Therapy, counselling, or psychotherapy - however you want to refer to this psychological service - is an inherently vulnerable process that can feel uncomfortable at first! It's also an investment in time, money, and energy. Further, most people start looking for a therapist because they have specific concerns they want to address. However, finding the right person to address those concerns can be difficult! What follows is some information that I hope will be helpful in your journey to finding a therapist who can meet your needs and feels like the right fit.
Consideration 1: Finances
First and foremost, therapy is unfortunately expensive as we have a poorly funded, inadequate, and nearly nonexistent public mental health system. Consider your financial resources and what your financial requirements for engaging in therapy are. Questions to ask yourself:
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What health benefits for psychological services do I have, if any?
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Does my health benefits plan allow for direct billing for psychological services?
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What is my yearly maximum for psychological services and what month of the year do my benefits renew?
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Is there a maximum I can use per session, hour, or day? Can I expect to have to pay for some of the fee out of pocket (i.e., a copay; for example, some benefits plans cover 100% with no limit, 100% to a maximum of x dollars, or 80% with or without a limit)?
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What types of professionals does my plan provide coverage for? (E.g., Services provided by Registered Psychologists are typically always covered but coverage for services provided by a Registered Provisional Psychologist, Social Worker, Occupational Therapist, etc. may vary by plan)
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What forms of payment are accessible to me?
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Do I typically have the money in my account to be able to etransfer at the start of a session without compromising my financial wellbeing?​
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Do I have a credit card available to pay for sessions? If so, will this add additional financial stress to use this form of payment?
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Do I require a provider who can direct bill to my benefits company?
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Based on the concerns I want to address, how often I might need to see someone to address that concern, and my financial situation, do I require a sliding scale fee to be able to adequately address this concern? (This is something that is difficult to provide blanket general guidance on, so figuring out how frequently you need to see someone could be discussed in a free consultation with a provider).
While addressing mental health and wellbeing concerns are certainly important, it is also important that the pursuit of addressing these concerns does not create a secondary crisis - a financial one. Most if not all therapists will list their session fee, whether they have a sliding scale, accepted forms of payment, and whether they can direct bill to benefits companies on their websites. For example, you can find this information about me here. If you're trying to find a therapist that is a good fit, there's no point reading through websites of people who do not offer the form of payment you require or whose services are financially inaccessible to you. It's a good start to identify if a prospective therapist offers what you need financially. If seeing a therapist in private practice is inaccessible to you, there is a list of resources you can use as a starting point here.
Consideration 2: Availability
The second consideration is also a practical one - your schedule. If someone's fees don't fit with your financial needs and/or their availability match yours, there is no point going further as it will become too stressful to continue investing in the psychological work you'd like to do. Questions to ask yourself:
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What time(s) of day and day(s) of the week am I most consistently available for at least an hour of uninterrupted time to myself?
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Am I available during the day on weekdays?​
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Am I available in the evening on weekdays?
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Am I available on weekends?
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Do I have time to commute and, if so, how far each direction?
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​Is it important to me that I see my therapist in-office versus virtually versus other options, such as walk & talk therapy?
Therapists often advertise their availability and the format of their offerings, such as in-office and the location, virtual services, or walk and talk therapy, on their website. Reflecting on when you will consistently be available for sessions without significant added stress and whether in-office, virtual, or alternate environments, such as walk and talk therapy, will be best for you will help you identify which therapist's websites are worth spending further time on. For example, you can see my availability on this page. You can also read more about virtual services here or walk and talk therapy here to reflect on whether either of these would work for you. If you require in-office services, how far you're willing to commute will also limit geographically which therapists will be accessible to you.
Consideration 3: Expertise
The third consideration is by far the most important in making sure you receive services that will meet your needs once you've figured out fitting therapy into your life financially and logistically. I would personally not seek out a cardiologist if I had issues with osteoarthritis in my knee, and I hope you would not either. The same concept applies to therapy - you want to find someone whose area of expertise - that is their knowledge, training, skills, and experience - matches the concerns you want to address. Questions to ask yourself:
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What am I most having issues with that I want to address in therapy?
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Is it important to me that my therapist either belongs to or has experience/training in working with clients that fit into the same demographic as me? Examples of demographics to consider include military/first responders, race/ethnicity, culture, religion, sexual orientation, gender identity, and parent.
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Is there a specific intervention or approach that I am looking for? For example, is there a specific intervention or approach you have experienced success with before, learned about, or heard about from a friend or family member who have had success with it?
Making sure you find someone who has the appropriate expertise can be the most complicated part of finding a good fit. Part of what makes it complicated is that clients do not often have the knowledge required to identify what treatments are evidence-based for which presenting concerns or even to necessarily name what their more pressing presenting concern is. The hope is that all therapists are following ethical practice, which requires that therapists are honest with their clients about their training and expertise and that they refer clients to another professional when the client's needs are outside of their training and expertise. Unfortunately, this does not always happen, which puts clients in the position of having to try to identify who might be a good fit for them. There are a few different strategies clients can use to make sure they find someone with the appropriate training and expertise. Here are some ideas of where you can start:
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If you know what concern you most want to address is (e.g., ADHD, anxiety, depression, PTSD, OCD), make sure that the therapist you are considering lists this as an area they have experience addressing on their website.
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Most therapists offer a free 15-minute phone consultation to new clients. Write down a list of questions you would like to ask and use the consultation to identify if the therapist has the expertise you require or not:
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If you know what the concern you most want to address is, ask them what the evidence-based treatment for that issue is and if they provide it
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If you do not know how to name your concern, describe it to them and ask what they think and how they would approach working with you
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If any demographic preferences you have are not obvious on their website, ask about them in the consultation
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Don't be afraid to ask about a therapist's training and experience working with a specific concern or population in the phone consultation
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There are some nationally available guidelines for evidence-based treatment that you can try searching - for example, if you search "evidence-based treatment PTSD" you will be able to find PDF copies of guidelines that identify first- and second-line treatments for PTSD based on the current available evidence. Most therapists list the primary treatments they use with clients, so you can look on therapist websites to see if they list the treatment that is evidence-based for your concern.
Consideration 4: Personality
The last consideration for finding the right fit is personality. Going to therapy is experiencing a human relationship and it is within the therapeutic relationship that change occurs. Having a good personality fit can help the therapeutic relationship feel right. Having a good personality fit means feeling understood by and in tune with another person. It also means that it feels good to be around them. Therapy work is vulnerable work and working with someone whose personality is a good fit for yours can help make that vulnerable work feel more comfortable. Questions to ask yourself:
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Do I prefer working with someone who:
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comes across more casually or more formally?
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has a distinct professional self or whose professional and personal selves are mostly similar?
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is direct in their communication/approach or more gentle?​
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uses humour?
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uses or is okay with occasional curse words?
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uses a more human-centred approach or a more medical approach?
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allows the client to lead the session, collaboratively leads, or takes the lead?
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Personality is probably the hardest consideration to gauge from a profile on Psychology Today given its short format or even on a website as it can be hard to infuse personality in text. However, you may get some clues to personality by reading through what a therapist has written on their profile/website. The best way to determine personality fit may be by booking a free 15-minute phone consultation, which most therapists offer for new clients.
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