The savvy consumer's guide to picking a therapist

Friends sometimes ask how to pick a good therapist.  Since I can't just say say "Me!" I have had to give this some thought.  So here's what I say...

1.  It is reasonable to be concerned about price

Therapists want to make money doing what they like to do and -- within reason -- therapists can set their prices based on the market.  Therapists who are highly sought after can charge up to 135$/hour.   Some professionals (me included) offer a sliding scale based on your income, others don't.  Here in Quebec, there can be a difference in price of around 65$ per session depending on who you see.  That can add up over ten or twelve or more sessions.  Figure out what you can afford to pay and then look around and see if you can match that.

2.  Membership in a relevant professional order (Boring but important)

There are a lot of different kinds of professionals who can offer therapy in Quebec.  The biggest difference for a member of the public is that medical doctors, including psychiatrists, can prescribe medications and nobody else can.  Aside from that there isn't a hard and fast rule about whether a social worker or a psychologist or a drama therapist is going to work better with a particular kind of person or problem.  Whatever his or her professional training, a therapist should be a member of his or her professional order, the Order of Social Workers and Family and Couple Therapists, the Order of Psychologists, the College of Physicians, the Order of Occupational Therapist etc.  There are three reasons; one, a professional body has looked at this person's professional qualifications and said "S/he is able to do the work."  The second reason is that the person is bound by a code of behaviour which you can read.  If you aren't sure whether the person has the right to ask for payment in a particular way, for example, you can check (For example, I cannot take barter according to my professional order.  Sorry, cabbage growers).  Finally, if you have some dispute with the person or if you think his or her behaviour is unprofessional, you have an organization that serves the public interest that you can go to. 

Here in Quebec we have a new licensing regime which requires everyone practicing psychotherapy to become a licensed psychotherapist with the Order of Psychologists whether or not he or she is a psychologist.  So whether someone is a drama therapist or a nurse or a couple and family therapist she or he will eventually need to be licensed for psychotherapy by the order of psychologists.  Among other things, this means that the fabulous art and drama therapists of Quebec -- who haven't had a professional order until now -- now have a place to hang their hats.

3. Clear goals

A therapist should work with you on setting realizable goals for therapy.  If a therapist doesn't ask what you want to achieve and can't say what you are working towards and it is something that you want then you should look for someone else. 

4. You should feel heard

This will come and go.  Sometimes I do a better job listening than other times.  But if my clients don't feel heard and understood most of the time then I am not doing my job. 

5.  Non-defensiveness

You should feel like you can talk to your therapist (politely) about the therapy including what isn't working.  Recently a client told me that she was really mad about something I had said in a previous session.  I was glad because if she had just continued being angry without raising it we wouldn't have gotten very far.  I spent a lot of time asking her about what had bothered her so much and when I understood better why it was so hurtful for her, I apologized and we talked about how I could avoid doing something similar again.   Most therapists are happy to have this feedback.  If you don't feel like you can, then you need to consider whether you can really get what you need out of therapy with this person. 

6. Professionalism

A therapist should be professional about how s/he conducts business; timely, efficient, knowledgeable, organized, respectful of you. 

7. Strong

You should feel that your therapist is strong enough, emotionally, to be able to hear things that are painful for you without falling apart.  You should not have to worry about taking care of your therapist.  Some people have a very hard time with this.  Because they are used to caring for others, it can be hard for them to let go and be cared for.  But if you don't feel that your therapist can handle your hurt, you need to talk about that with him or her and if you can't resolve it then s/he may not be right for you.

8.  Recommendations are helpful, but only to a point. 

At this point in my shpiel people usually ask for names.  I can give names of therapists I like and admire but fit is important.  Ultimately it doesn't matter that much what I think.  What matters is, do you feel good about this person.  If you try therapy with someone that I recommended or your best friend said was amaaaaazing and after two or three sessions it isn't working, take that seriously.  Talk about that in therapy.  You may find that turns out to be really helpful.  It gives the therapist the chance to adjust.  But If that doesn't work, try someone else.  It doesn't mean therapy isn't right for you and what you want to deal with.  It doesn't mean the therapist is no good.  It may just mean that the fit between you and the therapist wasn't right. 

Good luck and please leave comment about what has helped you find a good therapist or how you would suggest a friend make a choice.