How to choose a therapist who is right for you

You’ve decided. After months (perhaps years) of weighing it up, you’re ready to find a therapist — and immediately run into the next obstacle: which one? The websites all look alike, the titles sound mysterious, there are dozens of therapeutic approaches, friends’ recommendations contradict each other. And the question that worries you most is entirely reasonable: how am I supposed to know whether this person is right for me?

The good news: choosing a therapist isn’t a lottery. There are things you can check, questions you’re allowed to ask and — most importantly — feelings you’re allowed to trust. In this piece I’ll give you a practical map: what to check before first contact, how to make use of the introductory session, which red flags to take seriously, how changing therapists works, and how much the therapeutic approach should weigh in your decision.

First things first: look for fit, not perfection

If you take one single thing from this piece, let it be this: decades of psychotherapy research consistently show that the quality of the relationship between you and your therapist is one of the strongest predictors of a good outcome — as a rule stronger than the choice of any particular method. The large review analyses led by John Norcross and Bruce Wampold confirm this again and again: therapy works through the relationship that carries the technique, not the other way round. Why that is, and what actually happens in a good therapeutic relationship, I’ve described in detail in the piece on why the therapeutic relationship heals — here let me draw out only the practical consequence.

And that consequence is freeing: you aren’t looking for “the best therapist in town”. You’re looking for the therapist who is best for you — a person with whom you’ll be able to be open, to feel safe and challenged at the same time. A therapist who worked wonders for your friend can be entirely the wrong choice for you, and vice versa. So the decision isn’t made by qualifications alone; it’s made by a combination of verifiable facts and your own sense of things. Both count — and we’ll now take both in turn.

Step one: check the training and the practical frame

Before you even get in touch, check a few basic facts. The title “psychotherapist” in Slovenia isn’t (yet) as strictly protected in law as it is in some other countries, so a degree of self-protection is in order:

• Education and training. A serious therapist has completed several years of psychotherapy training (not merely a weekend course) and states it clearly: which approach, where, how many years. If that isn’t on the website, ask.
• Status and supervision. Check whether the therapist is a member of the professional association for their approach and whether they work under supervision. Let me be open about myself here: I’m a therapist in training in marriage and family therapy, which means I regularly review my work with an experienced supervisor — and I state that clearly on my My Approach page. Transparency about one’s own status is in fact a good litmus test: a therapist who says honestly where they are on their path is likely to be honest about everything else too.
• Understand who’s who. Psychotherapist, psychologist and psychiatrist are three different professions with different competences — who prescribes medication, who diagnoses, who conducts therapy I’ve explained in the piece Psychotherapist, psychologist, psychiatrist.
• The practical frame. Location and accessibility, appointment times, cost, the option of online sessions, work with couples or families if that’s what you’re looking for. Therapy is a marathon — a frame you can’t sustain long-term isn’t a good frame, however excellent the therapist.

Where to look in the first place? Good starting points are the directories of the professional associations of individual therapeutic approaches (they list therapists with verified training), a recommendation from your GP or a psychiatrist, and recommendations from people you trust — with the caveat I mentioned above: a recommendation tells you that a therapist helped someone, not that they’ll suit you. Once you have two or three candidates, look through their websites and writing: the way a therapist writes and talks about their work often tells you in advance whether their language feels close to you. Many (myself included) also offer a short introductory phone call or answer questions by email — make use of that before committing to a first session.

Step two: the introductory session is a two-way interview

An introductory session isn’t an exam in which you’re being assessed. It’s a conversation in which you too are assessing the therapist — and a good therapist knows this and even makes room for it. (How an introductory session works in general I’ve described step by step in the piece on the first session with a psychotherapist.)

After the session, take a few minutes and ask yourself honestly:

• Did I feel heard? Not necessarily fully understood — one session is too little for that — but: did they really listen? Did they summarise in a way you recognised yourself in? Or did they listen only long enough to be able to say their piece?
• Can I say no? This is my favourite test. Imagine contradicting the therapist, turning down their suggestion, saying you disagree with something. Does it seem they’d meet that with interest — or do you sense they’d take offence? Therapy is full of moments when you’ll need to say “that isn’t right” or “we’re going too fast”; you need a person with whom that will be possible.
• Was there enough room for me? A sense that the session was about you, not about the therapist and their theories.
• Can I go into the hard places with this person? Don’t ask whether you’d enjoy their company over coffee — ask whether you can imagine saying the hardest thing to them.

You don’t have to rely on a blind impression here either. The researchers Mick Cooper and John Norcross have even developed a preferences questionnaire (the Cooper-Norcross Inventory of Preferences) that helps put into words what style of work suits you: more structure or more space, more challenge or more support, a focus on the past or on the present. You can make use of these dimensions without the questionnaire too — simply as questions to yourself before choosing, and as topics for the introductory conversation. A therapist who takes an interest in your preferences and is willing to accommodate them is as a rule a good choice.

Research on the alliance shows one more useful thing: fit usually becomes apparent quickly. After just a few sessions you can judge fairly well whether the relationship holds. So you don’t have to persist for six months to “give it a fair chance” — three to five sessions is a reasonable test.

Red flags: when to go elsewhere

Most therapists work well and with dedication. But because the therapeutic relationship involves a great deal of trust and vulnerability, you need to know the signs that make leaving the right choice — whatever the certificates on the wall:

• They promise miracles. “In five sessions I’ll rid you of anxiety.” Serious therapy offers no guarantees and doesn’t sell shortcuts; promises of quick cures are marketing, not professional practice.
• They judge and moralise. With them you feel shamed, lectured, “wrong”. Challenge and confrontation belong in therapy — contempt never does.
• They mainly talk about themselves. A measure of therapist self-disclosure can be useful; sessions that regularly revolve around their stories are a sign that they’re occupying the space meant for you.
• They breach boundaries. They suggest socialising outside therapy, comment on your appearance inappropriately, extend or shorten sessions without agreement, are unreachable and unresponsive without explanation. Any romantic or sexual overture is an absolute line — that isn’t a grey area but a grave breach of professional ethics.
• They can’t take questions or criticism. Taking offence at a question about training, supervision or way of working tells you more than any of their answers.
• They isolate you from other sources of help. They advise against medical care, medication, second opinions — as if they were the only one who can help you.

One flag in a shade of grey can be a topic for conversation. A pattern of flags is a reason to leave.

Questions to take with you to the introductory session

You’re allowed to ask anything — and a good therapist will welcome the questions. Here’s a list you can take with you word for word:

• What education and training do you have? In which therapeutic approaches?
• Do you work under supervision, or how do you ensure the quality of your work?
• Do you have experience with my kind of difficulty?
• How does the work go with you — how often are sessions, how long does the process usually take?
• How will we know that therapy is working? How do we check progress?
• Where are the limits of confidentiality?
• What happens if I feel it isn’t right for me — how do you view changing therapists?
• What is the cost, and how does cancelling an appointment work?

The last two questions aren’t rude — they’re adult. And the response to them will tell you a great deal.

Which therapeutic approach? Less important than you think — but not unimportant

Cognitive behavioural, gestalt, psychoanalytic, systemic, marriage and family, body-oriented … Choosing an approach feels like the hardest part of the decision, but research puts it on realistic ground: differences in effectiveness between established approaches are small for most difficulties — considerably smaller than differences between individual therapists and than the weight of the relationship itself.

Even so, your preferences count, and quite literally: meta-analyses by Joshua Swift and colleagues show that clients who receive a form of help consistent with their wishes have better outcomes and drop out of therapy less often. So it’s worth asking yourself: does structured work with tasks and measurable goals suit you better (closer to CBT)? Exploring the origins of your patterns and relationships (closer to depth and systemic approaches)? Including the body? If your subject is a relationship — a couple, a family — it makes sense to look for a therapist trained to work with several people in the room at once; what that work involves I’ve described in the piece on marriage and family therapy.

So a practical guideline: let the approach be a filter, not a verdict. Use it to rule out approaches that clearly don’t suit you — and leave the final decision to the experience of meeting someone in person.

Changing therapists is legitimate — and how to do it well

And if after a few sessions you sense it isn’t working? Let me say it plainly: changing therapists is entirely legitimate. It doesn’t mean you’re a “difficult client”, it doesn’t mean the therapist is bad — it means the two of you didn’t fit, and that happens even with the best. There’s only one worse choice than changing: spending months going to someone you never open up with, and concluding from that that “therapy doesn’t work for you”.

How to do it as well as possible:

• Say it first. If you possibly can, tell the therapist you sense a mismatch before you leave. Two things can happen: the conversation clears up a misunderstanding and the work starts afresh — or it confirms your decision. Either is a gain. And the conversation itself is excellent practice in saying difficult things.
• Don’t disappear — finish. One closing session (or at least a message) is healthier than a silent vanishing, for you as well: an ending that’s spoken is an ending that doesn’t hang over you.
• Ask to be pointed onwards. A professional therapist will help you take the next step without resentment — including by recommending a colleague who might suit you better.
• Tell a pattern from a coincidence. If you’re on your third or fourth therapist and the story is always the same, it’s fair to consider whether some theme of your own is repeating in the choosing (leaving at the moment it gets real, for instance) — and that can be an excellent subject for therapy.

Let the choice be a beginning, not an obstacle

To close, a thought I like to offer people who get stuck in choosing: you won’t find the perfect therapist, because there isn’t one. If you put off deciding until you’re “completely sure”, you’ll be putting it off for a long time — certainty before a first session simply isn’t possible, because fit only shows itself in live contact. So the smart strategy is a different one: make a reasonable shortlist by the criteria above, go to an introductory session with open eyes and allow the experience to decide. Even a “wrong” choice isn’t a disaster; it’s information that makes the next choice easier.

What you’re looking for, then, is a good enough person for you — professionally grounded, honest, someone you can breathe around. Everything else gets built along the way, including through a sometimes awkward start.

And if you’re weighing me up among them: who I am, how I work and where I am on my own path I’ve written down without circumlocution on the My Approach page, what I offer and the practical frame you’ll find under services — and an introductory conversation is exactly what’s described above: a chance to check me, ask me things and get a sense of me. Every question on that list included.