Choosing a Therapist

(without going totally crazy)

by Jenn Fredette LPC, NCC, MA, M.Div., Clinical Coordinator.

Originally published on:

Choosing a Therapist

Choosing a therapist can be completely overwhelming. What makes the process worse, is that often you’re already feeling overwhelmed by stress, worry, and good ol’ plain agony. Decisions may already be hard to make, and this is a decision to pick who can see you at your most vulnerable, hear the secrets that you keep under lock and key, and who, yeah, you’re going to pay to do that.

I know that the process of finding the right psychotherapist can be really hard.  It’s so worth it though when you finally get connected. When you find the right person for you, you find that you’re willing to really invest in yourself in a way that didn’t seem possible before, it feels kind of like magic.

So how do you find a good psychotherapist the first time around? It’s actually not that complex, though it definitely takes some time self-reflecting and being thoughtful about who you contact. Below are some questions to consider as you begin or continue your search.

what kind of issue/problem/desire are you bringing to therapy and what are you wanting to get out of the experience?

In my experience, the most common responses to this question can be broken down into four categories:

“I feel terrible. I am in so much pain. This is unbearable, I need to feel better.”

“This horrible thing [major loss such as death, break-up, job loss, etc] just happened. I don’t know what I’m going to do. I feel stuck. I want to move forward.”

“I’ve been wrestling with [anxiety, low self-esteem, over-compensating, using substances to numb out, etc.] for as long as I can remember. I’m really curious and want to get to the root of what’s going on here.”

“My [partner, probation officer, sister, mother, father, brother, friend, etc] says I really need therapy for this ‘issue.’ I don’t know that I really do, but I guess I ought to give it a try.”

You may resonate with more than one category, or maybe none of them seem to sum up why you’re coming to therapy. I encourage you to consider how you might share your presenting problem with potential therapists. When we, therapists, know why you’re coming to therapy, we’re able to tell you how we work with that problem and help you move towards your goals.

who often works best for you, in terms of personality, gender, race, language, life experience, etc.?

Therapy is an intensely personal experience, so you really want to make sure you’re setting yourself up to be as comfortable with your therapist as possible. For some people, that means you absolutely want to be with someone who is the same gender, race, and speaks the same primary language.

For other people, what matters more is that this person is an “expert” in both professional and personal experience in what they are looking to work on. You may think you don’t have a preference, but I’d encourage you to really think about what kind of person you imagine being your therapist.

  • Are they male or female?
  • Are they the same race or ethnicity as you? Or is different okay?
  • Do they give feedback? Or remain neutral to your questions?
  • What kind of education and training do they have?
  • Do they advertise that they work with clients like you?

what kind of therapy is the best fit for you?

In my experience, people care more about feeling comfortable with their therapist’s personality than his or her theoretical orientation. That said, not all theoretical orientations or intervention styles are going to work for you. Knowing which you prefer will help you find someone who is on the same page.

Are you in acute distress, feel that things are completely unraveling because you don’t have the skills to change your situation, and do you desperately want concrete steps to do things differently? If so, you’ll likely resonate with doing-oriented therapies. The gold standard among these theoretical orientations is CBT (cognitive behavior therapy), which comes in a variety of styles, such as solution focused, dialectical behavior therapy, motivational interviewing, and strength based therapy.

Are you someone who has a chronic issue (such as anxiety, shame, low self-esteem, relationship issues) and who really wants to get to the root of the issue and change in a deep way? If so, you’ll likely resonate with depth-oriented therapies. There is a whole range of these kinds of therapies, including psychodynamic, Alderian, Jungian, and transpersonal therapy (to name just a few).

Many therapists describe their theoretical orientation as eclectic. When it is done with skill and experience, eclectic oriented therapies provide a way for therapists to combine both a depth-oriented perspective with the use of doing-oriented interventions. I definitely fall in this camp. I talk more about my theoretical orientation and how I concretely help people on their journey here.

how much can you afford, both in time and convenience?

The long and the short of it is: everyone has to pay for therapy. Not just financially, but also in terms of convenience (and that’s to say nothing of the blood, sweat, and tears–though to be honest, it’s mostly the last). If you have less of one, you often have to pay more of the other. That is absolutely not that a therapist’s worth is directly correlated with what they charge. However, it also doesn’t mean that if a therapist charging a lower rate than average, that they are necessarily a better deal.

In the DMV (DC/Maryland/Virginia), the average rate for a licensed psychotherapist (such as a LPC, LCSW, LMFT) is approximately $150 per 50-minute session, often with a higher rate for the initial session (which also may be longer). Non-licensed therapists often charge less. They typically have less experience and health insurance companies rarely reimburse for their sessions. The Center for Pastoral Counseling is committed to helping every person be connected with a therapist and offers a sliding fee scale that allows people to pay based on their gross annual income.

how do you find a good therapist?

Once you know what you’re looking for, then go look for it! If you’re comfortable, you can start by asking friends and family if they know of anyone they’d recommend. Many people end up looking online (probably how you found me!). Search for someone who looks like they fit what you’re looking for (in terms of personality, skills, and location) and then contact them (which is definitely harder than it sounds, I know!). Almost every therapist I know offers a short, free consultation call. Take them up on it!

I’m really excited for you–find the right therapist for you is like finding a guide who will partner with you as you discover and learn to use your own brand of magic.

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