A how-to guide for getting the most out of therapy
(hint: it starts with finding a therapist who is a good match for you, and I’ll describe that part first.)
This field of mental health can be difficult to navigate. I created this guide as a way to help folks feel empowered in their therapy experience. I posted a poll recently on my Instagram asking: have you ever had a bad therapy experience? This was a teeny tiny poll, but 78% said yes. The other 22% said “more like subpar.” Wow! And you know what? I have also experienced both bad and subpar therapy.
That’s why I am so passionate about creating resources to demystify the process of finding the right therapist, how to get the most out of the experience, know when to leave, and end a therapy journey gracefully.
FIRST STEPS: GET SOME CLARITY BEFORE YOU MEET WITH A THERAPIST
Get clear on what you want to get out of therapy
Maybe you have specific goals, such as recovering from a hard break-up, finding closure and opening yourself to love again. Or maybe you’ve been feeling a TON of anxiety, self-doubt, and you want to develop a more trusting relationship with yourself. Sometimes it can be more open-ended, such as wanting to gain more self-awareness and to be challenged to see things from other perspectives. Whatever the case, get quiet with yourself to determine what you want to get out of therapy.
Consider what type of environment would support that growth / healing
Just like there are about a million reasons to start therapy, there are quite a few of us therapists out there roaming the earth. What kind of personality would mesh well with yours? Who do you feel most comfortable around — confrontational or more passive; someone older and wiser, or about your age; someone more logic-based or more feeling-intuitive? Do you want someone who is no-nonsense who will tell you like it is? Do you want someone who is tender, gentle, and will make you feel nurtured? A little of both?
Based on your identity, would it be helpful to speak with someone who had your lived experiences? This could be gender, sexuality, cultural/racial/religious background, life experience, etc.
NEXT STEPS: FINDING THERAPIST CANDIDATES + EXPLORING THE INVESTMENT
Consider if you need someone with a specialty
The field of therapy is VAST. If possible, you’ll want to find someone who is less of a catch-all generalist, and more well-versed in areas that will benefit you. For example, if you’re looking for couples therapy — you’ll want someone with specific training in couples work. The LMFT after my name stands for “Licensed Marriage & Family Therapist” — which lets clients know that I’ve had extensive training in relationship and family dynamics. If someone claims to work with couples, make sure they have some credibility there, whether a degree, trainings or certifications.
Therapists specialize in treating specific mental health diagnoses, treatment approaches, experiences, etc. For instance, I specialize in treating couples and individuals who want to develop deeper connections, and heal past traumas and wounds. I also specialize in sex therapy, body image, inner child work, mindfulness and somatic (body-focused) interventions, and religious trauma recovery.
This is a really important aspect to explore before you reach out to a therapist, since you want someone who is experienced in supporting folks just like you.
Determine if you’ll pay out-of-pocket or go through insurance (or both, I’ll explain)
Take some time to get a clear picture on your options:
If you go through insurance to find a therapist in-network, what’s the co-pay?
The “both” option is that many private pay therapists offer the option to provide a superbill for out-of-network reimbursement.
You’ll need to reach out directly to your insurance to find out if you have these benefits. Check out the section “do you accept insurance” in my FAQs for more info on how to do this.
Leverage your community for recommendations
There’s just nothing like a word-of-mouth recommendation. Here are some ideas of who you can ask: friends, coworkers, other providers you trust (such as your dietician, doctor, physical therapist, acupuncturist, etc.). Other ideas: post anonymously in a community Facebook group. Do a Google search and see if the therapist has a Google listing with reviews.
If you find someone via your insurance website, look them up on Psychology Today. If you’ve found them on Psychology Today, see if they have a website. You’ll want to see how they express themselves, what populations they serve, some details about their training/background, and whether they have any specialties.
NEXT STEPS: THE INTERVIEW PROCESS
Schedule a few free consultations
Many therapists offer free 15-20 minute phone or video consultations for prospective clients (I do!).
This is mutually beneficial, as therapists are also interested in making sure that you are a good fit for them! Therapists are ethically required to take clients who fit within their “scope of competence” — meaning they have adequate training, background, expertise and capacity for their clients specific needs. A phone consultation helps a therapist to understand whether they can help, or if it would be better to send you a referral for someone else who has more qualified training for your needs.
Reflect after each call. How did it feel to speak with the therapist? Whose personality did you vibe most with? Did they sound confident and knowledgeable? Did you feel like you could chat easily with them? Were they clear and transparent about next steps? Take some time to jot down your thoughts and reflections before you book that first session.
Expertise is nothing if you don’t feel safe
Someone may have all the credentials in the world, but if you don’t feel safe, free from judgement, and empowered in the relationship — they are not going to help you make progress. In grad school, we learned about a phenomenon called “Common Factors” — ingredients that influence positive change, regardless of the therapist’s approach and training. One of the most profound common factors is the ‘therapeutic alliance’ — aka the bond you have with your therapist. Research shows that “the stronger the alliance, the more effective the therapy.” So if you’re feeling uneasy, constricted, misunderstood, dismissed, or otherwise not aligned after meeting with your therapist a couple of times — abort mission.
Is therapy uncomfortable, or am I just not liking my therapist?
We’re all nervous at first. But when you start to feel more comfortable, does your body relax? Do they put you at ease? Do you feel like they are present with you? Do they remember things you’ve told them? Do you ever feel like you are bracing yourself or holding yourself back? Can you be open with them about that? Could you imagine crying in front of them?
If you feel calm, relaxed, heard, understood, and generally harmonious in your therapist’s presence — huzzah! Yay! That’s great and I’m so happy for you. After you establish more trust, a good therapist will lovingly challenge you and express their observations — which are beautiful ways of growing your self-awareness.
If you’re feeling unsure, judged, uncomfortable, and generally unsettled — LISTEN TO YOUR GUT. This may not be your person, and that’s okay. BELIEVE YOUR INSTINCTS. Ask yourself: what is it about them that I don’t vibe with? Am I feeling judged? Could it be my own discomfort with being vulnerable? Once you get some clarity, decide if you’d like to stick it out or find a new therapist. Don’t force yourself to keep seeing someone you don’t feel comfortable around, you will not make any progress!
Therapist green flags:
they put you at ease
they are present with you
they remember things
they seem attuned to your feelings
they go at your pace
Therapist red flags:
they share a lot about themselves
they make you feel judged
they tell you what to do
they aren’t respectful of appropriate boundaries
Staying with a therapist that’s not a good fit can be a waste of time at best, and truly harmful at worst. So stay aware of the relationship, and move on if you need to.
NEXT STEPS: COMMIT TO DOING THE WORK
Take responsibility for your part
Most often, therapy starts on a weekly basis. My clients that experience the most growth do the work. Aka: willingness to be vulnerable and deeply honest in our sessions. Actually applying what came up in sessions to the outside world. Having the brave conversation. Reflecting on a question. Reading the book. Being consistent. Really investing in the process.
Check your expectations
Therapy can help us in incredible ways … but we aren’t miracle workers. Get honest with yourself about your expectations of this therapy experience. Is your hope that working with this therapist will change your life in 5 sessions? Have you ever hoped or wished that your therapist would “fix” your situation? (This can be especially common in couples work.)
My dear friends, if you’ve found yourself wanting your therapist to fix or rescue your situation — I hold you with compassion. And, that’s just not realistic. This is your journey, and as therapists we are just here to help you till the soil, excavate any hazardous waste, recognize what nutrients you most need — but you are the one doing the growing.
Ask for what you need
Be transparent with your therapist. If you need more structure, ask for it. If you’d benefit from more homework assignments, let them know. If you’re struggling to pay for weekly sessions, be open about that. Giving your therapist feedback not only strengthens the therapeutic alliance, but it gives you the opportunity to practice this essential skill in a very safe atmosphere. Also! If your therapist responds poorly to your (reasonable) requests — that’s a red flag and it might be time to move on.
Decrease frequency of treatment gradually, if possible
There are always going to be circumstances (financial, insurance, life demands, etc) that require therapy to be cut short. But if possible, it’s most beneficial to gradually decrease the frequency of sessions. The logic here is that at a certain point you’ve done the insight-building, processing, etc., and as you gain more internal resources from your work in therapy, you don’t need to see you therapist as much. This model helps you to maintain your progress while you build your confidence. Cutting the cord too soon can mean that we backtrack.
Recognize if/when the relationship has run its course
It’s my personal belief that most therapy doesn’t need to be ongoing indefinitely. Stay connected to yourself about how it’s feeling. Do you still feel like you’re growing? Check in about the “rightness of fit” now, vs. when you first started therapy. For example: maybe your cognitive, logic-based therapist helped you SO MUCH with reframing, and working through automatic negative thoughts. But you’re now at a point where you want to do some deeper inner child work around your core beliefs … and they just don't have the skillset to take you there. Recognize when it’s time to either take a break from therapy altogether, or find someone else who can take you on the next leg of your journey.
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About the author: Jaclyn Zeal is a licensed marriage and family therapist, specializing in helping women and couples develop more embodied, trusting relationships with themselves and each other. Jaclyn has a solo private practice and operates out of a wellness center in Royersford, PA. Learn more about Jaclyn, and her services and fees.
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