Danielle* looked perfectly fine, from the outside. She had graduated from college two years earlier with a degree in marketing and immediately found a job in an advertising firm. She lived in a beautiful neighborhood, had many friends, and was valued by her colleagues. At first, nobody knew how depressed she felt. For almost four months, however, it had taken every ounce of her energy just to get out of bed in the morning. It wasn’t long until her work began to suffer, and her friends started wondering what was going on. One Thursday, after realizing she couldn’t muster the energy to get out of bed, she called her best friend and finally admitted how much emotional pain she was in.
“This isn’t you,” her friend told her softly. “You need to get help.”
That evening, Danielle sat down at the computer determined to find a therapist. At first, she was thrilled to discover many therapist search engines, including one offered by Psychology Today. But when she entered her zip code, nearly 50 therapists materialized on the screen. Her insurance provider’s web site gave her a list of 50 more, including some she could video chat with on the computer. As she read their profiles and visited their web pages, she quickly felt overloaded with information about their expertise, education, skills, and favored techniques. It wasn’t long until, overwhelmed by the whole process, she closed the browser and went back to bed.
Almost half of Americans will experience a mental illness at some point in their lives. And, like Danielle, nearly 1 in 5 people will suffer from Major Depression. Despite their pain, most of these people will not seek psychotherapy. Although there are many reasons that people fail to seek therapy—including lack of funds and fear of being stigmatized—sometimes people simply find the whole process of locating a therapist intimidating. Although search engines make finding treatment simpler than ever, it’s easy to suffer from information overload.
Luckily, most therapists will be happy to talk with you over the phone, providing a more personal opportunity to ask questions. Some therapists may even be willing to offer a free or discounted first session. Although such conversations can be extremely valuable, unless you know what you’re looking for, it may not always be obvious what to ask.
Whatever your reasons for seeking care, you deserve to find a therapist who fits you. Here are five questions that may help you to discover the right match.
1. What is the therapist’s general approach to clients?
Different therapists approach the therapeutic relationship in different ways. Some therapists are very active in session, while others take a more passive or non-directive role. So it’s important to ask yourself whether the therapist’s approach fits you and your needs. Therapists who draw primarily from the Cognitive-Behavior Therapy (CBT) tradition, for instance, will tend to be goal-directed, active, and collaborative. In the first few sessions, they’ll help you articulate your personal goals for treatment, with the purpose of arriving at a set of objectives that you will work on together. Although you’ll do the majority of the work yourself, the therapist will be an energetic guide, suggesting techniques, exercises, and even homework assignments. Therapists who draw from other traditions may take very different stances. Person-Centered Therapists, for example, will generally avoid offering techniques, tools, and assignments, instead favoring an approach that will help you find solutions to your own problems from within. Neither approach is necessarily right or wrong, as long as it’s compatible with what you’re seeking.
2. Do you find the therapist trustworthy and likable?
At its core, therapy is a relationship. It’s important that the therapist be someone whom you trust, respect, and even like. By necessity, therapy isn’t always easy or enjoyable—it often requires facing up to painful difficulties and life patterns. So it’s essential that the person companioning you on your therapy journey be someone you respect who you feel truly “gets” you. With this said, it’s also important that therapists have appropriate boundaries. Therapy isn’t the same as friendship, and it certainly should never feel like a romantic relationship. It’s a professional alliance with the express goal of helping you change your life for the better.
It can be difficult to discern from an online profile or even an initial session whether the therapist has that special something that will allow you to form a good working relationship. For this reason, it’s often useful to think of the first few sessions as a mutual assessment. Ask yourself whether you feel that he or she is a good “fit” for you and your problems. Not all human beings fit well together, and that’s okay. The important thing is for you to find a therapist who fits your needs at this point in your life.
3. Does the therapist have expertise working with issues like yours?
Like medical doctors, psychotherapists have areas of expertise. Although most therapists are legally licensed to treat a wide variety of clients and issues, this doesn’t mean all therapists are equally good at everything. Not surprisingly, most therapists have strong skills in working with issues that are experienced by a large number of people, like depression, anxiety, and stress. But many problems, including trauma, grief, marital conflict, and work-related issues, don’t fall neatly into any of these categories. If in doubt, it’s always appropriate to ask potential therapists whether they have training and experience in working with clients who have issues similar to your own.
4. How available is the therapist?
Certain problems require more frequent therapy meetings than others, and some people may value a higher level of availability in their therapist than other people. Nonetheless, clients rarely consider this factor when choosing a provider. Some therapists, for instance, work in small private practices where their ability to take spontaneous phone calls or set up extra meetings may be severely limited. Others may work in large clinics that offer 24/7 crisis hotlines and the availability of group therapy, in addition to regular one-on-one weekly meetings. If you think you’ll need more intensive therapy than a once-a-week session can afford, it’s worth bringing this up with potential therapists before committing to treatment.
5. Do you think this therapist has the potential to provide the help you’re looking for?
There is no “quick fix” for the difficulties most people face. Though it’s certainly possible to feel relief after only a single session of psychotherapy, this is rare. According to research, at least a couple of months of weekly sessions are necessary to make headway on most problems. Nonetheless, during the first few sessions, it’s important to ask yourself whether you believe that there is at least a potential that this therapist will be helpful to you. Although the information you’ve gathered in response to the previous four questions will be an important part of how you’ll make this determination, you’re also likely to have a strong “hunch.” Many therapists make it a habit during these first few sessions to ask clients for frequent feedback about how they think therapy is going. Whether or not you’re asked, however, it’s perfectly appropriate to express your opinions about what is and isn’t working. There’s never an obligation to continue a therapy process that you feel isn’t helpful. Therapy is ultimately about you, not about the therapist.
Eventually, Danielle tried her search again. She entered her zip code and, for lack of anything better to do, she contacted the first three therapists on the screen. Over the next couple of days, she managed to speak with each of them over the phone. One, a middle-aged woman with a specialty in treating depression, particularly impressed her. She found the woman easy to talk to, with a soothing voice and down-to-earth practicality. She decided to give her a chance, and they’re still working together three months later.
“I never thought I’d go to therapy,” Danielle later told the friend who had encouraged her to get help. “But it was the best decision I’ve ever made. I’m finally feeling like myself again.”
*Danielle's name and some story details changed to keep her identity confidential.
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