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How to Choose a Therapist

Updated: May 17, 2022

When is therapy helpful?


I'm a huge fan of going to therapy, but it's good to know when it's going to be most helpful or when something else, like working with a life coach or support group, might be more helpful.


To help with the decision-making, here are some of the differences between coaching and therapy:

  • Working with a life coach, the coach delivers the content and facilitates an experience related to their specialty or expertise

  • In therapy, the work is client-guided. So if you were going to therapy, you would go in with what's called a "presenting problem"—a specific thing you want to work on or a specific experience you're having trouble with.

  • Coaching is often curriculum-driven, offering a specific curriculum for you to follow and work through.

  • Therapy is circumstance driven. The work you do in therapy will flex and flow with what's happening in your life. As new things come up that change or alter your circumstances, that impacts the therapy work.

  • Coaching often focuses on learning broad, foundational changes.

  • In therapy, the focus is on processing and working with a specific problem.

  • Coaching often incorporates immersive work you do on your own to help you experience, process, and integrate everything you're learning.

  • Therapy relies heavily on the format of talking during weekly or bi-weekly sessions. Some therapists assign homework, while others don't.

  • Coaching often follows a program for a set amount of time, with the option to discuss further support if needed after the initial program has been completed.

  • Therapy is open ended and can go on for months or years, depending on the goal and the focus.

  • Coaching is not regulated the same way therapy is, and this means a few things. You can work with anyone you find who is your jam. You'll need to do your own reading about their background to determine if you feel comfortable with their level of expertise and experience.

  • Therapy is regulated by state laws and licensing boards, which means that you can only work with people in your state. That licensure doesn't guarantee expertise or experience beyond what is required by the state.

Both therapy and coaching can be hugely beneficial, but it does involve choosing the right person.


Looking for a Therapist


The important thing to remember is therapy is simply one component of your healing. Depending on your presenting problem, some therapists may ask you to get a physical so you can both have a picture of how your physiology is being affected. Personally, I ask my clients to take up some kind of movement practice—yoga, walking, anything that gets them moving, simply because this is a vital way that our body heals and it makes it easier for you to deeply integrate therapy work.


Which brings me to another important point—the therapist cannot heal you. The therapist is the expert about the mind, behavior, relationships, attachment, emotional experience. You are the expert about you and your life. Therapy is the process of putting those two expertises together, and the work is done by you, the participant. No one else can do our inner work for us.


When you're thinking about going to therapy, I recommend writing down your problem in your own words. Write down the symptoms or effects that are most difficult for you, in your own words. I say to do this in your own words, because we're inundated with a lot of pop-psychology and pharmaceutical commercials, sometimes we get fed the words we're supposed to say. Like, "If I have A problem, then that means I have B symptoms." Define your experience in your own terms. Also know that the presenting problem is almost certainly not the whole of the problem. You will probably discover layers once you get into the work of therapy, and that's good, that's what it's there for.


Next you move on to finding a therapist. This can feel overwhelming if you've never done something like this before. You can ask around if anyone you know has a therapist they enjoyed working with, and then ask if they have a website or a business card so you can look them up on the Internet. It's great if someone else likes them, but that doesn't necessarily mean they'll be a good fit for you.


You can also find a therapist by looking online. I recommend TherapyDen.com. It's the most inclusive listing and search site I've found. When you go there, make sure to click "or, search by gender, ethnicity, cost and more."

When you click that, here's what the different category filters will help you find:


Service

This is where you choose:

  • Individual

  • Couples

  • Family

  • Child

  • Adolescent/Teen

  • Group

  • Medication Management

  • If you are on psychotropic/psychiatric medications, I do recommend finding someone who is able to help with medication management. You will probably be seeing your therapist more often than you see the prescribing doctor, and they will be able to help you monitor progress and side effects, as well as consult with your prescribing doctor under your consent.

Specialty

This is where you select the specific issue(s) you are seeking help with.


Insurance

If you live in the US and have mental health insurance coverage, congratulations! Even if you do, be aware that some insurance companies require a diagnosis from your therapist in order to cover your sessions. That information does not stay confidential, but gets shared with your insurance company. Some insurance companies also dictate the treatment techniques that can be used or the amount of sessions they will cover.


Cost

You can choose a price range you are comfortable with.


Specialized Experience

This is where you can choose to filter for therapists who have special experience for:

  • Body positive/Health at every size

  • Racial justice framework

  • Sex-positive/kink friendly

  • Trans-competent

  • Queer-competent

  • 12-step friendly

  • Veterans

  • Sex worker positive

  • Open relationships/non-monogamy

  • Psychedelic Integration Therapy

  • Vegan

More Filters

Make sure to select whether you are looking for online or in-person visits. You can also select for free consultation, ADA and gender accessibility, LGBTQ affiliation, language, therapist gender and ethnicity, and faith.


A note about Treatment Techniques:


What this means is there are a lot of different theories or approaches to counseling. Cognitive Behavioral Therapy is a theory. Existential therapy is a theory. Adlerian therapy is a theory. Psychodynamic therapy is a theory. Typically, therapists work from one or a few theoretical approaches that inform how they work with participants. You do not need to learn all the theories. I'm going to tell you which theories I like and which ones are most common.


CBT is probably the most common theoretical approach right now. It's popular because insurance companies love it. It follows a manual and they can prescribe the number of sessions it should take you to get through the work. There is some research support for CBT and similar therapies that work from an outside-in perspective—these work on correcting your thoughts and behaviors with the goal of those changing your emotional experience. These tend to work best for more surface level problems, like I have a phobia of snakes and want to take my child to the zoo. Or, I'm feeling depressed about this specific change in my life.


However, if the reason you're afraid of snakes is because you were there the day Harry Potter let the snake out from behind the glass barrier, and it slithered right over you and you were afraid for your life, and that was a traumatic experience for you, then CBT probably won't help you. Or if you're feeling depressed about graduating college and that's weird! You should be happy! But it's actually related to your family's story around success and money and your experiences around that, CBT will only be able to help directly with the transition out of college, not all the underlying stuff.