How to choose a therapist
& my red flags for the first sessions
In my field of work, autumn is a good time for people to start therapy. Could be the darker days, or the start of a new season (apparently it’s hard to check out of the 12+ years habit of autumn starting school/ university).
In any case, me and my colleagues get a fairly larger amount of requests for therapy start than in the summer.
If it’s hard to find an available therapist in this period, that’s the reason.
At the same time, I get a lot of questions about therapists I recommend and feedback about current therapists that people want to change.
This is a substack about how to choose a therapist & about what are red flags when going to a therapist. It might be longer than usual, but bear with me, it’s worth it.
How to choose a therapist:
Look for recommendations - ask people who are doing therapy, and don’t be shy about following therapists online.
Choose 1-2-3 names that stand out to you and stalk them online. Most therapists will have a blog or a website where they present themselves or write about different topics. This will give you a good idea about their tone of voice and what their areas of expertise are.
Schedule a session with the one you choose and see what happens. If there are no major red flags in the first session (see below what my red flags are) then stick with that person for 2-3 sessions to see the vibe and the relationship building.
If it’s not what you need, go to the next one.
It’s perfectly okay if you don’t find the right therapist for you the first time. In my experience, some therapists might be right for you in some periods of your life, others in others.
I have worked with people for whom I was their 3rd or even 5th therapist and that was ok.
The idea is to get the right fit for you.
My red flags at the first sessions:
Judgments & hasty explanations about what is happening to you. You are looking for someone with curiosity and compassion, not someone who is a know-it-all or acts like they’ve won at the life game and gives you lessons on life.
Not giving you an outline of what’s going to happen next. If you have no idea how that therapist works & what his approach is, I would ask. It’s really important to understand the approach and the framework that a person is working on.
Otherwise, it’s hard to get an outlook on the progress or for you and the therapist to be on the same page. If the therapist acts like it’s not your business to know, then check the first red flag again :).
Blaming you for the therapy not working - this is a big one. Therapy is always a two-way street, there’s a relationship going on and when therapist & client are disconnected, you can feel it. You will find rationalizations, you will debate your thoughts, but the emotional stuff will remain the same.
The therapist is in charge of noticing that something is off and becoming open and curious if the client raises the question of efficiency of therapy. This is usually a good moment to re-evaluate the therapy goals.
Not setting therapy goals. This is especially important. I never work without therapy goals - even if the goal is exploring. I would ask what is the purpose of this exploration and what would change in the client’s life after the exploration.
Goals help keep the therapy session structured.
Not offering or giving a receipt for the session fee. Or asking you to pay online in an account that is not linked to their professional registration.
I know we don’t like to talk about money (right?) but
one of my goals is to model honesty, integrity, and fairness in therapy.
That’s all make belief without actually living those values, right?
Needless to mention the attempt to coerce, flirt or not keep boundaries in therapy. That’s just common sense.
Good signs to seek in a therapist
Showing compassion. This is a no-brainer for most therapists but I’ve had my share of stories where therapists were offering more criticism or blaming than compassion.
This does not mean that the therapist will always be okay with your behavior, but he will always accept and value you as a person.
Setting clear boundaries. A good therapist will tell you if it’s okay to call or message them between sessions and that is a good sign of healthy boundaries.
Also, most therapists have a cancelation policy (usually cancel with 24h notice, otherwise the session will be fully invoiced).
This is a really good sign that the therapist values their time and that means they will value your time as well.
Bridgeing between sessions. Of course, sometimes we don’t talk about the same issue the next session, but it’s a good sign that your therapist will ask you about how was the last discussion for you.
It’s a sign of attentiveness & structure.
Understanding & being there - this might seem like compassion, but it’s a more nuanced attribute. It means that the therapist will cater the explanations and techniques to your style.
Being overly didactic or showing your PowerPoint in session (it happens, unfortunately) is a good sign that the therapist is not well connected with themselves or you.
Treating you with kindness. As therapists, we sometimes forget how privileged we are for being let into the personal & intimate space of someone. So a good therapist will always treat you with kindness & care.
I am really curious what your experience with therapists is. Write and let me know.
And if you know someone who might benefit from this piece of info, please share this.