What do I ask to determine if the therapist is a good match?

The first visit is where you get to assess the therapist and they get to give you an "in-take" interview. They will differ in what information they need to know from you, but it is important that you have in mind what you want them to tell you. Here are my suggestions of things to say or ask:

  • Tell them why you are here…inform them that you are shopping around. This will help them know what they can tell you.
  • Tell them why you want to be in therapy, and then ask them if this fits their training or interests.
  • Ask them what kind of therapy they suggest, how long they would want to do therapy, how much it costs, up front. Compare this with your preferences and needs.
  • If it doesn't fit, tell them what you want and ask them if they would be willing to accommodate. Either way, be prepared to shop around more.
  • Pay close attention to how you feel–it is normal for you to feel a little uncomfortable or nervous. Sharing personal information can be nerve-racking. However, do you feel like you would be unable to trust them? Tell them your feelings and ask them how they would deal with it if they were your therapist.

Should I choose a male or female therapist?

Many people have asked me this question, and I have always been wary of answering this with a either/or answer. I try to emphasize the trust factor, so I am more likely to suggest the gender in which you would feel most comfortable and trusting with. However, I think that even if you are uncomfortable with one gender it could turn out that it could be a worthwhile experience. One reason for this is the fact that not all people's personalities are typically male or female, e.g. a women therapist could have pronounced male qualities, making it hard to determine just by gender whether they would be a good fit. Yet, I have known certain people who are argued vehemently that they would only go to a female therapist, since they feel that their experience as a women would be best understood by the female therapist. But, you could say the same for race or class, and some people do use these as factors in choosing therapists, just as we use gender, class and race in choosing friends, employees and lovers. So, I would suggest to people who have stringent preferences, that there is no reason to go to someone you can not trust. For example, if you are a woman who has been abused by a man, it might be really hard for you to trust the male therapist.

Yet, there aren't hard and fast rules for this. I have had both male and female therapists, and I think the differences between them occurred more from their techniques, or simply because they had different personalities. It is hard for me to point out gender as the factor in what made them more compatible. Now I have a therapist who is female and has a very similar background–yet, I am aware of the fact that she emphasizes our similarities as a way to both form trust between us and for me to work out problems using her own experiences as a reference. But having a male therapist before helped me when I was having problems with a boyfriend–it gave me evidence that men could be trust-worthy, good listeners, and especially made me feel validated when he supported "my side" when my boyfriend and I had a disagreement. So if you are up for a challenge, or even just for an experience that could be worthwhile, I would say there is no reason not to try a therapist of a different gender, or race or class. No matter what therapist you get you need to pay close attention to your progress and your comfort level–and don't forget that it helps if you discuss these kind of issues with a prospective or current therapist.

What makes therapy successful?

In short, you make therapy successful. I said before that not all therapy experiences are the same and the biggest cause of this is that each person is different and brings in different expectations, talents and experiences into the therapy relationship. However, despite the fact that you are the determining factor in whether therapy is successful, many people think of therapy as if it is a doctor/patient relationship. I read a post on alt.psychology.help which said, "I have been going to various therapists for 15 years, and nothing has helped." Or there is the great part in Woody Allen's Annie Hall where Allen's character complains that Annie Hall has been in therapy for a few weeks and making more progress than he has made in 15 years. The problem with these people is the fact that they see success in therapy to be something outside of their control. Other people can't even define what success in therapy means. If you don't take responsibility for your own mental health, there isn't much a therapist can do. Practically, this means:

  • Taking therapy seriously, as if it is a class you want to get an "A" in by doing the assignments the therapist assigns you.
  • Think about the session and what you and your therapist have talked about outside of the session.
  • Get family members or friends involved in your therapy experience, by talking about your sessions and assignments and tell them what they can do to help you.
  • Keep a journal, writing down times when you feel like you have "slipped up" or when you feel like you are making progress, and keep it in mind to talk about with your therapist.
  • Be patient–sometimes the most "productive" therapy session or time while your are in therapy is when you feel frustrated or even depressed.
  • Do one nice thing for yourself a day, and take one day a month to do something totally nice and fun _just_ for you–therapy will be helped by your appreciating yourself, making mental health more valuable.
  • Remember, therapy is hard work, an investment in your mental health, but just in exercise, the rewards can be invaluable.