Mind Mental Health

How to Choose a Therapist and Prepare for Your First Appointment

January 23, 2020
A therapist speaks with a client.
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Quick Read

Good therapists meet you where you’re at

  • They make you feel respected and understood.
  • They help you set goals for yourself.
  • They have skills that match your needs.
  • They will challenge you and help you find strength in yourself.

You scroll through the profiles, find a few people who look promising and reach out to them, asking about them and sharing about yourself, then finally arranging a time to meet in person.

 You’re a little nervous. What if you don’t find a good match? 

No, you’re not arranging a Tinder date. You’re looking for a new therapist.

Though finding a therapist doesn’t involve swiping right or left, it’s not all that different from the dating process. You’re looking for someone who will be a big part of your life, who will know things about you most people don’t, and who will need to respect your goals and boundaries. 

It’s a big commitment.

“There are as many different styles as there are therapists out there. It’s really important to have somebody you feel respected by and somebody who understands and listens very well,” says Dr. Erin Gonzalez, a clinical psychologist at UW Medicine and Seattle Children’s. 

What if you’ve never been to therapy and aren’t sure what to look for in a therapist? Or maybe you’ve gone before but things didn’t go the way you’d hoped? Read on for how to deal with any hesitancies you might have and how to find a therapist who’s right for you.

If you’ve never been to therapy before

Deciding to start therapy is a big step toward feeling better. First, congratulate yourself on being willing to make change in your life and help yourself. It’s not always an easy thing to do. 

If you’re feeling a little overwhelmed or hesitant about therapy, however, Gonzalez wants to reassure you that it’s not the stereotype you see in movies.

“There is now lots of science showing how therapy helps with all kinds of difficulties in life as well as with mental health. We no longer expect people to lie on a couch and tell their darkest secrets,” she says.

Trying therapy also doesn’t mean you have to commit to it indefinitely. 

“It’s OK to tell yourself you’ll try a first session with more than one therapist before making a final decision on whether therapy is right for you,” she says.

Talking with a therapist on the phone before making an in-person appointment is a helpful way to ease yourself into the idea of therapy versus jumping right in; plus, it gives you a chance to screen potential therapists and make sure you find one who’s a good match.

And if you find yourself feeling embarrassed or ashamed of the idea of therapy, Gonzalez hopes you’ll think of it more like getting help for any other medical issue, like a sprain or a bad cold. 

“If you had a physical health problem and your doctor recommended physical therapy, would you feel the same way? Mental health struggles are not a personal fault. Everyone has times when they struggle and could use support,” she says.

If your past therapy experience didn’t go well

If you have gone to therapy before and didn’t have a good experience — either because the therapist wasn’t a good match, you didn’t see the improvements you wanted or something else — it can be hard to get up the courage to go again. 

But just because your first experience didn’t go the way you wanted doesn’t mean subsequent experiences will also fall short. It also doesn’t mean you failed in any way or that it’s not worth trying again.

“Sometimes people try therapy with one counselor and they don’t feel they can be themselves or open up; that can be a matter of personal connection or personality, something that might be completely different if that person tried a different therapist,” Gonzalez says.

It’s also possible it just wasn’t the right time in your life to try therapy, she says. Maybe you had too much else going on and couldn’t devote enough time or attention to it, or maybe you just weren’t ready to confront your problems yet. 

No matter the reason, if you’re interested in trying again, go for it. You don’t have to make any commitments until you’re certain you’ve found the right therapist. 

What to look for in a therapist

Just like dating, the first person you find probably won't be "the one," but there are things to keep in mind that can increase your chances of finding a good match. 

Here are some qualities to look for in a new therapist and how to prepare for your first appointment.

They’ll meet you where you’re at

You want a therapist who can jump in and help right now, wherever you’re at in life. When you talk with them, you should feel that they are really listening to you and never judging you. 

“You want to have a first session where you feel the therapist understands something about you and what you’re experiencing,” Gonzalez says. 

If you feel like they’re misunderstanding, that you have to over-explain yourself or that they’re bringing their own opinions into the discussion, it’s probably a good idea to look elsewhere. 

They’ll challenge you

One misconception about therapy is that just the act of going will magically solve all your problems. 

In reality, therapy is hard work and is often challenging. It can be uncomfortable, especially when you have to confront truths or feelings that are particularly painful. 

“Therapy should change and should feel challenging at times, or else it’s probably not helping,” Gonzalez says.

This doesn’t mean your therapist should push you to confront your deepest fears or insecurities from the start. Rather, the challenge of therapy should show up gradually over time as you slowly work to build resilience and strength. Look for a therapist who indicates this is part of their approach.

They’ll teach self-reliance

Of course, you want your therapist to be there when you need their help — but you don’t want someone who makes you feel dependent on them in order to make progress. 

Instead, your therapist should help you discover your own power and strength.

“As time goes on you should feel like you’re gaining confidence in dealing with challenges in your life and coping and solving problems on your own, versus feeling like you need more and more help from your therapist,” Gonzalez explains. 

This means they will push you to improve on your own — with their guidance — instead of teaching you to rely solely on them.

Gonzalez says it’s important to think of your therapist like a coach. 

“They’re going to be guiding you and encouraging you and giving you direction, but the bulk of the work has to be done by you,” she says.

They’ll tell you about their approach

Each therapist has their own approach to providing care, and it’s important to know what that is if you want to start working with them. 

Therapists shouldn’t be reserved when talking about their particular approach that they developed over years of education and practice. They should be able to tell you about their therapy style and work background and how both will inform their work with you. 

If they aren’t able or willing to tell you these things, that’s a red flag, Gonzalez cautions.

Their training will meet your needs

You also want to make sure their approach meets your individual needs.

“If you’re looking for treatment of a mental health problem like anxiety or depression, you’ll want a therapist using an approach that’s proven to be effective,” Gonzalez says.

Evidence-based treatments for mental health disorders include things like cognitive behavioral therapy for anxiety and depression, and dialectical behavior therapy for borderline personality disorder. 

If you’re really struggling with a mental health issue, talk therapy alone might not be enough to help you. If instead you’re looking for someone who can help with more general things, like stress or relationships, going to someone with specialized training probably isn’t as important, Gonzalez says.

They’ll set goals and a timeline

While your therapist should help you come up with goals you want to reach in therapy, they shouldn’t set them for you. Instead, you should both come to an agreement on what you’ll work on, in what order, and use that as a blueprint for how your time together will be spent.

Your therapist should also help set goals for how long you’ll be in therapy, with a specific plan in place. It’s common for therapy sessions to be more frequent at first then taper off as you build skills that you can use on your own. 

While you want your therapist to be flexible, having an open-ended timeline isn’t helpful because it doesn’t set up any milestones for you to work toward.

“A red flag would be if a therapist tells you that you may always need therapy,” she says. “Good therapy is time limited like any medical treatment.”

How to prepare for your first appointment

For your first appointment with a new therapist, spend a little time beforehand thinking about what you want them to know about you to help them understand who you are. 

This can include things like specific issues you want to work on, formative experiences in your life, aspects of your identity or background that are relevant, what you’re passionate about, and what’s currently going well in your life. 

Gonzalez also recommends having a few goals in mind before you step into the therapist’s office. 

“Imagine three months from now what would you like to be different in your life so your therapist can have that vision,” she says.

If you’ve already spoken to them and had some of your questions answered on the phone, this is the time to ask any follow-up questions you have. 

If you haven’t talked yet, the first meeting is a good time to hear about their specific treatment approach and what types of issues they specialize in helping with. 

Generally, therapists will focus the conversation on you and won’t talk much about themselves. This is standard, and while you probably don’t want to ask prying personal questions (even while they get to ask those questions of you; we know, it’s not fair) it’s totally OK to ask about their education or career or any other aspect of their professional background that you’re curious about. 

After your first appointment

Once you’ve met with a potential therapist, it’s important to take a little time to replay the meeting in your head and be honest with yourself about how it went. 

Did you feel comfortable? Did you feel heard and respected? Listen to your gut and don’t dismiss small things that could become bigger problems later on. 

If you didn’t click with the first therapist you met, it could seem like a hassle to try to find another one — but ultimately it will be worthwhile. A good therapist will make you feel encouraged and make you want to continue the work because you know it will pay off in the end. 

“A first session can be hard because you’re talking about things that are personal and getting to know each other, but you should leave feeling that they heard you and that there’s hope for things improving,” Gonzalez says.

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Editor's note: This article was updated on February 3, 2020, to make a clarification about what dialectical behavior therapy is for. It is primarily used to treat borderline personality disorder, not bipolar disorder.