20 Sep How to Find a Therapist that is the “Right Fit”
The most important feature of any therapeutic interaction is to build a rapport. Research has shown that having a good rapport, or feeling as though the therapist-client relationship is the “right fit,” can seriously improve the therapeutic assessment, treatment outcomes, and the overall success that a client experiences (e.g, Leach, 2005). But what does a strong therapeutic relationship look like? How will you know if you and your therapist are a “good fit” for each other?
There’s no one size fits all kind of therapy. What works for one person may not work for you. As a client though, what you should feel is that you have a trusting connection with your therapist, which may include: open and honest communication, collaboration, empathy and validation, mutual understanding, respect, and any additional values and beliefs you feel are important to your comfort, safety, and growth throughout the therapeutic process.
Just as one example, about 5 years ago I sought out a therapist to support me with developing certain coping skills. During the initial meeting, she asked me about the qualities a past therapist had that facilitated our positive relationship. I replied that he would swear with me. When he did this, I felt comfortable. He made me feel as though what I was feeling was valid and that he understood and could empathize with what it was that I was feeling, as if he had been there before. She nodded her head, but told me she wouldn’t be able to do the same.
As we continued our session, I felt a tinge of judgment and regret for having made the request. I tried to rationalize these feelings. I kept telling myself that swearing in sessions was such a minor part of the therapeutic relationship and that I was grateful she was open and honest with me about her boundaries. I was certain she could offer empathetic understanding and listening in other ways.
After a few sessions, I realized that my intuition had been right. I didn’t feel as though I could be authentic about what it was that I was feeling during our sessions. Eventually I began missing and cancelling our appointments. I wasn’t excited about the idea of going and would often forget we had even scheduled a session. I also felt as though I wasn’t learning any new skills, developing any new insights, or making any kind of progress … really. Ultimately, I avoided calling the office to reschedule any additional meetings.
As a client and a therapist, you want to feel a genuine connection during your sessions. Everyone in that room needs to feel as though they can be… well…real! This means that there are important considerations to keep in mind throughout the therapeutic process.
Before the Consultation
Do your homework!
Search for therapists online. You could facilitate this by using search engine tools, such as Pyschology Today. You can start off by checking out which therapists or wellness organizations are accessible (e.g., located nearby, within your budget, fit your schedule, etc.) or what kind of therapist you would like or need to see. For instance, if you have benefit coverage you may want to chat with your insurance company first to see what kind of therapist they will reimburse (e.g., registered social worker, registered psychotherapist, psychologist, etc.) as well as how much and how many sessions they will reimburse. If you don’t have benefit coverage, you could pay out of pocket or you may want to find therapists and organizations that offer sliding scale or reduced rates to their clients. Depending on your needs, you may also want to consider whether the therapist is in an office that you can access or whether they offer in-home visits or online sessions (e.g., by phone, text, or video calling).
Another option is to ask friends or family members who they may be seeing, what they like about their therapist, if their therapist is currently accepting new clients or if there is a waitlist, and/or if they could ask this therapist for a list of referrals on your behalf. Be mindful of reading too much into the online reviews a therapist may have. Different approaches work differently for everyone. But keep in mind red flags, such as: insufficient training or education, not being registered with a professional regulating body, having unresolved complaints (e.g., breached confidentiality and/or neglected clients’ rights, acted unprofessionally, etc).
Most therapists will have website, or a profile on an organization’s website, that will provide the following information:
- Educational background (i.e., certifications and specializations)
- Credentials (i.e., registration to a professional body that regulates their practice)
- Philosophy (i.e., theoretical approach and modalities, therapeutic tools)
- Experiences with certain demographics or presenting issues and challenges
Examples of some theoretical approaches, modalities, or tools a therapist may use include: cognitive behaviour therapy (i.e., CBT), mindfulness-based stress reduction, eye movement desensitization and reprocessing (i.e., EMDR), narrative, solution-oriented, relationship and sex therapy, family and systems therapy, etc. Some therapists may be inclined to use only a few of these approaches systematically, while others may use a whole blend of these approaches, depending on the client’s needs. However, research has found that the therapist’s approach to the sessions has far less significance than the actual relationship they have with the client (e.g., Thompson, 2003).
You can also take a look at their photo and see if you have any gut reactions. Do you feel you could easily sit in front of them and chat without any concerns or apprehension?
During the Consultation
Most therapists offer free 15-minute consultations either by phone or in person. During the consultation, the therapist will ask you about the specific issues or challenges you are intending to work on, as well as your goals in seeking therapy. The consultation is your chance to ask the therapist questions as well. Consider the following:
- Is the therapist an intern or practicum student?
- What is the therapist’s fee?
- Does the therapist offer reduced fees or sliding scale?
- Will the therapist directly bill your insurance provider or will you be required to pay and then be reimbursed?
- What is the length of each session?
- What is the therapist’s availability like?
- What are the therapist’s experiences with the challenges you are facing?
- What are the therapist’s specializations?
- What is the therapist’s cancellation policies?
When we’re seeking therapy, we often ask how much time or how many sessions will we need until we’re “all better.” But, it’s important to remember that how long a person attends therapy is contextual and unique to them. The therapist may be able to give you an average if asked during the consultation, however therapy is considered “complete” only once you feel you’ve developed the skills and tools to cope with the challenges you are facing or what brought you to therapy to begin with. If the timing of your progress is important to you, make this well known to the therapist during the consultation.
During the consultation the therapist may also share their approach to therapy. if you don’t understand it or if you have concerns about it you can always ask more questions and get that clarity. While you are chatting, take note of the therapist’s communication style and whether it aligns with your own. Is the therapist taking an active or passive role in the consultation? Are they actively listening to you and processing your concerns, or providing you with coping skills and feedback you will attend to in your next sessions? Do you sense that you feel heard and understood? Do they seem compassionate, non-judgmental and open to your experiences?
If you feel like it will work out, you will be able to book your first appointment. If not, ask for a referral to somebody they feel could be a better fit.
During the First Session
During the first session you will go over your intake forms and will be asked to sign an informed-consent document. This document tells you information about your rights and responsibilities as a client, as well as their rights and responsibilities as a therapist. Feel free to take your time reading this document and to ask the therapist any questions you may have about it.
The therapist may also spend more time getting to know you, your personality and the nature of the presenting challenges. The objective of this first session is for you and the therapist to get to know one another and to collaborate on your short and long- goals. For instance, you may spend your first meeting together coming up with a treatment plan or objectives and strategies to help you meet your goals in seeking therapy, and perhaps a rough timeframe to getting there.
During this session, look for therapeutic boundaries, such as: whether the relationship feels professional, whether they are limiting how much they share about themselves and are listening to you, whether they are alert and responsive to you, and aren’t pushing their own agenda (e.g., selling a book). A therapist that is the “right fit,” will make you feel comfortable and will work with you to support your goals. They will suggest coping skills that could work for you, and acknowledge those that will not. They will consistently apply new knowledge as the sessions proceed. At the end of the first session, you may ask yourself:
- Do I feel validated and seen?
- Are they curious about me or are they analyzing me?
- Do they seem genuine in their approach?
- Are they patient with me?
- Can I be my authentic self?
After a Few Sessions
After a few sessions you should be able to sense some small changes in yourself or be able to identify some new insights about yourself or your relationships. If you don’t it could be time to have a discussion with your therapist about your progress. Some red flags that you may want to consider is whether a therapist is:
- Watching the clock too much
- Making you feel guilty or ashamed about your behaviours or experiences
- Threatening that you will get worse without therapy
- Talking more than you
- Interrupting you often
- Acting inappropriate or unprofessional
- Violating your confidentiality or your rights.
The last two are reportable. If you find this is happening, you can file a complaint to their professional regulating body.
You may also want to consider whether the therapist is giving you advice. Although advice may be desirable and come from the best of intentions in that moment, it is a reflection of the therapist’s own biases and life experiences- not yours. You and your therapist are different people. You may have different ideas, experiences, values, beliefs, and challenges, so their advice may not be relevant for you.
A therapist is trained to provide you with a stronger sense of your own values and beliefs and to support your agency and your autonomy to make your own decisions. When you ask your therapist to give you advice, it comes with the assumption that your therapist is perfect or more competent than you are in terms of your own life, which is far from the truth. Instead, find a therapist who provides guidance, who reflects what you are telling them, works with you to define your needs, provides you with opportunities to learn new skills, and inspires you to develop greater capacity for growth.
“As a therapist, I am a companion. I try to help people tune into their own wisdom.” — Virginia Sartir
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Written by: Jess Boulé, Pronouns: they, them, theirs / she, her, hers
Jess is our office strategist at Bliss Counselling. Jess is a Master’s graduate from the University of Guelph. During their degree, they focused on aging and end-of-life, communication, human sexuality, LGBTQI2S+ health, inclusive practice and policies, knowledge mobilization strategies, research methods, and program evaluation.