So You Want to See a Therapist… Now What?!

If you have made the decision to seek therapy, you are making the right call. Good for you! There is a lot of stigma with regard to obtaining professional help and if you have made this decision, it likely was not easy. If you are having difficulty managing your emotions, thoughts, or behaviors on your own and it’s interfering with your sleep, relationships, or work, then therapy could be super helpful! Now that you have made the decision, you may feel stuck on where to look and how to actually find a therapist that is right for you.

Things like someone’s age, gender, ethnicity, and additional cultural values, may be important to you. Take some time to think about what factors are important to you. Once you start the search for the ‘“right therapist” consider asking these questions to your prospective therapist.

1. What is your theoretical orientation? What kind of therapy do you do?

   • In my opinion, this is one of the most important questions to ask. Theoretical Orientation means the type of therapy that you will be receiving- and trust me, it matters! There is traditional talk therapy, where you go in for a therapy session, and talk to your therapist about your week and while this may feel nice to vent and get a new perspective this is not the most effective method to treat your depression, anxiety, or other mental health concern.

   • Stick to an Evidence-Based Treatment, that is- a treatment that has science and research backing its efficacy and effectiveness.

   • Cognitive Behavioral Therapy is the gold standard treatment for many mental health concerns. It has the most research and no other form of therapy has been shown to be systematically superior to CBT, and it works for a variety of mental health diagnoses (check out these resources for the following diagnoses: Depression, Anxiety OCD, Schizophrenia, Insomnia, Trauma ).

   • It’s also useful to know that CBT is the umbrella treatment and there are specific types of CBT treatments (i.e., exposure-based CBT for OCD, Prolonged Exposure and Cognitive Processing Therapy for PTSD); however, all of these treatments are rooted in the theoretical orientation of CBT.

   • Dialectical Behavioral Therapy and Acceptance and Commitment Therapy are considered to be “third wave” CBTs. These treatments are rooted in CBT principles, but they incorporate mindfulness-based and acceptance-based strategies of our thoughts and behaviors, while CBT treatments typically focus on prioritizing changing our thoughts and behaviors.

2. Look at their title- PhD, PsyD, MFT, LCSW, etc.

   • Knowing someone’s letters after their name can give you more insight into what type of early training experiences they had and how long they were in school.

   • If someone is a licensed clinical psychologist, then they received their doctorate and have a PhD or PsyD. Master level clinicians will have MFT and LCSW after their name. All of these different types of therapists can have different theoretical orientations. Check my previous blog to learn more about titles

3. How long will my treatment last?

   • Therapy is not a cookie-cutter approach, but we do have an idea of how long treatment should last, based on diagnosis and current symptoms. CBT treatments are more short-term treatments. Panic Disorder treatment can take a few months and Specific Phobia treatment could be as short as ONE session. CBT for anxiety or depression may last around 6 months.

   • DBT is either 6-months or 12-months of treatment. Adherent DBT includes once a week individual therapy, once a week group therapy, and access to call your therapist outside of session.

4. What will sessions look like?

   • Well- here is the tricky part. One study showed that 71% of clinicians who said they were CBT therapists actually did not deliver CBT. AH! Okay, well here’s where you will become SO much more informed to determine if your therapist is actually who they say they are in session.

   • Here are components of CBT sessions:

     • Structure! Your therapist will create an agenda at the beginning of each session so both of you are on the same page of what you will target in therapy.

     • Homework– yep, homework is crucial because if you are only doing your work IN the therapy room, then the skills will not generalize to where it matters (at work, in your relationships, etc.).

     • Collaboration– You and your therapist will work together to make a plan that works for you. Your therapist will take an active role in therapy.

     • Skills and Interventions: Your therapist may use worksheets or a whiteboard in sessions to actively assist you in challenging your negative thoughts or in facing your fears.

   • Some therapists are certified in Cognitive Behavioral Therapy which is a really great way to know if your therapist is truly adhering to CBT in session. You can check if they are certified by the Academy of Cognitive Therapy to ensure you are receiving CBT.

5. How do you incorporate culture into the therapy room?

   • If you are questioning whether your therapist may not culturally responsive to your multicultural identities, here are some potential questions to ask. You can inquire about their training experiences, patients they have worked within the past, and their comfort level in talking about diversity . Also, you are the expert on YOU, so take your feelings and first impressions into account when having this conversation.

     • How do you incorporate culture into the room?

     • What is your comfort level when it comes to talking about topics such as white privilege, racism, discrimination, or systemic oppression?

     • What is your understanding of diverse sexualities and gender identities? Are you LGBTQ affirming and competent?

6. How will you know if therapy is working?

   • You will want to know if therapy is working! I personally use both quantitative and qualitative measures to understand how my patients are progressing throughout treatment.

   • Just like evidence-based treatments, there are evidence-based assessments, which means that the measures are actually measuring the symptoms accurately. For example, if you are in treatment for depression, there is a measure called the PHQ-9 which does a really great job of measuring your depressive symptoms throughout treatment. Your therapist can tell if your scores are dropping throughout treatment, which is what we want!

   • Your therapist will also be asking you about your goals in treatment and will be regularly checking in on the status of these goals throughout therapy. If you are seeking treatment for anxiety and tend to avoid work tasks because of this anxiety, are you now able to tolerate the anxiety and engage in the behaviors that you want?

   • You can also ask your therapist, “what will it look like when I don’t need therapy anymore?”

Find a Certified Cognitive Behavioral Therapist

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