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How to Choose a Therapist – Illustrated

When you’re new to therapy and aren’t really sure what therapy is supposed to feel like, it can be really confusing to try and figure out if a first session or initial consult went well – how to choose the right therapist or how to know if they’re the right fit.

Choosing a Therapist

After navigating the hurdle of deciding to start therapy and the process of finding a therapist, there is still the task of choosing to work with a specific therapist – and how to even know if that therapist is the best choice for you. Asking questions about experience, training, specialties, and method can be helpful, but research indicates that these things matter less than the degree of trust that therapist and client build together.

Tips on how to choose a therapist.
This image outlines my list of questions to ask yourself after the first contact to get a sense of whether this is a person you could work well with. View a detailed image description by clicking here.

Since we know that the quality of the relationship between the therapist and the client is the best predictor of therapy having a good outcome, it’s worth the time to meet with several potential therapists and see which “clicks” for you. 

The Consult

After choosing a therapist, the next step is to do a consultation. Some therapists may do this over the phone while others may ask for you to come in for a session or two. This is the best way to feel out the client-therapist relationship.

Meeting new people is always a little scary, and people often feel especially vulnerable in the first few sessions. The therapist knows it’s scary and- trust me- thinks you are a strong and brave person just for reaching out and showing up.

If it helps, it is okay to come in with a list of questions or concerns. Your list can be a really good place to start. It’s also ok to show up without anything to talk about! Therapists often have a structure they follow for the first session or two- so know that you are NOT responsible for filling the space.

Post-Consult

After consulting with a therapist, it is helpful to reflect on the process, how you felt during the session, and if you think you want to choose to work with this therapist. 

Good questions to ask yourself after a first session with a new therapist are:

Hand drawn sticky notes.

Did they feel authentic?

While a good therapist will speak and behave in a professional way, especially while handling the initial paperwork and disclosures, a good therapist should leave you with a sense that they really showed up as themselves, with authenticity. 

 If your first session felt like talking to an emotionally-focused robot or an actor playing a therapist role, it may be a sign that this therapist is not a good fit for you. While it’s normal for it to take a few weeks- and sometimes longer- to find a connection with a new therapist, most of us have a pretty good read on whether someone is really showing up or hiding behind a mask.

Trust your gut, and if you aren’t sure, give it a few more sessions to decide. 

hand drawn doodle of a green colored waving flag.

Green Flag: After your first meeting, you felt like they were really tuned in to you- perhaps you even have a little bit of a sense of who they are, their personality type, and vibe. 

Did they interrupt you?

Just like in conversation with friends or family, being interrupted in a therapy conversation is frustrating! Although sometimes interruption can be part of treatment in therapy (like being cut-off when you begin speaking to yourself in a cruel way) usually this occurs later in treatment, after trust has been established.

 If, during your first meeting, the therapist cut you off mid-thought (besides a reflective “hm” or “mhm” every now and then), especially if it happened multiple times, it’s a good reason to pause and potentially choose another therapist.

One of the benefits of therapy is that it can help us organize our thoughts and thinking patterns- but this is difficult to do if we’re interrupted before we can express full thoughts! 

hand drawn doodle of a green colored waving flag.

Green Flag: In the first meeting, you felt like there was space to speak at the pace that was right for you, without interruption. When you were done speaking, the therapist offered their thoughts or a reflection on what you just said.

 

Did they listen well?

Almost all of us know what it’s like to have a full conversation with someone only to realize at the end, they weren’t listening at all! Or worse, to be in a conversation where we couldn’t get a word in edgewise because the other person took up so much space speaking. This should not be the case in therapy- even in the first session! (In the first session, a therapist generally does speak more than usual, as they go over paperwork, disclosures, and norms for the space)

A good therapist may ask you to clarify, repeat, or explain something, but never because they weren’t listening the first time.

hand drawn doodle of a green colored waving flag.

Green Flag: In the first session, the therapist was an attentive listener- listening more than speaking and offering reflections that indicated they were listening well.   

Did they seem scripted?

The language of therapy can feel like a very different way of speaking, and some types of therapy make this more noticeable than others. However, even “manualized therapies” that use a specific roadmap to a session should not result in an approach that feels scripted. 

When therapeutic language and good technique are used well in therapy, they should feel like a natural way of diving deeper into a thought or feeling in a productive and caring way. 

hand drawn doodle of a green colored waving flag.

Green Flag: Noticing that the therapist sometimes has to search for words, take time to formulate a response, or rephrase something. (Always being ready with a quick response might come from a therapist’s own anxiety or inexperience).

 

Hand drawn sticky notes

Did they overshare personal details about themselves?

Therapists are trained to navigate internal and external boundaries well. This means that a therapist should have a good sense of balance between sharing enough to connect and empathize, but not so much that they burden clients with their own concerns. 

If a therapist is consistently bringing themselves into the conversation in the first session in a way that feels distracting or not to the client’s benefit, it’s a sign that this may be a therapist with less stable boundaries. 

hand drawn doodle of a green colored waving flag.

Green Flag: Feeling like the therapist is allowing themselves to be known enough to create an authentic relationship, without oversharing.

Did you feel empowered or examined?

Sharing our stories of harm and hurt is incredibly vulnerable. When responding to these stories, a good therapist responds with curiosity and care that feels empowering- not in a way that feels like examination or interrogation. 

What’s the difference? An examining response can feel like being placed under a microscope while they pick and pull at a sensitive topic we’re reluctant to explore. An empowering response, on the other hand, looks like an acknowledgment of the bravery involved in sharing something so deeply personal and a cooperative negotiation about how to move forward (curious exploration or simply validating and holding) with what you’ve shared.

hand drawn doodle of a green colored waving flag.

Green Flag: In the first session, the therapist expressed curiosity that felt genuine, but didn’t pry or pressure you to expose portions of your story you weren’t ready to expose. 

Hand drawn sticky notes

Were you surprised by anything?

Surprises in a therapeutic space can come in one of two forms: pleasant or troublesome. It is important to reflect on an experience with a therapist and ask “What surprised me?” If the answer is that of a troublesome surprise (not having a good gut feeling, not loving how the space felt, or something that was said not sitting well), then reconsider. If the surprise was pleasant (feeling more comfortable with the therapist than expected, having an insightful realization, or not noticing the time go by), then this may be a good fit.

hand drawn doodle of a green colored waving flag.

Green Flag: In the first session, the therapist was able to deliver a comment or reflection that caught us off guard in a good way, stirred something positive, and left us with something important to think about. 

How did you feel when you were with them?

Because the quality of the relationship between the therapist and the client is the best predictor of therapy having a good outcome (source), it is important to feel comfortable and safe with a therapist. Of course, there will be a time at the beginning of the relationship with a therapist – just like with anyone else – where the new relationship feels very awkward. Trust your intuition here: did they feel like someone who you could grow comfortable with?

Green flags: When you were with them in the first session, you felt positive emotions stirring. Your intuition told you the space felt safer than others you may have known. 

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How to choose a therapist: the consult
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Knowing when You’ve Found the Right Fit

When choosing a therapist it’s a good idea to do a few consults and trust your gut. If you meet with one therapist and aren’t sure it is a good fit, try another. 

If you are able, consult with three therapists before choosing one to find the “best fit” for you and what you’re wanting to work through in sessions.

Ultimately: trust your gut on this one – it’s easy to overthink it, but after meeting with a few, ask yourself which therapist you WANT to see again, and which therapist you can imagine yourself opening up to. “Right fit” really comes down to a sense of safety, connection, and competence.

Image Description for Screen Readers:

The image is a hand-drawn brown bulletin board on a purple background. The bulletin board has sticky notes all over it.
A purple sticky note in the top center says: “How to pick a therapist: the consult.”
Around it, yellow sticky note read:
“Did they feel authentic?”
“Did they interrupt you?”
“Did you feel empowered or examined?”
“Did they listen well to you?”
“Were you surprised by anything?”
“Did they seem scripted?”
“Did they over-share personal details?”
“How did you feel with them?”

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Karen Frances McCarthy

Wednesday 25th of August 2021

I feel so validated to see "Did they interrupt you?" on the list of red flags. In grad school, we were taught the Rogerian active listening technique (paraphrase, reflect feeling, reflect meaning) and my professor told me I didn't paraphrase enough. I said it felt like interrupting (and often my "client," played by another student) would lose their train of thought or shift their emotional presentation. The prof insisted I should "pop in and pop out" and I kept trying to, and it kept feeling wrong. So now, in my practice, I just listen, especially in early sessions. Paraphrasing and Reflecting can come later.