This post was created in collaboration with Silver Lake Psychology.

By: Dr. Brandy Engler, PsyD.

Therapy is not a uniform experience. It is the intersection of science, art, and relationship. A variety of therapy approaches exist—in fact, you are essentially choosing amongst different services.  Here is some guidance for choosing a good therapist for yourself.

Most people understand that therapy is a place to share your story; a safe, confidential space to heal, grow and explore oneself under the guidance of a licensed professional. However, the workings of therapy can seem opaque. What exactly happens in sessions? Who takes the lead? How do I know if it’s working?

What to expect from a therapist

There is a wide variety of therapy styles, each with their own treatment protocol and philosophy on human behavior. Your experience in the therapy room could be very different from one therapist to another. So how do you know what modality your therapist uses and if it’s right for you?

We can break down most therapy modalities into two broad categories: symptom-focused and exploratory.

Symptom-focused

Many therapists using the popular Cognitive-Behavioral Therapy (CBT) offer a goal-oriented approach focused on symptom relief. Sessions are structured, and the therapist is active and takes the lead in each session. A Cognitive-Behavioral Therapist is focused on the present moment, and therefore less on your past. She will want to examine your immediate thoughts, behaviors, and emotions, guiding you toward change. Interventions may include role-plays, thought experiments and exposure therapy.

Exploratory

Conversely, some therapy modalities offer a more open-ended, free form exploration of your life. Sessions focus on insight and a deeper understanding of your past and how it contributed to who you are. The client is more likely to take the lead, while the therapist follows. Your therapist may offer some creative interventions such as dream analysis, art therapy or ‘empty chair’ techniques where parts of self can converse with each other to expose hidden feelings that may be influencing your behavior. 

There are many therapy methodologies that range on a spectrum across these two poles. Thus, deciding which general style fits your personality and treatment needs is a step in the right direction.

What constitutes a good therapy experience is individualized and based on the therapist’s ability to create a treatment plan for your unique needs. A therapist typically explains her approach to treatment at the end of the first session. Additionally, the first one to three sessions are an assessment phase where the therapist and client collaborate on goals. For this reason, I recommend meeting a therapist at least two times before deciding about proceeding. You are also assessing the therapist and should share what you want from the therapist.

How do I know what kind of therapy is right for me?

In general, if you are coming to therapy because you are experiencing anxiety, depression, trauma or any other symptoms and you want to feel better, then you want to choose a structured, goal-oriented therapy like Cognitive-Behavioral Therapy, Solution-Focused Therapy or EMDR (for trauma).

If you are coming to therapy to explore life decisions, transition, relationships, or self-esteem, a more creative, open—ended therapy may be better.

A group private practice, like Silver Lake Psychology, offers a professional matching service to assist you with finding the right therapist for you. Intake teams have vetted the therapists and are skilled at hand-picking therapists for you based on your goals and desired therapy experience. This is much more efficient than scrolling through therapist directories and reading endless therapist bios.

Tip: Avoid group practices that function as ‘patient mills,’ assigning you to the next available therapist that takes your insurance without considering the relational fit. 

How do I know my therapist is a good fit for me?

Research on what makes therapy effective shows that there is a single factor that is more important than the treatment modality: the relationship fit. The connection must feel right. Going to therapy is a decision to be vulnerable with a total stranger. When you find the right connection, the relationship itself becomes healing. It may take more than one meeting to find the right match. Here are some questions to ask yourself post-session:

• Did you feel understood?
• Did you feel comfortable sharing with this person?
• Do you trust this person?
• Did he explain his therapy approach?

What are the qualities of a great therapist?

• A balance of validation and challenge
• Support and warmth
• A good therapist is active; an active listener or provider of techniques and exercises designed to move you forward.
• A good therapist provides culturally relevant therapy. Your therapist should show a curiosity about your background and contextualize your therapy accordingly. A good group practice is inclusive and will offer a diverse range of therapists.
• A good therapist attunes to you; he is flexible in his ability to tailor therapy to your unique needs rather than rigidly adhering to his therapy techniques.
• A good therapist engaged and curious in the session–often demonstrated by non-verbal behaviors such as head nods, leaning forward, eye contact, enthusiasm, and her natural ability to follow your story and offer empathy.
• A good therapist will check in with you during the course of therapy to get your feedback from you. Therapy should be a collaborative process where therapist and client discuss progress and expectations on a regular basis.

What is expected of me in therapy?

Research on therapy outcomes also indicates that another important factor in the success of therapy is you. Do you challenge yourself, take risks and put in effort?

Getting better requires effort from both client and therapist.

• Therapists will expect you to take a risk in each session, to open up, be vulnerable and continue your process outside of therapy.
• Your therapist expects you to ask for what you want to get out of therapy
• Therapists expect you to let them know when therapy isn’t working for you or if you felt disappointed by the therapists

Should I choose a Psychologist, Marriage and Family Therapist or Social Worker?

When it comes to therapy, all of these clinicians are good choices. When reading a therapist bio, look for their areas of interest, certifications, and specialties. Therapy is meant to be a healing relationship. Regardless of therapy approach, all therapists have training in forming affirming, compassionate and non-judgmental relationships. A good therapist can help you to feel better, to develop emotional intelligence and overcome your past. The positive effects can have impact in your relationships, career and across your lifespan. Take your time to find the right therapist for you.

Here are some resources that might be helpful to you

• The Pros and Cons of Online Psychiatry
• The Importance of Medication in Coordination with Therapy
• Therapy and Medication for Your Mental Health