When it comes to finding the right therapist, the factors that play into your decision extend beyond the baseline of scheduling availability. It is also far from a “one-size-fits-all” model to encompass the variability of practice in the field. According to the New York State Office of the Professions, there were 7,438 active licensed mental health professionals in 2021.
In fact, these therapists span through types of therapy they practice and theories they employ, concentrated specialties that they have more training and/or expertise in, modality of administering therapy (as teletherapy has since exploded on the scene post-pandemic), and degrees they hold titling psychologists, marriage and family therapists, mental health counselors, and social workers, among others.
In addition to these more objective components of therapeutic fit, there is also the cultural and therapeutic competence of the clinician, their personality and style of administration, and the general sense of safety, comfort, ease, and trust that can be felt in the session. Packaged together, and you land on “fit,” the seemingly abstract concept that we’ll break down and mold into a more concrete set of ideals for you to reference when searching for the best therapist for you. If you’re ready to get searching today, you can also take a look at the several New York Behavioral Health therapists and their range of offerings.
Therapeutic Fit: A Circumstance, An Experience, and A Feeling
Upon thinking about the concept of “fit” we can more tangibly break it down into circumstantial, experiential, and emotional fitness. When pulled apart, therapeutic fit becomes a combination of what is needed before, during, and after the completion of sessions.
Though the circumstantial elements of therapeutic fit can be determined before ever stepping foot into session, and this can inform part of your overall perspective on the fitness of your therapist, it can be crucial for many individuals to also gain the experience of at least a few sessions with a particular therapist to fully gauge their personal viewpoint.
Working in session can also help assess the more “human” elements of the therapeutic experience in order to address how you feel, and if you’re getting what you need. Below, you will find a 4-step outline to help determine such fitness on your search for appropriate care. Each assessment step is paired with a series of questions to guide your valuation as to whether or not your therapist is a good fit for you. You can also head to the NYBH site to get started on your process.
STEP 1: Assess Your Circumstances
As mentioned above, assessing your circumstances can be done entirely before ever entering into a therapeutic session. This is often the step that many individuals take (most notably in terms of financial fit, scheduling availability) prior to booking in their first session. Assessing your circumstances is intended to cover all objective components of finding the right therapist for you.
In essence, this step answers the question “Can the therapist provide you what you need on paper?” This covers the aforementioned financial fit, modality, and availability, as well as therapist credentials, specialties, and theoretical orientation. The circumstances you present with are on the front-line of finding the best-fit therapist for you. Take a look through the questions below to help in the first steps of assessment.
- How do they approach therapy?
Consider the types of therapy the therapists practice, the theories of psychology they ascribe to, and the models of practice they implement. These can often be found on therapist’s websites, in their bios, and through their company resources pages. How the therapist approaches therapy will help you understand what your conversations and sessions might look like.
Do they employ a psychodynamic approach and primarily help to generate insight from an individual’s past? Or a cognitive-behavioral approach where the therapist focuses more on the thoughts, feelings, and behaviors in the present? As these are two of many models a therapist can practice, do some research to help you better understand what you’re looking for.
- Do they specialize in a specific content area?
Specialization is an important factor to consider because it can inform you of any additional licenses, certificates, or advanced training the therapist might have, as well as what they feel most competent in practicing. Checking for areas of expertise could be particularly helpful when working with complex difficulties, spanning across trauma, grief, anxiety, depression, relationships, anger, and many more possibilities.
- Are different service modalities offered?
This question is particularly important in the post-pandemic world we now live in, where work-from-home has also transitioned to therapy-from-home. If you are more partial to teletherapy, in-person therapy, or a hybrid model, checking for service modality is going to be an important factor in your circumstantial assessment. Additionally, understanding if there are flexible scheduling options that could accommodate for bi-weekly or other considerations could be crucial to fitting sessions into a busy schedule.
- Are their services a financial fit for your budget?
However simple the concept, financial fit is an important factor in finding the best-fit therapist for your needs. Checking to see what their financial policies are, how they work with insurance companies (and more importantly, your insurance company), what the out-of-pocket expenses will be, and reimbursement eligibility are all crucial in navigating the fitness of your therapist for your financial needs.
STEP 2: Assess Your Experience
Assessing your experience is the second step after you’ve found a therapist who is a circumstantial fit for you. Many therapists offer a phone consultation before committing to sessions which is a good segue into treatment and can provide a small window of assessment to understand if the clinician will be fitting for your needs. In this step, you want to look for the nuances of therapeutic care that are found in the skills, competencies, abilities, and overall effectiveness of the clinician.
Assessing your experience seeks to answer the question “Can the therapist provide you with what you need in practice?” Your experience in the therapeutic setting will illuminate the therapist’s ability to recognize who you are as a cultural and individual being, address what is being experienced by you and brought into sessions, and administer appropriate interventions that foster reflection, understanding, and growth. Use the below prompts as your guide to check-in on your experience with the therapist to decide if they are the right fit for you.
- Does the therapist appear competent to treat your needs?
Consider what you are experiencing and don’t be afraid to ask the therapist questions to help understand how they can better help you through this. Therapeutic competence is important because it informs the clinical work that you will do together. Can the therapist accurately and appropriately address and assess your needs? And can they offer you an idea of what their treatment plan might look like for your future sessions?
- Can the therapist appropriately address your needs from a cultural perspective?
Perhaps one of the most important questions to reflect on when considering therapist fit, is the therapist able to not only recognize, but incorporate salient elements of your cultural experience and identity into the clinical picture? This is inclusive of religious and spiritual identities, economic background, sexual and gender identity, racial and ethnic identity, unique physical and developmental features, familial experience, and any other cultural factors that inform who you are as an individual and your overall worldview.
- Are you receiving the help you need and care you expect?
This question pushes into the therapist’s ability to employ the skills necessary to elicit a healthy and appropriate clinical experience. Listening, validating, communicating, educating, respecting as well as challenging (when appropriate) are elements that can move the needle on the therapeutic experience.
According to Ackerman & Hilsenroth (2003) therapist techniques such as exploration, reflection, noting past therapy success, accurate interpretation, facilitating the expression of affect, and attending to the client’s experience were all found to contribute positively to the therapeutic alliance. Ultimately, is there value being shared in the clinical experience?
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STEP 3: Assess Your Feelings
Assessing your feelings in regards to therapeutic fit might arguably be the most important step in the process, because it is our subjective experience often informing us of how we wish to proceed, most specifically in relationships. If the circumstances are right and the experience is professional and well-paired, then we have to push into our emotional selves to help inform the fitness of our therapist in regards to how we feel during and after sessions.
Here, you are looking to sense if you feel validated, seen, heard, and genuinely cared for. Assessing your feelings seeks to answer the question “Can the therapist provide you with what you need in personal compatibility?” Meaning are the human elements of the therapeutic relationship present? Does the therapist “get” you? And if they don’t “get” you, did they demonstrate effort in trying? This is inclusive of comfort, connection, authenticity, and validation.
Checking-in on how the therapist makes you feel is essential in a successful therapeutic relationship; it addresses how willing you are to be transparent, honest, and organic in sessions which are necessary for treatment to work. The questions below can serve as a guide in your assessment of feelings in therapist fit.
- Do you feel safe, comfortable, and understood in session?
According to Ackerman & Hilsenroth (2003) therapist’s personal attributes such as being flexible, honest, respectful, trustworthy, confident, warm, interested, non-judgemental, and open were all found to contribute positively to the therapeutic alliance. The importance of feeling seen, heard, understood, safe, and comfortable in session are all elements that can be qualified as necessary for successful outcomes to be rendered in therapy.
- Can you “be yourself” with the therapist in session?
Simply stated, are you able to be “authentically you” in session? Can you remain open, honest, organic, and transparent in discussing with your therapist some of the deepest and most closely guarded parts of yourself in therapy? This is also to be monitored over time, as it is not typical to the human experience to “let your guard down” in session number one. However, if you can see yourself eventually letting these “walls” down, then that is a strong indicator for therapist fit.
- Do you trust your therapist?
Arguably the most important question in the entire post, do you trust your therapist? Or can you see yourself trusting them over time? This can be a “gut feeling,” intuitive experience, or process of building over the course of treatment, but trusting the care of your therapist will open up the therapeutic experience beyond credentials and competencies, and into the realm where the real, deep, clinical work can be done.
STEP 4: Assess the Fit
Bringing together the elements of circumstance, experience, and feelings will provide you with a semblance of “fit” that should feel comprehensive enough to assess if your therapist is the right person to help you on your therapeutic journey. With the proper assessment tools, “fit” can help facilitate a healthy therapeutic alliance, which, according to Elvins and Green (2008) constitutes a major variable in explaining the outcomes of treatment.
Some may say that finding the best-fit therapist for you can be compared to dating. Following the steps outlined here, as well as leaning into intuitive senses and instinctual factors will provide you with the tools you need to ensure your therapist is the best-fit person to help you navigate your clinical path forward. Head to the NYBH website to see how we can help on your journey!
Ackerman, S., & Hilsenroth, M. (2003). A review of therapist characteristics and techniques
positively impacting the therapeutic alliance. Clinical Psychology Review, 23(1), 1-33.
Elvins, R. & Green, J. (2008). The conceptualization and measurement of therapeutic alliance:
An empirical review. Clinical Psychology Review, 28(7), 1167-1187.
NYSED Office of the Professions (2021). Professions Index, License Statistics. https://www.op.nysed.gov/professions-index