How to Choose a Therapist: A Step-by-Step Guide
No longer reserved for closed-door whispers, therapy is now a topic of everyday conversation. People talk about therapy as casually as they talk about going to a medical doctor for a physical check-up.
It’s wonderful—we’re starting to realize that therapy is for everyone and that it’s just as essential as medical care. This important shift in public attitudes about therapy means that more people seek therapy when they need it.
There are a few downsides to therapy’s growing popularity, though. One is that people talk about therapy as if it’s one-size-fits-all. It’s easy to get the impression that every therapist has the same approach when in reality, there are almost as many specialties in therapy as there are in physical medicine.
Choosing the right therapist and right type of therapy are essential first steps in having a good therapy experience, so we’ve put this guide together to help you get started.
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What to Ask When You're Looking for a Therapist
There are two important first steps to take before you choose a therapist:
- Learning more about therapy, and
- Learning more about yourself.
Learning more about therapy increases the chances you’ll start out strong with a therapist who’s a good match, because you’ll know what kinds of therapy are best for your specific needs. But method isn’t all that matters—it’s just as important to understand yourself, your own preferences and the reasons you’d like to see a therapist.
Where Do You Begin?
The best way to start your journey is by asking questions. Some of the most important questions to ask yourself include:
- Why do I want to go to therapy?
- What issues do I want to work on in therapy?
- Do I have any specific goals I want to accomplish in therapy?
- What kind of philosophy or approach do I want my therapist to have?
- Do I have a preference about my therapist’s gender, religion, or cultural background?
These and similar questions will help you make important decisions about what kind of therapist you want to see. Don’t forget to keep some practical questions in mind, too:
- How far am I willing to commute to see a therapist?
- How will I pay for therapy? Do I want to use insurance?
- If I can afford to pay out of pocket, how much can I budget for therapy?
The way you answer these practical questions may depend on how you answer the others. For example, if you want help with a goal most therapists can help you achieve, it wouldn’t make as much sense to choose a therapist who was further away or cost more to see. However, if you want to see a therapist with a rare specialization, it might be worth driving further or paying more.
You don’t need to perfectly understand your goals or motivations for therapy—learning about yourself is part of the therapeutic process. But the more you understand your reasons for going to therapy, the more likely it will be that you’ll pick a therapist who’s a good match.
How to Learn More About the Therapists You Find
There are so many things to consider when you’re researching therapists: where they’re from, what they believe, what degrees or licenses they have, and how long they’ve been practicing.
How important any of these factors are depends on your personal needs and goals, but in general, these are the most important things to look for:
- A therapist with a valid license to practice in your state
- A therapist who has experience treating people like you
- A therapist whose methods will help you achieve your goals
Whether you’re using OpenCounseling, a search engine, local therapy websites, or another source for your research, you should be able to find and read a therapist’s online biography to learn some basic information about them.
In their bios, therapists usually highlight the type of clients they’ve done the most work with and how long they’ve been doing that work.
For example, one therapist’s bio might highlight their work with the LGBTQ community, while another’s might emphasize their expertise in helping people resolve creative blocks.
You’ll be more likely to benefit from this kind of information if you know what you most want to address in therapy. So ask yourself: What concerns are central for you right now? Do you want to focus on issues of identity, relationships, love, work, creativity, spirituality, health, meaning, or something else?
It’s also important to determine whether you’re primarily seeking therapy for the purpose of mental health treatment. If you have (or suspect that you have) a mental health condition and want to address it in therapy, it’s a good idea to find a therapist who specializes in treating people with that condition.
For example, if you have borderline personality disorder (BPD), you’re more likely to be successful if you choose a therapist who has experience working with clients who have BPD, whose understanding of BPD is up to date, and whose vision of recovery is similar to your own.
What Therapeutic Method Is Best for You?
There is no therapeutic method that is best for everyone. Which method is best for you depends on your needs and goals.
For example, while studies show that cognitive behavioral therapy (CBT) is highly effective in treating a wide range of conditions, even CBT is only effective when it’s a good match for what you want to accomplish in therapy.
Matching Methods to Conditions
It can help to know which therapy methods are most effective in treating the conditions or issues you want to address in therapy. For example, if you have borderline personality disorder, you may want a therapist who’s certified in dialectical behavior therapy (DBT), a method that was designed to treat BPD, or you may want to focus on trauma work using a method like eye movement desensitization and reprocessing (EMDR).
Understanding the differences between therapeutic methods is one of the least intuitive steps in choosing a therapist.
Unless you’ve already studied styles of therapy, terms like “cognitive” or “psychodynamic” aren’t going to be very helpful when you’re choosing between two therapists. This is where it’s important to do a little bit of research to make sure you have all the information you need to make the best choice.
You could spend years studying the way different therapeutic methods work, but you don’t need to study that much just to be able to choose a therapist with the best approach for you. The following section provides a general overview of the most common methods therapists use.
An Overview of Therapeutic Methods
Cognitive or behavioral therapies like CBT, DBT, acceptance and commitment therapy (ACT), rational emotive behavior therapy (REBT), and many other therapies with the word “cognitive” or “behavioral” in the title focus on managing cognitive symptoms. This means they help you examine and change your thinking and the emotional and behavioral patterns that are triggered by your thoughts. These methods are particularly effective if you have a mental health condition that is caused or worsened by negative thoughts, such as depression or anxiety.
Trauma-informed therapies like EMDR, neurofeedback, cognitive processing therapy, exposure therapy, and trauma-focused CBT help you heal from trauma. They work by helping you learn your triggers and “reprogram” how you respond to them. They are effective for treating post-traumatic stress disorder and other trauma-related conditions. They are a great choice if you know you need to heal from something traumatic that happened in the past, including trauma from childhood.
For More Information
For more in-depth information about different therapy methods, including definitions, case examples, and questions you can ask yourself to help you figure out which method might be a good match for your needs, you can read our article “What Therapy Method Is Right for Me?”
For more information on trauma-informed therapy methods, recovery from trauma, and how to recognize trauma symptoms, you can read our article “Is Trauma the Reason I Feel This Way?“
Psychodynamic therapies include Freudian, Jungian, object relational, and other analytic methods. Most modern psychodynamic therapists have updated their approach, so it’s unlikely you’ll be lying on a couch if you go to one. You will, however, be asked to delve into childhood experiences. You may also examine your dreams for their subconscious symbolism. Psychodynamic methods help resolve inner conflicts and bring unconscious “complexes” into conscious awareness so you can change them. They are a great choice if you want to figure out why you feel how you feel and why you do what you do.
Narrative or existential therapies help you examine and update the stories you tell yourself. Your inner narrative is based on your past experiences and determines how you think and feel about your life and the meaning you find in it. Narrative therapies help you question the biases and beliefs your narrative is based on. They help you see where your story hurts you or holds you back so you can start to change it. They can be a great choice if you’re struggling with questions of purpose, life direction, or meaning.
Mindfulness-based therapies are often integrated into other therapies, including cognitive, behavioral, and trauma-informed therapies. Mindfulness-based therapy incorporates meditative practices that help you connect with your immediate experience, counteract negative thinking, and calm down when you’re anxious or stressed out. Mindfulness-based methods and tools can also help you become more aware of your reactions, triggers, and inner states. They’re a great option if you’re feeling disconnected from your body, yourself, or your life in general.
Is a Therapist's Method the Most Important Thing to Consider?
It’s good to understand your therapist’s method and whether you have any philosophical conflicts with it before you begin, but it’s not necessarily the most important factor in choosing a therapist. Sometimes a person who uses a method that you wouldn’t normally choose can still be the best match for you.
Research shows that the relationship you have with your therapist is more important than any other part of therapy. Your therapist’s method and philosophy will impact how you feel when you’re in session with them, but other elements may affect that connection more, including your therapist’s personality and background. Whether your therapist expresses empathy well and is able to make you feel heard and understood goes a long way in helping you heal.
Choosing a therapist with a similar background can prevent awkward misunderstandings and facilitate a good alliance. If you’re from a minority or oppressed group, it can be important to find a therapist who shares that with you. And if you want to incorporate spirituality into your therapy, you might prefer working with a therapist who understands and finds value in your spirituality or religion.
In the end, you have to decide whether any potential differences between you or your therapist would be an issue for you in therapy and whether you’d work better with someone different from or similar to you.
How Do You Know When a Therapist is a Good Match?
Just because a therapist’s bio makes them sound like a good match doesn’t mean they will be. A therapist recommended by a friend or family member might not click with you in the same way. It can help to ask the person who recommended a therapist why they like them, but there are things you just won’t know until you’ve met with your therapist in person.
Personality preferences can be just as vital in ensuring a good match with a therapist as the method a therapist uses or their cultural background.
In many ways, choosing a therapist isn’t that different from choosing a person to date: it’s about how you feel while you’re with them. This is why it’s important to set up an initial trial or “interview” session with a potential therapist before you commit to them. In fact, you may want to meet with several therapists before choosing one.
Other factors to consider include a therapist’s view on essential subjects like psychiatric medication. If you want to use psychiatric medication but your therapist doesn’t believe in using it, for example, you’re going to have a hard time avoiding conflicts over the topic.
It’s good to be open to learning and shifting your perspective over the course of therapy, but it’s not a good sign if you feel like you and your therapist are on totally different pages from the very beginning.
Be sure to ask any questions that could highlight important philosophical differences in your first phone call or interview session.
A good therapeutic relationship is one in which you feel safe to be vulnerable. Therapy may confront you with painful memories or unpleasant truths, but it will also empower you to believe in yourself and make the changes you need to make your life better. Good therapy gives you hope.
Watch Out for Red Flags
If your therapist does anything that raises ethical red flags or makes you uncomfortable, you should walk away and find someone who makes you feel safe. Without this basic sense of comfort with a therapist, you won’t be able to be vulnerable or do deep work with them.
To learn how to spot red flags in therapy and warning signs of a bad therapist, you can read our article “Don’t Even Think of Going Back to a Therapist Who Does Any of These Things.”
If you feel ready to start therapy, there are many resources you can use to research and find a therapist. You can use the search tools on OpenCounseling to find an affordable local therapist, try low-cost online therapy at BetterHelp (a sponsor), or review websites for local clinics.
Whatever method you choose, know that you’re taking an important step. Even if the first therapist you try isn’t a good match, you’re that much closer to finding the right one.
Stephanie Hairston is a freelance mental health writer who spent several years in the field of adult mental health before transitioning to professional writing and editing. As a clinical social worker, she provided group and individual therapy, crisis intervention services, and psychological assessments.