Folks who love their therapist: How did you find/choose them?

October 15, 2024 10:02 AM

How did you know they were right for you? Did it take time or did you immediately now? Where did you first hear about them? How did you do your evaluation to land on this person?

I have seen several therapists throughout my life. In the early days, I was just stuck with whoever was in driving distance and had the availability/time slots open that worked for me. That narrowed things down very quickly.

But now in this post-COVID era of telehealth -- I am overwhelmed by the number of therapists available. And, don't get me wrong, I LOVE having this problem. The services I use let me slice and dice in so many ways that I never could before, and I can now find therapists with the exact backgrounds/experiences/skillsets I want (which was impossible before). But even then, I still end up with more than a dozen options!

Once you got to the "call and screen" step when choosing a therapist, what kind of questions do you ask/what do you do to find one that fits? And I am looking for things beyond the basic asks of how long they have been in practice, which methodologies/strategies they use, how many patients they have, etc. These are the suggestions I see when I google, but honestly it doesn't even matter to me what their answers are as long as they are the right fit for me.

Thoughts?

posted by dede to Health & Fitness (12 answers total)

I focused on whether I thought they had similar values to me in trying to narrow down the field. In particular are they clearly LGBT+ friendly, do they appear to be aware of neurodivergence, are they likely to be accepting of alternative lifestyles.
posted by plonkee at 10:13 AM on October 15 [2 favorites]

Just a note, despite being shown that many therapists, it’s very possible that your options will still be quite limited because many people aren’t taking any patients right now, or are only taking for hard-to-fill spots like 10am on a Monday or whatever. I struck out on five therapists who seemed like great fits for me and ended up going with someone who seemed like they wouldn’t be a very good fit, but ended up being great. So I would caution against screening too many people out. I’ve generally found the first phone call to not be very helpful in telling me what someone will be like, but the first actual session is usually an indicator of how the rest of therapy will go. So I would say I knew from the first session, but not before. And it was essentially finding people with background in LGBTQ and disability stuff; there wasn’t anything else that particularly distinguished the therapists I ended up really liking from others on their profiles/phone calls/etc.
posted by brook horse at 10:35 AM on October 15 [1 favorite]

I went with how easy it was for me to talk to them. (In fact, I'd already been talking her ear off prior to seeing her as a therapist - she used to run a new-agey shop in my neighborhood and I was constantly coming in and telling her about the complicated backstory for whatever witchy thing I was getting, and she was the one who finally said "you know, I'm also a therapist, maybe we should start doing that?")
posted by EmpressCallipygos at 10:41 AM on October 15 [2 favorites]

For me, I looked at some listings from a local psych association in my area, narrowed down to people who accepted my insurance. (Later that changed, and we worked out pricing after that.) I definitely wanted a woman with similar attributes to what plonkee mentions. Personally, I also wanted someone with many years of experience—maybe just my specific bias, but I was a psychology major in college and I didn't want to work with someone just starting out who might've been my peer in school. I wanted to talk to someone with more clinical and life experience.

Also, I didn't select for this, but I got lucky: The person I found is very warm but also very action-oriented, and helped me come up with specific actions to take and things to try after each session. I could try things, gather data points, and report back on what worked (or what didn't happen, and why). Also she had lots of great fidget objects and decor in her office, but that's not relevant for your search!
posted by limeonaire at 10:46 AM on October 15 [1 favorite]

Helping people find the right therapist is part of the job of therapists, so after narrowing down your list the best thing to do is to call a few and tell them you're looking to find The One. They will know what questions to ask and can either connect you with the right person or at least help you narrow your search further.

Having found a candidate, my #1 requirement by far is whether I enjoy talking to them. Are they present, sincere, listening and responding thoughtfully? Do I feel even a whisper of a warning sign? I'm going to be rooting around in my brain with this person, so they had better be a comfortable companion. There's no one question that will reveal that; it emerges naturally as you converse with them.
posted by Tell Me No Lies at 10:53 AM on October 15

How I have gotten bad therapists: Personal recommendations, EAP program at work, random attempts to find anyone taking patients.

How I got my current very good therapist: Asking my (wonderful) primary for a recommendation and then patiently waiting for the therapist to have an opening and taking widely spaced appointments in the beginning until her calendar started opening up more.
posted by HotToddy at 11:00 AM on October 15 [2 favorites]

I am going through something similar in trying to find a good therapist.

I am looking for someone in CBT field, but I am also in AA. I have heard many stories in the rooms of CBT therapists actively discouraging AA as a means of recovery from alcoholism and recommending CBT based for that too. Problem for me is I am happy using AA for that. Heck, I've been sober 10+ years and go to Secular AA meetings to get my fix. I am having trouble finding someone who is okay with my using AA, but help with the other stuff I want help with.
posted by indianbadger1 at 12:32 PM on October 15

The initial phone call never helped me much. If I felt good when looking at their online picture and they didn't have fifty "specialty areas" listed then I booked the appointment. After the first appointment I either felt Wow or I felt Ok or I felt Nope. The times I went with the OK I always ended up dropping out after three sessions. Go for the Wow. YMMV.
posted by SyraCarol at 1:08 PM on October 15

Just talk to them. See if you hit it off. Do you have rapport? Don't so much worry about asking about their education or whatever, just say "here's the issues I got going," and see if they are willing to take you on. I've had a few reject me/say I wasn't quite their cup of tea, whatever, when I was last therapist hunting.

If you have any "dealbreaker" things about you--let's say you're a hippie sort who has things happen to you that aren't in a lot of people's philosophy, you're polyamorous, you've got ADHD/autism/some other shit, etc.--and whoever you end up seeing needs to be someone who's cool with dealing with that, that's what I would use to filter. I have Weird Things Happen To Me and any therapist I see has to be able to cope with that and be fine with it, and thankfully my new one is. If you've got nonmonogamy stuff going on, you need someone who can deal with it and not urge you to go monogamous. My friend with heart issues, if she can *ever* get permitted to have therapy (long shit story), has mentioned having issues finding someone who can deal with discussing her being medically complex. So whoever you see needs to be able to reasonably deal with whatever your special is.

Also, frankly depends on whether or not they take your insurance and you can make the time slot they have available.
posted by jenfullmoon at 1:29 PM on October 15

Sometimes, the best result comes from contacting a crisis centre related to your needs. A crisis centre is more likely to have invested in a navigator approach, which approaches the critical need for an ideal partner in healing. An ideal navigator will be a trained psychologist who can evaluate your needs. They'll ask a number of questions, some of which may be challenging, and use these to make a formal recommendation. I highly recommend you consider your preference for gender in advance.
posted by parmanparman at 1:59 PM on October 15

I ask hard questions at the consult and then do 3-6 test sessions looking for rapport, reliability, affirmation of my identities, and willingness to pursue conflict. Will they challenge me when I need it, and can I stomach their approach?

These questions have been great for sifting:

- Do you prefer set session times or are you flexible? How often can you see me? What forms of communication do you accept outside sessions?
- Tell me about your educational background and what you're learning right now.
- How do you conceptualize [my identities, or whatever I'm here to work on...]?
- What's your feeling on the utility of diagnosis? Will you seek my consent before making one or reporting it to insurance?
- If a client brought up suicidal ideation, how would you react?
- How do you handle transference, or parts with extreme feelings?
- Do you lean anxious or avoidant?
- What do you look for when measuring progress?
- If you feel stuck with a client, who do you go to for help and how do you take care of yourself?
- Am I the kind of client you like to work with?
- Anything else you think is important?

I also really like working with therapists who treat other therapists. They are awesome at cutting through intellectualization.
posted by lloquat at 2:37 PM on October 15

If you've narrowed down to therapists who have what you want on paper, I recommend two things:

First, treat the consultation call as a vibe check. You've already screened out therapists who don't have the expertise or specialization you're looking for. Pay attention to how you feel in the conversation. You don't need to ask super precise questions or get exactly the right information out of them. You mostly need to have enough interaction to imagine how it might be to trust this person (picture the scene in an action movie where they need to keep someone on the phone long enough to trace the call--this is like that, but you need to stay in the convo long enough to feel something about the person). Consider asking for a video call if you think that might help you make a more informed choice. Ask yourself: Do you like talking to this person? If not: do you dislike talking to this person because you fear they will challenge you in productive ways, or do you just not like talking to them? Does this person feel trustworthy to you? Do you feel motivated to get started in therapy after talking with them? Let yourself take these things seriously. The best therapist for you isn't just smart and well-trained, they're someone with whom you feel safe, supported, and empowered.

Second, if you feel like you click with someone, meet with them 1-3 times, and then reassess. How well does the feeling of being in session with them match your expectations based on the consultation? Are there things you would like to address and change within this therapeutic relationship? Bring them to the therapist's attention, and see how they integrate your feedback. If after one or a few sessions you don't feel like this is the therapist for you, and you've either brought concerns to their attention or your concerns aren't things they can change, cut your losses and do some more consultation calls. (Email script: "Dear [Therapist], I have decided this therapeutic relationship is not the right fit for me and would like to cancel all future sessions. I have appreciated our time together and wish you the best. Sincerely, [Client]")

If this advice feels completely wrong to you, perhaps you have very different needs or experiences when assessing prospective therapists--which is fine. This is based on my experiences as a therapist and therapy client, but this isn't the only possible approach. I do find it's a nice way to get moving if you're feeling stuck on finding THE right therapist as opposed to A right therapist for you.
posted by theotherdurassister at 4:19 PM on October 15 [1 favorite]