How to Choose a Therapist

What matters most and how to choose wisely.

Posted Jul 18, 2018

Psychology is a field made up of fragments. We are far from having a unified theory of the mind and, in my opinion, that will come only with advances in neuroscience and that will come only with advances in technology. Meanwhile there is a plethora of therapies from which to choose and they are based mostly in the experiences of their founders and practitioners.  

Psychotherapy is still more of an art than a science. In fact, research has confirmed that it does not matter so much what brand of therapy one practices as does the relationship between client and therapist.1 These are known as often known as the common factors.2

That is, these are aspects of therapy that cut across professed schools and mostly have to do with the quality of the relationship. We all know that feeling when we meet someone and just “click” with them. It is that click that a prospective client should be looking for in choosing a therapist. Interviewing three potential therapists is often recommended before choosing one.

While the quality of the relationship, affect and empathy can override the specific technique, it does not cancel it out. For example, Freudian approaches will want to treat the unconscious, while Cognitive Behavioral the conscious ideas and behaviors. Gestalt therapy searches for unexpressed anger, while the humanists aim for growth. Freud was concerned with the psychology of the son that he was, feminists have focused more on growing up as a daughter.

These emphases are generally based on the experiences of those who developed them and those who adhere to them. Some are narrower; for example those who do only EMDR (Eye Movement Desensitization) to treat PTSD (Post Traumatic Stress Disorder) and others will examine early childhood through the present. Obviously the latter will become long term therapy. In general though, whatever issues emerge will emerge in various ways during various treatments

The most important issue in making a good decision is to choose a therapist that you feel understands you, respects you and can help you. It is the relationship that really matters.

References

1. Wampold, B. World Psychiatry. 2015 Oct; 14(3): 270–277.

2. Jensen, P.S., Weersing, R., Hoagwood, K.E. and Goldman, E. (2005) Mental Health Serv Res, What is the evidence for evidence-based treatments?