Considerations in Choosing a Therapist

Photo courtesy of stockimages/
Photo courtesy of stockimages/

Since I have been a therapist for a number of years now, I have often been the first therapist a person has seen.  Other times I’ve heard about people’s difficulties and frustrations in finding the right therapist.  And since a certain match and the right expertise are essential, I may not always be the best therapist for some people.  So I thought I would put together a short list of things to look for in your search.  These may not be the only factors, but I believe they are some of the most important.

1.Cost.  It’s true that therapy is an investment in yourself, so it’s likely to pay dividends in the long run that you just can’t put a price on.  Still, the reality is that not anyone can afford to see just any therapist.  Some participate with insurance (in-network), while some do not (out-of-network).  And some insurance plans offer out-of-network benefits and some do not.  So, when it comes to cost, here are some factors to look at:

  • Do you need to use health insurance?  Or would you prefer to (that’s why you have it, right?).  If so, is the person you’re considering in the network (which means lower cost to you)?  And do you have mental health benefits and do you know what they cover?  For example, is there a deductible you need to meet first, or do you simply pay a flat copay or percentage of the visit?  Even with a high deductible, the fees you pay would count toward that, and the amount per visit will be lower than the therapist’s standard rate, since he or she is contractually bound to only charge rates set by the insurance company.  For example, if the therapist charges $150 per hour, the insurance company’s rate may be $130, so this would be the maximum fee allowed.  If the person is out-of-network, will your insurance cover any of the cost?  Sometimes they will reimburse you a percentage of what you paid.  Call your insurance company to get the answers if this is important to you.  Though a potential therapist can or may look into this ahead of time, it’s up to you to be informed so there are no surprises later.
  • What are the therapist’s fees for the services you are looking for?  How often might you need appointments?  If you can’t afford it, does the therapist have any flexibility in those fees?
  • Do you have a Health Spending Account (HSA) or Flex Spending Account (FSA) that could help pay for your services?

2. Was the person recommended to you?  Oftentimes I’m recommended to a potential client by another therapist or another professional like a physician, school counselor, or staff at a treatment center (i.e. hospital or rehab).  I may also get a recommendation by a friend or family member.  If a particular person was recommended to you by someone you know and trust, often this carries a lot of weight.  This person knows you and/or your situation, so he or she is in a position to offer names of people who could help.

3. Do you need an expert?  Most therapists work with common issues like depression or anxiety, often with people of various ages.  But if you’re looking for someone who specializes in working with young children, older adults, LGBT individuals- or with particular issues like trauma, OCD, or substance abuse, it may be important to find someone who specializes in that area.  If you’re searching online, looks for words like “expert”, “expertise”, “specialty”, or “specializes in”.  Although this may not always be accurate, most often it indicates that the person has particular knowledge and experience in a certain area.  If you want to be sure, ask.  Most therapists would not claim to be an expert in something they’re not- and if they’re not the person you’re looking for, most should be able to help you find someone who is.  If you don’t need an expert necessarily, you might be ok to look at other factors in your choice.

4. Face value.  Does this person look like he or she would be a good fit for you?  Nowadays pretty much every therapist has a website or a profile on a Web directory (Psychology Today is one of the most popular).  Websites and directories may include a personal statement by the individual, the populations and areas they work with, and of course information on their location, how to contact them, and what methods of payment they accept.  They even have photos!  So you can use this information to get a general idea of what kind of therapist this person is and whether or not you might be able connect with them.  It would be worth a try to contact them and ask a few questions to see if it might work.

5. The first visit- or the second or third.  Of course sitting in the room with the person, talking with him or her, and seeing if there is a connection is the best indicator of whether it’s going to be a good match or not.  I know this sounds like dating or something, but it is crucial that you feel a good (or at least a good enough) connection with your therapist.  You need to feel heard, to feel like you’re not being judged, and to feel comfortable enough to say just about anything, much less disclose private details of your life.  Of course, this may not happen in the first session- particularly if the therapist is more focused on getting paperwork completed and gathering information during an initial session than usual.  But by the second or third meeting you should know if this is the right person or not.  If not, don’t feel bad about telling the person you want to check into some other therapists.  Even ask for some referrals if you like.  A good therapist should also be a professional, so their feelings should not be hurt by you saying it’s not a good fit.  And whether they are or not, therapy is a service you’re paying for, so you deserve to feel good about it.

2 bonus factors…

6. Location.  The person you see is important, so hopefully you’re not basing your choice solely on the fact that you can walk to the therapist’s office.  However, in reality this may be important.  You might be going close to home or close to your work or school, which of course would be preferable to driving 40 miles out of your way.  If this happens, great, but at times traveling a little farther might be necessary- especially if you live in a rural area, need an expert, or just want to see a certain person.

7. Hours.  Obviously, this is important too.  Most therapists have at least some evening hours, since that’s what most people who work or go to school need.  Some even offer weekend hours.  If you have limited availability it might be harder to find someone, so the more flexible you can be the better.  I see a lot of people at night, but it’s not uncommon to see adults before or after work, or even on their lunch break.  And though I typically see kids after school or in the evening, at times I need to see them before school or at some other point in the day.

If you’ve never looked for a therapist or you have found the process to be frustrating or daunting, I hope this list will give you something to go on.  Sometimes people see one therapist and have a negative experience, so they give up- either because they don’t want to try again, because they assume all therapists are the same, or due to some other factor like difficulty scheduling.  I tell people, “If you went to a new hair stylist and got a bad haircut, would you give up haircuts?”  Or, “If you went to one mechanic and felt like he didn’t do a good job, would you stop getting your car worked on?”  I know therapy is different, but the same premise remains.  I encourage you to be thoughtful in your search and not to get discouraged if it takes some time to find the right person.  This is common, but hopefully you will find a good match without much trouble.

All the best,

Dr. Matthews

Published by Dr. Jesse Matthews

I'm a practicing psychologist and director of Matthews Counseling & Coaching, a private practice in Chester Springs, PA. I work with clients 18 and older, and my specialties include: depression; addiction/substance abuse; relationships; anxiety; ADHD and behavioral issues; and Autism/Asperger's. Our group works with individuals from tween through older adult, helping them with a variety of life issues. Check out the practice website for information on other clinicians and their services: .

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