So You Want to Start Therapy, How to Choose a Therapist?
Starting therapy and choosing a therapist can feel overwhelming. There are so many options and the idea of sharing potentially embarrassing topics is vulnerable. Add in that there are so many different credentials and specialties and it becomes hard to narrow down. This guide explains the different types of therapists and what to look for, but really the best advice is to find someone YOU are comfortable with. You can see the best trained therapist in the world, but if you don’t feel comfortable talking to them, there is no point.
What am I even looking for in a therapist?
At a minimum, you want to find a therapist licensed in good standing in your state. Therapists must be licensed in the state in which the client is physically located, and you can check their license status through the state board website. Some therapists have masters degrees, others have doctorates, and many have additional special training. But this is the bare minimum, let’s dive into what makes someone the best therapist for YOU.
Different types of therapists
- Psychiatrists – These are medical doctors (MD) who can provide talk therapy and also can prescribe medications. They tend to be more expensive and many (not all!) do shorter talk therapy sessions and focus mostly on medication management
- Psychiatric nurse practitioners (NP)/physician assistants (PA) – Similar to MDs, NPs and PAs focus on providing medication management for mental health, but they work under an MD
- Psychologists – These therapists usually have PhD or PsyD after their names. They have doctorates and training in different area of mental health and can provide talk therapy but cannot prescribe medication (note, they can prescribe meds in a few states)
- Licensed clinical social workers (LCSW) – These therapists have masters degrees and extra training for therapy. They often work in hospitals, community mental health, or private practice therapy offices. If a social worker is not yet licensed (ie they are still in training), you may see the letters “MSW” or “ASW” depending on the state. LCSWs cannot prescribe medications.
- Licensed marriage and family therapist (LMFT) – these therapists have masters degrees and are very similar in training to LCSWs. You will see them in the same settings as licensed social workers. If an LMFT is not yet licensed, you may see the word intern or the letters “MA” or “MS”. LMFTs cannot prescribe medications.
Does the type of therapist matter?
Honestly, no. All of the categories above have the training necessary to make great therapists. Decades of clinical research have shown that what really matters is the quality of the relationship you have with your therapist. If you don’t feel comfortable with your therapist, you don’t open up, and if you don’t open up, you won’t get anywhere. Therapy is not very helpful when its only surface level.
What to look for in a therapist?
It’s a good idea to formulate your goals and ideas of what you are looking for. Maybe you’re a busy mom who feels like another mom would best understand you, or maybe you feel more comfortable with an older therapist. Maybe you want someone who has specific expertise with grief or trauma. These are all fair and valid filters for your search and any good therapist will answer enough questions that you can quickly see if they are a good fit in these areas. Here are some good questions to ask yourself while you’re searching:
1) Do I have a specific demographic that matters to me (i.e. age, gender, occupation, religion)? Why does it matter? Is this something I could compromise on?
2) What do I want to work on? Examples could be grief, anxiety, perfectionism, relationship stress, etc. You want to make sure that your therapist has a good level of competence for whatever issue is really bothering you
3) Do I care about seeing them in person or virtual? There are benefits to both, so this completely depends on your comfort level
4) How much am I willing or able to spend? Many therapists do not take insurance, but there are plenty of great ones who do. Financial stress is a real thing and therapy should not add to it. Side note, many therapists do have sliding scale spots for clients who need it. It’s always worth asking about!
Identify your own goals
Before meeting with a therapist, it is helpful for you to get a sense for your own goals for therapy. A good therapist will help you narrow down the goals and the way to get there, but you should start with at least a general idea of why you are seeking therapy now, and what you hope to get out of it. Some questions to ask yourself here are:
1) Why am I seeking therapy now? Is it my choice or is someone else pushing me to do it?
2) What has been bothering me most this week?
3) If I could look ahead to the end of therapy, how would I know it had been helpful? How would things be different for me?
How do I find a therapist?
You want someone who you feel comfortable opening up to, and to find this, you may need to talk to a few different therapists. This is totally fine and expected. If you do not have any word of mouth recommendations, start with the listing on psychology today (link here: www.psychologytoday.com). Here you can filter by the basics (virtual/in person, gender, specialties). It’s a great starting place, but heads up, it’s not always accurate. Choose a few therapists you like and reach out to them. Most will offer a free short consultation for both of you to decide if it’s a good fit.
During this consult, you can tell them a bit about what you’re looking for, and then they will tell you a bit about what they offer. You can ask anything that is important to you – their background, their beliefs, their style, their cost, their schedule. You can even (appropriately) ask sensitive questions. If you want to know their politics or religion because these are important for you to feel comfortable, that’s fair game for you to ask. Of course, it’s also fair for them to decline to answer, but this conversation helps to see if you are a good fit. It’s important for this relationship to be genuine and you are allowed to have personal preferences in your search. Again, if you don’t feel comfortable enough to open up, it’s a waste of your time.
What if I don’t like the therapist I choose?
This is awkward, but important to address head on. Why don’t you like your therapist? Do you feel like it’s not helpful? Do you feel like they don’t understand you? Or do you feel judged or uncomfortable in a way you can’t put your finger on? Any good therapist is going to be open to feedback. If you didn’t like the way they interpreted something, tell them. If you don’t feel like you’re getting anything out of it, tell them. Sometimes this is all that’s needed to pivot and make it better. Not only is this important for your mental health, but it should be a safe place to practice advocating for yourself. If things don’t get better or you truly feel that it’s a bad fit, you can say that. I would suggest saying something like “I appreciate your time and help, but I don’t feel like this is the right fit for what I need right now. I’m going to take a break from therapy/find someone more aligned with my needs.” It’s direct and to the point, and a great practice for those of us who struggle giving honest feedback.
So what to do next?
Reach out to me if you’d like more information! If I’m not the right fit, I will walk you through finding someone who works best for you. I truly love introducing people to therapy and explaining about how therapy can help, hopefully making the process less intimidating and more welcoming. You can reach me via email at morgangrosscounseling@gmail.com, via phone or text at (312) 933-8106, or click the contact me button above!
