Consider this startling statistic: Twenty percent of clients will drop out of therapy before completing treatment. That's according to the American Psychological Association, and it's not particularly surprising. Finding a good therapist can be a daunting task. But with therapy, more than almost anything else, it's the relationship between client and therapist that matters most.
"I cannot emphasize ... how important it is to find a therapist that you get along with, who understands you and who can help," says therapy client Karis Rogerson.
Indeed, research suggests therapy will have the best results when client and therapist are a good fit, says Erica Curtis, a therapist in San Juan Capistrano, California. "Education, theoretical orientation, all of that, is secondary, tertiary, to just plain liking your therapist."
But navigating the complexities of the mental health system — searching for the right combination of personality, credentials, theoretical orientation, identity, and payments — can be overwhelming. To help destigmatize the process and make it more manageable, keep these five tips in mind while searching for the perfect therapist:
1. Search smart
Finding a therapist who works for you requires research. You can streamline the process by asking friends and family for referrals to find a personal touchstone.
"You want to know someone who knows you a little bit or maybe has worked with the therapist," says New York psychotherapist Lisa Brateman. "It's about the connection to you, so a lot of times, some of the best ways to find therapists are through your family and your friends."
If referrals aren't available, there are many other places where you can start your search: Try a good old Google search. A lot of people rely on Psychology Today's therapist directory. Or you can try the list of providers available through your insurance company. From there, check out the reviews, read each therapist's website, search for papers they have written, and look for speeches they have given to see what resonates with you. "Use whatever information you can find about the person," says Berkeley, California, psychotherapist Leslie Bell.
To narrow your search, make a list of the characteristics you feel are a must-have in your therapist. For example, LGBTQ clients may want a queer-identified therapist. Those recovering from trauma may want a board-certified traumatic stress expert. Many people have preferences as to whether their counselor is male or female.
"Knowing yourself a little bit and doing a little bit of that thinking before you start to make calls can help you find … what you're looking for," says Bell.
2. Shop around
After you find two to three potential therapists, it's time to do a little shopping. Reach out to a few of your options to get a sense of how they react to your unique situation and how well the two of you gel. Like any relationship, a therapist can look great on paper, but in person, the connection may not be there.
"Just because somebody has a specialty in an area that you want to work in doesn't mean that they're the right person for you," says Brateman. "They may intellectually know your area but that doesn't mean they're the best fit. It's like dating in a sense."
Many therapists will be game for a phone consultation or an introductory session for just this purpose.
"Lots of therapists will do an initial free 20–30 minute consultation on the phone and most people can get a pretty good sense in that amount of time how comfortable they feel," says Bell. "If you talk to a couple people you'll start to get a sense of [what] felt comfortable."
3. Make sure the price is right
There's no way around it: Therapy can be expensive. Some therapists take insurance, but others are private fee-based only. Some may offer a sliding scale, with fees adjusted based on income on a case-by-case basis. It's important to get this information upfront with every therapist you talk to.
If insurance won't cover mental health treatment or the therapist you like doesn't take insurance or offer a sliding scale, try getting referrals for psychotherapy students or more junior mental health professionals with expert supervisors. This ensures mental health care with an expert nearby, but at a cost that won't entirely empty your wallet.
"A great option a lot of the time is either to see somebody who is being supervised … or to ask [more seasoned therapists], 'Do you know somebody who's more junior who you've worked with in the past whose fee is going to be slightly lower?' I think that can be a great way to find somebody," says Bell.
4. Don't assume talk therapy is the only option
Straight talk therapy might not work for everybody, especially those who have unsuccessfully tried it in the past. But there are a lot of alternative methods that might be worth looking into, including animal-assisted psychotherapy, or somatic therapy that focuses on the relationship between mind and body.
"A lot of people find that talk therapy either isn't enough or it only takes them so far," says Curtis. "And after that, we need to start paying more attention to other aspects of our brain and our body than the rational, thinking, verbal part of the brain. When you bring art, for example, or creativity into a session … it taps into other parts of a person's experience. It accesses information ... or emotions that maybe can't be accessed through talking alone."
Curtis (a credentialed art therapist) uses a combination of art therapy, talk therapy, mindfulness meditation, and EMDR to create comprehensive treatment plans for her clients. This type of holistic approach to mental health challenges clients to grow and make new discoveries about their lives.
5. Use technology
An alternative to traditional in-person therapy could be high-tech options like e-therapy over Skype or newer app-based texting services like Talkspace or BetterHelp. These apps match clients with a therapist from their roster and allow for unlimited text messaging. Their prices are far less steep than traditional therapy, plus they basically put a therapist in your pocket, so this option opens the door to treatment for a wider audience.
"The two biggest barriers to going to therapy are cost and stigma," says Roni Frank, co-founder and head of clinical services at Talkspace. "By making licensed therapists available both on the web and mobile, Talkspace is introducing a flexible and affordable new way to get mental health support."
But does it work? Indeed, digital services like Talkspace have been shown to be nearly as effective in both positive outcomes and connection between client and therapist. Worth a shot, right?