Who’s Your Therapist?

By
Reesa Morala, MA, Licensed Marriage and Family Therapist

Looking for a therapist can be a daunting task. It can almost feel like a bad dating show, instead of looking for the love of your life you’re trying to find someone to trust with your deepest secrets. How do you know if it works? Will it be a good fit?

First, let’s get honest. What’s holding you back? Maybe the societal stigmas have gotten you spooked, hesitant about what getting a therapist might say about you. Perhaps you tend to have an aversion to asking for help and the idea that it is associated with weakness. Or possibly that poorly portrayed therapist on that television show left a bad taste in your mouth – I promise most of us don’t actually ask you to lie down on a chaise lounge while we doodle pictures. Some other reasons I’ve heard, as well, are “I tried it, once, it’s not for me” or “I’ve got friends I can talk to – I’m good.” Whatever your reason – I get it.

Good news! If you’ve decided you want to take the step towards improving your mental health (so proud of you!) I’ve got some tips that can help you get started.

I want to start off by setting up a realistic expectation – therapy is hard work and you will have to participate. At times, it will likely feel uncomfortable. Change and challenging learned behaviors is NOT easy. The difference between friends and your therapist is that a good therapist won’t be there to give you advice/solve your problems for you. Instead, your therapist ought to be teaching you skills to take with you into the future so you can make the healthy, problem-solving decisions yourself. My goal for my clients is that they will get to a point where they don’t need me. That won’t happen if they are reliant on me solving it for them. Challenges will keep coming up – it’s the reality of life. Your therapist cannot be there every minute but with time and learning, your skills might make it appear as if they were.

Now let’s talk about some of the options you have. Please keep in mind, this list is not exhaustive. If you are looking to be assessed for possible medications to assist, a psychiatrist is what you’ll be searching for. Some psychiatrists will also offer talk therapy so you can always ask if they provide that service. In addition, you might find psychiatric nurse practitioners or physician’s assistants that may fit that bill, as well. PsyD and PhD, these will be your doctorate clinicians that do talk therapy, some specialize in psychological testing if you’re wanting more clarity on a diagnosis. PsyD clinicians, generally, cannot prescribe medications. Some PhD clinicians can, depending on state and licensure – best practice is to ask. Then there are a variety of licensed clinicians that, also, do talk therapy (titles may vary slightly by state). Some common ones you might see – Licensed Professional Clinical Counselor (LPCC), Licensed Clinical Social Worker (LCSW) and Licensed Marriage and Family Therapist (LMFT). Though they all can do talk therapy, each license is based on their area of focus/training. If you find a provider you want to know more about, don’t be afraid to ask them what’s up with the alphabet soup behind their name! Asking is an important step in advocating for yourself and getting the care that is going to be most useful.

Once you have decided if you have a preference for their credentials, let’s discuss some other topics that can help you narrow your list down. It can be helpful to think about what is most important to you and what style of interaction is most useful for your growth. Some examples: you have a lot of past experiences you want to process; you have little interest in talking about the past, you are wanting to talk about the present and looking toward the future; you’re an external processor that really needs to talk it out; you’re a get to the point type; you need someone warm and comforting; you need someone who will call you on your stuff; a sense of humor is necessary; you want a space that will nurture your spiritual/religious beliefs; or a competent, LGBTQ+ affirming clinician is paramount. Getting a sense of your non-negotiables will allow you to define the space that will be most impactful for your journey.

Great job thinking about your needs! We want this to be useful for you and you’ve just taken some wonderful steps to moving towards your goal. If you are someone who would feel more comfortable with a little bit more research, feel free to use your favorite search engine and look up therapy modalities to find out some styles of practice that you would identify more with, as an added step.

With some of the exploration that you have completed you can use that content to figure out some questions you’d like to ask the therapist to get a feel of the fit. If some of the clinicians you are looking at offer a short, complementary initial consult, that is a great opportunity to ask some of these questions. Either way, during your first session, just as they are trying to get to know you, it is your opportunity to get to know their practice style, as well. Now, I’m not talking about asking them about their deep, personal details – boundaries are important. But it is okay to ask them how they might approach a certain issue or their beliefs when it comes to how they practice.

If you decide it doesn’t feel comfortable or safe, it is okay to determine that it doesn’t fit and try another. Disclaimer here – be mindful that you aren’t getting nitpicky as a function of resistance or a self-fulfilling prophecy. If you find your instinct leading you there, I would challenge you to examine that first and explore the function it is playing before you try with another therapist. And don’t forget the realistic expectations up above – dumping your therapist because they challenged you for growth may not be productive. If you are on the fence, if you feel comfortable, I would encourage you to share that with your clinician. It’s acceptable to give them feedback (when done in a respectful, constructive manner). After all, we are human, too. We make mistakes, we are not perfect and we are not always everyone’s cup of tea. And if we are not your therapist, that’s okay! I would much rather you tell me it’s not working out and we work to find you a space you can grow than for you to just “tough it out” and not make any progress, hating your experience and not getting the help you need.

Now, go on out there and start finding your match! Your mental health and well-being will thank you!