No two therapists are created equally and finding the right match for you can sometimes be difficult. Hopefully the list below will provide some helpful questions to consider when looking for a therapist. Most therapists will provide a free consultation in which you can ask a few questions to see if they're a good fit. Use this time to your advantage!
1. What is your general approach to helping others?
Finding the right type of therapy for you can be complicated by the fact that there are over 50 different types of therapeutic approaches! One way to group therapies is by whether they work exclusively with conscious content (thoughts and feelings you are aware of) or if they also include unconscious aspects of your experience. For example, Cognitive Behavioral Therapy (CBT) is focused on the connection between our conscious thoughts, feelings, and behaviors. The belief is, if you change the way you think about a situation, you will feel differently, and therefore act differently. In comparison, therapies that work with unconscious content aim to explore thoughts and feelings that lay under the surface of our awareness. This is accomplished by paying close attention to a person's pattern of thoughts, feelings, and behavior which operate outside of their awareness. Bringing this type of content into therapeutic discussion provides rich information to help discover what started, and is maintaining, difficult symptoms. If you have found yourself wondering why you feel, think, or act the way you do, or if you have tried to change your thoughts but haven't been able to, therapy that works with the unconscious can help provide answers. When these answers are obtained, the symptoms often clear up on their own. The approach I use (ISTDP) is a type of therapy that includes unconscious elements of our experience.
2. My problem is _______. How would you go about treating that?
This is a straightforward question if you know what your problem is. Oftentimes, describing some of your symptoms can help. For example, ‘I struggle with feeling down, low motivation, and loneliness. What would be your approach to helping me?’. You are looking for a therapist who can describe their process in a way that you understand, and that makes sense to you. If they use a lot of jargon that leaves you feeling confused, you will likely have a similar experience in therapy with them.
3. How effective are you? How is this measured?
It is not safe to assume that a therapist improves their effectiveness over time. One large study comparing outcomes from 6,591 patients seen by 170 therapists over many years showed that, while some therapists’ effectiveness did improve with time, many did not. In fact, the average therapist had a small but statistically significant decrease in effectiveness over time (Goldberg et al, 2016). This illustrates that therapists need to put effort into monitoring and improving their skill set. Therefore, if a therapist is unable to clearly answer how they are measuring and improving their success rate, they might not be able to offer you the best service available.
Goldberg, S., Rousmaniere, T. G., Miller, S. D., Whipple, J., Nielsen, S. L., Hoyt, W., & Wampold, B. E. (2016). Do psychotherapists improve with time and experience? A longitudinal analysis of real world outcome data. Journal of Counseling Psychology, 63, 1-11.
4. How regularly do you get feedback from other, trusted, counselors?
This question is a great add on to the previous question if it was not addressed. As a therapist, we can improve our practice by gaining an outside perspective from a trusted advisor. Early in a therapist’s career, this is a mandatory part of learning and is termed ‘supervision’. During supervision or peer consultation, a therapist will present a case they are looking for feedback on. This may be due to feelings that have been stirred up in the therapist that they want to resolve so they do not interfere with treatment. The therapist may also be looking for different perspectives on a client’s presenting issue if they are not familiar with it. They may also wonder what other techniques might have been more effective given the circumstance. In all cases, client confidentiality is strictly maintained. If a therapist engages in regular supervision or peer consultation, it is like they have a team of professionals they are bringing into your therapy to provide you with the best treatment possible. If they do not, you may want to consider how they are able to recognize their blind spots and providing you with the best therapy they can offer.\
5. Have you been in therapy yourself?
No one goes through life without any difficulties, so it is not surprising that many therapists have also been through therapy themselves at one point. In fact, in certain types of therapy, it is a requirement for therapists to have undergone treatment first to be sure they do not transfer any of their own problems onto their client. In any case, you want to be sure that your therapist is able to be fully available to you. This can be difficult to do if they are struggling with personal issues of their own. In addition, having the experience of seeking support helps a therapist gain perspective into what it is like to be a client walking into a therapist’s office. It may be helpful for you to know that they can relate to you in this way.
I hope these questions help you think about what might be important to consider when looking for a therapist. Understanding some key elements up front can be useful in knowing what to expect. There are so many more questions that can be asked, and I encourage you to ask anything that is on your mind before starting therapy with someone. Beginning the therapeutic relationship from a place of exploration and discovery can only benefit you moving forward.
Best of luck!