Finding the Right Therapist

** This piece was adapted for a column in the Five Town Jewish Times.

If you clicked on this blog, kudos to you for wanting to do the work and for seeking the right support to do it! This is the first step in getting the help you want.

Finding the right therapist is a lot like finding your soul mate. You have to have a clear picture of what you want, be honest with yourself about what you need, be open to suggestions from family and friends (sometimes and selectively), and be willing to try a few duds before you find the right one. Further, just like any relationship takes effort and commitment from both sides, it’s important to know that therapists are not magicians and we don’t “fix” people. You get out of therapy what you put in to it. Being aware of your role and responsibility in your own healing is crucial. Therapists are not people you pay to care about you, they are professionals (who genuinely care and) you pay to help you figure out how to care for yourself.

Now that you have you made that first step decision that you want to see a therapist there are a few steps that follow that can help lead you in the right direction to find the professional who is best for you.

1.  Identify why you are seeking therapy

 If you have a medical condition, you want to go to a doctor who specializes in that specific area of medicine so that you get the right treatment. You don't go to the foot doctor for your vision issues (don't argue, no you don't). The same is true for a therapist. Are you sure that you are going to a clinician who works specifically with the issues you are seeking treatment for? Do you know what exactly it is that needs work? If you are a victim of trauma, you should be seeing a therapist who specializes in trauma. Don't assume that because you have anxiety and depression that you should go to a therapist who treats anxiety or depression. Are you grieving a loss? See someone who has experience with or specializes in loss and bereavement. Also, it is important that your therapist is educated about the different modalities of treatment that are out there to treat your specific issues. They should be open to discussing options for you. You can find this out with a consultation phone call, which I discuss below.

2.  Get referrals

Ask a good friend or family member if they know someone they can recommend to you. Chances are that someone you know has used a therapist they felt positively about or they may know a therapist on a personal level who they think would be a great fit, based on your personalities. Finding that perfect match will require some networking on your part. Also, there are many therapists on social media. This can be a great way for you to see their approach, style of communication and get a feel for their personality which can help you decide if they could be the right fit for you.

3.  Ask Questions

Now that you've got a name, does the therapist offer an initial phone consultation? Take it. Ask a million questions. Ask about their approach to therapy, how long they generally have clients in therapy, and the frequency of visits they'd recommend for you based on the information you discuss with them. Discuss insurance (if they take it) and what their expectations are of clients. This first phone call will be a lot like a "first date." You'll get all the information and "vibes" you need to know whether or not to proceed. Remember, don't be discouraged if you are not happy with the selection you've seen until now. It's not a reflection of therapy and how "it doesn't work."  Keep going, the right therapist for you is out there.

4.  Educate yourself with an open mind

 In order to be a strong advocate for yourself (and save yourself wasted time), it is extremely important that you do research about the different kinds of therapy that are out there and the issues they are used to treat. Kids tend to respond better to behavioral/cognitive-based therapies rather than hypnotherapy (not appropriate for kids). Cognitive Behavioral Therapy (CBT) can be great for anxiety and depression. EMDR and somatic therapies show great success for people with trauma. Marriage and family issues should be treated by professionals who treat couples and family dynamics. Attachment based couples therapy can be really impactful. Don't get stuck on what YOU think should be done to treat the issues. Have an open mind and get different opinions so that you can make the best decision for yourself or whoever you are seeking therapy for.

5.  Understand that things might feel worse before they feel better

Some people find that going to therapy brings some really tough feelings and realizations to the surface. This can feel really hard but it is important to know that good therapy isn’t creating problems that didn’t already exist. Therapy does not always feel good and it shouldn’t! It makes sense that it might feel hard or bad sometimes (note, this says sometimes. If you are always feeling bad, please pay attention to this). Very often in therapy people will start noticing feelings, patterns and dynamics that have been affecting their mental health in a negative way for far too long. When they start paying attention to and prioritizing their mental health sometimes, they begin shifting how they show up in other areas of their life; this can make their environment shift too and for those around them this isn’t always pleasant or easy to accept. I had someone once tell me that a mutual friend’s therapy “failed’ because this friend ending up getting divorced but see that’s the thing, sometimes these perceived “negative” outcomes are not actually negative. We cannot know what is best for someone else’s life. This is for them to know and decide. FYI, this should be a therapist’s approach to therapy as well: You are the expert of your life, not us. A therapist does not have to live with the consequences of any of their client’s decisions so they should really refrain from ever telling a client what to do.

6.  A life coach is NOT a therapist

I often get asked about life coaches and I have very mixed feelings. Coaches do not have any formal training. They can be certified but this is not required and there is no official certification. Anyone can call themselves a coach. There are a lot of areas where coaches make a lot of sense and can be really great and I see the value in their work. I have worked on projects professionally with coaches, have referred clients to them in the past and have had positive experiences.  For me, life coaching gets a little more complicated because I find that many times these individuals practice outside of their scope and end up doing more harm than good. I know some great coaches who know when to refer out and unfortunately, I know many more who don’t. Contrary to what I’ve seen stated, therapists do not only focus on the past or mental illness. A therapist can do what a coach can do but a coach cannot do what a therapist does. Therapists are often helping people meet their personal growth goals. Many therapists offer life coaching services as well (they do this because it can be less restrictive in terms of geographic location of clients among other factors.) I am by no means anti coach. I would simply advise anyone considering a coach to do a lot of research first.

Just as (I hope) you would not want to settle when looking for a life partner, you do not want to settle for just any "therapist." Therapy is nothing to take lightly. Letters at the end of a name do not equal a qualified or knowledgeable professional and knowledge and qualifications do not equal an effective therapist. That being said, it is really important to see a licensed professional.

For your safety and wellbeing it is important that the person you are see is a qualified practitioner. A therapy license is a document that proves someone meets the professional requirements to practice therapy. It is illegal to practice a licensed profession without a license. Licensing laws can help protect consumers from incompetent and unethical therapists. They establish rigorous education and training requirements that must be met in order to be licensed. They also make sure therapists follow ethical guidelines and professional standards after they are licensed. It bears mentioning that licensing does not always mean that a therapist is 100% ethical or knowledgeable (sadly, I personally know too many stories) but the risk is definitely lower and there can be recourse in the even that they do cause harm.

At the end of the day, good therapy really comes down to chemistry. A therapist can have all the checklist items but if you don't jive, the therapy will simply not go anywhere. You have to feel that your therapist understands you. You should feel comfortable sharing your personal thoughts and feelings. You should be motivated to go to sessions, feel a push to follow through with treatment recommendations, and value the relationship. This only happens if you have that "connection." When a person says they "give up" on finding love it's often because they've been in the wrong relationships and haven't found that special connection. We reassure them, “Don’t give up on love, the right one is out there somewhere!" The same holds true for therapy. Don't give up on therapy. It DOES work. You need to find the right one. 

An important caveat to the above is that if you find you have trouble trusting a therapist, often feel judged in therapy offices or even find yourself feeling really unmotivated to go to sessions, this isn’t necessarily because the therapist is not for you. Sometimes, people put up walls in order to avoid vulnerability or for fear of uncovering uncomfortable truths or history. Sometimes, our own narratives and feelings of shame dictate that others are judging our thoughts, feelings or stories but this might not be the reality. It’s a good idea to check in with yourself to determine if any of these feelings are because of the actual relationship with the therapist or because your brain is trying to do what it’s wired to do (for better or worse) and “protect” you.

If you feel like therapy "doesn't work" that might just mean that you haven't found the right one. Don't give up. They are out there. The relationship is one of the biggest factors for success in therapy. Don't settle and definitely don't give up.

Wishing you luck on your new journey. May it bring you self-reflection, self-compassion, connection and love.