Therapy is often uncomfortable, and it is probably the most so when you’re just starting out. While the first few sessions will probably be a bit uncomfortable (and that can be okay and even, a good thing), it shouldn’t feel like you’re being observed or studied, that you’re just another person walking through a therapist’s office, or that they can’t handle what you’re bringing to them. When looking for a therapist for the first time, it can feel daunting to sift through the multitude of choices of therapists to find a good fit while steering clear of bad therapy.
In order to help patients avoid getting screwed by bad therapy, I’ve answered a few key questions about looking for therapy for the first time:
What questions should I ask a potential therapist to figure out if they’re a good fit?
What is most important to ask will–and should–vary from person to person. With that in mind, rather than asking questions, get to know the therapist in a different way. Be receptive to how they speak and listen: Are they interrupting you? What questions are they asking you? Does it seem like they are listening? Does it feel like they “get it”? Do you feel comfortable with them? Those last two are, of course, the trickiest to figure out in the first few sessions. Pay attention to how you feel during and after the session, and that should give you some good feedback.
As a final (and very important) consideration, a good therapist should be conscious of the difficulty of getting to know someone intimately and the significance of the information with which they are entrusted. They should work to pace the sessions so you don’t feel overexposed. That doesn’t mean you should hide anything from your therapist, but if your therapist feels like they’re “stealing” information from you or if it feels like they haven’t earned what they are asking for, that should be a big warning sign.
How can I tell if my therapist gets it?
Therapy has changed quite a bit in its short history; gone are the days when all there was to choose from was old, Upper East Side offices and stuffy, distancing therapists. A good therapist, regardless of age, should be nonjudgmental and treat you with respect. If you’re not feeling that, run. It is worth noting too that a young therapist does not equal an inexperienced therapist. Many very good therapists live rich and exciting lives outside of their work, and have an incredible and impressive work experience, training and base of knowledge on which to draw.
Therapy is intimate. Some of the things you’ll want to talk about will be hard, and a good therapist will help make it feel not so shame-y. It is absolutely okay to talk to your therapist about parties, about drugs, about sex–but (and this goes back to pacing), make sure that you create the conditions to do that together so that it feels safe. Being able to do that will be a big part of knowing if your therapist “gets it.” The reality is that your therapist simply won’t be able to have it all completely figured out in the first session. And that’s a good thing. Knowing that they won’t know everything is part of “getting it,” as is knowing when (and when not) to push.
How do I find a therapist whose values and politics are similar to mine?
There are a few options: One is to be upfront about the things that are important to you in the call or first session. Explaining your concerns about therapy and what you need is important, and will give you a lot of information about how your therapist thinks about these issues.
However, there is another way that I feel pretty strongly about. Politics and culture have become more pervasive parts of our lives and therapists would do well to realize that. Many therapists provide a brief description of who they are and what they’re about on their website, but it is becoming more incumbent upon therapists to take a stand on certain issues that matter. Many therapists have stopped shying away from these issues, writing about them publicly both as a part of their professional duty, but also as a way of letting patients and potential patients know where they stand. Blogs, journal articles, interviews and opinion pieces can be an invaluable resource for an informed patient looking to spare themselves the compound pain and discomfort of explaining their views on certain important issues.
Now, that isn’t a substitute for discussing these things in the session. A good therapist will explore them in a way that feels safe, and makes you feel seen and understood. But, it should serve as a way to gauge familiarity with issues of concern and the politics of the therapist.
Is there anything I should specifically look out for when I first go into a therapist’s office?
A therapist’s office will often gesture toward the way the therapist thinks, their interests or what they like. So a messy office could be a pretty big turn-off. With that in mind, though, I don’t think the therapist’s office needs to match your tastes exactly. If they have a Magritte painting, but you are more of a Basquiat fan, that shouldn’t immediately disqualify them. The most important thing is that the office is comfortable and makes you feel safe. For some, that might mean a lot of art supplies, while for others, that might mean framed paintings. It almost never includes an open DSM-5 on the desk…
I should add that some things that might look like a mess might actually not be. I have a colleague who does a lot of art therapy and makes slime with patients, so don’t let a few bowls of mysterious pink or green slime throw you off!
If I feel unsure or things don’t feel exactly right in the first session, should I voice my concerns to the therapist?
If you feel unsure about your therapist, I think it is fine to let them know. Know that it is ultimately a judgment call and I want to empower patients to make that judgment. Getting close to someone takes time. It can start rocky and end up amazing, or it can start rocky and end terribly. Having a therapist who is really willing to put in the work to get to know you is invaluable, and having one that isn’t willing is valueless. If you feel uncertain but overall good about the person, give it another go and see how it feels. Intimacy takes time.