Shopping for a Therapeutic Connection

Nancy Bergeron, R.Psych.

Choosing a therapist is no easy task. There are thousands of psychologists, counsellors, and therapists in Alberta alone! Selecting a professional with the training, experience, and personality that fits your needs can be daunting. You will be forming a relationship with this person, whether it's for three sessions or a lifetime. A great therapist is just like your family doctor…they are there for you through the many transitions and challenges of your life. It's important you feel comfortable and safe with them.

Research shows that the factors ranked as most important in making therapy successful are:

• the therapist's listening skills (63%)

• the therapist's personality (52%)

• the personal connection with the therapist (45%)

• the therapist's being active in the session (38%), and

• the cost (38%)

As you can see, it’s important to choose a therapist that’s a good fit. It's something we therapists learn early in our training. It's all about the relationship. A clinician with a wall full of credentials and 25 years of experience may seem to have the edge on paper, but if the first-year therapist has a better connection with the you, they may provide a better outcome. Referrals, degrees, and demographics matter, but the quality of the relationship seems to matter more.

Here are a few things to consider in your search:

+ Referral

In order to develop a therapeutic relationship (which is crucial in any type of therapy), you have to feel some ease of rapport with the therapist, and feel comfortable opening up to them. Asking friends, family members, and colleagues about their experiences with their therapists is an excellent way of getting a sense of different types of therapy and therapists. Have any of your connections gone into therapy and had a positive change as a result? These are the people to ask. Although it's not always easy to find the right therapist for you, referrals from people you trust are a much better basis for choosing a therapist than who has the lowest fees.

+ Age/Ethnicity/Gender/Sexual Orientation/Religion

In general, people tend to choose therapists similar to themselves in these areas, with the belief that someone with shared demographics or shared experience will better understand them. Have they walked a mile in your shoes? For many people, knowing that their therapist has experienced or overcome a similar challenge may make them more comfortable, like their therapist “gets it”.

+ Cost

Fees for therapy vary widely, from free (or nearly free) at some community agencies to $250+ in private practices. Great therapy is an investment of not only money, but time and emotional energy, so it's important for you to honestly assess your resources. Therapy can be expensive, but consider how much money you would spend on other things like: shopping for clothes, dining out, getting your nails or hair done, buying the latest cell phone/technology/vehicle, not to mention entertainment to help us feel better, none of which produce a lasting change.

+ Insurance

Licensed therapists are registered with major employee health insurance providers which cover most, if not all, therapy fees to a set limit per year. You can check with your insurance provider to determine how payment works.

+ Location & Availability

How flexible is your time? Some therapists offer evening and weekend appointments, but these tend to fill up quickly. How close to your work place or home is the therapist or clinic located?

+ Training

Many paths lead to careers in psychotherapy.

• Psychiatrists have an M.D., tend to focus on the biological elements of behavior and may or may not do psychotherapy.
• Psychologists have a Ph.D., Psy.D. or a Masters in Counselling Psychology, typically conduct psychotherapy and may have training in psychological assessment.
• Clinicians with a Masters in Social Work provide therapy with an emphasis on the client's social system.
• Marriage and Family Therapists or Marriage, Family, and Child Counsellors hold a master's degree and specialize in relationship issues.
• Licensed Professional Counsellors have master's degrees and conduct general therapy as well.

Again, cost and areas of focus vary widely among these professionals.

+ Experience

Clinicians with years of experience have seen and treated many people with a variety of issues; they know what has helped and what hasn't. Newer clinicians are fresher in their training and are potentially equipped with the latest techniques and theories. More experience usually means a higher fee.

+ Therapeutic Orientation

Also called treatment modalities or theoretical orientations, influence how we understand and treat your problem, or even how we relate to you. There are hundreds of therapeutic orientations, but they tend to fall in a few major groups that help explain your thoughts, feelings and behaviors. Some therapists use several theories, based on what their client’s needs are, which is referred to as an integrative approach.

+ Expertise

Through training and/or experience, most of us focus on a few areas of clinical interest or specialty. Some of us have written books on the topic, published articles, spoken at conferences or received special training in the areas.

So, where do you start? Call your top three choices and arrange for an initial consultation. Most therapists will offer this complimentary. It's okay to let them know you're consulting several therapists. The consultation is not meant to go into the details of your challenge, but instead, to interview the potential therapist and get a feel for their personality, therapeutic style, and expertise. When you consult, ask them to elaborate on anything you're not clear about. The therapist should be able to communicate their experience, style, and approach in a way that makes sense to you.

The research is pretty clear: the therapist's ability to listen, their personality, and the connection you feel with them is vital for successful therapy. Your subjective experience of them is just as important as their credentials, so trust yourself. Who did you feel the strongest connection with? And if you don't find a match in your top three, please continue your search, or even ask for a recommendation. Like I said, there are thousands of us out there, and we want the best fit for us both.