By Published On: October 10, 2016Categories: Therapy

Starting a relationship with a therapist is very personal and can be nerve-racking for many. It’s hard to know who’s going to be a good fit without taking the time to meet a few. 6 Suggestions for Choosing a Therapist | Nathan Feiles, MSW, LCSW-RThere are many posts out there that offer tips on how to find a good therapist. However, each time someone releases a “how to” for choosing a good therapist, it always seems key points are overlooked. There are many schools of theoretical approaches in the therapy world, and it’s important to remember that the therapist you choose is practicing from her/his theoretical perspective — there isn’t one universal form of therapy.

Here are some suggestions that can help narrow the search to locate a therapist who will hopefully be more effective for you.

Post-Graduate Training

It surprises me how many therapists there are in private practice who have little to no training beyond their masters programs and clinical licensing hours. Most masters programs do not give someone the tools to be a psychotherapist; and while clinical hours gives experience and supervision, it doesn’t necessarily provide the foundation, or study in a theoretical school of psychotherapy.  When I graduated from NYU’s school of social work, I remember believing I was ready to be a therapist —  because I knew how to actively listen to someone, be with them them and their struggle, and empathize with them. However, while working towards my clinical licensing hours, I soon learned how naive I was. I began to realize I didn’t know how to truly intervene, help change deeply held attachments to life-long maladaptive patterns, or understand the ways in which to listen to certain types of patterns (emotionally, relationally, etc.), and more importantly, how to respond to them in ways that would foster insight and change. All of these skills I learned in post-graduate study that focuses on being an effective therapist — rather than only a supportive listener.

If you’re just looking for a supportive ear, then it’s possible that any therapist with a chair and a couch would work for you. But if you’re looking to go deeper with self-understanding, self-reflection, and looking to change negative patterns, then make sure to ask the therapist about their post-graduate training up front. A solid training will generally involve a multi-year program (I completed a 4-year post-graduate program in contemporary and comprehensive psychotherapy and psychoanalysis for adults, and work from an integrative approach). In some cases, consistent workshops over a period of time (such as Gottman, Imago, EMDR, etc.) can be useful. But, be wary of therapists who only describe short workshops or brief seminars as the totality of their post-graduate training.

Be wary of the “yes” therapist

People often focus on finding therapists who are nice, warm, and caring. I also agree that these are basic essentials. However, be wary of the therapist who simply “yes’s” everything you do or say. Validation is nice and does tend to feel good…however, the collusion of a therapist with you when negative patterns are repeating (in life or in the room), just for the sake of making you feel good, is generally not helpful, and can perpetuate exactly what you are there to work on changing (it’s also a sign that therapist is afraid to not be liked by you, and has an impact on how they approach and respond to you). Warmth, support, and care are necessary, but a good therapist won’t be afraid to constructively challenge you at times.

There is an opportunity with every (trained) therapist

The reason I re-emphasize “trained” is because people who aren’t well-trained will have a harder time working constructively when negativity enters the room between you and the therapy couchtherapist. Some therapists may be really good, and still activate you or trigger some old feelings in the course of the therapy. Many untrained therapists will say maybe this is the time to find a another therapist if you’re not always feeling warm and good in therapy. Or, people may believe that being angry at your therapist at times means it’s time to leave. On the contrary, when there is emotional activation in the room, it often means deeply-rooted experiences are surfacing that can be central in the areas where improvement is needed. There are times where therapy won’t feel good, and may be difficult. But even if your therapist is frustrating you, or activating you in a negative way, there is an opportunity to work through something significant from your personal life history. If your therapist is upsetting you all of the time (even after you’ve spent time working on it together), then, yes, it may be a good time to try someone else. But, keep in mind in your search that negative feelings in therapy can actually lead to some of the most progress (as long as you bring them up to the therapist).

The Basics — Care, Warmth, Support, Openness

There should always at least be a base of care, warmth, support, and openness. The reason I don’t include “trust” here is many people come in already having difficulty with trust. Trust takes time and shouldn’t be immediately expected. But at the least, even when there is anger or frustration in the room, a person should have a sense of care and support from their therapist as a whole. The caveat to this is that sometimes old experiences or relational patterns may come into the room that may be blocking the experience of the care and support from being received, so it should be addressed with the therapist if you find yourself not experiencing this care or support, especially if you did earlier on. Generally, you should at least feel your therapist has your back (or early on, at least has the potential for trust).

Therapist’s Self-Awareness

The importance of a therapist having undergone their own therapeutic process can’t be overstated. Knowing one’s self is essential when working to help others know themselves, especially in dynamic work, where the dynamics in the room are part of the work (yes, there are actually many therapists out there who haven’t been in therapy themselves). I know that I function much better as a therapist when I continue to be in my own therapy because it keeps me attuned to my own emotions and dynamics, which plays a role in how I interact, dynamically, in the room with people. It’s hard to help someone else emotionally if we don’t have a grip on our own emotional states and dynamics.

Therapist’s Supervision

Supervision is essential, even for the most seasoned therapist. Supervision isn’t about how much you know or how qualified you are. In this field, supervision is about checking therapy chairsyourself within the context of the work. Being a therapist is an emotional job, and any therapist who tries to tell you the work doesn’t have an emotional impact on themselves shouldn’t be a therapist (or they’re lying to you or to themselves…which is a problem, either way). The process of supervision helps therapists manage the emotions and dynamics of treatment, and work through subjective blocks, in the service of improving their perspective and, therefore, their ability to help you on deep psychological and emotional levelsA therapist who is in supervision doesn’t mean they’re still new and not qualified, it means they have an interest in tracking themselves within the context of their work to better help you. It is okay to ask the therapist you meet if they are in a process of professional supervision.


Finding what you need now

There are other things that can be included here: obviously a therapist who has appropriate boundaries (poor boundaries include therapists who talk too much about themselves, make sexual advances, look for a friendship or relationship with you beyond the treatment, or starts/ends sessions consistently late, or who eat, check their phones during sessions, and other points can be included here).

While the above points are basic essentials, there are many people who are well-trained, compassionate, warm and caring therapists, who are devoted to their work. Many have their own self-awareness and continue their education to work to be a better therapist. But it’s also all too easy to end up in the office with someone who meets few, to none of the above. Having been in this field for a while, there is a noticeable improvement in the quality of therapy when the therapists meet the points above.

To learn more about therapy and how I can help you, contact me to discuss. 

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