Picking a therapist for yourself or a loved one can be overwhelming and often frustrating. There are many factors that come into play and one can only hope they find the middle point to that Venn diagram that fits well. As a therapist who is in therapy and has had to choose therapists for my own family, here are some hopefully helpful tips to choosing your own therapist.

1: Insurance.

Yes. That is a full sentence. Who your insurance covers is key. If you are choosing to pay out of pocket, this will not be a concern. The best way to find out who is covered under your insurance is to either call the number on your insurance card or go to your insurance’s website and search their directory. It is also wise to take the second step of calling the agency, practice, or clinician themselves to confirm because sometimes the websites are outdated or not updated.

Another option to check into is called, “Out of Network coverage,” otherwise known as a, “Superbill.” Sometimes a clinician is not covered by your insurance, but your insurance will agree to cover the costs, or some of the costs, via a Superbill. This can be a good option if you are looking for a specialist or there is a lack of covered clinicians in your area. There are several downfalls. First, you will have to pay out of pocket for each session up front. It will then be your responsibility to obtain reimbursement from your insurance by submitting the agreed upon paperwork. Reimbursement can take several weeks.

2: What are you looking to address?

What you are seeking support for can be tricky. Is it anxiety? Or is it anxiety stemming from a relationship stressor, a family issue, job stress, or self-esteem, or a possible undiagnosed neurodivergence? When we are more clearly able to identify what we are seeking support for, it can help us identify who or what modality may be a better fit.

3: What type of therapist should I pick?

Ultimately, most types of therapists and licenses can serve most generalized issues. However, looking at the graphic below, we can see that different types of education and licenses tend to also have different specialties or categories.

An blue and gold colored image with rows and columns describing the types of clinical licenses in Illinois: specifically psychiatrist, psychologist, social worker, counselor, and marriage and family therapist.

It is also important to look at what specific certifications and trainings the clinician has. While we all get our own general education through our degrees, just like in the medical world, we too further our education by choosing different modalities that best serve our specialties.

4: Safety.

Not every clinician is safe, nor is going to feel safe to you. Felt safety in session is important in a therapeutic relationship, but being safe is more important. Especially if you are a person who is oppressed or part of an oppressed community. While we are taught that we should be able to work with and hold space for all, our own personal biases, beliefs, and experiences come into play. You need to vet your clinician and there are several ways to do this:

Reconnaissance. Here is a fun fact! A clinician cannot look you up on the internet, but you can look them up! Take your time in looking up the clinician’s internet presence. This may be able to give you clues into different aspects of their lives that can either help or show you that they may not be the best fit for you.

Word of mouth: If you have a friend who has recommended someone to you, that friend knows you or you know you can trust that friend. A recommendation may not mean the clinician is the best fit, but it may be a good place to start.

Asking them. Some clinicians offer free consults or are willing to email a bit before you decide. Ask them the hard questions: What is your training? What communities do you work with? Who do you NOT work with? If you are a part of an oppressed community, you can ask what trainings they have in their anti-racist work, LGBTQIA + ally-ship, religious bias, etc. A current hot topic amongst clinicians right now is divulging political views. How someone responds may be an indicator of safety for you personally.

5: Vibes.

Research shows that you do not have to connect with your clinician to have positive growth, BUT it sure does help! Check the vibes! I personally tell my new intakes that research shows it takes 4-6 session for both clinician and client to really get a good vibe check. You may know sooner and that’s ok. However, assessing your clinician’s vibes, especially when doing long-term work, is another way to decide if they are a good fit. This can be personality, office vibes, modalities offered, etc.

Now keep in mind that a good therapist isn’t your, “yes man.” A good therapist will be able to create that felt safety with you but also will be able to tell you hard things or hold you accountable. Therapy isn’t comfortable. So, who makes it feel comfortable enough that you can do the work you want to do?

This short list is not extensive. Yet, I hope that it can be helpful in narrowing down the difficulty in finding a therapist or clinician.

A few notes from my perspective as a therapist. When you put in the work in choosing us, we are more likely to have successful long-term outcomes because you’ve already eliminated possible barriers for your own success and our ability to serve and support you.

The bad news? Sometimes we don’t think it is a good fit, and it can be REALLY hard for us to tell people that. This can happen for several reasons. First, we are human. There may be things that we know we don’t work well with, or that trigger our own traumas, or that we know we do not have the capacity or competency for. If a therapist decides to not take you on or end the therapeutic relationship for their own reasons, remember it may be in your best interest. A good clinician will help you find other options.

Choosing a therapist can be hard and daunting. Therapy comes with vulnerability and we have to feel safe enough to be vulnerable with the person we choose. Even if we are successful, it is pretty common for people to outgrow their therapists, need another type of modality, or just feel like they need a change of perspective. No matter how you chose your therapist, know that you have autonomy in this process.

- Andie Coston, LSW

How to Pick a Therapist