Choosing a Counselor or Therapist (6/19/2020)

After scouring lists from insurance companies and dozens of online profiles full of buzzwords, abbreviations, and jargon fit to drive someone into an intense teeth-grinding session, choosing a therapist can be nerve wracking. Nobody really teaches us how to find a therapist and some assume that one can just call whichever clinic they want and take the first available appointment. There are several reasons why that isn't a good idea:

• They may not be a good fit for you

• They may not be in-network with your insurance plan

• They may not have expertise to treat your particular condition

• They may not have the time to give you the support your condition requires

• They may not be a good therapist

The Importance of Fitting

I've had many clients share with me that they have had a hard time finding a good therapist. They report that they either didn't feel a connection with the therapist, didn't personally like the therapist, or didn't feel as though their services were helpful. It can be extremely frustrating to start a therapeutic relationship with someone only to find that it just isn't a good fit. Clients sometimes worry that they were the problem or come to believe that the therapist was incompetent--sometimes either one of those things can be true. More often than not, the problem is simply that they just weren't a good fit for each other.

As with any potential relationship, people either fit or they don't. Both can be totally good people with wonderful intentions and capabilities, but something just doesn't "feel" right or "click" sometimes between some people and it isn't always somebody's fault. Some people have heard that they don't have to like their therapist because they don't have to necessarily like their doctor, which fools people into thinking that they have to keep working with a therapist they aren't clicking with. But what's the big deal with that? Well, research has shown consistently that the quality of the relationship between the therapist and the client is a stronger predictor of positive treatment outcomes than the type of therapy used.

To get a better idea for how well you might click with a therapist or counselor, there are options beyond just scheduling an appointment and hoping for the best:

• Determine who you'd feel more comfortable with: some clients feel more comfortable with a person of color, a specific gender, or a member of the LGBTQ community and that's okay!

• Give them a call and pay attention to how you feel during and after the conversation is over

• Ask friends or family who they see and if they're any good--they know you and would have a decent idea of whether or not they'll fit

• View their professional profile content and pictures and reflect on how you feel about them

Insurance and Treatment

If you identify a couple therapists or counselors that you feel would be a good fit for you and you see in their profile that they treat the condition you're seeking help for, contact your insurance company by calling the number on the back of your card to see if they are in-network with your plan. If they aren't, strongly consider the possibility of seeing someone outside of the network. Clinicians can supply you with something called a Superbill that you can submit to your insurance company for possible reimbursement for your treatment and treatment with a good therapist you connect strongly with will be more effective (and likely shorter) than seeing someone you feel mediocre about. Otherwise, ask for a directory and use that to guide your search for someone who is a good fit.

What To Do If You Don't Fit

Sometimes even the most thorough searches don't work out. If you feel as though you aren't clicking with your therapist, tell them. Good therapists and counselors are ready for these sorts of conversations and will not take it personally. Perhaps there is something that can be done differently in session to improve the quality of the relationship or maybe the awkwardness is something you experience often in other relationships--which might be useful to explore with the therapist to see if there is something you could be adjusting. Sometimes it might just be a one-off session that ended poorly and you didn't feel like you said everything you wanted to or you didn't feel heard. A good therapist would take your critiques seriously and consider the possibility of structuring your sessions a little differently so you can get what you're looking for.

If your clinician also determines that maybe another clinician would be a better fit for you, they can help you find someone else--a good therapist will want you to have the treatment you need even if that means referring you to someone else.