There’s like… a million therapists out there. And therapy can be extreeeeemely helpful; it's also a huge financial investment.
I think I'm a great therapist. And I push myself to learn and grow every day. I also know that I'm not for everyone. I am challenging, blunt, and a lot of my philosophy goes against what we're taught about health, strength, and we should be. For some clients, this fits really well; for others, it doesn't. And that's okay. You deserve to work with someone who feels like a good fit for you.
Starting therapy can feel daunting—especially if you've been raised to think that your feelings and needs are selfish or wrong. For that, and many other reasons, the therapeutic relationship is still the number one factor in predicting successful outcomes. If you're thinking about beginning therapy, wondering if you should switch therapists, or simply wanting to understand more about this type of work, here is a breakdown of things you can do BEFORE meeting a new therapist and DURING your first few sessions with them.
The first thing you need to do is to reflect on what you want to be different in your life. One way to think about this is: if therapy were “successful,” what would change in my life? This is very different than giving a breakdown of the current events of your life. This reflection requires you to think about your internal experiences (feelings, thoughts), your relationships, your values, etc. Rather than contacting a few potential therapists and saying “well this happened and this happened and this happened,” you can instead say something like “I’m feeling like this and I want to feel like that” or “I need to change this part of my life.” Taking a minimum of 5 minutes to reflect on this stuff is an important first step before you even look up therapists. Side note: you may not know what areas you want to change and that’s okay. This reflection can still be useful by bringing attention to your current life & experiences.
If you are searching for therapists in your area, take some time to think about (and write out—I promise it helps clarify things!) these things for yourself:
what do I think is the major problem(s) in my life?
if therapy is helpful or effective for me, what changes would I expect to see in the future?
Does my therapist's age, gender, or other piece of their identity matter to me and my ability to connect with them? (if so, you can search for people of particular genders, sexual orientations, faiths, and other allyships on directory sites like psychologytoday.com)
Then, it is also helpful to think about what things you want from your therapist, by asking them:
what would a typical session with you look like? (do they use worksheets and written assessments? are they more directive or am I expected to drive the conversation? how would they typically address _____?)
how many sessions do you typically prefer to see clients for?
what is your understanding of mental health?
How would you make sure that we are on the same page in terms of my goals?
Remembering that safety & trust is crucial between you and your therapist, look at your current relationships and identify what characteristics help you feel comfortable and safe with someone. In other words, what aspects of someone’s personality helps to put me at ease and make me want to open up to them? The following questions can be helpful to reflect on in your first session or two with a therapist, to see if it's the right fit:
Do I prefer when someone can use humor or sarcasm to lighten a situation?
Do I want someone who will immediately jump to solutions or do I need a bit more time to explore and be validated?
What kinds of support are missing from my existing network of people? (do I just need someone to listen without judgment? do I need to be challenged? do I need skills and strategies to make myself feel safe?)
Additionally, your therapist should seek feedback from you. Period. In my opinion, if they don't, run for dear life. The scale below shows some examples of what things should be felt & maintained in your work with a therapist.
I always try to explicitly ask 1 or 2 of these questions at the end of every session, but even if your therapist doesn't, these scales are good indicators for you to assess whether or not your therapist is a good fit. You can also think about some of these:
am I walking away from sessions with something to think about?
note that this one takes time: do I notice changes or improvements in my day-to-day life?
do I feel like I can be my honest, truest self with this person?
The relationship between you and your therapist is important for so many reasons:
you need to feel safe and trusting enough to disclose private events from your life
you need to have clear and respectful communication to make sure that you are consistently working towards goals or outcomes that are important to you
you need to feel empowered and supported enough to expose yourself to painful feelings or memories
What frustrates me immensely is that our healthcare system does not make private psychotherapy accessible to many, and those working in not-for-profit settings are often burnt out and way above their capacity to actually meet your needs. In opportunities where you are fortunate enough to exercise choice, however, these questions can be helpful to consider before or during (and even after) your experience with a therapist.
NOW LET ME BE PERFECTLY CLEAR.
If you are struggling to connect with your therapist or you feel a disconnect on any of the things described above, mention it to them. As much as we try, we cannot read minds (I'm hoping it will kick in any day now). You do not owe it to your therapist, by any means, but you do owe it to yourself to advocate for your needs when they aren't being met. We will not take it personally—it's our job. You may find that you bring up your concern and they are quickly and effectively addressed, saving yourself the $$ and hassle of finding a new clinician. Or, you may find that it just isn't a good match and you need something different. What matters is that YOU will know what's right for you.
So get out there people! We've got therapy to do!
As always, your friendly, honest, neighbourhood psychotherapist,