How You Choose A Therapist

There is an inconvenient truth about choosing a therapist: you cannot really know beforehand.

You can read profiles, check qualifications, ask friends, attend a discovery session and spend an unreasonable amount of time comparing websites. None of these can tell you what will happen when you begin talking to this particular person week after week.

Therapy is a relationship, and relationships reveal themselves over time.

This doesn’t mean choosing blindly. There are things worth checking before you begin. There are also things worth returning to six months or three years later when you find yourself wondering, Is this still right for me? They won’t give you certainty. Think of them as anchors when certainty isn’t available.

Before you begin

Check what can actually be checked

Qualifications, professional training, experience, fees, session frequency, cancellation policy, confidentiality, communication outside sessions and emergency arrangements are not glamorous questions, but they are knowable.

If someone uses terms such as trauma-informed, somatic, integrative or names a specialised therapy, you can ask what training sits behind those words.

A therapist should be able to tell you clearly what they are qualified to do and how their practice works.

Ask how they think about therapy

A list of modalities tells you less than you might imagine.

Ask what therapy with them tends to be like. What do they pay attention to? How active are they in sessions? How do they think change happens? What happens when therapy gets stuck?

You are not looking for the correct answer. You are listening for whether there is a coherent way of thinking behind their work—and whether you are curious enough to experience it.

Notice how your questions are received

You are interviewing someone with whom you may eventually become extraordinarily vulnerable. Ask something you genuinely want to know.

Then notice what happens.

Can they tolerate your uncertainty? Can they say they don’t know? Do they explain rather than impress? Do you feel pressured to commit, disclose or agree?

You don’t need to feel completely safe. It would be a peculiar demand to make of one conversation with a stranger.

Perhaps the more realistic question is: Is there enough here for me to risk another conversation?

When you have been in therapy for a while

This is where continuing to choose becomes more complicated.

A therapist who has known you for years is no longer a stranger you can evaluate from the outside. There may be attachment, history, gratitude, anger, dependence, trust, disappointment and knowledge of one another. And therapy itself sometimes requires staying with things that make us want to run.

So ‘I feel uncomfortable’ cannot be the only test. Neither can ‘my therapist says this discomfort is good for me’.

When doubt appears, there are still things you can look at.

Can you disagree?

Can you tell your therapist that their interpretation is wrong? That something they said hurt you? That you don’t want to do something they suggested?

More importantly, what happens after you do?

A therapist doesn’t have to agree with your account of everything. But there should remain room for two minds in the room.

Can the relationship survive being examined?

Therapists misunderstand. Clients misunderstand. People disappoint each other. Therapy can become repetitive, irritating, confusing or temporarily worse.

A rupture is not necessarily evidence of bad therapy. Sometimes enormously important work begins there.

The question is whether the rupture can itself become part of the conversation.

Can your therapist become curious about their contribution? Can you examine yours without automatically being assigned all of it? Can something change between you after the conversation?

Are you becoming more yourself—or better at being their client?

This can be surprisingly difficult to notice.

Over time, every therapy develops a language. You learn what your therapist notices, what questions they ask, perhaps even what explanations interest them.

That shared language can deepen the work. It can also quietly become something you perform.

Occasionally it is worth asking whether therapy is making you more capable of encountering your own experience—or merely more fluent in your therapist’s understanding of it.

Is there room for not knowing?

Good therapy can produce insight. It should also be able to survive uncertainty.

Be cautious if your therapist always knows what your silence means, why you chose a particular partner, what your resistance signifies or which childhood experience explains the present.

Human beings are too complicated for that kind of certainty.

An interpretation can be useful without becoming a verdict.

Is something moving?

Not every difficult period is stagnation, and change is rarely tidy. Sometimes nothing visible changes for months while something less obvious is being understood.

But particularly in long-term therapy, it is reasonable to ask occasionally: What are we doing here now?

What has changed? What hasn’t? What keeps repeating? Have your reasons for coming changed? Does the way you work together need to change too?

A long relationship should not make those questions forbidden.

And finally, don’t demand certainty from yourself either

You may like your therapist and doubt the therapy. You may be furious with them and still be doing important work. You may feel deeply attached and eventually decide to leave. You may want to leave and discover that talking about leaving changes something. You may have an excellent therapist who is nevertheless not right for you. You may also reach the limits of what your therapist is able to offer.

There isn’t a reliable feeling that announces, Yes, this is definitely the correct therapeutic relationship.

Perhaps choosing a therapist is less a decision you make once than something you remain capable of examining.

At the beginning, you know very little. So check what can be checked, notice what happens between you, and allow some uncertainty.

Years later, the same principle may still apply.

You don’t need certainty. But you do need enough freedom within the relationship to keep asking whether you want to be there.