Finding the right therapist is like finding a long-lasting, comfortable pair of shoes. As we walk through life, our mind and heart, just as our feet, get a few bruises – some big, some small. They say injuries to feet take the longest to heal because we use them all the time. The same applies to our mind – we use it constantly, incessantly, it doesn’t even rest completely while we are asleep. Healing our mind takes time - which is why therapy is never a quick fix and it often takes several sessions to note progress. Finding a competent therapist who will support us through that process is imperative.
A good therapist provides a safe, non-judgmental space to talk about our psychological distress and is qualified to support us in ways that are insightful, knowledgeable, empathic and empowering. An uncomfortable shoe can sometimes make injuries worse, which is why choosing the right therapist to fit your needs is so important. Here are some practical tips to think about while choosing a therapist.
Pick a good therapist, not a convenient one.
While cost and convenience are important considerations, so are priorities. Making your mental health a priority is crucial because it is difficult to perform most daily activities when you are in psychological distress.
While choosing a therapist close to you and finding someone whose time is more flexible etc. is important, it does not always lead you towards the best option. There are always going to be practical constraints such as job/college timings, but remember, therapy doesn’t always fit into free time. You have to create time in your schedule for self care. Therapy is an active process on the client’s part and so picking the first name that comes off Google because it is ‘easy’ or going to the first referral without researching them might be quick but not valuable. Make time, take effort in this process and it will be a lot more gratifying. In India, there is a dearth of qualified therapists so it might be useful to explore the online counselling option as well to get better quality help from wherever you are.
With respect to cost, a healthy therapeutic alliance is rewarding and valuable, which makes it a worthwhile long-term investment in your mental and psychosomatic physical health rather than an expense. Therapists fees vary significantly based on experience and qualifications. The most expensive therapist is not always the finest, but a cheaper therapist who is not well-trained can worsen your experience when you are feeling vulnerable, causing further damage.
There is no universally good therapist, find a therapist who is good for you.
No shoe fits two people the same way – our sizes, preferences and injuries are all different. We often try on a few to find the right fit. Calling up a few therapists before you choose yours might give you an idea of what you are looking for. Most therapists' websites/write-ups give you a fair idea of their approach with which they work. It is worth taking some time exploring and comparing these in order to find the right fit for your worldview and needs. Which takes me to the next point.
Trust your intuition
See how you feel when you speak to the therapist either before you take an appointment or after your first one. Are they easy to talk to? How did you feel before/during/after you spoke to/emailed them? Did you feel judged? Notice how you feel around them and trust that. It is important to note however, that therapy is not a quick-fix solution. So experiencing a significant metamorphosis after just a few sessions is unlikely. However, if you just don’t feel comfortable talking to the person in the first few sessions and are completely unable to open up for a variety of reasons – they might not be the right fit for you. It might be helpful to address this with the therapist and explore why this is happening. Addressing these issues honestly is at the core of a healthy therapeutic alliance and your therapist’s response to your concerns will often give you a good idea about the way they work through issues within the counselling space.
Understand their theoretical orientation
A theoretical orientation is the intervention approach a therapist uses to address the particular psychological vulnerability that the client presents. There are two overarching schools of thought in counselling and psychotherapy – solution focused and insight oriented. To simplify, if the presenting issue is quitting smoking, there are a number of ways a therapist can work with it. A solution-focused therapist, say a CBT practitioner, might work with it by recognizing and changing thinking patterns, identifying environmental triggers, aversion therapy etc. Therefore, it focuses predominantly on the problem at hand and perhaps some others linked to it.
An insight oriented therapist might want to explore the deep-rooted issues that drive a client to smoke. It involves exploring the more unconscious, repressed motivations and desires that lead to smoking. It requires a more comprehensive examination of one’s feelings, intrapsychic dynamics and accessing parts of the self, our relationships and our memories that are usually repressed or neglected to gain insight into our pervasive patterns with addiction. This form of therapy is like a magnifying glass into our inner world, searching for patterns amidst the chaos, releasing the individual from the destructive behavior holding them back.
Qualifications, qualifications, qualifications
Unfortunately, due to the lack of a regulating body, there a number of people who call themselves ‘counselors’ in India without having a formal education. Before you visit one, it is essential to look up the person’s qualifications. A minimum requirement is a masters degree from an accredited university/college. Generally, more reputable universities produce more reliable therapists. It is a good idea to look up the post-graduate program listed if you are unsure about its authenticity. Be wary of counselors with online degrees as they may not offer supervised clinical work without which, by international standards, the person cannot ethically see clients. Many private institutions in India offer counseling ‘certificates’ or ‘diplomas’. Note, that these are not interchangeable with degrees and do not qualify their students to work with clients. Psychiatrists too are not necessarily qualified to be psychotherapists/counselors without formal training in the same.
Ethics are paramount in the work therapists do. Confidentiality is the most significant one and must be broken only under exceptional circumstances (For eg. if the person is actively suicidal, if there is a risk of harm to somebody else, if it is court mandated etc.) A good therapist does not reveal the intimate details of your sessions to your family members, friends or their own non-professional circles without these dire circumstances. Good therapists are also nonjudgmental, encourage independence and empower clients to be themselves. It is worth looking up the code of ethics for international accrediting organizations like APA [American Psychological Association] or BACP [British Association for Counselling and Psychotherapy] to know your rights and what you can demand from an ethical therapist.
Therapy is notfriendship
Good therapy is not like friendship - it is not just about having a shoulder to lean on and a listening ear. It does not involve receiving advice and imposing opinions. It might not always make you feel better because it holds up a mirror of truth – one that your friends cannot because of their own biases. Therapists, unlike friends, listen deeply and empathically while holding complex psychological theories in mind, recognizing patterns in thoughts and feelings, helping you work through them. It should open up a safe space for you to express your vulnerabilities and psychological struggles within a space that is nonjudgmental and kind. Good therapy is when the client does the work. The therapist provides a crutch but the client has to walk.
Rhea Gandhi is a psychotherapist and researcher trained at the University of Edinburgh, Scotland. She runs a private practice in Mumbai and works within the dialogue of the psychodynamic and person-centred theoretical orientations.