How To Choose a Therapist

Begin Your Search

On a practical level, your ability to meet with the psychotherapist of your choice may be determined largely by such factors as scheduling, fees, and location. Even so, you’ll be facing a wide selection of therapists and types of therapy, so it’s important to take into account other considerations as well.

For example, you’ll probably want to find out something about a therapist’s training and education. You’ll want to consider how his or her approach to helping clients fits with your own ideas about the kind of assistance you want. You may also want to familiarize yourself with the different types of therapy to help clarify your own thoughts about what you are seeking.

Many studies have demonstrated that the single most important element in successful therapy is the relationship between client and therapist.

So making the right choice is a very personal matter; it’s largely a matter of “fit.” Only you can decide if you feel comfortable talking to this person and if you believe he or she has the expertise to help you with the difficulties you are facing. In addition to following your intuition and common sense, these steps can help guide you in the selection process.

In-person, Video, or Phone Therapy?

For many years, meeting in person was the preferred—sometimes the only–form of therapy available. That changed with the growth of the Internet and, more recently, with therapists taking precautions during the COVID epidemic.

Human beings may never develop an adequate substitute for the level of connection and understanding that can be achieved through live, face-to-face contact. Additionally, a therapist’s office can be a safe and protected space free of the usual distractions, thereby allowing you to stay focused on your personal work.

On the other hand, therapy via video or phone avoids the inconveniences of travel and frequently offers more flexible scheduling opportunities. It opens up the possibility of working with any therapist licensed to practice in your state, regardless of their location. Many types of therapy once delivered only in person have been successfully adapted to these new formats.

No matter how and where your therapy sessions take place, the most important decision is to pick someone who has the expertise you’re looking for, takes a professional approach that works for you, and establishes a productive working alliance within the first one or two sessions.

Narrow Your Choices

Develop a list of at least three potential therapists. Talk to people you know and respect about therapists they may have seen. Ask doctors, lawyers, massage therapists, teachers, or members of the clergy for referrals. Visit websites of professional associations of therapists, such as www.camft.org (for Licensed Marriage and Family Therapists) or www.calpsychlink.org (for Licensed Psychologists). Counseling agencies and community counseling centers may be able to provide low-cost therapy, although you are more likely to see a therapist in training than a seasoned professional.

Become familiar with the different kinds of therapists. Whether you seek therapy for yourself, your relationship, or your family, you can choose from a variety of professionals.

Licensed Marriage and Family Therapists, also known as MFTs or LMFTs, have a master’s degree in psychology, clinical psychology, counseling psychology, or marriage and family therapy; they typically have other training as well. The general assumption is that emotional and psychological problems are rooted in relationship troubles, past or present.

Licensed Professional Clinical Counselors, also knowns as LPCCs, treat many of the same issues as MFTs. However, they are prohibited from working with couples or families unless they meet certain educational requirements.

Licensed Clinical Social Workers, or LCSWs, have a master’s degree at a minimum. Although they often work in hospitals, clinics, and agencies, many are also in private practice. The underlying assumption is that emotional and psychological problems are rooted in the psychosocial environment.

Licensed Psychologists have a doctoral degree in psychology, counseling, or clinical psychology. They often have advanced training in research methods, psychological testing and evaluation, learning disabilities, and other aspects of psychology.

Psychiatrists are licensed physicians with advanced training in prescribing medication to treat emotional or mental problems. Some psychiatrists conduct psychotherapy as well, although many frequently collaborate by providing medication while other therapy professionals provide the therapy, typically at a lower fee than what psychiatrists charge.

Interns, Trainees, and Psychological Assistants are graduate or post-graduate students who can provide psychological services under the supervision of a licensed psychotherapist. Because they have less experience, their fees tend to be lower.

Unlicensed Counselors can provide services but have not met the educational or experiential requirements for licensure. They may not advertise as therapists, are not regulated by any government agencies, and are not eligible to accept insurance.

Consider Cost and Schedule

Determine how much you’re willing to invest in therapy and how you’ll pay for it. Fees vary widely and typically reflect the therapist’s location, area of specialization, and level of experience. You’ll have the widest choice of therapists if you can afford to pay the full fee yourself. Many therapists offer reduced fees on a sliding scale, particularly if you can attend sessions during the less popular times such as mornings or early afternoons.

If you’re planning to use insurance, check with your insurance company before you contact potential therapists. Many insurance policies restrict you to a certain list of therapists; some policies will reimburse you partially or fully for out-of-pocket expenses.

If your funds are limited, you may wish to contact a low-fee referral network, community agency, or local psychotherapy graduate school to see what they have to offer.

Figure out when you’ll be available for therapy appointments. If other family members will also attend, find out everyone’s schedule. The greater your flexibility, the more likely it is that you’ll be able to see the therapist of your choice. Knowing your availability before you start calling therapists will expedite your search.

Interview the Candidates

Conduct a brief telephone interview. Expect to spend 10 or 15 minutes outlining the issues you hope to address in therapy and asking questions about the therapist’s education, training, and licensure.

What is the therapist’s experience in working with issues similar to yours, and what has the therapist found to be generally helpful? How does the therapist conduct therapy, and can he or she convey this in a way you understand? What is the therapist’s fee and typical availability?

Develop a list of additional questions before you telephone so that you can make the most efficient use of the time.

Schedule an initial session. If a clear preference emerges from your telephone interviews, see if you can arrange for an initial therapy session. If a few promising candidates have emerged, consider scheduling an initial session with more than one–especially if you’re planning to be in therapy for a while.

Make a Selection

Take notes. Following the initial session, jot down answers to some of the following questions:

• How do you feel after spending an hour with this person? Is this someone with whom you (and other family members, if they’re involved) can feel relatively comfortable in discussing difficult subjects?

• Did the therapist answer your questions about therapy in a straightforward, forthright manner?

• How does the therapist understand and uphold professional boundaries? Is the therapist cold and remote–or, at the other end of the spectrum, does he or she disclose too much information about him or herself?

• If the office is in the therapist’s home, what precautions have been taken to shield you from the therapist’s personal life?

• What are the therapist’s policies regarding missed appointments, cancellations, billing, and other similar matters? Are there any policies you disagree with or would have trouble following?

Decide on a therapist. Reflect on what you’ve learned in your search. Discuss your findings with friends or family if you need help in making a final choice. If you have questions that came up after the initial session, call the therapist and ask them.

Don’t wait any longer than necessary to make an informed decision. You began your search because something was bothering you, and therapists’ schedules can fill up suddenly. The best time to get help is when you feel motivated enough to pursue it.

Maintain Open Communication

You and your therapist can work together to set goals for your therapy and evaluate your progress along the way.

Some people go to therapy for a short while to resolve relatively simple problems; others continue for years if the problem is complex or if new goals come up along the way. Still others return to therapy periodically as needed.

Open discussion of these matters, as well as any other concerns that arise in the course of your therapy, can help keep your personal growth on track.