Rightness of Fit With a Therapist

Choosing a therapist should be something you approach very carefully.  I'm not talking so much about the danger of landing in the office of some crackpot or dangerous or troubled therapist, though of course one should remain awake to that possibility.  But by and large I think the profession does a fairly decent job of weeding those people out and protecting the public.

No, I'm talking more about rightness of fit. Last week I outlined the different specialties in their broadest terms.  Today I want to help start to hone in on what kind of therapist you might be looking for.  When you go to buy a new car or a new appliance, you think carefully about what you're looking for in terms of features, or color, or size.  When you shop for a therapist, you should ask yourself some of the following questions, to help you determine what you're looking for:

a)    Specialty: Do you have some specific issue such as panic attacks, depression, or substance abuse?  If so, you want to make sure the person you're working with has both training and experience in your issue.

b)    Style: What kind of person helps you feel safe and comfortable?  Do you prefer someone direct and concrete or someone quiet and reserved?  Someone who will tell you what to do or help you figure it out for yourself?  Most therapists have the ability to switch gears depending on the situation, but will still have a more natural default position and it's worthwhile to be looking for that when you are therapist shopping.  I've had clients complain to me that their previous therapist "just listened and didn't give me any feedback" and I've had clients complain that their previous therapist "did all the talking."

c)    Gender:  Even after 25 years in practice, I still haven't figured out how important gender is or isn't when choosing a therapist.  I think it can be very important for some people, though you can't always predict what will work.  For example, a female who was molested by her father may need to see a woman in order to feel safe enough to open up or may need to see a man in order to work through her wounding around men and vulnerability.

d)    Orientation:  Most therapists have a particular orientation in their work, although not one which always adheres to a particular theory.  For example, if I have to choose what to call myself, I'll say I'm a Jungian because Carl Jung's spiritual and meaning based approach to mental health most nearly matches my own.  If someone is looking for cognitive behavioral therapy (looking at how thoughts and feelings interplay) I will refer them elsewhere because it's just not me.

e)    Cost/Insurance/Location: Can you afford the person you're interested in seeing in terms of convenience, fees, and insurance coverage?  It will always feel like a challenge when you're adding something new to your life and your budget, but you want to start with someone who, if it works out, you will be able to see without going into bankruptcy or having to travel three hours each way.  You want to have the logistics make possible the development of a routine.

Next week:  questions to ask your prospective therapist in a first meeting.

Do you have a question about your marriage or relationship? Is there a particular topic on relationships or individual psychological issues you would like addressed in this blog? Ask Josh in the comments below or email him at josh@joshgressel.com.

Josh Gressel, Ph.D., is a couples and individual therapist based in Pleasant Hill, CA. Visit his website at joshgressel.com.  He is currently accepting referrals.