably isn’t. While there is no litmus test for good chemistry between a therapist and a client, here are questions you can ask yourself to help determine if the fit is right for you.

Do you feel comfortable with this therapist? Do you find yourself getting defensive, or sharing openly? You’re looking for someone you feel safe enough with to disclose your problems, thoughts, and feelings with total honesty — and without feeling judged. If you’re not comfortable enough to be truthful with your therapist, your therapist cannot help you.

How do you react to the therapists style? Do you find yourself getting defensive? Sharing openly? Thinking of new ideas?  How does the therapist treat you?You’re looking for someone who treats you with respect and talks to you as an equal. If your therapist often interrupts you, dismisses your ideas, or talks down to you, you may want to find someone else. Do you feel judged by your therapist?Are you able to simply be yourself. Are you fully yourself around the therapist? You’re looking for someone you feel safe enough with to disclose your problems, thoughts, and feelings with total honesty. If you’re not truthful with your therapist, your therapist cannot help you.

Does the therapist seem professional? You’re looking for someone responsible and appropriate.  If your therapist forgets your appointments, dresses inappropriately, or crosses professional boundaries and interacts with you inappropriately, you will want to find someone else.

Do you like the therapist’s style? You’re looking for someone you mesh with. Is your therapist directive or solely a sounding board, and which style do you prefer? Does your therapist interact with you or remain silent, and which style do you prefer? Do you think your therapist talks too much or is there room for you to talk about what you need to?

Are you getting immediate feedback? A good therapist will start giving you useful feedback during the very first session. Do not expect miracles from one session, however, as it often it takes several sessions for a therapist to get to know you and to fully understand your problem.

Is the therapy helping you? You’re looking to gain insight about yourself and your behaviors, learn new skills, and experiment with new and more productive behaviors. If you like your therapist but don’t think the treatment is helping — despite your commitment and hard work — you may want to find someone else.

Experience: When choosing a therapist, ask if he/she has experience handling your particular problem. For example, if your current problem is a marital problem, you should choose a therapist who is experienced with couples work. Similarly, if your current problem is a sexual problem, choose a therapist experienced in sex therapy.

Cost of Treatment: Therapist’s fees can vary greatly, and you should choose a therapist whose fee fits your budget. Therapy is a luxury — it is not a necessary condition of survival (in most cases). But if you want more than to survive, but to thrive, paying for the luxury of good treatment is worth every penny when you emerge happier and more fulfilled. Therapy is certainly an investment of money, but the reward of living your best life is priceless. If you’re not sure if you can afford to be in therapy, ask yourself if you can afford not to be.

Office Location: The location of your therapist’s office is a consideration. Do you want the convenience of seeing a therapist close to home or work? Or would you prefer to see someone across town to minimize the chance of bumping into him/her on the street? Might it be best to see a therapist whose office is in a different community, adding anonymity and privacy to your experience (as well as affording you built-in time to prepare for and reflect on your sessions during the commute)? This is a personal choice. Take time to assess your needs. Whatever scenario you choose, make sure you feel comfortable in your therapist’s office.

Training: There are many different disciplines of therapy, and one discipline isn’t inherently better or more effective than another. Psychiatrists, psychologists, social workers, professional counselors, and marriage and family therapists can all practice competent therapy, so don’t focus too much on the letters (which will indicate academic degree and license) that appear after a therapist’s name.  Rapport, skills and experience are more important. There are some exceptions, of course, and your particular needs will help direct the type of therapist you should see. For example, if you require a psychological evaluation to assess for ADHD or mental illness, you will need to see either a psychologist or a psychiatrist. If you need psychotropic medication, only psychiatrists (and other medical doctors) can prescribe. If you are involved in a court case and want to submit formal documentation before a judge, then it’s important to choose a therapist at the doctorate level.  Ask a therapist before scheduling a first appointment if he/she is qualified to address your particular issue.  In regards to the nitty gritty of therapy. It’s experience and skill that counts in how people talk to one another.  How someone writes a paper or prepares for court testimony is a different skill set.

Licensure: It is important that your therapist is licensed in his/her discipline. Seeing a licensed therapist guarantees you that his/her training and experience have met the state’s criteria for competent practice, and that he/she has passed a comprehensive and rigorous licensure exam.

Your Part of the Equation: Finally, don’t forget that you have a crucial role in the success of your therapy. Choosing a good therapist is important. What you do with that therapist is just as important. Therapy is not passive. Your therapist can be the most helpful to you when you are motivated to learn, dedicated to your growth, and trusting of the therapeutic process. Clients who work hard at helping themselves have the best outcomes in therapy.

Anne Aja, Ed.D.

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