How Do You Find a Good Therapist?
A seasoned psychiatrist shares his expertise on finding the right match.
Posted Nov 07, 2018
When you need to buy a piece of clothing or something for your home, it's easy to read reviews online to narrow your options. But what about finding a psychotherapist for yourself or a family member? It's hard to tell simply from reading a therapist's online profile whether he or she will be a good fit.
There are many variables to consider when choosing a therapist. You certainly want someone who's very familiar with the concerns you're bringing to therapy. For example, I feel confident providing treatment to adults with all forms of obsessive-compulsive disorder (OCD), but I refer children with OCD to other therapists I trust. You can gather an idea of a therapist's areas of specialty if they have a listing online, like in Psychology Today's "Find a Therapist" directory. However, therapists often share a long list of conditions they treat, so how do you know where their deepest expertise lies? And what about attributes that are harder to capture in words, like warmth, empathy, and wisdom?
I recently spoke with psychiatrist Dr. Richard Summers on the Think Act Be podcast. He specializes in psychodynamic psychotherapy and has written books and lectured around the world about the process of effective therapy. I was interested in his perspective on how to find an excellent therapist when there are often so many options. So I asked him what we should look for to find someone we would gladly send a family member to see. He offered these four guidelines.
Get a Recommendation
According to Summers, the first consideration is a personal recommendation. "You have to get a referral from somebody you trust," he told me, "or from someone you trust who got it from somebody they trust." The value in a referral is that the other person knows you and knows the therapist, and so is likely to have an idea about the fit between you (or your loved one) and the therapist.
A physician who knows you well may be able to provide a helpful psychotherapy referral, just as they can guide you to specialists based on your preferences. For example, my primary care doctor knows I prefer a more conservative approach to prescription medication, and has made referrals accordingly. Of course, there's no guarantee that you'll mesh with the person you're referred to, but the odds are greater than if you have to choose blindly.
Look Into the Person's Background
Therapists vary widely in their degree (e.g., MSW, Ph.D., MFT), their profession (e.g., psychiatrist, social worker, psychologist, counselor), their specialized training (e.g., cognitive behavioral, psychodynamic, EMDR), and their experience. Most therapists will include information about their training and experience on their website or online directory listing. Summers recommended examining "the basics—the person's credentials, and whether they have an excellent education."
And while it may not be the most important feature, he noted that "you want somebody who has some degree of clinical experience." That doesn't necessarily mean seeking out the number-one most experienced therapist in a given area. Studies have shown that experience is an imperfect predictor of therapy outcome and no guarantee of quality. But generally speaking, you want a therapist who is highly skilled, well-trained, and very accustomed to working with the kinds of issues a person is bringing to therapy.
Get a Feel for the Therapist
Having a referral and looking into a therapist's background can help to identify a potential match, but it's hard to know what it will actually be like to work with the person. The "proof of the pudding," so to speak, requires speaking with the therapist and gauging whether they're the right person, as Summers recommends:
"After maybe the first appointment—and certainly after a few appointments—you should feel that there is a connection, and a feeling that you and your therapist somehow have a shared understanding of the key elements of who you are and what you're working toward."
It's also important to feel that this alliance will be helpful in addressing the things you're dealing with. Summers advises asking yourself early in the treatment relationship whether "you have some glimmer of a feeling that you're starting to move in the direction you want to go. And if you don't, it doesn't necessarily mean it's not a good fit and it's not the right person—but you have to ask yourself that question."
Pay Attention to Your Reactions
It's crucial that we stay open to our experience with a new therapist. If we've spent a lot of time finding someone, and have invested time and money in the initial sessions, we may be reluctant to acknowledge that things aren't going the way we hoped. It might also feel awkward to express that awareness to the therapist. However, it's better to be honest with ourselves sooner rather than later, because a therapy relationship can last for months or even years.
While it can be daunting to find an excellent therapist, it may be one of the most important decisions you make when you or a family member is going through a difficult time. So it's worth choosing carefully and, as Summers says, "paying attention to that inner voice" and using "good interpersonal judgment" when considering the fit between you and your therapist.
On the other hand, there is no such thing as a perfect therapist—which I can certainly affirm from my own experience as a therapist—and every close relationship will have strengths and limitations. The aim isn't to find the one right therapist, but one who's a good fit and will provide skilled and compassionate support through a period of difficulty and growth.
The full discussion with Dr. Summers is available here.