JOURNAL
Choosing a therapist
Seeking therapy takes courage. The decision to reach out for support means you're already taking your emotional reality seriously—and that deserves recognition. Now comes the next step: finding a practitioner who can truly meet you where you are.
Your healing journey is unique, and the therapist you choose will play a crucial role in how that journey unfolds. This isn't about finding someone perfect; it's about finding someone who's right for you.
Before diving into credentials and directories, take a moment to consider what brought you here. Getting specific about what you'd like to get out of the experience right off the bat helps you seek out a therapist who matches your goals.
What's your experience been like lately? Maybe you're dealing with hurt feelings that won't seem to heal, navigating a major life transition, or simply feeling like life isn't going the way you want it to go. It's also okay to go into therapy without really knowing precisely what you want out of it—sometimes the clarity comes through the process itself.
Consider these questions:
Your answers will help guide your search toward practitioners who specialize in the areas that matter most to your experience.
The letters after a therapist's name tell you about their training and what they're qualified to do. Here's what you need to know:
Psychiatrists (MD/DO) can prescribe medication and provide therapy. They can provide an accurate diagnosis, therapy and medication when necessary and collaborate with your PCP and therapist. If you're considering medication as part of your treatment, this might be relevant.
Psychologists (PhD, PsyD) have the most extensive graduate training, and while they are therapists, they can also provide psychological testing for developmental disabilities, dementia, ADD and other conditions when help is required to clarify the diagnosis.
Licensed Clinical Social Workers (LCSW) have a master's degree and usually advanced training in psychotherapy. They have special expertise in navigating the social services system and can often serve as case managers.
Licensed Marriage and Family Therapists (MFT) have a master's degree and are trained primarily to provide couples, marital and family counseling.
The specific title matters less than finding someone who understands your experience and has training relevant to what you're dealing with.
It is expected that competent therapists hold advanced academic degrees. They should be listed as members of professional organizations, such as the Association for Behavioral and Cognitive Therapies or the American Psychological Association. Most importantly, they should be licensed to practice in your state.
Look for practitioners who have:
Some therapists also may have extra certifications in specific therapeutic approaches or techniques. For example, they might hold certifications in Cognitive-Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), or trauma-informed care.
All providers have different specialties and focus areas, so answering these questions will help you narrow down your options. Most therapists can help with general concerns like depression and anxiety, but some experiences benefit from specialized expertise.
If you're dealing with trauma, relationship issues, addiction, eating concerns, or identity-related struggles, seek out someone who has specific training in these areas. When considering addressing your specific concerns — like anxiety, depression, relationship challenges, or something else entirely — seek out therapists who specialize in those issues.
This doesn't mean you need someone who's exactly like you, but it does mean finding someone who understands the unique aspects of your experience and won't require you to educate them about the basics.
Therapists use various methods, and different approaches work better for different people and situations. In reality, most therapists are trained to use an "eclectic" approach that combines several methods and they will tailor the therapy to meet your needs.
Some common approaches include:
Cognitive Behavioral Therapy (CBT) focuses on the connection between thoughts, feelings, and behaviors. CBT is a helpful approach that focuses on teaching people to identify and change unhelpful, negative thought patterns.
Narrative therapy helps you explore the stories you tell about your life and author new ones that better reflect who you want to be. This approach recognizes you as the expert on your own experience.
Psychodynamic therapy explores how past experiences influence current patterns and relationships.
Trauma-informed approaches like EMDR (Eye Movement Desensitization and Reprocessing) are specifically designed for processing traumatic experiences.
Somatic therapies work with the body's responses to emotional experiences and trauma.
You don't need to become an expert in all these approaches, but having a general sense of what resonates with you can help guide your choice.
Having good rapport with a therapist is the most important factor in determining the outcome of therapy. This matters more than having identical backgrounds or experiences.
Personal connection is so important that the lack of it, as research shows, is why one in five clients drop out from therapy after just one session. You want someone who makes you feel:
Nguyen says when she's researching therapists online as a patient, she looks for indications of who providers are as individuals – to get a sense if she'd feel comfortable with them. Many therapists now share something about their personality and approach on their websites or profiles.
Cost and insurance: If you have health insurance with mental health benefits, you can look for a provider who accepts your specific plan so you can pay less. Some private practices and individual therapists offer a sliding scale based on income or financial means.
If cost is a barrier, some county mental health departments and non-profit organizations like Mental Health America provide free and low-cost therapy for people on Medicaid, people who receive social security for disability, and those without insurance.
Scheduling and availability: Consider whether you need evening or weekend appointments, and whether the therapist's schedule aligns with yours long-term.
Location and format: Decide whether you prefer in-person sessions, online therapy, or want the flexibility of both options.
Personal referrals: A very common and effective way to seek out a reputable therapist is to get a referral from a friend or family member. You can also ask your primary care doctor for recommendations.
Professional directories: You can try online therapy directories, professional associations such as the American Psychological Association (APA), or your insurance provider to find a mental health professional.
Online therapy platforms: The popular app BetterHelp offers memberships from $60-$90 per week, depending on your location, and many platforms now offer matching services to help you find compatible therapists.
Before committing to ongoing sessions, consider scheduling a brief consultation call. Here are questions that can help you assess fit:
The therapist should be able to describe the merits and drawbacks of different types of treatment, including ones he or she doesn't offer. They should also be transparent about their process and willing to answer your questions.
While most therapists are well-intentioned and competent, there are warning signs that indicate a practitioner might not be right for you—or anyone.
Boundary violations: A therapist should never try to start a relationship with you outside of therapy. A bad therapist may try to form additional relationships — called dual relationships — with a client outside of therapy.
Inappropriate behavior: They should never yell at you or forcefully tell you what to do. Bad therapists will lose control of their emotions, become overly defensive or criticize you when given feedback.
Dismissive attitudes: If your therapist brushes off your experiences in such a way, defends the offender, or shifts into victim-blaming mode, it's time to move on. Feeling invalidated in your identity or experience is a red-flag behavior.
Poor boundaries around self-disclosure: When a therapist tells you too much about their life, they're using up your time for their own gain. And in some cases, therapists may reveal inappropriate personal information that has no place in therapy.
Lack of specialized knowledge: If therapists advertise themselves as specialists in an area yet have no experience, they're likely practicing outside of their scope.
Breaching confidentiality: You should feel comfortable that your therapist isn't sharing with other people, and if they are, that's a huge red flag.
If you've ever left therapy and wondered "is it just me, or should I find a new therapist?" you may want to be aware of these red flags. Your instincts matter here.
If you get an uneasy feeling about your sessions with this person, trust your gut. While it's true that sometimes you have to work through some challenges if your overall feeling about therapy is negative, it may be time to reevaluate a particular therapist.
That said, remember that therapy isn't always comfortable. Therapy is meant to be healing, but the irony is that some of the biggest breakthroughs happen through feeling pain and getting uncomfortable. The difference is that discomfort in good therapy feels purposeful and supported, not shaming or dismissive.
Even with a good therapist, you might find that the fit isn't quite right. Some signs it might be time to consider other options:
If you're comfortable, let your therapist know about your concerns. Most good therapists will work to understand your point of view and plan ways to adjust the course of treatment.
Remember that a good therapist will provide you with the tools to figure out a path forward, rather than unilaterally telling you what to do. You're not looking for someone to fix you or solve your problems for you—you're looking for someone who can walk alongside you as you do the important work of understanding yourself and creating positive change.
A good therapeutic relationship is the key to successful therapy, and if you ever feel that something is off or notice any red flags, trust your gut.
Finding the right therapist often requires some patience and persistence. You could compare finding a therapist to apartment-hunting in a crowded housing market. Demand is high, availability is limited. It requires persistence, flexibility, and the knowledge that you may not be able to check every one of your boxes.
But this search is worth the effort. When you find a therapist who truly understands your experience and creates a space where you feel genuinely seen and supported, therapy can become a powerful tool for growth, healing, and creating the story you actually want to live.
Your emotional reality matters. Your hurt feelings make complete sense. And finding the right person to support you through whatever you're facing is not just possible—it's exactly what you deserve.