Is My Therapist a Good Fit?
Seven Things To Consider To Determine If Your Therapist is Right For You
It’s the age old question- how do I know if the therapist I am seeing is the right person for me? I talk about this with my friends, family, and patients all the time. It is hard to know how to vet a therapist because there are so many factors that go into what we call “goodness of fit”. Let’s talk about some of those things to consider, whether you’re looking for a therapist, are new to therapy, or are questioning if your current therapy relationship is right for you.
1. Do Their Values & Morals Align With Mine?
This is a fairly new conversation within mental health spaces in the last 10 years, one that I believe is long overdue. The key determinant of success in therapy is the safety that you as a patient experience or do not experience within the therapeutic relationship. So, basically if you don't feel safe with your therapist then you're not going to have success in therapy. A pretty understandable cause and effect, I'd say.
Safety is not just about physical safety (which is also extremely important), but also emotional safety. In order to establish and maintain emotional safety, patients need to believe that their therapist is working in their best intentions, supports them as a whole individual including all aspects of their identity, is actively challenging limiting beliefs they may carry and examining the origins of those beliefs, has experience in training and working with the population the patient is a member of and the concerns the patient is coming to therapy to address.
This is especially important for individuals from marginalized or historically disenfranchised communities. Think about it, if I am coming to therapy to discuss and seek support around the most painful experiences of my life, oftentimes things that I have not shared with anyone else before, and I learned that my therapist actively supports policies and people who do not believe in my inherent personhood, my rights and protections, and work against my safety in numerous domains of life then how am I going to feel safe with that provider?
I believe everyone deserves the support they need when they need it and it's important to know that the person you're seeking help from is your advocate in the therapy space but even more importantly when you're not in the room.
2. Do We Have Shared Goals?
Supportive therapy is a valuable tool and resource for many people and it is important to remember that most people are coming to therapy to address specific concerns in their lives that require the therapist to have clear and identifiable goals and an understanding of the route to achieve those goals. If you and your therapist have not discussed treatment goals then I would recommend having a conversation with them.
That discussion can be as simple as asking what they think you should be working on in therapy. It also can involve you saying what your goals are and asking them if they have any other goals that you may not have thought of.
No matter how you bring up the conversation I believe it is important that when we are on a road trip with someone everyone in the car should know the destination we're driving towards.
3. How Do They Know Therapy Is Working?
Along with that question around shared goals it is important to know how your therapist is measuring success in therapy. Are they thinking of symptom reduction? Building insight? Behavior change?
Do they measure these successes through the use of self-report measures? Observation? Feedback from you? Collaboration with other providers? Knowing how your therapist evaluates success in therapy is another way to be an active, collaborative participant in your treatment.
4. Can You Disagree With Them?
If you're already in therapy ask yourself “how comfortable might I be pointing out something I disagreed with my therapist on?” Obviously this is a complex question for many of us as assertiveness and fear of perceived conflict are oftentimes factors that motivate people into therapy in the first place, but there is a difference between a fear that someone may be upset with us for disagreeing and a learned understanding that the person in front of me will not receive feedback collaboratively.
If you are interviewing potential therapists, a question you can ask them to gauge this factor is “ how do you handle disagreements or ruptures in therapy?” You're looking for a clear answer that is non-defensive, focuses on repair and collaboration, engages with accountability, and values the relationship.
Therapy is a process between two humans and when two humans interact over time there will be natural disagreements and potential ruptures in relationships. It is important that your therapist is fostering an environment where you feel safe enough to disagree with them and work through disagreements in productive ways.
5. What Is Their Style In Therapy?
There are countless ways to facilitate therapy and because of that every person will not respond the same to every therapy style.
“Is your therapist a more solutions focused therapist who will help you identify actionable decisions?”
“Does your therapist think that you benefit most from finding that solution on your own?”
“Is your therapist more active or passive in their approach?”
The therapist’s style requires that you, as the patient reflect on what kind of help you might benefit from the most. It's important to keep in mind that oftentimes we may not know what kind of help we will benefit from so remaining open-minded is really important. This is also a time where the last point, whether or not you can disagree with your therapist, comes into play. If your therapist has a style that you are realizing doesn't work for you, you want to be able to advocate for changes that might work better.
6. Do You Like Them?
Oftentimes I believe that this is the most important factor in the therapy relationship. Time and time again research shows that the therapy relationship is the most powerful determinant of success in therapy. Long-term therapy relationships will have their ebbs and flows like all relationships do. Some weeks you will have so much to talk about that it feels like the time flies by. Other weeks you will come into therapy questioning if you should have canceled because it doesn't feel like there's anything to discuss. Liking your therapist allows you to build trust with them that they will remain present and help navigate through both scenarios and every one in between effectively and empathetically.
Also, if we are meeting with someone for at least an hour every week or even every other week, and we don’t enjoy talking to them or find them to be a person we feel connected to or enjoy, that sounds absolutely miserable. If we are investing our time, energy, and money into a service like therapy, liking the person we work with is essential to making progress and for therapy to feel like it’s worth it.
7. Do They Challenge You?
While therapy can be enjoyable and it can be fun to talk with a therapist, at it’s core it is a process of self-discovery, exploration, insight building, motivational enhancement, and growth/change. That is not an easy process, nor does it always feel good. This requires difficult conversations, sometimes ones that we have avoided most of our lives. Our therapist needs to be the mirror that we have avoided looking in, reflecting back the ways in which we are standing in our own way, behavior patterns that are hurting us or those we love, and things that we need to change that aren’t always easy to hear. Our therapist needs to be able to challenge our world views when it aligns with our goals and not always make us feel “good” because always feeling good means that we aren’t changing. Change is difficult and uncomfortable and therapists need to be challenging us, not just a yes-man who makes us laugh once a week.
These are just a few of the ways to determine if the therapist we are or are hoping to work with is a good fit for us. It’s important to reflect on our relationship with our therapist and remember that this is a relationship between two people, which means that things will change, not always feel good, not always feel bad, and may meet our needs at one point but not at others. The best thing we can do is to recognize when therapy might not be meeting my needs to actively advocate for what might. Even if you don’t know what might make it better, if you can work with your therapist to try to improve the therapy experience then you’re half way there.
