Choosing a Therapist

Therapists listed in Good Therapy's directory are fully accredited and qualified for private practice. Counsellors, Psychotherapists and Psychoanalysts have Professional Association membership. Psychologists and Clinical Social Workers are registered with the Australian Health Practitioner Regulation Agency (AHPRA)

Why see a therapist?

Some people think that seeing a therapist is an admission that something is wrong with them. This is an unfortunate misconception. Seeking support for one's self or wanting to fully participate in one's personal development is a positive affirmation of life, a creative undertaking that requires courage and curiosity.

From the outside it might appear that counselling or psychotherapy is just a bunch of talk, but it is much more than an exchange of words. Practitioners may use a range of techniques, yet therapy is more than someone practicing a set of skills or 'going through the appropriate motions'. So what is it that makes therapy truly effective and worth our while?

Human beings have an uncanny ability to intuit another person's capacity for understanding. A therapist may be appropriately educated and have completed relevant training, but this will never be enough. For therapy to be effective; a genuine connection is essential.

How will I know if a therapist is right for me?

This is a difficult question, but an important one nonetheless. For those who have the good fortune of finding a suitable therapist first time, this question may not even arise. For others however, it can be quite a different story. The search for the 'right' therapist is not unlike searching for the 'right' accountant, doctor, builder or hairdresser. Whether it be entrusting our finances, our health, our home or our hair to another person, few people would settle for just anyone.

However, many of us are seasoned procrastinators. We rarely seek anything unless we perceive or feel an immediate need for it. How many people do you know who can say that they have found a therapist but not yet engaged their services? As it happens, most people wait until they are suffering intense emotional pain or in the midst of a crisis - and need help right away. Such a time is probably not the best time to choose a therapist.

When discomfort is extreme, there is a great deal of pressure to find relief - and find it fast. These less than ideal circumstances can make it difficult to focus our thoughts and make sound judgements.

A typical scenario: After struggling for an extended period of time we finally 'hit the wall'. Desperate, we make an appointment with the nearest and first available therapist. At the initial meeting we discover that the therapist operates on a wavelength that is not compatible with our own. We sink into despair and disappointment. Unaware of alternatives, some of us opt to persevere - albeit half heartedly. Or we might become disillusioned and give up on the idea of therapy altogether. Neither of these outcomes is satisfactory; there is little joy in settling for mediocrity and perhaps even less in allowing ourselves to become jaded.

Factors that influence the client-therapist relationship

There is no universal fail-proof formula for choosing a therapist, but this needn't discourage us. Many choices in life require discernment and some deliberation. We identified ten factors that may impact on the therapist-client relationship. This list is by no means exhaustive, and is included here only to encourage you to reflect on your own experience.

1) Atmosphere. Therapists' rooms vary a great deal. And, though we are not all equally sensitive to our surroundings, we are all affected; just differently. For example, some people may feel constricted in a small space; whereas others may find the same room cosy and preferable to a larger one. Brightly coloured walls may be intimidating to some and inviting to others. Some of us are comfortable sitting on the floor; others would rather sit on a chair. These sorts of things will contribute to overall impression. Still, it is the quality of presence engendered by the therapist that ultimately sets the scene.

2) Gender. Does it matter whether the therapist is male or female? Gender won't be a critical consideration for everyone, but some of us will gravitate towards a particular gender. There are no rules here, just preferences.

3) Age. Though birthdates are part of the therapeutic equation, they need not play a big role in relationship dynamic. Some people may be apprehensive about a therapist who is several years younger or older, others may be delighted by an age difference.

4) Cultural background. Persons from vastly different cultural contexts may encounter some difficulty understanding each other, even if diversity is warmly embraced.

Although I try to be universal in thought, I am European by instinct and inclination. -Albert Einstein

On the other hand, some people believe it is possible for us to simultaneously acknowledge and transcend our cultural heritage.

5) Philosophical orientation. No two people share exactly the same views and values, we are each one unique. This truth doesn't seem to prevent us from carrying around the belief that others are or should be just like us. Many of our assumptions operate underground; this lack of awareness makes it difficult to see our biases 'at work'. Do you want your therapist to be a kindred spirit? In what way might this impact on your expectations around how therapy should proceed?

6) Personal attitude. Recent research indicates that personality has a significant sway on how we evaluate therapy. If we don't like the person we perceive a therapist to be, there is little chance we will want to engage this person on a meaningful level; especially if the aversion is particularly strong. This response may be tempered however, by a belief that the therapist can help. Does the therapist instill a genuine sense of hope?

7) Physical appearance, manner and voice. Whether we want to acknowledge it or not, the judgements we make about another person are influenced by how we perceive his or her appearance, body language, and voice quality. When you are greeted by your therapist in person for the first time, do you find yourself being drawn forward or wanting to pull back? As we get to know someone, it is not uncommon for our perceptions to change. Someone who appears quite ordinary in the beginning may become beautiful in our eyes once we've spent time in their company. Of course, this can happen the other way round.

Distance tests the endurance of a horse; time reveals a man's character.

8) Therapeutic approach. There are so many schools of thought now; the myriad possibilities can be daunting. Still, most of us find that certain modalities and methods appeal more than others. Depending on whether we are motivated by strong feelings, a hankering to make sense of our experience, or swayed by the pragmatism of what works, we tend to lean towards a particular style. This may change from time to time; what appealed to us before may not be what we want now. There has been much research and even more written on the processes of learning. However, insights and shifts often occur when we least expect them, and in ways that defy explanation. The Types of Therapy reference page on this site provides a summary of 50 contemporary approaches in counselling and psychotherapy.

9) Academic accomplishment. A practitioner's level of education may figure very highly for some and not at all for others. While a therapist's university degrees and specialised training are important professional prerequisites, they offer no guarantees as to personal competence or compatibility.

10) Availability. Practical matters, like location, finding a time that is mutually convenient, and negotiating an acceptable fee may seem relatively minor concerns, but proximity, flexibility and/or affordability can turn out to be major deterrents.

'Good therapy' as a concept is meaningful because sometimes, therapy is not so good. Exactly how each person determines where on the good - not so good continuum a moment in therapy falls continues to baffle even the keenest of minds. This doesn't mean we should dismiss our yearning to understand. After all, it is this very quest that imbues life with wonder and magic, from one moment to the next.

Asked about the difference between a well-made work and a masterpiece, Nadia Boulanger (a French composer, conductor, and teacher who taught many of the leading composers and musicians of the 20th century) replied, 
"I can tell whether a piece is well-made or not, and I believe that there are conditions without which masterpieces cannot be achieved, but I also believe that what defines a masterpiece cannot be pinned down. I won't say that the criterion for a masterpiece does not exist, but I don't know what it is."

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