The stigma tied to talking to a therapist has had a stronghold in the mental health space for decades. Previous generations kept their marital problems to themselves. They internalized struggles and pushed aside unfavorable emotions. Family issues were kept within the confines of the home. No one talked about depression—let alone admitted to themselves they might be experiencing it. Even as society became more open-minded, therapy was still seen as something for the fairer sex. If a man was seeing a therapist, it’s because his partner or job coerced him into attendance.
Now, thankfully, it seems the time has finally come where men and women of every age acknowledge the benefit of seeing a therapist. People mention their therapists in everyday conversations, quoting advice or coping mechanisms as breezily as discussing the weather. Even if there isn’t a major life event or crisis, people are seeking out therapy to better themselves—as a partner, father, son, employee, or friend.
You likely see ads for online services like TalkSpace (often accompanied by Michael Phelps’ face) that give more access to people who need it. And that’s a good thing, considering one in five U.S. adults have a mental illness, according to the National Institute of Mental Health.
The thing is you don’t have to have a diagnosed mental illness to want to talk to a pro about your problems. If you’re feeling down for a reason you can’t quite figure out, you’ve experienced a big loss or a rough breakup, you often get super stressed and anxious and don’t know how to deal, or there’s simply nothing wrong at all, it could be time to have a seat on a therapist’s couch. The biggest catch is finding one who lets you open up and helps you get to the root of your problem—then work to solve it.
To do that, Ryan Howes, PhD, a licensed clinical psychologist in Pasadena, CA, says to think of finding a therapist like you would finding a good personal trainer. You want someone who offers the motivational style that works best for your personality—except instead of encouraging you to physically sweat it out, you’re now putting in mental and emotional work. (That still might require some sweat, though.)
“Just seeking a therapist out means you have an investment in your health and wellbeing,” Howes says. “But after you gain their guidance, the work is ultimately yours. You will sweat and feel uncomfortable and question whether or not it’s worth it. That’s a normal part of the process, and a normal part of growth. When you accept that growth is uncomfortable and also rewarding, the whole process makes sense.”
When you decide you want to get after that growth factor, consider these tips for finding a therapist that will get you through the hard times and straight to your goals.
Define What You’re Looking for in a Therapist and the Type of Therapy You Want
Do you want someone to give you advice? Do you want someone to help you figure out what’s going on? Do you want a safe space to tell your story? Do you just need a quick fix for a specific event? Howes suggests working on answering these questions to help streamline the therapist-finding process.
You also want to consider a few factors like location, availability, insurance, whether you prefer a male or female, or if you need someone who specializes in something like anxiety, depression, eating disorders, or relationships, says Howes.
Another important difference between therapists is how they approach treatment and that usually falls into one of two categories—directive or non-directive, says Howes. A directive therapist gives you a game plan, offering up some homework, advice, and recommendations for helping you reach your goals. A non-directive therapist attempts to help clients find their own way by asking questions that aim to steer them into making a choice, Howes explains. “If you’re aware of your own needs, know that you’re looking for advice, and like for someone to tell you what to do, ask if the therapist is directive,” he says. “If you want to learn the lessons on your own so you don’t repeat them in the future, you should ask if the therapist is non-directive.”
No matter which one you go with, you still have to do the work and be open to change, it’s just how you get to that change that can help you determine the therapy you need.
Ask Around and Look Online
After you lock down what you’re looking for in a therapist, it’s always a good idea to ask your friends or family if they have any recommendations. Just like finding restaurants or other doctors, word of mouth offers a strong kickoff point for finding a therapist. You can also check out Psychology Today’s therapist finder or the one on GoodTherapy to look for therapists that fit your needs. You’ll find full profiles for the docs on there, so you can read about their specialities and how they approach therapy.
If you need more help narrowing down the list of docs, you might consider their credentials. A psychologist (typically a PhD or PsyD) has training in different types of psychotherapy, as well as psychological assessment, says Howes. They typically have the most training. Also, psychiatrists (your MDs and DOs) usually treat mental health through medication, while a licensed clinical social worker (aka a LCSW) often has experience not only looking at an individual’s problem, but also their social system and can help you find community resources. Finally, a marriage and family therapist (MFT or MFCC) has training in family relationships, so they can help with those specific areas.
But keep in mind, the letters behind a person’s name should only be the first step in helping you choose a therapist, says Howes. The most important part comes down to the connection you have with him or her.
Play the Field a Bit
To figure out whether you have a good connection with your therapist, Howes recommends reaching out to at least three potentials and seeing if you can get a free initial session or phone consult. “You should ‘test drive’ a few to determine who’s the best fit,” he says. “A good fit is someone you feel comfortable talking with who has a helpful approach to your problem that makes sense for you. If you don’t feel like you can talk openly with the therapist, you probably won’t be able to make the most of the sessions, regardless of their credentials.”
During that initial phone call, briefly explain what you’re experiencing and ask how the therapist would help. “As they respond, listen for how clearly they communicate their approach and hope for progress,” Howes says. “If they speak with too much jargon or suggest approaches that you disagree with or don’t understand, you may want to move on. If their response makes sense to you, setting up an appointment sounds like a good idea.” If you don’t feel good after that first phone call, move on to the next one.
Prepare for Your First Session
When you head to that initial in-person visit with your therapist, get ready to talk about exactly what you’re going through, what you’ve done so far to try to deal with it, and whether you’ve tried therapy before and how it’s gone, says Howes. Your therapist will also likely ask about your goals for treatment and a bit about your childhood. “You are the boss in a therapy relationship, and can choose to hire them or not, and leave whenever you’d like,” he says. So make the most of that first session so you can get a better view on whether you want to keep going back.
Also, know that many people find their first therapy session kind of tough, says Ravi N. Shah, MD, assistant professor of psychiatry at Columbia University Medical Center. “If you feel a little emotional or discombobulated after a first session, that may or may not be a bad thing,” he says. “You may need to go back for a second or third session before you get a sense of whether it’s a good fit for you.” The key is being open with your therapist about what you want from a session—say, more feedback, advice, or more silence so you have time to talk more. “The more you can share about what works and doesn’t for you, the faster you’ll get to a good working relationship,” Shah says.
Keep an Eye Out for Red Flags
As with any relationship, you want to feel like your therapist is listening to you, says Howes. You also definitely don’t want to feel judged or disrespected or like you’re getting a sales pitch. “This is one time where trusting your gut is the best approach,” Howes adds. “What may look best on paper might not feel the best in the room… If you feel it’s not working out early on, please keep looking.”