As a potential client, you may discover that there are tens of thousands of therapists out there practicing in the United States. While the opportunity to connect with a clinician that meets your needs has never been easier, doing a standard Google search or reading pages after pages of profiles on Psychology Today can feel overwhelming and choosing the right therapist can become another source of anxiety. Whether your decision is based on your geography, health insurance coverage, or the specific problem area you are interested in addressing, it is important to ask any potential therapist these three questions prior to scheduling your first appointment:
Q: What are your credentials? What type of training do you have?
“Therapist” is a general term that can mean any kind of helping professional (ex: occupational therapist, physical therapist, child therapist). It is important to understand and inquire about your therapist’s degree and state licensing since not every clinician has the same credentials and they do not all emphasize the same things. For example, in the state of Michigan you will find Licensed Professional Counselors (LPC), Licensed Psychologists (LP or LLP limited) and Licensed Social Workers (LSW) who all provide mental health counseling. Some states have different variations of these names but they tend to be roughly equivalent nationwide. I have outlined the differences here. Note: Psychiatrists are medical doctors who prescribe medication but do not typically provide psychotherapy.
You will want a clinician who has at least a master’s degree in the mental health field, is trained in your specific area of focus, has sufficient experience, and is working toward or has met the state requirements to be fully licensed. For example, I am a fully licensed professional counselor (LPC) in the state of Michigan with a masters degree in mental health counseling and a specific focus in couples and sex therapy. All those extra letters (NCC, CAADC, AASECT) after the license indicate post-graduate training which allow someone to further specialize with certain populations like addiction, sex therapy, couples and family, etc.
Q: What is your therapeutic style and what are the first 3 sessions with you like?
Most therapists approach counseling from one or two different therapeutic styles
which dictates the course and type of treatment you will receive in session.
Cognitive-Behavioral therapy (CBT) is considered the most empirical and
evidence based approach in the therapy world because it has been studied and proven effective for numerous mental health conditions. It is also very structured and evidence based so you may see results more quickly. Similarly, Dialectical Behavioral
Therapy (DBT) therapeutic techniques are well researched and considered effective in the treatment of mood, personality disorders such as Borderline Personality Disorder, and/or substance abuse. Solution-focused or Brief therapy, Acceptance commitment therapy (ACT) and Motivational Interviewing provide structure for sessions but should also incorporate evidence-based practices. Other styles of therapy may be less focused on research or structured treatment planning.
In Couples Therapy, training in “The Gottman Method” is considered the gold standard to provide evidence based techniques for couples. It is based on the 30+ years of studies and empirical research by Dr. John and Dr. Julie Gottman. To read more about the Gottman Method, click here. Emotion Focused Therapy (EFT) and Imago therapy are also popular for couples but are newer styles or have less of a research focus. If a therapist describes themselves as “eclectic” or “a little bit of everything” you will want to inquire about their treatment plan and how they measure progress and success in therapy. Similarly, receiving information about the first three sessions with the therapist will give you a sense of their therapeutic style and effectiveness (a good clinician should have you identifying and setting goals as well as creating a treatment plan by the 2nd or 3rd session).
Q: What is your area of specialty? How many couples / specific population(s) do you see weekly?
If a therapist states that they work with a specialized population—such as couples,
children, the LGBTQ community, substance abuse, eating disorders, borderline personality disorder, OCD, severe mental illness, grief, trauma, abuse—you will want to ensure that they have a significant amount of experience and training with this group. Just like you seek out an oncologist (rather than your primary care doctor) for the treatment of cancer, your therapist should also have additional post-graduate training and education in their area of emphasis. This is where all those acronyms / alphabet soup after their name comes in but I also like to ask what percentage of a therapist’s current caseload make up this specialized population. For example, my current caseload is 60% couples or I see anywhere between 10-15 couples per week. Some therapists are part-time and may see fewer clients in general but should be able to tell you what their caseload percentage and expertise in this area looks like.
And don’t forget: The most important thing is that you are comfortable with your
So you’ve found someone (or a few someones) who check the first three boxes and you’ve set up an intake or initial appointment with them. That feeling or first impression you get from your therapist in session is worth even more than all those fancy letters after their name. Research consistently tells us that the therapeutic relationship between client and therapist is one of the most important indicators of retention and success in therapy. Finding the right counselor, someone who is warm, professional, and knowledgeable in your area of difficulty is a process and I have heard horror stories from clients who have had very negative or lukewarm experiences in their past. Do not be afraid to “shop around” for the right therapist, try out a few different professionals, and don’t stop until you’ve found the one that empowers you, challenges you, and makes you feel heard! I do not pressure a new client to reschedule with me because I know it’s a big decision to begin treatment and an even bigger decision to open yourself up, devote your time and money into growing and navigating change with another person. You should always feel listened to and supported by your counselor. Therapy is one of the greatest gifts we can give to ourselves and you should never settle for “just okay.”
If you have questions about any of the information that was written here or are seeking a referral for a specialist in your area, please do not hesitate to reach out to me.