Finding a counselor that is a good fit

Making the choice to see a counselor isn’t made lightly. I think that most people tend to notice that they’ve been feeling uncomfortable in regard to their thinking patterns or mood, and they decide that they need to do something because this discomfort isn’t working for them. Many people might decide to try some lifestyle changes first, and why not? There is a ton of evidence that suggests a potential mental health boost through exercise, mindfulness, improved nutrition, increased socialization, yoga, journaling, etc. Plenty of people make a few changes to their routines and get the results/relief they’re looking for. Unfortunately, this isn’t quite enough for many people, though. Sometimes the weight of the problems that people are dealing with is too much for them to handle alone, and it becomes time to ask for help. This can be a scary realization, though. People often know when they should reach out for professional help, but sometimes they don’t know where to start or how to ensure that a counselor is a good fit for them. My hope is to make this process a little less intimidating today. 

An article* from Psychology Today recommends: 

  • Figure out where you need support or what you’d like to accomplish in therapy. On the surface, this seems simple, but sometimes it is hard to put this into words. 

  • Are you more comfortable with in-person or telehealth services?

  • Consider accessibility needs. This is most obvious regarding what you need in relation to your physical abilities or language, but also consider your availability during the day, insurance assistance, and how far you are willing to travel. 

  • Figure out if a therapist’s values or life experiences are important to you. 

This is more of a starting point which can help aid you as you begin your search. As far as the actual search for a counselor, Psych Central** has a nice 10 step plan, but I’m going to be presenting it out of order. The link to their article is at the end of this blog. 

Consider** your budget first. If you have Medicaid or Medicare you’ll want to choose a counselor that takes those options. There are many who do not, but usually those of us who don’t will have a sliding scale or reduced fee for any insurances we don’t accept or for the uninsured. If you have private insurance, consider checking with them for a list of in-network counselors. It is also helpful to know what kind of deductible you have (If you have a high deductible, you will be paying what the insurance company would pay until that deductible is met). You will also want to know your copay or coinsurance rate. This stuff is all very confusing unless you deal with it frequently, so don’t be afraid to keep asking questions until you understand it fully. 

Next** you may want to consider getting referrals from family, friends, or your doctor. Keep in mind that a good fit for a friend doesn’t guarantee a good fit for you, but it is a nice place to start. As you start to make calls or explore counselors online you’ll notice different credentials behind their names. Most common are Licensed (L), Clinical (C), Social Worker (SW), Professional Counselor (PC), and Marriage and Family Therapist (MFT). You’ll also see other acronyms for therapy types, such as: ACT=acceptance and commitment therapy, CBT=cognitive behavioral therapy, DBT=dialectical behavior therapy, EMDR=eye movement desensitization and reprocessing, and this is only a few of the many therapy types. Consider a quick search to make sense of the different therapy methods and whether they seem like they would be helpful for your goals. 

Consider** their cultural competence. In order to maintain our licenses, we have to undergo continuing education that often includes this very thing, but while I may have an academic understanding of challenges that someone may experience based on an identity, sexuality, religion, or ethnicity that differs from my own, I have to acknowledge that I won’t have a personal understanding of these differences. Some people may want to speak with a counselor who has similar lived experiences as they have, which is completely understandable, and it can make it easier for some to open up. 

When you’ve figured out your therapy goals** you can see if a potential counselor’s expertise fits with your needs. When you reach out, through email or phone calls, you should feel free to ask questions as well. You may want to see what they can tell you about their experience, expertise, and therapeutic approach. You may want to also confirm with them about fees for services and any insurance questions. 

Of course, you can consider trying someone out** for a little while and possibly switching to another counselor if you feel it isn’t a good fit. It does take time to build rapport and trust, but admittedly, there are times where it just isn’t a good fit with a given counselor. It is the counselor’s job to earn your trust, so if you have “trust issues” this may take a little while, but you’ll know quickly if they seem interested and curious about what you have to say, warm, inviting, and respectful. 

Things to look out** for: specializing in everything (though someone who has been a counselor for multiple decades could potentially have a variety of knowledge), anyone who talks about “curing you” (much of mental health treatment is about relieving symptoms), inappropriate boundaries (the counselor-client relationship needs a certain level of distance in order to be effective, which is why we aren’t supposed to treat friends or family), or someone that you simply feel uncomfortable around. 

I’ve found that most of the counselors I’ve met are conscientious, kind, and well educated. In theory, any of us should be able to work with any person, but the reality is that we are all human. We can’t be experts in all areas, and we are actually supposed to avoid working with problems outside of our expertise. I know that some people have had bad experiences in counseling, but I encourage them to keep trying to find a good fit when they know they would benefit from having someone to talk to. 

*https://www.psychologytoday.com/us/blog/the-stories-we-tell-ourselves/202108/how-choose-therapist 

**https://psychcentral.com/blog/10-ways-to-find-a-good-therapist