Finding a Therapist and Developing a Positive Therapeutic Relationship
Authors: Rachel Westlake, BCPA Jaan Altosaar, PhD
There are a few helpful factors in finding the right therapist. Much is in the preparation. It’s essential to be direct in your communication. If you put in the effort to find the right person, you will feel more comfortable when you work with them, allow yourself to trust and be guided, and be encouraged to trust yourself.
Preparing to get help
Before you start your search, write out a few things you know you want to work on and what you believe could be some sources of your struggle. Inspecting your beliefs and where you are at in understanding your need for therapy is a helpful task. Doing this self-reflection is an opportunity to start your therapeutic process with integrity and a baseline of your understanding. It’s ok if all you can write at this point is “I am depressed” or “I am anxious, and I don’t know why.” If possible, write this after clearing your head through exercise or relaxing.
Starting your search
Do a general google search of therapists in your area. Psychology Today offers a search tool to narrow down based on modality and if they offer telehealth, etc. It is not extensive. Usually, you can request a list of providers in your network from your health insurance provider.
Making your first call
After reading what’s available about the therapist, and if you like what you read, add them to a list of folks to consider, for example, in a Google Spreadsheet. If you are curious about them, call them. Call them anytime. Don’t set the task aside for too long. Get in the habit of feeling casual(ish) about making these calls. I recommend calling between 5-15 therapists and meeting with two or three. Leave a message or have a conversation that begins with an honest and simple explanation of what you want to work on and tell them you are willing and ready to work.
What to say during the phone call
Explain what you think might be bothering you or tell them you don’t know.
If you’ve worked with a therapist before, share with the person what worked in past relationships with mental health providers and what didn’t. For example, you can share if/why your previous therapist wasn’t or was a good match, if they provided enough feedback if they honored your experience in a way that felt good for you, or if they had a pleasant place to meet. How they respond to this information may inform your understanding of what they value in therapeutic relationships.
Ask them what they think, how they may help, and their modalities of practice and interests. Observe if you laugh or smile while talking to them. Therapy can be playful and satisfying. It makes sense if you don’t feel like laughing because of what’s happening for you, and that is very ok.
If a therapist doesn’t have time to talk with you over the phone for 10 minutes, call you back, etc., they probably aren’t able or are too busy to give you good care. Forge ahead.
If you like a therapist, but their practice is full, ask if you can briefly explain what you are looking for and ask if they have recommendations for someone who might be a good fit for you.
Follow your gut. Without being too critical, if you don’t feel good or even great about a therapist on a call, keep calling people. If you feel so-so, consider making an appointment and continuing to reach others. If you interview some people you like more than others, try to schedule them ahead of the person you felt less enthusiastic about. You can always cancel future appointments if you have found a match. It’s respectful to cancel at least 24-48 hours before the appointment.
What to expect at your first appointment
It’s helpful to have a mindset that recognizes therapy as good work, life-hacking, fun brain science play, kindness, and care for yourself. Going somewhere to be heard and supported emotionally and mentally is just as important as checking your physical health.
Go to the therapist hydrated, alert, and sober if possible. Take time to pause and see what the mental health professional says or asks in response to your sharing. If they ask you how you “feel about that” all the time, but that isn’t the kind of help you want, ask them why they do it and check in with them and yourself to see if it’s a good fit.
If you’re able, provide in-time feedback to the new therapist. Be as much a participant in your care as you are able. For example, “I’m interested in hearing more from you in our sessions,” or “I’d like to try Eye Movement Desensitization and Reprocessing (EMDR). Would you be able to work on that with me for this trauma?” or “I want to think about how this relates to an event in my earlier life.”
In your first session, you’ll both be checking each other out. Try not to worry too much about embarrassing yourself, be authentic and present – for some of us, this is a complex and rare opportunity. You may want to cover some ground and give them a scope of what’s happening. Observe them and yourself. Do you feel heard and cared for? Do you feel safe? Do you feel understood? Do you feel aligned in other ways? Will the environment of their office or their telehealth services be comfortable for you?
Maybe therapy is fun. Perhaps it is challenging. Worthwhile work can be difficult, and worthwhile work makes us satisfied creatures. If you’ve found someone you like, give it some time. Establishing trust and getting into some more profound work can take time.
There are many forms or “modalities” of mental and emotional therapeutic care. Learn more about those here or here. Cognitive behavioral therapy is a modality that focuses on what we tell ourselves and how that leads to behavior, and how we can disrupt behavior that doesn’t serve us. The psychodynamic approach focuses on where the problems or symptoms came from. Attachment theory approaches focus on healing unconscious processes in the brain and finding ways to develop the capacity for processing our thoughts and emotions. Interpersonal and systemic therapy work focuses on the here and now of current relationship dynamics. Ed. note: Jaan likes acceptance and commitment therapy as a modality, which got him out of a tricky spell of PTSD; fun fact: it also led to the founder of this modality, Steve Hayes, to join our board!
Many forms of expression-focused therapy can help you work through things in supportive containers (i.e., dance therapy). If you have had a trauma, or even if you don’t think you have therapists trained in trauma-informed care is helpful to find. Trauma is not always what we think it is, and it informs life experiences for most of us. You haven’t done something wrong if you have had a traumatic experience.
You may have to try a few different types of therapy, and one might be better in one phase of your life than another. It can be challenging to work through figuring this out while you are struggling. If you want to find an independent patient or health care advocate to support you in finding the care you need, go to GNAnow.org and AdvoConnection.com.
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License (CC-BY-ND-4.0), available at https://creativecommons.org/licenses/by-nd/4.0/
Signed-off-by: Rachel Westlake