How do I know I’m seeing the right psychotherapist?

Once you have met with your psychotherapist a few times you should ask yourself whether the therapist you are meeting with is the right fit for you.  Here are some ways to determine if the counsellor you are meeting is right for you:

• Does your therapist provide a safe environment?  Do you feel comfortable disclosing the intimate details of your life?
• Does your therapist understand the risks you have taken and respond to you in a supportive, caring manner?
• Does your counsellor treat you with respect and dignity?
• Is your therapist non-judgmental?
• Do you feel your counsellor is ethical?

Your therapist should be able to provide you with a “roadmap” of where you are going.  Your therapist should be able to describe what is happening in the counselling room and his (or her) (for simplicity for the remainder of the article I will use the pronoun “he” because I am a male therapist) reasons for approaching things in a particular way.  Your therapist should be able to describe the theoretical framework being used in language you can understand. 

I work from a perspective that integrates Narrative, Brief Solution Focused, Feminist, Cognitive, Family Systems and EMDR therapies.  Although I work intuitively, I will be able to describe to you theoretically why I asked a certain question or took the therapy in a particular direction.  You have the right to know what is happening in our work.  If you are curious or uncertain, you should feel comfortable asking your therapist these sorts of questions.

Look for someone who shows interest and curiosity in what matters to you; someone who will ask questions to probe for more information; someone who shows empathy and understanding about the issues you are facing.

You should expect your therapist to have lots of questions.

You should not expect your therapist to have all the answers.

Your counsellor is someone who has a set of skills that help him to listen attentively and to help you to explore your situation by asking thoughtful questions.  This is your counsellor's area of expertise.  However, you are the expert on your life.  You are the person who can identify when you have been successful and when you have run into barriers.  Your counsellor cannot know the best way for you to deal with a situation — he should not have those types of answers for you.

One goal of therapy is to provide you with an opportunity to gain alternative perspectives or new ways of looking at your situation. Your counsellor should be able to ask you questions that make you reflect, observe, understand, gain insight and so on.

Once that has happened, your therapist can help you to explore new possibilities or new ways of dealing with your situation.

Your therapist should help you to identify goals for therapy.  Periodically, you should review those goals together to see if some have been met, some have changed, some are no longer important and so on.  Ask yourself what your goals are for therapy.  Are they being met?  If not, why not?

Feedback is important.  You have the right to expect ongoing feedback: 

• That might take the form of observations about your strengths or reminders about times you have been successful. 

It might be about contradictions your therapist notices when you are telling a story.

• "You keep mentioning how difficult Connie is to work with, yet all you have told me are instances where she has been especially pleasant, kind and helpful.  Can you help me to understand what you mean by difficult?"

Or maybe your therapist notices contradictions in the counselling room during therapy.

• "I notice that although you were smiling when you said that, your message and tone of voice sounded really angry.  What is really going on?"

These types of feedback can help you to gain insight and make choices about your behaviour.

You should feel comfortable challenging or questioning your therapist if he seems:

• to be judging
• does not seem to take your concerns seriously (or to be giving them enough weight)
• not understanding you
• not seeming focused enough. 

Ideally, your therapist should respond non-defensively and should not take what you have said personally.  Instead, he should clarify, answer your questions and help you to gain an understanding.  Your counsellor should recognize the importance of your being able to challenge other people (including your therapist!), and see the counselling room as an opportunity to practice that skill.

I say ideally, because it is possible that when you confront your therapist, in the moment, he may become distracted or frustrated or irritated by your question.  Clearly this is not the preferred response — but it is certainly a human response and not necessarily a bad thing.  What is important is what happens after the less appropriate response.  Hopefully in the moment, (but certainly the next time you meet), you therapist should be able to explain what was happening in that moment of distraction/frustration/irritation, and to apologize to you for that response.  This can demonstrate that it is alright to have difficulty communicating but that relationships can heal (inside or out of the counselling room.)

To return to safety, you want to be able to discuss whatever is troubling you, to know that you will not be judged and to know that your therapist will help you to find ways to deal with the issue you have raised.  Sometimes your therapist is the first person to hear a part of your life story.  You want to feel comfortable to take the risk to discuss the issue and to know that your therapist will help you to feel okay afterwards.

There should be an end to your work together.  Your issue may not feel "resolved" but you should

• find that you have gained a new perspective (or a range of ways of looking at the situation),
• have noticed any life experiences that were similar to learn how you have been successful in the past and how you might be able to be successful now,
• have a range of strategies to try to deal with the situation. 

That is the time to end therapy.  You do a "piece of work" which may last 4 to 6 sessions or a few months or a year, then you stop counselling.  You may have issues to address at another point (with the same therapist or a different therapist), but you need to stop attending therapy sessions in order to try to implement change and to evaluate how those changes influence your life.  It is your therapist's job to work himself out of a job, by helping you to gain perspective and by helping you to look at new approaches to your situation.

It is important to remember that you are a consumer receiving a service and you are entitled to the best, most appropriate service to address your mental and emotional health needs.  Make sure that you have found the therapist who is right for you.

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©Jeremy Tomlinson, M.Ed., R.M.F.T., R.S.W., EMDRIA Certified
jeremy@alternativehorizon.com
www.alternativehorizon.com

Jeremy Tomlinson, M.Ed., RSW is a therapist in Toronto. He specializes in EMDR therapy, DBR, trauma therapy, life transitions, and sex therapy. Many of his clients are survivors of childhood sexual abuse or have experienced attachment issues in childhood, are survivors of adult sexual assault, or are living with symptoms of depression or anxiety. He currently has a virtual practice in a home office.