Choosing a Therapist
Affirming, effective therapy has the potential to help everyone–and yet, so many of us are deterred from starting therapy because the search for a therapist who “fits” is just too daunting. So where do we begin? Here are a number of considerations to keep in mind throughout the search process:
Modality
Therapists have different kinds of training, and they also have adopted different modalities. If you’re just starting out in therapy, you may not know what resonates with you best. If you’ve worked with clinicians in the past, you might have noticed that some approaches have proven validating and helpful, while others have felt off-putting or even delegitimizing. Here are just a couple of modalities that you might see listed when doing your research:
Cognitive Behavioral Therapy (CBT) - Like other forms of behavioral therapy, CBT focuses on helping the client better understand and shift their thought patterns, which should in turn impact their emotional responses and behaviors. CBT may involve some “homework” (worksheets or assignments to complete in between sessions), with the assumption that in order to shift our experience of the world, we have to become more aware of our underlying thoughts.
Dialectical Behavioral Therapy (DBT) - Another form of behavioral therapy. DBT offers concrete skills around living in the moment, developing coping mechanisms, emotional regulation, and improving interpersonal relationships. Dialectical approaches encourage clients to accept themselves, their thoughts, and their emotions as they are, while simultaneously pursuing change.
Psychodynamic Therapy - An outgrowth of psychoanalytic therapy (think Freud, but modernized), psychodynamic therapy focuses on the impact that early childhood experiences and unconscious content have on current life experiences and emotions. This form of therapy is more about gaining insight and understanding than about directly changing behaviors.
Sex Therapy - Sex therapy aims to do one of two things. The first is to resolve an issue a client is facing related to their sexuality or sexual relationships (like sexual anxiety, or negotiating sexual interests with a partner). The other aim of sex therapy could be to increase a client’s comfort with their own sexuality. It may involve practical assignments to complete in between sessions.
Internal Family Systems (IFS) - IFS operates under the belief that we have many “parts,” as well as a Self. The work in IFS is around identifying these parts, understanding their history and the purpose they serve, and ultimately becoming “Self-led.”
Client/Person-Centered Therapy - In person-centered therapy, you (the client) will likely do much of the talking. The therapist is responsible for relating to you, demonstrating unconditional positive-regard, and listening empathically. The idea behind this type of therapy is that, in feeling validated interpersonally, clients will naturally move toward self-actualization–in other words, they will grow and become fulfilled.
Mindfulness-Based Therapy - In this type of therapy, many components of CBT are blended with mindfulness activities that allow clients to examine their thoughts and emotions without judgment. This may mean meditating or practicing other grounding techniques.
Somatic Therapy - Somatic therapy centers bodily sensations and is built on the assumption that our experiences (particularly those that are traumatic) directly affect our physical selves. This approach combines psychotherapy and physical therapies to take a more holistic approach toward healing.
By Therapists’ Areas of Focus/Expertise
If you’re looking for a provider on practically any search engine (like PsychologyToday or Manhattan Alternative), their profile should also include their areas of focus and/or expertise. This should indicate the type of issues they have worked on with clients before–and they may have training or certifications in working with these topics as well. An area of focus could be a diagnosis, like ADHD or Bipolar Disorder, or it could be something more general, like the therapist’s target populations (BIPOC and/or LGBTQ+ folks, for example). Seeing these listed on a therapist’s profile doesn’t guarantee that they will understand your unique experiences, of course, but it is often a sign that you will have to do a little bit less explaining or educating in order to get the therapist on your page.
By Therapists’ Identities
It can be deeply validating to see your identities reflected in the therapy office–and this also may be totally unimportant to you in your search for a therapist. As with areas of focus/expertise, sharing identities with a therapist can indicate that you may have to do a little less explaining or educating about your experiences. Someone who doesn’t share your identities may be incredibly validating and affirming, and yet still may not have first-hand experience of dynamics or experiences you describe in sessions. It can also be empowering to see someone with your own identities providing support, accompaniment, and even guidance as you navigate the vulnerability of therapy. Some people, though, may not wish to work with someone who shares identities with them, and this too is perfectly valid!
By Cost/Insurance Coverage
Unfortunately, this is typically going to be a deciding factor in which therapists you are able to work with. Many search engines allow you to search by insurance company, which will allow you to find providers who are in-network with your insurance company. This will likely mean that the cost of sessions will be covered apart from a co-pay. You may also find providers who are “out of network,” meaning that if your insurance plan includes “out of network” benefits, you may be able to pay upfront for a session and submit a claim to your insurance for reimbursement after the fact. Some therapists and therapy offices will submit reimbursement paperwork for you or are able to charge only a copay and receive the rest of the payment from the insurance company directly.
Keep in mind that the details of out of network benefits will vary widely from plan to plan and different therapists and therapists offices have different capacities for being able to work with out of network benefits.It’s always a good idea to contact your insurance company early on in your search for a therapist, to get a better understanding of your benefits as they apply to mental health. There are also some therapists and therapy offices that will look into your benefits for you and explain the different terms and rates to you. Ideally, your therapist and/or their receptionist team will be able to work with you to maximize use of your insurance coverage (in fact, it’s an ethical imperative for therapists to do so!).
By Gut Feeling
Therapeutic relationships are highly unique. Going to therapy is vulnerable, and stepping into an office (or logging into a virtual office) for a first session means entrusting your clinician with at least some part of your story. You might just get a good vibe when meeting with a therapist, and that can be enough of a reason to stick with them–you are also entirely justified in terminating work with a therapist when that gut feeling just isn’t quite right.
It’s also helpful to reflect on your feelings about seeking therapy and working with a therapist more generally. Do you feel hesitant to begin therapy because the idea of diving into past experiences and emotions is painful? Are you uncomfortable with the idea that the interpersonal transactions within a therapeutic relationship are different from those in a friendship? You might also recognize that your attachment style impacts your process of building intimacy and a relationship with your therapist. Beyond modality, are you looking for a therapist with a nurturing energy, who can offer a repairing or healing experience if you’ve struggled to feel supported by a parent? Are you looking for a therapist to whom you feel comfortable speaking casually, like a friend? Better understanding those “gut feelings” can aid not only in the search for a therapist, but in your work with that therapist moving forward.
You deserve to work with someone you like and respect throughout this very personal process, and therapists know this–we won’t be offended if it just doesn’t click, and will be happy to provide you with referrals to other clinicians. Ultimately, while therapy may delve into difficult topics, it should not feel like an added burden to your life–in fact, you might even look forward to meeting with your therapist every week!
BLOG AUTHORS ALL HOLD POSITIONS AT THE GENDER & SEXUALITY THERAPY CENTER (G&STC). THIS BLOG WAS WRITTEN BY G&STC THERAPIST IN TRAININGSULA MALINA. FOR MORE INFORMATION ABOUT OUR THERAPISTS AND SERVICES PLEASE CONTACT US.