How to Choose a Therapist
Written by Steff Brand, M.S., LPC, NCC, CCATP
San Antonio Clinical Director
Choosing a therapist that is right for you is so imperative and a lot of people do not know where to start in their research. Different clinicians have different letters after their name, and to someone that is not in the field, those letters can sort of just look like alphabet soup. The letters indicate the degrees, licenses, and certifications that therapists decided to pursue and can be a great starting point in determining if the professional is qualified to show up for your unique needs. The first set of letters will specify if the therapist has a master’s degree or a PhD. All practicing therapists will at least have a master’s degree or will be in the final stages of their program and working towards a master’s degree. The rest of the letters will denote all licenses that the therapist holds and any certifications that the therapist earned through advanced trainings, examinations, and usually a recertification process every two to four years. If you are unsure of what any of the letters mean, you can always call our office and anyone on our Admin Team can provide education and help make sense of the alphabet soup. On our website, you can also find valuable information about all of our therapists’ licenses, specialties, and trainings by visiting our Houston and San Antonio team pages.
Once you find someone that you know works with your age and needs, you should also consider the clinician’s availability, theoretical orientation, experience diagnosing suspected mental health concerns, and general approach to therapy. This way, you can really make sure you are getting scheduled with the best fit for you. A quick call or email to our office might be sufficient in determining this information. Most of our therapists also offer free 15-minute consults to provide more information about their qualifications and answer any preliminary questions about therapy. Whenever I am referring clients to other professionals, I always recommend they take advantage of the free calls!
Inquiring about Availability
Before you schedule your intake appointment, I recommend taking some time to reflect on what kind of commitment you would like to make to the therapeutic process. When new clients ask me how often we should meet, I often say, “that’s up to you!” We know that building rapport and making progress in therapy works best when individuals can start with weekly sessions. However, this is not always in the cards for those with busy schedules, financial restraints, or other personal limitations. Think about what works best for you and ask if the recommended therapist has the respective availability to meet your needs. You should also ask what future appointment options they have available. For example, if you know you will always need a 5pm session time due to inflexibility with school or work, make sure that you are confirming that your therapist can consistently support that.
Understanding Theoretical Orientation
If you are not in the field, sometimes the jargon you read in a therapist’s bio might not resonate. Again, you can always call our office and ask questions. Our intake specialists are trained to provide appropriate education on the different theoretical approaches. If there is ever a question that they do not feel comfortable answering, they will check in with our therapists and get back to you with confident feedback. You can also read about the recommended approaches for different concerns by visiting our specialties page on our website. Most of our kid therapists utilize Child Centered Play Therapy when working with young children. Many of our couples therapists utilize the Gottman Method when working on relationships. If you are healing from significant trauma, we recommend getting scheduled with one of our therapists that is trained in Eye Movement Desensitization Reprocessing (EMDR) or Cognitive Processing Therapy (CPT). For those struggling with obsessive compulsive disorder (OCD), we recommend finding a clinician trained in Exposure and Response Prevention as this approach is known to be the most effective. If you are dealing with more generalized anxiety, finding someone that offers Cognitive Behavioral Therapy (CBT) would likely be a good option.
These are recommended orientations for only a small handful of concerns. The best thing you can do to ensure you are finding a qualified fit for your needs is to offer some vulnerability on that first phone call. Tell our Admin Team where you are needing support and what you are hoping to work on, and they can make sure you are getting scheduled with the most appropriate therapist.
Determining Diagnostic Experience
While all licensed therapists have general training in diagnosing mental health concerns, most therapists will choose a niche to specialize in after working in the field for a bit. Symptoms can be qualifiers for several different diagnoses, so being able to differentiate between diagnoses sometimes requires specialized training. A common misdiagnosis I see is generalized anxiety disorder instead of obsessive-compulsive disorder. Both involve the same physiological symptoms, intrusive thoughts, and catastrophizing thinking. A difference is that anxious thoughts from obsessive compulsive disorder will always be paired with rituals to mitigate the anxiety, significantly disrupting everyday life. Sometimes the rituals are super obvious like needing to check if the oven is off every night before bed. Other times, the rituals can be mental acts and easily missed if the client is not sharing certain information. Since I specialize in OCD, I know the appropriate questions to ask to help identify both physical and mental ritualistic behaviors that occur for clients. Because, I have completed intensive training in ERP, I am also qualified to administer the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and offer a comprehensive assessment to confirm an accurate diagnosis for OCD. If you suspect that you might meet criteria for a certain diagnosis, always ask if the therapist being recommended has the appropriate diagnostic training or ask how they handle outside referrals for appropriate evaluations. This is a great way to advocate for best possible care.
Sussing Out Personality
This is arguably one of the most important steps in selecting a therapist. Someone can complete all the trainings in the world, but if their personality clashes with yours, it is going to be tough to make progress in therapy. To overcome barriers, identify triggers, and practice coping skills that are specific to your needs and capacity, you must feel emotionally safe and comfortable with your therapist. If anything makes you feel reluctant to be honest and vulnerable in a counseling office, it is important to address it with the therapist or find someone that might be a better fit for you. Do you want to work with someone that is calming and gentle or someone that is more of a loud, assertive cheerleader? Look around at the various people in your life and try to assess what type of personality is known to be most supportive for you.
Some clients have told me that they appreciate how my personality is like theirs. They feel they can be raw and unfiltered because I have modeled that it is okay to toss in some occasional humor or a cleverly used F word at times. The clients that have been working with me for many years also do well with my non-directive nature. Most of the time, I ask them what feels important to process instead of being overly structured with session plans from week to week. Sometimes a lot happens in between sessions, and I think it is okay to pause on certain goals and pivot if a new stressor needs attention. I value the importance of empowering my clients to advocate for their needs and I think providing them ample space and autonomy is critical for good therapeutic work. On the flip side, I have referred clients due to them wanting to work with someone that is more directive and structured. I have also referred clients due to them wanting to work with someone that is older or younger because they feel that makes them more relatable. At the end of the day, this is your journey. Don’t rush into starting with just any therapist. Ask questions about availability, theoretical orientation, diagnostic experience, and personality. Then, choose someone that makes you feel encouraged to do the work. There is no room for using shame as a tool of motivation when the action is born of love. I am sending you patience and confidence this year in your journey that guides you both back to yourself and into your future!
Counseling can be a scary step, but we want to make it as easy for you as possible. We have Counseling options in Houston, San Antonio, and virtual counseling! Contact us to learn more.