A Guide to Finding the Right Mental Health Therapist (2023)


Whether your mental health needs feel pandemic-specific or not, help is available

A Guide to Finding the Right Mental Health Therapist (1)

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Barbara Stepko,


En español

May 02, 2022

This too shall pass, goes the old adage. But when life takes a challenging turn, it can be hard to take things in stride. Perhaps you're feeling persistently irritable (a frequent sign of depression) or experiencing the stress that often comes from caring for an elderly parent. Maybe your marriage is in a rut or you're grappling with a major life change, such as adjusting to retirement or an empty nest— or in the midst of a pandemic.

For whatever reason, if you're depressed, anxious, worried or out of sorts, and it's taking a toll on your life, it may be time to turn to therapy to help you cope.

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There are a range of approaches to therapy, but many therapists combine elements from two schools: cognitive behavioral therapy and psychodynamic therapy. Before you look for a therapist, it pays to understand these two approaches.

Cognitive behavioral therapy

Cognitive behavioral therapy (CBT) is a directive therapy, which means the therapist leads the process, teaching patients how to develop effective ways of coping with a range of problems, including depression, anxiety and panic disorders. “Cognitive behavioral therapy is based on the idea that the person is having difficulties because of faulty thinking and behaviors,” says Burton Hutto, a psychiatrist and director of the Crisis Stabilization Inpatient Unit at the University of North Carolina, Chapel Hill, School of Medicine.

These “cognitive errors” or distorted thinking often manifest in self-criticism or guilt. “You may catastrophize situations, tending to imagine the worst or overestimate the likelihood of something bad happening,” says Lynn Bufka, associate executive director for practice research and policy at the American Psychological Association (APA). “For example, you might think, ‘It's all my fault,’ or ‘I never do anything right.'”

How CBT works

CBT, Hutto says, helps you identify and change those negative thought patterns and behaviors that are wreaking havoc on your well-being. “You try to get a more realistic view of what's going on,” Bufka says. “Someone who is really anxious about the coronavirus might be convinced that they're going to get it and are going to die. That's a possibility, but it's not necessarily true.” CBT also helps you recognize and accept events that are beyond your control.

The therapy is structured and focused: You set a plan with the therapist at the beginning of the session. “Because there's an agenda on what you're going to accomplish, it's a shorter-term therapy that typically doesn't last much more than six months,” Hutto says. Patients learn coping techniques during sessions, such as learning practical, more productive ways to respond to distressing or anxiety-provoking situations or feelings (deep breathing exercises, for example). “There's also homework,” Hutto says. “For example, keeping track of thoughts, feelings and situations, then discussing them in the following therapy session."

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Psychodynamic therapy

While CBT concentrates on the here and now, psychodynamic therapy (PDT) is an exploratory therapy that delves deep into the past and your unconscious to help you gain insight and get to the root of your problems. The idea here is that most people's thoughts, feelings, behaviors and the choices they make are tied to earlier (sometimes forgotten) experiences. By becoming aware of connections, you may find it easier to break unhealthy patterns. For example, Bufka says, “a significant loss as a child may contribute to current fears about losing a loved one.”

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Another part of PDT involves focusing on the role that repressed emotions and experiences play in our problems. “It looks more at the unconscious — how thoughts and feelings, that are out of our awareness, are making us sabotage ourselves or repeat negative patterns,” says Eric Sherman, a therapist in private practice in New York City and Montclair, N.J. Put another way: It sets out to make the unconscious conscious.

One technique is dream analysis, based on the idea that the mind is less guarded when we're slumbering, making it easier for repressed ideas to emerge. PDT may also be more broadly focused, Hutto says: “If you feel like you have a nice life, but you're just not happy and don't know why you can't be satisfied, you might use therapy to understand yourself and build your capacity for gratitude and acceptance.”

How PDT works

PDT is nondirective and unstructured. “The patient is encouraged to take the lead by talking freely about whatever is on his or her mind,” Hutto says. “It's the therapist's job to organize the information over time, looking for patterns and themes.”

In CBT, the therapist is like a teacher or coach; here, the patient sets the agenda. In PDT, the patient is on a journey, with the therapist pointing out things along the way. PDT can be short-term, long-term or open-ended. “Some people get out of it what they want within months, others within a couple years,” Hutto says. “And there are those who decide to continue for many years, in a more supportive way.”

Understanding different kinds of therapists

The sheer number of types of therapists — beyond whether they specialize in CBT or PDT — can be daunting. Here's how to make sense of the field. First of all, “psychotherapist” is basically a blanket term for any trained professional who treats people for emotional problems or mental health issues. This includes psychiatrists, psychologists and clinical social workers.

Psychiatrists and psychologists

A psychiatrist has attended medical school and has an M.D. Since they have medical training, psychiatrists — unlike psychologists — can prescribe medication. Typically, a patient receives “split treatment,” with a psychiatrist handling the management of medication and a psychologist providing talk therapy, though some psychiatrists also practice psychotherapy. A psychologist has a doctorate in psychology, which can result in a Ph.D. (with a focus on research) or a Psy.D. (concentrating primarily on talk therapy).

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Clinical social workers

These therapists typically have a master's degree. “When some people hear ‘social worker,’ they think of professionals who work in hospitals, helping with transition care, for example,” Bufka says. “But there is a segment of social workers who are trained to provide psychotherapy.” Social workers may be an LCSW (licensed clinical social worker), LICSW (licensed independent clinical social worker) or LSW (licensed social worker).

There's no evidence that one kind of provider is better than another. “A person's professional degree doesn't really tell you what level of therapy training they've had,” Hutto says. “Therapists can have very different levels of training, ranging from almost none to many years of supervised casework.” A licensed marriage therapist may have 10 years of training, he says, while a psychiatrist could have had minimal therapy training. “You might think the psychiatrist, with his or her medical degree, would be the ‘better’ expert. But in fact, the other person is the therapy expert.” It just depends.

One thing that may affect your decision: money. Fees often reflect a therapist's degree. “The fee of a social worker would typically be less than a typical psychiatrist or even a psychologist,” Hutto says. “In fact, a licensed clinical social worker, with 25 years of experience providing therapy, may charge only half of what a newly trained psychologist does."

How to find who's right for you

"A good way to find the appropriate person is to get a referral,” Sherman says. “Your doctor, a close friend or family member who sees a therapist might be able to recommend someone.” Or you can do some digging on your own.Psychology Today's Find a Therapist, the APA's Psychologist Locator, or ZenCare (a therapist database) are terrific resources. Type in your zip code and you'll find a list of professionals near you. Refine your search by clicking on treatment methods (CBT, PDT, etc.), specialties (such as emotional problems, life transitions or marital problems), age group specialization (seniors, for example), qualifications and years in practice, or cost per session.

Another way to go: Narrow the prospects based on your insurance. “If you have private insurance, Medicare or Medicaid, contact them to find in-network providers,” Hutto says. “You can cross-match that with, say, thePsychology Todaylist.” After you've pared down your search, interview potential therapists by giving each one a call or requesting a free consultation. (Keep in mind, some therapists are still conducting sessions over the phone or via teletherapy — a practice begun during the pandemic.)

TheAmerican Association for Geriatric Psychiatrylists hundreds of psychiatrists around the U.S. who focus on older patients. Many psychiatrists provide medication rather than psychotherapy, but they can be a good resource for referrals.

Questions to ask a candidate

Ask about their credentials and their training, related to your specific problem, and what their approach to therapy might look like, Hutto says. Let them know why you'd like to see them ("I've been really depressed,” or “I'm having a difficult time dealing with retirement"). You want to get a sense that they're a good fit, Sherman says: “You're going to open up to this person, share things that are tough to talk about, and be vulnerable, which is not an easy thing to do. You want to think, ‘This is a person who I can unburden myself to — someone who can create a safe space for me.'”

Editor's note: This story, originally published on May 22, 2020, has been updated to reflect new information.

Barbara Stepko is a longtime health and lifestyle writer, and former editor at Women’s Health and InStyle. Her work has appeared in The Wall Street Journal, Parade and other national magazines.

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(Video) Which TYPE of Therapy is Right?


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Why is finding the right therapist so hard? ›

One of the primary reasons many people have difficulty finding the right therapist is due to a lack of specialization. Many practitioners focus primarily on anxiety and depression.

How to find the right therapist when going through a mental health crisis? ›

You can contact your healthcare provider for a referral; ask friends and acquaintances for recommendations; contact your insurance provider for referrals or search its website for a database of mental health professionals; or consult Psychology Today's directory of therapists.

How do you know therapy is not working? ›

How Do You Know If Therapy Isn't Working?
  • feeling judged by your therapist.
  • omitting information from your provider for fear of their reaction.
  • consistently feeling worse in-between sessions and not receiving tools to move through the discomfort.
  • a complete lack of progress over the course of months.
Nov 25, 2022

Why do I feel like my therapist isn't helping? ›

Reasons, such as lack of trust or feeling misunderstood, may make you feel like therapy isn't helping. Here's how you can improve your experience. There are many reasons why therapy may not be working for you. Your therapist, the type of therapy they provide, and how they relate to you may be the reasons.

When therapy is not enough? ›

When therapy isn't enough, try asking your doctor for blood work, and ensure that you give them an accurate, detailed list of your symptoms. If you or a loved one needs help with behavioral health or drug & alcohol addiction, please find a facility that can can help as soon as possible.

What is the most important factor when choosing a therapist? ›

Stated simply, the most important thing to look for in a therapist is the quality of the relationship that you have with them, otherwise known as the "therapeutic alliance." You can judge this by how comfortable you feel with the person.

How do I know if I trust my therapist? ›

7 Signs your Therapist is a Keeper
  6. THERE IS TRUST. ...

How do I choose between two therapists? ›

Ask a therapist of interest for a consultation session to get a sense of what it would be like to work with them. Some things to look for are: you feel understood by them, you feel you'll be able to open up and speak freely with them, and you feel a sense of confidence that they can help you.

What are 3 signs you are seeing a good therapist? ›

Signs Your Therapist is Good For You
  • They actually listen to you. ...
  • You feel validated. ...
  • They want what's best for you. ...
  • They're a strong communicator. ...
  • They check in with you. ...
  • They take the time to educate themselves. ...
  • You view them as an ally. ...
  • They earn your trust.
Sep 30, 2020

What's the difference between a counselor and a therapist? ›

Counselors tend to offer short-term care, while therapists tend to offer long-term care. Therapists can be more past focused and counselors more future focused. Counselors often have a set number of sessions, and therapists often work on an ongoing basis. Therapists are more likely to treat mental health conditions.

What is the difference between a psychologist and a therapist? ›

Licensed therapists must have, at minimum, a master's degree in a field related to psychotherapy. Psychologists must have a doctorate-level degree such as a PhD or PsyD.

How long is too long in therapy? ›

Ruth Wyatt, MA, LCSW: With therapy, there usually is no set length of treatment. Therapy can last anywhere from one session to several months or even years. It all depends on what you want and need.

What to talk about in therapy when you have nothing to talk about? ›

If you don't know what to talk about in therapy, some things to consider talking about include recent life events, relationships, traumas, and more.
  • “Small” issues. ...
  • Patterns and behaviors. ...
  • Present feelings. ...
  • Rumination. ...
  • Relationships. ...
  • Past traumas. ...
  • New life challenges. ...
  • Avoided thoughts and conflicts.
May 24, 2021

What is considered a crisis in therapy? ›

A number of events or circumstances can be considered a crisis: life-threatening situations, such as natural disasters (such as an earthquake or tornado), sexual assault or other criminal victimization; medical illness; mental illness; thoughts of suicide or homicide; and loss or drastic changes in relationships (death ...

What does bad therapy look like? ›

The bottom line

This could mean trying to have sex with you, often showing up late for appointments, talking about themselves too much, or answering text messages during your sessions. A bad therapist can prevent you from meeting your goals or can even harm your mental health.

Why do I feel like I have nothing to say to my therapist? ›

Reasons you might have nothing to say in therapy

It could mean a lot of things. Having nothing to say doesn't mean that your problems have gone for good. Sometimes you've been working hard through some issues, and your brain needs a break. So it's kind of like the feeling when a computer shuts down for a little while.

How do you know if you don't like your therapist? ›

Examples of poor boundaries from a therapist are: Dominating your session by talking about their personal problems or accomplishments — and then you're the one who has to give them advice! Pushing you to talk about things that you're not ready to talk about, such as your sex life or the details of past trauma.

Is crying in therapy a breakthrough? ›

In these instances, tears indicate that the person is at least temporarily giving up the struggle. Although this is commonly thought of as a “breakdown,” we optimistically consider it a potential breakthrough.

Why do I struggle to talk to my therapist? ›

There are a few things that might contribute to this: you may not have developed the level of trust you need to feel safe with the therapist you are working with, you may be fearful of being judged by the therapist, or maybe you are afraid that opening the pain of the past might be too much to handle.

Is it normal to cry every therapy session? ›

The short answer is that no, not everyone does cry in counseling. However, pretty much everyone who participates in counseling does explore very strong emotions and most clients will experience tears at some point in their therapy journey.

What are red flags in a therapist? ›

Red flags in therapy include violations of confidentiality, boundaries, and licensure, among others. Therapy can be ineffective when the therapist is unable to communicate or lacks the training to treat a patient's specific problem. Patients can raise concerns with their therapist directly.

When should you take a break from therapy? ›

A number of things could prompt a pause, but common reasons include financial concerns, health problems, schedule conflicts, lack or time, money, or a move. Sometimes the problem isn't with you, but with your therapist. Therapists are people, too — people who may relocate, retire, or take a medical leave.

Do therapists get frustrated with clients? ›

Therapists do get frustrated with clients from time to time, but some can handle difficult clients better than others. This may be due to training or inherent personality traits.

What is the number one predictor of successful therapy? ›

Interestingly enough, patients and therapists often (but not always) agree on the quality of their relationship. However, it is the patient's perception of the quality of the relationship that is the strongest predictor of treatment success.

What are two or three important qualities of a good therapist? ›

The Qualities of a Good Counselor
  • Communication skills. Communication skills will play a key role in your relationship with your clients. ...
  • Patience. Patience will become a critical trait as a counselor. ...
  • Confidence. ...
  • Non-judgmental. ...
  • Observant. ...
  • Listening Skills. ...
  • Trust. ...
  • Respectful.
Jun 21, 2021

What determines the success of therapy? ›

The most powerful of those common factors have been referred to as the “therapeutic alliance,” referring to the bond between client and therapist. Study after study has shown that the quality of the relationship between client and therapist is the only reliable and the most powerful predictor of a positive outcome.

What type of therapy is most effective? ›

Cognitive behavioral therapy is considered the gold standard in psychotherapy. Numerous clinical trials have found CBT to be effective for a spectrum of emotional health challenges, from anxiety and depression to addiction and schizophrenia.

What are the 3 basic tasks of the therapist? ›

Therapist Job Responsibilities:

Establishes positive, trusting rapport with patients. Diagnoses and treats mental health disorders. Creates individualized treatment plans according to patient needs and circumstances.

What type of therapy do most therapists use? ›

The Most Common Types of Therapy
  • Client-Centered Therapy (Person-Centered Therapy, PCT, CCT or Rogerian Therapy) ...
  • Cognitive Behavioral Therapy (CBT) ...
  • Existential Therapy (part of the Humanistic-existential Approach) ...
  • Psychoanalytic or Psychodynamic Therapy. ...
  • Dialectical Behavior Therapy (DBT)
Sep 27, 2016

Is it OK to ask your therapist personal questions? ›

It's okay to ask your therapist about their life. Any questions you have in therapy are valid and are likely relevant to the therapeutic process. Whether your therapist answers the question and shares personal information can depend on their individual personality, philosophy, and approach to your treatment.

What to do when you can't trust your therapist? ›

It can take time and patience to hit your stride and to form a bond of trust. You do need to give your therapist a chance. It's recommended that you try four appointments (an assessment and three sessions) before making your mind up about whether you can trust your therapist.

Do you tell your therapist everything? ›

What can I tell my therapist? The short answer is that you can tell your therapist anything – and they hope that you do. It's a good idea to share as much as possible, because that's the only way they can help you.

Is it OK to try different therapists? ›

Maybe you're not seeing any results in your personal life, or maybe you feel awkward talking to them about certain issues. Whatever the case, there is nothing wrong with switching therapists in order to find someone who better suits your needs.

Is it OK to see two therapists at once? ›

Many people have benefited from receiving concurrent mental health services from two therapists. Each therapist may provide a different service such as individual therapy, couples therapy, or group therapy. For example, you might see one therapist for individual therapy and another therapist for couples therapy.

Is it OK to see the same therapist? ›

There is no law that prohibits therapists from seeing two people who know each other, or even two members of the same family. In some small communities, there may not even be a choice. For example, a high school or college may only have one mental health therapist on-site.

What is the miracle question in therapy? ›

The miracle question is a popular intervention in Solution-Focused Therapy. It asks the client to imagine and discuss a possible world where problems are removed and issues addressed (Strong & Pyle, 2009). The question may take various forms, such as asking the client, “Assume your problem has been solved.

What questions should I ask my therapist? ›

What to Expect in Therapy
  • What type of therapy do you recommend for me? Is it effective for treating my concerns? ...
  • How long will therapy last? The length of therapy can't always be predicted. ...
  • How long is each session? ...
  • What will therapy sessions be like? ...
  • Is medication an option? ...
  • Are we a “good fit” to work together?
Nov 26, 2020

What does a good therapy session look like? ›


You'll be invited to speak openly. The therapist will listen and may take notes as you speak; some, like myself, take notes after a session. You won't be criticized, interrupted or judged as you speak. Your conversation will be kept in the strictest confidentiality.

Can a therapist diagnose? ›

On the other hand, therapists, while they can't prescribe medication, are licensed to assess, diagnose, and treat mental health issues — and they're usually much better equipped to diagnose emotional or behavioral disorders than your medical doctor would be since their education and training is focused on mental health ...

Does a therapist see another therapist? ›

Good Psychotherapists Do, and Should, Go To Therapy. Many therapists go to therapy, as a standard practice, or at different junctures in their life. I would never refer a client to a therapist who had never been in extensive therapy.

Do I need Counselling or therapy? ›

Signs You May Need Private Therapy

Generally feeling overwhelmed with everything. Overthinking and feeling as though you're unable to 'switch off' from your thoughts. Feeling low and more tearful than usual. Getting angry more easily or struggling to regulate your emotions.

What can a psychologist do that a therapist Cannot? ›

Psychologists can do research, which is a very important contribution academically and clinically, to the profession. A therapist is a broader umbrella term for professionals who are trained—and often licensed—to provide a variety of treatments and rehabilitation for people.

How long does it take for a therapist to diagnose you? ›

The reason for this is that mental health symptoms can affect self-care, vocational, life skills and relationship aspects of life. With all this being said, an accurate diagnosis for mental health disorders can take weeks to years to determine.

Is it better to have a psychiatrist or therapist? ›

If you want to spend time talking about an issue and working through it in a one-on-one session, a psychologist might be a good fit. If you're interested in pursuing psychiatric medication for symptom relief for a mental health disorder, you may want to start by talking with a psychiatrist.

How do I know if I need the right therapist? ›

There are three things you should feel if your therapist is right for you: safety, competence, and a sense of connection. Safety — You should feel like you can be yourself and honest. Your therapist should create a judgment-free zone where you can freely express what you feel and think.

How do I find the right mental health diagnosis? ›

To determine a diagnosis and check for related complications, you may have:
  1. A physical exam. Your doctor will try to rule out physical problems that could cause your symptoms.
  2. Lab tests. These may include, for example, a check of your thyroid function or a screening for alcohol and drugs.
  3. A psychological evaluation.
Dec 13, 2022

Will a therapist tell you your diagnosis? ›

You have specific rights when disclosing your diagnosis as a client receiving therapy. For example, it's your right to ask your therapist to tell you if they believe you have a mental health condition. If you want a diagnosis, you can ask your therapist upfront.

Can a therapist diagnose mental illness? ›

Therapists require master degrees and approval of their licensing boards to practice in the mental health field. Therapists provide mental health diagnosis and develop a treatment plan.

What is the most misdiagnosed mental illness? ›

BPD is one of the most commonly misdiagnosed mental health conditions. It's so misdiagnosed, in fact, that there isn't even an accurate prevalence rate for the condition.

What are the 7 main mental disorders? ›

What Are the 7 types of Mental Disorders?
  • Anxiety Disorders.
  • Mood Disorders.
  • Psychotic Disorders.
  • Eating Disorders.
  • Personality Disorders.
  • Dementia.
  • Autism.
Apr 6, 2021

What are 3 different types of treatments for most mental illness? ›

Treatment of Mental Illness
  • Drug Therapy.
  • Psychotherapy.
  • Electroconvulsive Therapy.

What therapists dont talk about? ›

Some of these topics include feeling incompetent; making mistakes; getting caught off guard by fee entanglements; becoming enraged at patients; managing illness; understanding sexual arousal and impulses; praying with patients as part of therapy; feeling ashamed; being fired; and not knowing what to do.

Why can't I look at my therapist when I talk? ›

Back to Fictional Reader's question about why it may be difficult to look a therapist in the eyes. Some possible root causes range from guilt, shame, anxiety, low self-esteem, shyness, past abuse, depression or autistic spectrum disorders to varying cultural norms and cognitive overload.

Does my therapist think about me between sessions? ›

Your therapist's relationship with you exists between sessions, even if you don't communicate with each other. She thinks of your conversations, as well, continuing to reflect on key moments as the week unfolds. She may even reconsider an opinion she had or an intervention she made during a session.


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