Finding a Good Therapist: When You’re Ready to Ask for Help
Written by Renee Brush, Ph.D.
I went my whole life feeling like I was different from others and that I didn’t fit in anywhere - not even in my own family. I knew I didn’t feel good about myself and knew it needed to improve, but never really knew how to do that. Looking back, I realize that my mother really never knew how to handle my emotions, so I was always told I couldn’t be mad or sad. I was never taught how to handle my emotions. Because this is the family I was raised in, it was normal to me and I didn’t really know it could be different.
I have shared with you that I was bullied in the past by a couple different people - and the one person became my “best friend” for three years. That person became my whole world in those three years, but I did not realize how I was being manipulated and controlled. The relationship ended - not because I got wiser and started setting boundaries - but because her parents thought we were lesbian lovers and ended the relationship for us. My mom had made it clear to me for at least two of those years that this person was manipulating me, but did not make efforts to stop it because she knew it would create more of a rift between us. But, after the relationship ended, she did something very weird… she talked to the girl’s mom (they had become friends over time - this is the same mom that she told me later she could say whatever she wanted to her, even if it hurt me) and suggested she take this girl to therapy.
Why is that weird? Because she did not do the same thing for me. I was left to handle the fallout alone. To figure out alone how to go on when everything I had been told for three years was a lie. To learn alone how to live without this person who had been my everything for three years. To live with the shame of believing what she had told me all that time. Alone.
Shortly before my mom passed - when I was in my early 40s - I asked her why she never took me to see a therapist when that relationship ended. She replied, “Because you were fine.” I acted fine. I looked fine. I didn’t cry. I didn’t hide in my room. I didn’t isolate. In fact, I was with the family more. I was out of my room more. And that is what she wanted.
But I was NOT fine. I was never fine. What she didn’t know is that it started way before that relationship ended. I didn’t really know either, to be honest. Because that was my normal. But I kept feeling like I didn’t fit in. Like I didn’t belong. And I was tired of feeling stuck, of not knowing how to move forward, of not knowing how to feel better about myself.
And then around that same time, I had a teenage daughter who was having some trouble. I was back in graduate school, learning to be a clinical psychologist and now I could see the damage my own mental health issues were doing to her. So I took her to get some help. A friend had recommended a therapist for my daughter to see. And, soon after, I decided I needed a therapist too. I chose someone in the same practice. Honestly, I chose Deborah because something in her bio resonated with me. Her description sounded like something I needed. And she took my insurance. That is the level of research I did to find my therapist and I got VERY lucky.
In all transparency, I need to add that Deborah is actually my third therapist, though I honestly had forgotten the first two. My first therapist was a counselor in the student center at my undergraduate school. I saw her several times and she was very nice, but I didn’t see her too long, though I cannot remember why. I saw the second therapist after I separated from my first husband. I only saw her about six times. Looking back, I found her to be too rigid and she made aggressively challenging comments without considering where our rapport was. I had not built up enough trust for her to come at me the way she did sometimes. Since being a therapist myself, I have had clients who come to me after their own bad experiences with a therapist. That is very unfortunate and I really hope that I can help you make a better decision if you want to find a therapist!
Why Do I Need a Therapist?
If anything about my story hits home for you, then you may need a therapist too. And honestly, even if you are not like me, you can choose to find a therapist simply because you want someone to talk to! That is fine! But many people are like me - they have experiences in the past that they have not been able to move past or to forget. Those experiences may keep them in bed or stuck at home or in a bad marriage or a bad job. They may believe that they deserve better but do not know how to make it happen. That is where a therapist can be helpful.
It is my belief that if you have a history with chronic and repeated abuse - which is known as complex trauma - healing really requires a therapist. A therapist might be the first person to let you know that your experiences are actually NOT normal. A therapist also will help you to learn coping skills, to identify situations that trigger you, and to learn healthy relationship skills. In fact, most of the healing that takes place in therapy occurs as part of the relationship between you and your therapist. Certainly your therapist will help you have better relationships with others, but those interactions with your therapist are where you practice those skills first. This is why choosing your therapist is so important.
Now having said all this, the only reason for you to see a therapist is because YOU want to see one. Any other reasons are just icing on the cake, so to speak.
How do you find a therapist?
The mechanics of getting a list of therapists are not too difficult. If you have insurance, you can first check with your insurance company to see who is “in network” with them, which simply means that the therapist has agreed by contract to take money from the insurance company to see you. You can get a list of therapists in network either by calling the number on the back of your card or by using the patient portal to search for therapists near you.
An alternative to using your insurance company’s list is to ask friends and family members if they have heard of good therapists to get recommendations. A potential downfall to this is some counselors will not agree to take on new clients that know current clients as this could cause some ethical issues. This will depend on a number of issues (e.g., in smaller towns, there are fewer available clinicians so they may be better prepared to deal with it), so it is best to simply ask and be open to the answer.
Another alternative is to search for local therapists on the internet. You can search through Google or try search engines like Psychology Today, Therapy Den, or Good Therapy. On those engines, you can search for the type of therapist in the location that you want.
Once you have a list, the next step is to call the people and find out who is taking new clients. These days, that is the biggest challenge. Most practices are likely to have wait lists, so you may need to call around to quite a few places. And, if someone is offering you a wait list, it is ok to put your name on the list, but not take a spot later when it is offered, especially if you find a therapist before they call you. It is difficult to find a therapist right now, so do whatever is needed to increase your chances of finding one.
On a side note, if you are a student going to college, check with your school. There may be a student center that offers free counseling services for students registered for classes. These services are usually offered by graduate students who are learning how to be therapists.
The beach in Virginia Beach, where I often go to clear my head
But how do you choose a good therapist?
So, with any luck, you now have a therapist, but how do you know that this person is actually any good?! This is where it gets a bit tricky!
Here is my list for deciding if a therapist is good. And, honestly, it is based off of the things I like about my own therapist, Deborah. Is this a research-based list? Ummm, no. But, as a therapist, these are traits in her that I try to emulate in my own practice so they are important to me.
The thing I love most about Deborah is that she accepts whatever I say without shaming me. I once made a comment that my life would be so much easier if so-and-so were not alive - and, without even blinking, she agreed with me. Honestly, I was shocked, but it was so freeing to have her agree with me without any repercussions from her. This has helped me learn how to live and speak authentically.
Related to that, if I have ever shared with her about how someone hurt or insulted me, she was just as mad at them as I was! Even as I backed off my anger to give them some credit (because I always did since I was trained to be that way), she stayed in the anger full force! I get it - she was holding that anger for me until I could feel it full force myself. It showed me that my anger was valid. And it is so comforting to know that this one person is on my side, no matter what!
I have learned to trust her over the 10 years we have worked together. All of the exchanges I am describing to you helped build this up. But, even from the beginning, I felt comfortable and safe with her. What I am describing is a somatic reaction that, as a culture, we often scoff at, but it is very important.
She knows how best to challenge me. This part can only happen because she did build that trust and rapport with me. She knows me well enough to see when my fears are holding me back from something and that is when she encourages me. She often says something like, “What would it look like if you did [this thing]?”
If she is ever wrong about something, she apologizes immediately and then is sure to change her behavior. I remember once I was sharing something and she started talking about “self-sabotage.” We processed it and my response made it clear it was not self-sabotage. I wasn’t blaming her. It just came up that way. Before I could even really say anything, she profusely apologized, acknowledging that her comment was victim blaming, adding that she never meant to do that. That phrase has never come back up. This is probably the most important trait on this list because I never got this from anyone in my life. And it brought me to tears when she did it. As a society, I don’t think we give enough credence to accountability and that is unfortunate.
She knows about trauma. One of the reasons I chose Deborah is because she knew EMDR and instinctively I wanted that as part of my therapy. But, as I have grown professionally, I have come to realize how knowing about trauma is vital to do well in this profession. Therapists who do not know about trauma, unfortunately, are very likely to retraumatize their clients. They don’t have to be “trauma certified” but having training in the area is important.
Deborah holds a good balance of sharing personal experiences to help make a point and holding space for me. In graduate school, they often teach “don’t self disclose.” But, I remember when I worked one time as a mental health technician in the addictions unit at an acute-care psychiatric hospital, I had a patient ask about my own addiction history. He said, “We have to know you’ve been there before we can work with you.” There is something trust-invoking when two people share similar experiences. But, a therapist needs to know the balance. You do not want to have a therapist who talks only about themselves. But having your therapist share a similar experience helps normalize your experience so you don’t feel so alone.
I would be remiss to mention that affordability is also important. At the beginning, I said I chose Deborah in part because she took my insurance. There was a whole year over the past 10 years where I did not see her because I did not have insurance and could not afford to pay cash. But, when I could afford it, I returned to see her. Another time when I lost my insurance but still wanted to see her, she worked with me on the cost of her sessions. She did not have to do that, but her actions show she is coming from a place that is client-centered. Healthcare is incredibly difficult these days, but hopefully research will help you find the right person for you.
When I started this article, I had planned on adding research to it about what research makes a good therapist. Obviously that did not happen, though I am planning a second article where we can go into that. But, what I do remember from graduate school is a good therapist is all about the relationship.
So, I’m going to leave it here - sharing about my own relationship with my therapist, who honestly has been more like a mother to me than my own mother. If you have decided this is what you need, I hope you can find someone who helps you in a way that is just as meaningful to you.
One caveat, if you find it difficult to trust people and you do not yet have a felt sense of safety (that “yes” energy we have discussed before), then I encourage you to be willing to give the person a chance and commit to several sessions to really get a good feel for who this person is. And notice how you are feeling before, during and after the session. Therapy could make you feel anxious, but, if after the session, you feel a tiny bit better, then you may have found yourself a good therapist like Deborah!
