Starting Therapy Off Right

You’ve decided to go to therapy. Maybe you decided on your own to go, or maybe a healthcare professional recommended it. Maybe you’ve been in therapy before, or maybe it’s your first time. No matter your reasons, finding the right therapist is critical. The good news is that thanks to a large increase in therapists offering telehealth or web-based services, you probably have a much larger pool of therapists to choose from than you did five years ago. The bad news is that it can be difficult to know exactly what to look for in a mental health professional, understand their backgrounds and credentials, and find someone who will help you feel better and stay better, and achieve your goals as quickly as possible.

As you begin your search, you will want to have a basic understanding of the concept of “evidence-based therapy.” Evidence-based means that the treatment has been scientifically tested and found to be effective at improving mental health conditions. There are several types of therapy that are evidence-based. The most popular and most widely practiced is Cognitive Behavior Therapy, or CBT. There are variations and offshoots of CBT that are also evidence-based and have been adapted for specific problems and situations, like Mindfulness-Based Cognitive Therapy; CBT for Insomnia; and Trauma-Focused CBT. Dialectical Behavior Therapy was originally developed to help chronically suicidal individuals but is also effective for the treatment of personality disorders and other issues. If you seek a therapist who practices evidence-based therapy, you will know that you are receiving a type of therapy that has been demonstrated by research to be beneficial.

Next, you will want to be sure that your therapist has adequate credentials and training. Anyone, literally anyone, can call themselves a therapist, a psychotherapist, or, for example, a cognitive behavior therapist, because these are not labels regulated by states. Therapists who are licensed by their state have different levels of education and specialty areas. Psychiatrists and psychiatric nurse practitioners can prescribe medication, and some also provide talk therapy. Clinical psychologists and master’s level counselors like clinical social workers, licensed professional counselors, and licensed marriage and family therapists can’t, in most states, prescribe medication but do provide talk therapy. No matter what credentials your therapist has, they should maintain a professional license to practice with their state licensing board.

You’ll also want to ask whether a mental health professional has expertise in the specific areas you’d like to address, and whether they have experience and training in adapting therapy to individuals with similar backgrounds and characteristics to yours. Some therapists specialize in working with older adults, religious minorities, the LGBTQ+ population, or with issues like grief, stress, insomnia, relationship problems, and others. Your therapist’s experience and expertise should be a good match with your goals for treatment and how you identify.

Just as important as the therapist’s credentials are their personal characteristics. Your therapist should demonstrate excellent basic counseling skills: They should be warm, approachable, a good listener, and they should convey realistic hope that they can help you. They should be straightforward and transparent about their credentials, experience, and training. They should also explain your diagnosis to you, work with you to create a treatment plan, and describe the process of treatment. They should answer your questions and welcome feedback, both positive and negative.

Finally, the process of treatment and your specific treatment plan should make sense to you and work within any limitations you may have relating to investment of time and cost. Does your therapist have a plan not only to address the problems and symptoms that may have prompted you to seek therapy, but also to help you achieve your goals and work toward your aspirations? Did the therapist take your strengths, resources, and values into account when creating the plan? Can the therapist give you a rough idea of how long you can expect to be in treatment? Therapy should not last indefinitely; your therapist should measure progress at each session and teach you interventions and skills that you can do on your own outside of therapy. Once you have achieved sustained measurable improvement with your symptoms, and made significant progress toward your goals, you and the therapist should collaboratively decide whether to start tapering sessions, and ultimately, to end treatment.

If you do decide to seek treatment, give yourself credit: I think it’s an act of courage for individuals to recognize that they need help and then to go to a mental health professional they don’t know. If you are seeking mental health treatment, you may have been struggling for quite a long time. In the U.S., the average person with a mental health disorder lives with it for over 10 years without receiving treatment. Some people face practical barriers, others fear judgment from friends and family, and still others have negative associations with therapy. They may picture themselves lying on a couch discussing painful events from their childhood with a detached stranger, as therapy is often portrayed on TV. (Luckily, therapy doesn’t have to look anything like that.) Be sure to acknowledge that what you are doing takes bravery.

To find a therapist, visit the Psychology Today Therapy Directory.