Your friend Sam, who was so moody over the last year now seems happier and calmer, even though his circumstances haven’t changed.

Another friend, Jenny, lost her mother in 2020. She couldn’t hold a proper funeral because of COVID  restrictions, but she says she’s now in a really good emotional space.

When you ask your friends about this shift in how they’re doing, they tell you they’ve both been seeing a therapist.

You’ve been trying to cope with your own stress and anxiety since the start of the pandemic and have considered therapy, but don’t know where to start.  Do you see someone in person? Will you benefit from seeing a therapist over Zoom? And what kind of therapy will work best for you? What kind of therapy do you need?

I want to help you sort through the overwhelm. First, I’m going to answer some common questions about therapy, then give you a plan for finding the right therapist to meet your needs.

DO I NEED TO LIKE MY THERAPIST?

Liking your therapist is a good entry to developing trust. Trust takes time to develop, but we can tell if we like someone in a split second.

The first thing to understand is that therapy is a very personal process. Unlike other healthcare and wellness-focused services, it’s absolutely important that you find your therapist likable.

If you’re having a mole removed or getting a facial, you just need to know that the person providing that service is competent. Therapy, on the other hand, is about the interpersonal relationship you develop with the therapist. You need to find them likable and trustworthy so you can settle in and get comfortable sharing the details of your life. You need to trust that they are looking out for your best interest. Certainly, you will feel more comfortable sharing with your new therapist if your first impression is that they are a likable person.

Once you have assessed their likability, take a few hours after the first session to decide whether you want to continue with this person. This is so that the emotions that may have been raised in the session, aren’t clouding your judgment. Ask yourself, was the therapist friendly? Did they engage with you? Did they make you feel at ease and like they were paying attention?

WHAT EXACTLY HAPPENS IN THERAPY?

In therapy, there is literally an assessment phase, a middle phase, and an end phase, although those phases are not so easily defined as far as time settings.

In the assessment phase, you discuss the details of your life experiences and how they went for you.  You discuss what’s currently going on and what you would like to change about how you feel or behave. This process usually takes between 1-5 sessions for the therapist to really assess who you are, what you have been through, what affects you, and what you want to change.

From there, the middle phase takes place. That’s the meat of the process. Week to week you are trying to learn new behaviors or emotional skills that can help you work towards your goals while learning to recognize old patterns or obstacles that might get in your way.

The end phase is like the maintenance phase of any other program.  You’ve made sufficient enough change that you feel you have the skills to live an improved quality of life, you’ve been enacting these new behaviors/reactions for some time, and you’re feeling like you can maintain them without the support of the therapist, so you terminate.

WHAT IS THE ROLE OF THE THERAPIST?

The therapist acts as a reflective tool. Their role can be that of a mirror, an accountability coach, an emotional traffic monitor, a cheerleader, a mindful observer, a vulnerability checkpoint, or a combination of these.

HOW LONG WILL I BE IN THERAPY?

Sometimes therapy lasts 6 months, sometimes 5 years, or even more. I tell people to expect, on average, 6 months to a year, depending on what their presenting complaint is. You probably didn’t develop whatever your complaint is overnight, so it will take some time for you to understand how or why it developed, how to change it, practice and then maintain the change. Some people attend therapy weekly until they terminate, but many people attend weekly for a couple of months, then move to bi-weekly or monthly sessions as they get closer to termination. The frequency of sessions can be discussed between you and your therapist based on your needs.

WHO CAN BENEFIT FROM THERAPY?

Everyone. You don’t need to be suffering to benefit from therapy. Therapy clients can include someone who wants to break a pattern in their dating life, someone with seasonal depression, couples who have recurrent arguments, those with severe and persistent mental illnesses. Most of the clients I see in my private practice want to improve the quality of their relationships, understand themselves better, or make some shifts in their career.  All of those things affect our emotional well-being.  I like to think of therapy as the gym for our emotional muscles.

HOW TO SELECT A THERAPIST

• Ask your friends if they have a therapist they really enjoyed working with.

If you’ve got a Sam or a Jenny in your life and they’re raving about how therapy has helped them, ask them what they liked about their therapist and if they would pass along their info. This is a great way to find a therapist, and a great way as a therapist to find clients to connect with. When a client feels connected to me as their therapist and that they’ve benefited from my services, having them refer their friends or family to me is not only a trusted privilege I take very seriously but also a great way to know that I am more than likely going to connect well with the person being referred.

• The letters after their name matter less than their experience with the symptoms or circumstances you are trying to change.

The common terms you’ll find for how a therapist describes themselves and their degrees: psychotherapist, social worker, psychologist, counselor, clinician. They all will have some list of initials after their name.  All can provide therapy, and most are familiar with the same general schools of thought. What is most important is where their skill set lies.  Do they treat people with depression, panic, relationship struggles, OCD, addictions, trauma? Someone can have a doctorate designation from Harvard or Oxford, but not be the right therapist for you if they specialize in OCD while you’re seeking someone whose strength is working with relationship conflict.

It’s not unlike bringing your car to the right mechanic. You don’t want to bring your BMW to a mechanic that has primarily worked on Fords.  You’ll end up spending more time, energy, and money waiting on the Ford mechanic to get familiar with your BMW’s problem.

Keep in mind, if you’re seeking medication treatment, only a medical doctor (MD) can prescribe this. If you are seeking meds for your mental health issue, I always recommend seeing a psychiatrist, even if you have a great primary care physician. Once you have a therapist, they can often refer you to a psychiatrist they trust. Or, your primary care physician may know of some qualified referrals. Your insurance provider may also have a directory of in-network psychiatrists as well.

• Do you need Cognitive Behavioral Therapy, Talk therapy, or something else? 

There are many different types of therapy.  If you’ve been to therapy and/or have some knowledge or interest in a certain technique, I encourage you to find a therapist with that specific skill set. If not, search for a therapist who has experience helping you with your specific complaint.  If that clinician then thinks you may benefit from a specific type of therapy, they will refer you to someone else at that time. I practice traditional talk therapy where I pull from multiple techniques, but I predominantly focus on helping my clients benefit from insight-oriented changes.

• In-person vs. telehealth (aka virtual therapy)

One positive shift that has taken place over the last 2 years is the way we can now access all sorts of healthcare services right through our phones or computers.  Telehealth allows you to access therapists outside of the area you live in rather than being limited to, says, a 10km radius. There were already studies completed before the pandemic that proved the efficacy of telehealth for mental health services.  I’ve moved my practice to fully virtual and have no intention of returning to in-person services as I personally don’t find it necessary for the client population I serve.

Anecdotally, clients have told me they benefit from not having to commute to sessions and enjoy the ease of talking from settings where they are already comfortable.  It allows them to take every minute to focus on their emotional needs and leads to more satisfying sessions. As a therapist, it allows me to see more clients and adjust my schedule more easily.

I do see only adults, so that is important for you to know. I do think my colleagues who see children and families have found it more productive to provide in-person services when they can.  If you are unsure of which you would prefer but find someone who you think would be a great match for you, but they only offer remote sessions, I would say to try it out.  The fear of virtual sessions usually comes from our perception of what therapy should be, rather than what it actually is.

I had a beautiful suite of offices for almost 15 years, thinking it was helpful to keep this setting so my clients would feel comfortable and cared about. I’ve since found they’re just as likely to make deep emotional strides while sitting in a car outside their office building on Zoom, as they were in my comfy office.

• Narrow down your online search for a therapist

Here’s what I recommend people do to narrow down their online search.  There are several online directories which list providers based on varying criteria. These are the data points I recommend to I input into the directories:

• Insurance (if you need to use it).
• Symptoms or circumstances (i.e., depression, anxiety, relationship conflict).
• Do you care if your therapist is a man or a woman, LGBTQ+, or BIPOC?
• Is there a relevant cultural component you’d like them to be familiar with? (This is not always available but worth looking for if it’s important to you).
• If there is a relevant type of therapy you wanted to try or you were referred by another healthcare professional, would include that in your search criteria.

One caveat to all of that is, although I want to tell you that your perfect therapist is out there waiting for you, it’s also a good idea to be aware of what criteria is most important to this being a successful process for you. If it’s cost, that’s important.  If it’s cultural awareness, that’s important. You might have a few “almost exact” matches but you have to choose a therapist based on what’s most important to you.

• Therapist Directories are Not All the Same

Whether you need a low-cost therapist, an LGBTQIA+ therapist, a Black therapist, a Latinx therapist, a poly-friendly, or a kink-aware therapist, a Christian therapist, or a therapist on your insurance panel who can see your child, here is a pretty comprehensive listing of the directories available:

Psychology Today, TherapyDen, NHS (search for Talking Therapies), UKCP Find a Therapist, GoodTherapy, Open Path, Shrink Space, Therapy for Christians, Inclusive Therapists, Latinx Therapy, Therapy For Black Girls, Mental Health Match, Native American Therapists, Clinicians of Color, Therapy for Black Men,  Alma, Poly Friendly

There you have it.  You now have the information you need to find a great therapist who can meet your needs, and if you were curious about the process, I hope this has helped untangle it for you. Be well and be kind to yourself.

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