January 09, 2023

By Vincent Atchity

Therapist talking with person
It’s estimated that nearly one in 10 Americans go to therapy over the course of a year, and nine out of 10 therapists reported witnessing growing demand for counseling during the pandemic. There’s no doubt that psychotherapy can be helpful for many, and it’s wonderful to see growing numbers of Americans taking this important step on their self-care journeys.

It’s also incredibly important that those seeking out therapy know that not all mental health professionals have the same training and specialties — and finding a convenient therapist is not nearly as advantageous as finding the right therapist. By taking some time to reflect on your needs and research therapists before diving into therapy, you are far more likely to reap the benefits that this kind of health care can bring to your life.

No matter who you are, the first step toward finding the right therapist is identifying your needs. Questions you can ask yourself to get a gauge on what you are looking for include: Where do I stand on medication? Am I looking for short-term support or longer-term therapy? And am I open to alternative pathways to well-being?

Once you have established this foundation, here are three questions you should ask a prospective therapist to be sure they’re a good fit:

1. How Do You Address Unconscious Biases and Judgments When Working with Your Clients?

Unconscious (or implicit) biases are judgments or social stereotypes we hold about others without recognizing that we are doing so. In many cases, these unconscious biases allow us to function as humans in our increasingly complex world, but they can also perpetuate racism, sexism, ageism, ableism and many other forms of discrimination. Therapists, social workers and psychiatrists are all human and therefore carry unconscious biases.

The mark of a mature, capable therapist is their ability to acknowledge when their personal judgments arise and to then provide mental health care in a way that does not perpetuate harmful stereotypes and biases. A therapist who denies the existence of unconscious bias is likely not the best person to work with. Instead, therapists should assure you that they are aware of their biases and actively employ tactics to ensure their judgments do not interfere with the care they provide. Better yet are the mental health professionals who actively seek out training opportunities to fine-tune their sensitivity to implicit biases.

To get a better sense of the judgments your potential therapist might carry, it is well within your bounds to ask about their religious or ethical formation and how it influences their practice. You might also get a sense of their cultural competence by asking the question, “What experience do you have working with someone like me?” This will help you discern their experience — and success — in working with individuals who share your cultural background, religious formation, sexual or gender identity, or role as a parent, caretaker of aging parents, first responder, veteran or refugee or any other characteristics you may identify with.

2. Are You Open to Alternative or Non-Pharmacological Pathways to Well-being?

A very common method for addressing mental health challenges in this country is the prescription of pharmaceutical drugs, and nearly 16% of American adults take medication to address symptoms tied to mental health in any given year. Medication can be a wonderfully effective pathway to healing and better quality of life for many people, but it is not the only path forward.

As it best aligns with your own values, it is important to ask possible therapists about their outlook on using prescription drugs to treat mental health issues. Your ideal therapist’s commitment to pharmacology and their openness to alternative pathways to well-being (such as yoga, prayer, meditation, exercise, nutrition and more) should mesh well with your own. Determining what other practices or non-pharmacological substances they incorporate into their therapeutic approach can drastically help you narrow down your list of potential providers.

It’s also worth noting that most psychologists are not licensed to prescribe medication directly, and that role typically lands with psychiatrists and primary care providers. If a care provider rushes to prescribe a complex pharmaceutical with numerous side effects without asking you about what you eat, your activity levels or how much time you spend outdoors, they’re missing some of the essentials of well-being, and may not be the right fit for you.

3) How Do You Set Goals and Progress Milestones with Your Clients?

It’s no secret that therapy can be incredibly expensive in the U.S. Some estimate that an average session can cost anywhere from $65 to over $250, even for those who have health insurance. To ensure that you are not spending your money on ineffective counseling sessions, it’s important to ask your prospective therapist how they measure success and hold themselves accountable in their efforts to help patients make meaningful strides toward better mental health.

A great therapist will accomplish this by setting goals at the onset of treatment that you will periodically revisit together. They might also work with you to set goals that are uniquely meaningful to you. No matter their treatment style, every great therapist will have an answer to this question, and their response should leave you feeling confident that you trust their approach to managing your mental health.

Maybe what you want most urgently is to recover the motivation to get out for a morning walk with your dog. Or, perhaps, you want to come to terms with the emptiness of your home after children have left to begin their adult lives. A good therapist will help you identify your objectives in specific, measurable terms.

Of course, it’s important to acknowledge that for many, therapy remains a privilege — and in the most serious cases — any therapist may be better than no therapist at all. But if you are fortunate enough to have a choice in the matter, it is imperative that you do your due diligence and choose a therapist that makes you feel comfortable, seen, valued and supported. 

Vincent Atchity, Ph.D., is president & CEO of Mental Health Colorado, a state affiliate of Mental Health America. He has worked nationally to disentangle mental health and criminal justice, and he has served on two Colorado governors’ behavioral health task forces and the Colorado Opioid Epidemic Symposia Steering Committee. Follow him on Twitter @atchityCO.

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