I talk to people a lot about how important “fit” is when it comes to therapy.  More than the theoretical orientation your therapists takes, their gender, or anything else, it matters that it feels like it’s a good fit.  But how do you know that it’s a good fit? What even is fit? 

Due to moving several times and many other reasons, I’ve seen a handful of therapists.  Some of them felt like perfect fits--others, not so much. They were all skillful, kind therapists, but some of them just felt right for me while others didn’t.  I saw therapists who used CBT, mindfulness, psychodynamic theory, existentialism, IFS, ACT, and any other acronym you can think of. Though some theories clicked more with me than others, our overall fit was still most important.  Here are some factors that I feel play into this vague concept of “fit”. 

1) Cost

Finding a therapist who you mesh well with is amazing, but you’re in for a lot of frustration if they aren’t within your budget.  I wish this didn’t have to be one of the top deciding factors, but for many people it’s the only factor to really consider.

Many therapists take insurance or offer “sliding scale” services, meaning that they’re willing to drop their fee for those who need it.  Don’t be shy when asking a potential therapist about their cost, and always feel free to inquire about sliding scales--sometimes they offer it, but they don’t publicize it.  If it still doesn’t seem like something you can afford on an ongoing basis, either weekly or every other week, they are probably not the right fit for you.

2)  You feel like you can bring up anything

A therapist is someone you talk to about things that you might not discuss with literally anyone else.  It’s vulnerable, and it can be intimidating. It’s so important to the therapeutic process for you to feel comfortable bringing stuff up.  

Some things can take time to open up about it, and it’s okay if you don’t feel comfortable discussing them right away.  But if you’re sitting with a therapist and you don’t feel comfortable bringing up tough topics, like how much you drink or who you’re sleeping with, they might not be the right therapist for you.

3)  They lift you up, but they aren’t afraid to challenge you

A therapist should always have your back.  We want to be on your side, we want to support you, we want to walk alongside you.  Sometimes, however, it’s our job to challenge your way of thinking--especially if we feel like it’s having a negative impact on your life.  This isn’t a fun thing to experience, but it can result in enormous growth.

The challenge can come in different shapes and forms, from blatant “you’ve been saying for a while that you want to quit drinking, what steps are you making toward that goal?” (that’s pretty blatant for a therapist!), to subtle “I’m wondering if this is similar to what happened in your last relationship”.  It’s important that your therapist challenges you sometimes, and it’s also important that they do it in a way that doesn’t make you feel like you’re being attacked.  

4) Theoretical orientation

Going through grad school, I thought I knew exactly what I wanted in a therapist.  I wanted someone warm, open, friendly, who used mindfulness. My options at my university’s counseling center were slim, and I ended up with a therapist who was very much the opposite of what I just listed.  She rarely smiled, and she used a psychodynamic approach to therapy. Though I was skeptical at first, she turned out to be a great fit for me. I felt comfortable sharing things with her that I hadn’t shared with any other therapist.  

Theoretical orientation is definitely important, but I don’t think it’s the most important thing in a therapist.  I have come to realize that I don’t like therapists who implement strict structure to our sessions. That’s a part of their theoretical orientation that I just don’t vibe with.  If your therapist keeps doing meditation exercises and you’re not into it, definitely let them know. But if that’s essential to their theoretical orientation and you just aren’t into it, it might not be a good fit.

I hope that this list is helpful in determining which therapist is right for you!  There are so many wonderful, qualified therapists out there. If you have some bad luck in the beginning, I encourage you to stick with it until you find one who works.  Don’t be afraid to tell your therapist “hey, you’re wonderful but I just don’t think you’re the right fit for me right now. Do you have any recommendations?” A good therapist wants you to get the best care for you. My experience has shown me that there’s something I can learn from many different therapists who come from completely different approaches. Be open, be willing, and good luck!