• Alexandra Skinner Walsh, LMHC

Starting Therapy 101

You think you're ready to begin therapy? Wonderful! Now begins the (sometimes) daunting task of finding a therapist - - da da daaaa. No need to worry though. Here we will cover what to look for when searching for a therapist, when you know to leave a therapist and questions to keep in mind to ensure you're on the path to finding your perfect fit!

Finding the right therapist for you is the most important and critical part of starting therapy. Research has shown that the treatment style (e.g., cognitive behavioral, play therapy, etc.) used by the therapist is important, but not nearly as important as the therapist themself when predicting successful treatment results(1). I always recommend meeting with your therapist for 3-4 sessions and if, by then, you aren't feeling connected to your therapist, it's time to find a new one. Finding a therapist is like dating. You wouldn't go on a date with someone you don't connect with or who doesn't understand you. The same should be assumed for therapy. Therapy is a place where self-exploration and intimate conversations about all areas of life occur. You need to feel safe, accepted, understood and connected to your therapist to truly dive deep. So, do your research! Every therapist is different. Some specialize in counseling services that utilize art, music, religion, and much more. If you are a recovering Catholic, for instance, maybe Christian counseling is for you... or maybe not. There is nothing wrong with deciding a therapist isn't a good fit for you based on their specialties, modalities or even their gender. In fact, being able to articulate that the therapist isn't right for you is preferred, because, believe it or not, they can also sense the level of fit.

So how do you find the right fit? Here are 8 qualities to assess when getting to know your therapist:

1) They have good interpersonal skills

The basis for therapy is a relationship. Thus, your therapist needs to be able to focus their attention on you, provide warmth, empathy and acceptance, while also having the vocabulary to communicate their knowledge and expertise with you. I know this one seems so obvious, but it is truly important! So be mindful of the therapist's level of eye contact, tone and ability to empathize with what you are saying.

2) You Feel Understood

A critical part of therapy is that you feel as though the therapist "gets it." That they know what you are communicating and you feel as though you can trust them to help you reach your goals. So many clients, come to therapy and share things with their therapist they have never told even their closest friend. Being able to know your therapist can handle all you are and all those emotions is critical. A therapist cannot help you work towards change if they don't know what is truly going on in your world. If you don't trust your therapist, then they aren't the one for you. You can usually tell within the first few sessions if that therapist can provide a space where you feel accepted, safe and understood.

3) You're a Team

A therapist isn't going to be able to change your life by snapping their fingers -- although this would be super cool, am I right?! -- Instead, it will take your hard-work and dedication to making adjustments that will change your life. The therapist is just simply there to help you get to where you want to go through guidance and suggestions. Think of it like driving a car, you are the driver and the therapist is the passenger. You're the one deciding when to turn, how fast to go, when to stop and who to pick up and drop off along the way. The therapist is simply there holding a map asking where you want to go and offering suggested routes to get there. Thus, you need to feel like you are a team because you will have to work as one. This is usually done by working together to set goals, assessing for progress towards goals and establishing a clear picture as to what life will look like once goals are met. If your therapist does not establish these clearly then don't be afraid to bring it up! We can't get to where we need to go, if we don't clearly know where that is.

4) The Therapist Knows and Believes in What They're Talking About

Your therapist should be able to describe (1) what they think the mental health issue or other concern(s) are, (2) where it could be stemming from, and (3) how to address it therapeutically. An effective therapist should know what the best treatment for your symptoms are based on present research and can communicate this in a way that anyone can understand. If your therapist explains this, but you still don't understand then ask them to explain again in a new way. From my experience, most therapist are able to provide an explanation as well as a solution. If they don't offer this right away, don't be afraid to ask! Therapy is also a space where hope is always present even if you, as the client, don't believe it. How does this make sense, you ask? Well, because the therapist should always believe that what they are doing will be effective. This means that the therapist holds hope for change even when the client doesn't. If you feel your therapist does not believe in what they are doing or lacks hope for change, then maybe you aren't with the right therapist.

5) The Therapist is Multiculturally Sensitive

So many people struggle with mental health issues and research continues to connect the impact of our demographics to mental health. Thus, effective therapists understand all of the factors that may contribute to your mental health. Some of these factors may include physical health, race, religion, gender, age, disability, socioeconomic status, culture, sexual orientation, and more! For example, we know there is a strong link between suicidal ideation and identifying as LGBTQ+. This is not because being apart of the LGBTQ+ community causes someone to feel suicidal. Rather society's rejection, abuse and discrimination against this community causes high levels of stress, which can result in suicidal ideation among other symptoms. If you have a therapist who is aware of this impact, they will address ways to navigate through the discrimination, abuse, rejection and stress. They will not attempt to change one's sexual orientation or gender identity -- for the record, attempting to change/alter one's sexual orientation or gender identity is called conversion therapy and it is truly horrible and unethical. Just don't do it ever and don't see a therapist who offers this -- An effective therapist is one that understands the connection between demographics and symptoms, which then assists the therapists in treating the symptoms ethically and appropriately.

6) Are They Flexible?

What works for one, does not work for all. An effective therapist will have an understanding that to some degree everyone needs a treatment that is tailored to them. There are treatment approaches that can treat a variety of symptoms, but how these these treatments are used will look different between clients. Effective therapists will also understand where in the change process their clients are. Some people come to therapy ready to hit the ground running, while others are thrown in without a say. Depending on where you are in the change process will affect the course of therapy. An effective therapist understands this and has tools to help increase motivation for change. We are individual beings, with individualized needs. Thus, therapists will need to tailor, adapt and/or be flexible in their approach to treat your mental health symptoms.

8) Consistent and healthy professional and personal boundaries are continuously set and maintained

There is this commonly held myth that therapists somehow have it all together at all times. Well, I am sorry to burst your bubble, but this is not the case. Therapists are humans who suffer from illnesses, stress and other factors, just like the rest of us. There may be days where your therapist seems off their game and this is normal. However, it is not normal or okay for your therapist to behave unprofessionally or unethically at any point in time. Also, if you're therapist always seems as though they are not fully present then they may be burnt out, meaning that it's time for you to find a new therapist. Your therapist should be modeling what it looks like to set healthy and appropriate boundaries both in and out of session. Would you eat food that the cook them self wouldn't eat? Doubtful. The same goes for therapy. It should be evident that the therapist is practicing what they preach by setting boundaries. Setting boundaries allows your therapist to be fully present with you in session so that you can appropriately address and meet your goals.

Now you may be thinking, "alright, I know what to look for, but how do I even find them?" Here are three ways to find a therapist:

1) The Google Gods are here to help! Google mental health agencies and private practices in your area. There is usually at least one in most places. Except if you live in the middle of nowhere, then you have much more difficulties ahead of you. Number two may be a good fit for the rural folk.

2) For those in rural areas or who travel frequently, there are new advancements in online or distance therapy services. One of which you could check out is Talk Space. This is a platform where one can get therapy services from a licensed mental health professional via phone call, video chat or other messaging services.

3) There is also this amazing website called Psychology Today. You can search for therapists in your area and read more about their specialties, treatment methods, and accepted insurances/payment methods. For those in the Quad Cities area check mine out here.

Now go, research away, and find your perfect fit! I know this was a lot of information and you are truly concerned as to how you will remember it all. But, have no fear, just click here to send me a message with what you found most helpful and I will send you a free pdf summary of things to look for in a therapist. It's great for on-the-go and contains questions to ask yourself and/or your therapist to help you find your perfect match. If you are wanting to learn more about a specific type of therapy, check out my What is Play Therapy? blog post.

I hope this mental health blog post will help you navigate through all the wonderful therapists out there to find the one that's right for you. Best of luck my M.A.D. friends!


1. Wampold, B. E. (2011). Qualities and Actions of Successful Therapists. American Psychological Association. Retrieved from

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