Good Therapy: How to Tell If Your Therapist Is a Good Fit for You
September 21, 2016“Your life is insane. You know that, right?” my coworker (and fellow therapist) declared over her cup of coffee. I had just finished outlining my family’s tentative plan for the next two years that included such notable features like PCS, selling or renting a house, a new job (for me), several TDYs for schooling (for my husband), and several other unknowns. You know, the usual.
I started to protest almost automatically, “No, you get used to…”
But after a moment under my friend’s totally-not-buying-it gaze, I conceded with a laugh, “Yeah, it’s nuts.”
It’s taken me the better part of a decade to admit it, but I’m finally at a place where I can say – unapologetically – that military life stresses me out at times. And that, at least for me, uprooting and re-creating my life every three years proves difficult—not to mention the things that can happen in between moves!
So what does a professional therapist do when her life gets to the point where it’s weighing her down?
She talks to her friends.
She runs.
She reminds herself of how lucky she is to live this adventure with the love of her life.
And sometimes, she gets her own therapist.
Yes, really. Investing in my own mental health is paramount to me staying healthy, present, and focused on my clients. Not to mention, not being a hypocrite is pretty important in my line of work.
Have you ever thought of working with a professional therapist? Maybe you have. Maybe you’ve even called around, and made your first appointment. But are feeling unsure about what to expect.
If you’ll allow it, I’d like to talk you through some considerations to keep in mind should you consider seeking professional therapy—as someone who’s been on both sides of the room.
Expectation Management
First off, let’s address the myth that people who go to therapy need to have earth-shattering problems.
The truth is that people seek professional therapy for a wide variety of concerns. In our community specifically, treating PTSD is a common reason for seeking therapy. And it is far from the only concern. Other reasons may include (but are not limited to): adjustment/transition challenges (hello, PCS!), depression/anxiety, marital concerns, developing better social skills/confidence, career/academic concerns, coping skills, learning how to create a better work/life balance, and many others.
Know this: There’s nothing to say that you need to work with your therapist forever—as if we in the military would ever live in one place long enough for that to happen. Timelines vary based on the issue you’re exploring. Some clients only need to come for a handful of sessions. Others may attend for longer. Your therapist should be willing and able to discuss this with you.
The First Session
The first time you meet with a therapist is a bit of an anomaly with respect to therapy.
The therapist will probably do more talking in the first session than they will in subsequent sessions. This is largely due to the legal/ethical requirements and their needing to ask questions to obtain key pieces of information.
The goals of the first session are often pretty simple: put a face to a name, find out what you would like to address, gather facts and relevant history, and most importantly, to begin building good rapport and comfort with you. While I mentioned that the length of therapy may vary, please do not go into the first session thinking therapy is a quick fix. You will often leave your first session with more questions than you walked in with—and that’s actually okay.
Getting Comfortable
When it comes to good therapy, the one thing that consistently ranks higher than any other factor in determining a positive outcome is the professional therapeutic relationship that exists between the therapist and his/her client. In other words, how comfortable you feel talking to your therapist.
How can that possibly be? Well, it’s simple. All the degrees, experience, and training in the world are worthless if you don’t feel comfortable expressing yourself openly and honestly.
When I meet with someone for the first time, I ask them to give themselves permission to be as unedited as possible. If that means you curse, then by all means feel free to do so! If that means you cry, I assure them that free tissues are included with every session. I also let them know this isn’t the time to be PC or worry about offending or shocking me. I assure them my threshold for both is very high, and I usually blame it on the fact that I’m from New Jersey. True story: I started adding in that last bit because I’ve found that people are much more likely to believe me if I tell them where I’m from. I have no idea what I would do if I came from a less offensive state, like…Delaware.
Of course it’s a pretty impossible-sounding task to expect someone to be 100% comfortable with you when you’ve only just met. And each therapist is going to have their own personal style. But it is far from that stereotype of the neutral-bordering-on-indifferent therapist sitting behind his client who is splayed out on a couch.
Who’s the Expert?
When seeking professional therapy, it’s always important to ask yourself, “Who’s the expert?”
You might be tempted to say, “The professional I’m paying, naturally…”
Sure, when it comes to techniques, interventions and theories, you are correct to expect that your therapist possesses specialized knowledge of evidenced-based interventions and skills. It’s also reasonable to expect your therapist to be able to explain current research related to your particularly problem and to provide a rationale for the interventions they suggest. And yet these are simply offerings, not mandates.
Remember that you are the expert on you. You have more years of experience being you than anyone else on the planet. A good therapist will welcome and value your insights. They may challenge them or want you to dig through them a bit more, but there should be a sense of general respect.
Friends?
When talking about the comfort and judgement-free dialogue that makes up the ideal therapeutic relationship, people naturally want to think about equating it to a best friend. Your therapist, however, is not your friend.
Friendship, or at least healthy friendship, is a two-way street. The relationship you have with your therapist, however, should be focused entirely on you. Now that doesn’t mean you can’t have a little small talk at the end of a session, or that they can’t share some personal insight from time to time. But if you start to find that your session is becoming more like a visit with your best friend minus the wine, or worse, more about them than you, then thats a huge red flag.
Special Considerations: Military or No?
So here’s a question that comes up quite a bit when speaking with friends in our community: Should my therapist be connected to the military in some way or not? Similar questions might involve religion, or a certain gender or age group.
The answer is perhaps the most infuriatingly “therapist-y” answer ever: “It depends.”
There are a million and one reasons why someone in the military or married to the military may seek counseling. And not all of those reasons have to do with being a military spouse, service member, or otherwise. So, it depends.
Not to mention, sometimes gaining the perspective of someone outside of your community or culture can actually be helpful.
On the flipside, there are certain issues that may require more specialized training:
- Children: Therapy for children and teens often looks different from therapy for adults. Children are a population that I always encourage parents to seek someone with specific therapeutic training to work with children.
- Trauma: There are specific interventions for trauma that are backed by solid scientific evidence. However, each of these treatments involves specialized training well beyond the basics of therapy most professionals receive in their degree programs.
When in doubt, ask your therapist if they have worked with or have training in addressing your particular concern.
This Isn’t Working
If after meeting with your therapist a few times, you come to the conclusion that this relationship is not a good fit, please tell your therapist.
A simple, “This isn’t working for me,” can open up a pathway to fruitful conversation. So can saying, “When you said, ____ last week, I wanted to walk out of the room and never come back.”
Sometimes the issue is something that can be fixed (“I feel rushed to answer your questions and would like more time to think before responding.”), and sometimes, it really is time to find someone new.
Good therapists understand that they are not going to be a good fit for everyone and shouldn’t take it personally. Don’t be surprised if they actually offer to help you find someone who would be a better fit. I’ve done this for clients before, and I’ve had clients referred to me from other therapists for the same reason. A good therapist cares about helping you get to where you need to be—whether that’s in their office or someone else’s.
10 Questions to Consider Asking Your New Therapist
Part of developing a comfortable working relationship with someone is knowing who you’re talking to. I don’t mean asking your therapist how many children or siblings they have, or how they take their coffee. But I’m always surprised how many people do not ask about their therapist’s background, training, or experience.
To help you get a better feel for the person you’re going to be working with, consider asking some of the following questions:
- What led you to become a therapist?
- What theory or theories do you use to inform your practice?
- What experience do you have working with ‘x’ (‘x’ could be a specific issue, population, age, and more…)?
- What is your favorite population to treat? Is there anyone you probably wouldn’t treat?
- How do you think about issues like ‘x’ (depression, anxiety, insert whatever concern is of importance to you)?
- Do you think people with ‘x’ issue can heal/improve? (Think of it this way: Why would you pay money to someone who doesn’t think your condition can be improved/managed better? Why?!)
- What kinds of treatments do you use to help with that healing/improvement and is there research to support those treatments?
- How will you or I know if therapy is working?
- Do you recommend any books or websites for further reading?
- Do you assign homework in between sessions? (You can include your preference to have some or not.)
While the answers to these questions may largely vary, the most important piece is that your therapist is willing and able to answer your questions. Any therapist I’ve ever met who was truly skilled and passionate about their work tries their best to answer their client’s questions. If your therapist responds defensively or acts insulted that you asked—that might not be someone you want to work with. I wouldn’t.
Remember that good therapy isn’t always rainbows and butterflies. You may not leave every session smiling, but you should be able to leave every session feeling like you were heard and that your therapist cared.
Note: “Professional therapist” or “therapist” for the purposes of this article are meant as an umbrella terms intended to describe an individual with at least a Master’s Degree and state license to practice professional mental health counseling and/or psychotherapy. Professional titles may vary and include licensed Clinical or Counseling Psychologists, Licensed Professional Counselors, Licensed Clinical Social Workers, Licensed Marriage and Family Therapists, and Licensed Clinical Mental Health Counselors.