How to Choose a Therapist
If you’ve been thinking about starting therapy for a while now, chances are you’ve either felt uncertain about where to start, or started looking at options, then felt quickly overwhelmed, and put off the decision for another day. Future you is not impressed. Even in smaller centers, like Canmore and Banff, choosing a therapist is not a simple exercise.
It’s natural to have some anxiety about starting therapy, but often that is just part of your nervous system getting ready to try something new, to prepare for change.
There are many ways to gather information about therapy options, and each has its own limitations. You can ask your social circle, but sometimes it’s hard to ask for help, or worse, you may encounter stigma. You can read Google reviews, but these are somewhat limited compared to other services, as mental health professionals must comply with regulations that prevent us from gathering testimonials from satisfied clients. This is to protect confidentiality and avoid creating weird expectations or funky power dynamics, but it does make it tricky to benefit from others’ perspectives. Even with general directories, like Psychology Today, where you can search by geographic area, it’s easy to get overwhelmed by the volume of profiles. On more specific directories, such as for those seeking a Highly Sensitive Therapist, the profiles can all start to sound the same. Let’s give this choice the attention it deserves and highlight some considerations to help you wade through the noise.
1. First up, let’s reduce risk by talking about credentials.
Did you know that anyone can call themselves a counsellor? Yes, really. Or that a therapeutic arts practitioner and an art therapist have vastly different training? Also true. No wonder it’s so confusing. You can reduce risk by ensuring that the therapists you are considering have appropriate training and are regulated by a governing body.
Practice standards vary by profession and by province; however, as a minimum baseline, you can look for someone who has completed a master ‘s-level program in a helping profession at an established university. Most often, it is during post-graduate courses that we deepen our therapeutic skills to work ethically with people during their vulnerable seasons. Think of it this way: undergraduate courses provide a general foundation, master ‘s-level classes specialize skill sets, and PhDs often advance the knowledge base through research. Usually, master 's-level programs will include:
Baseline competencies for skills and reflective practices
Courses in ethics and options to specialize in different types of therapy
Formal practicum sites with a required number of hours working directly with the public in a therapeutic context
Supervision for the learner by a more experienced professional
Does a Master’s degree guarantee you a great therapy experience? No, but it can help slim down your pool of choices and demonstrate that a foundation of knowledge has been built to support the acquisition of the skills needed for therapy.
*Pro Tip: If you have insurance benefits, it is worth contacting your insurer first to see which professions your insurance will cover as you narrow down your search for a therapist. This can be another measure of credibility.2. What is a regulatory body, and why does it matter?
Often referred to as a college, a regulating body is an organization that ensures a profession operates within its scope, navigates boundaries ethically and doesn’t cause harm to the public (aka you). They are bound to meet applicable legislation (for example, the Health Information Act). Typically, a regulating body will have guiding documents such as a Code of Ethics and Standards of Practice that define what is and isn’t acceptable.
These groups also have some specific powers. For example, a regulating college can:
Grant the licenses to work in a geographic area (usually by province)
Receive complaints from the public
Determine the regulations and the process for accountability
Dole out discipline to professionals who have not maintained the standards of care, or worse, who have harmed the public.
Define the requirements for staying current with professional development
If you have a terrible experience in therapy, the regulating body is the organization you can contact to make a complaint. A college or regulating body should not be confused with an association. Associations are often a separate group whose function is to advocate for the profession and support their members (aka your therapist). Generally speaking, long-established health professions will have both a college and an association, whereas newer or emerging professions will have neither.
*Pro Tip: When in doubt, look for their license number, or “Registered Social Worker” or “Registered Psychologist” designation in their signature or title. If you see "provisional" or "qualifying" in the title, it means they are likely newer to the field and working towards meeting the requirements to become fully registered.3. How much experience do they have?
I’m not throwing shade, but it’s worthwhile to consider the number of years of practice experience of any potential therapist. Questions you can consider:
Are they a student or a new graduate?
When did they complete their studies?
Where have they worked before and in what capacity?
Do they engage in supervision or peer consultation?
When and what was the latest training they took?
What areas are they passionate about and why?
What populations do they have experience working with?
While the length of service doesn’t automatically create quality care, it does build a solid foundation of knowledge and experience that can support your path.
*Pro Tip: Beware of the therapist profile who lists dozens of focus areas. We all need to be adaptable, but a therapist who offers to do it all might be too good to be true. A little therapeutic humility and self-awareness go a long way. You can also reflect on whether you want to work with a generalist or a specialist based on your areas of concern. When in doubt, schedule a meet and greet and ask your questions.4. First impressions and gut instincts.
Often, our conversations with a therapist are quite intimate, so it’s worth spending a little time seeking out a good match. We call this the “therapeutic fit” or the “therapeutic alliance,” and research shows that it is massively important to the overall process and your outcomes. If you don’t feel comfortable, if the dialogue isn’t flowing, or if the conversation is focused on things that aren’t important to you, consider finding a therapist who is a better fit.
Many therapists offer a free, short consultation so that you can meet, ask questions and have an introductory conversation before making your decision. It’s worthwhile to talk with a few therapists to explore your questions. Then, trust your instincts about fit. We can’t always pinpoint why we are or aren’t drawn to someone, but you will generally have a first impression of whether or not you would like to have more conversations. Listen to your gut; you don’t need to justify or explain your decision.
*ProTip: It can be helpful to prepare a list of questions in advance of your Meet & Greet to get clear on the factors that are important to you. This can include everything from practical details (hours, fees, cancellation policy) to process (therapeutic approach, areas of focus) to personality (passions, worldview, core values, etc). 5. Therapeutic approach
What’s the best way to support your needs? This is a tough call for most people, as there are hundreds of theories and evidence-based treatment modalities to choose from. Inconveniently, they are often in the form of an acronym or use professional jargon, such as:
CBT (Cognitive Behaviour Therapy)
EMDR (Eye Movement Desensitization Reprocessing)
Sensorimotor Art Therapy
Narrative Therapy
IFS (Internal Family Systems), to name a few
The average person won’t have a frame of reference as you consider which approach you prefer, and sometimes others have shared strong opinions about which approach would be helpful for you. You shouldn’t need to be a decoder to understand what you are signing up for, and you can bypass this confusion by asking a potential therapist to share information about their framework.
*Pro Tip: It is the therapist’s job to help you articulate your needs, and to help match you with a therapeutic approach. In lieu of trying to learn about every treatment modality, it is probably easier to share the areas you’d like to focus on, and ask a potential therapist to summarize how they would approach your situation. This will also give you more information about their listening skills, how collaborative they are, and their ability to explain concepts in ways that resonate with you. 6. Location, location, location.
Where and how you connect with your therapist has implications, whether virtually or via telehealth, downtown in a shared office, or at an in-home practice. There isn’t a “right” location, but ideally, we want therapy to be as low-barrier as possible, and sometimes having access to hybrid services can offer the best of both worlds.
For virtual sessions, you can ask about the platforms used and if they comply with health and privacy regulations. You can also ask about how/where your information is stored and secured, and if they maintain insurance for virtual practice. Virtual services allow you to reach beyond your local geography to find a therapist who is truly a good fit.
*Pro Tip: If you are a student or considering a move, you might check to see if your therapist is registered in more provinces so your therapeutic process can continue between semesters or while navigating life transitions. For in-person sessions, you might consider accessibility factors such as how much parking is nearby, whether there are stairs if you are injured, whether there are gender-neutral washrooms, and whether soundproofing is sufficient to maintain your privacy. You can reflect on your comfort level and explore whether you will need to interact with others, such as a receptionist or in a waiting room. If you have allergies, you can learn more about the cleaning practices and any guidelines related to animals in the space. For art therapy, it can be exciting to know which art materials are available and where they are located. For highly sensitive people, our environment is a very important factor, since we can be easily distracted by harsh lighting, a cold room, or the background noise coming from a hallway.
*Pro Tip: It’s worth asking yourself what you need to be comfortable and factoring that into your decision. Can you see the space ahead of time? Can you imagine yourself there? It's okay to support your nervous system by choosing a therapist with a space that you find soothing. The therapy space or studio becomes another container for your difficult experiences.7. Availability.
Part of finding a good match is finding a therapist with availability that fits your life. Take a peek at the therapist’s schedule to see if it’s compatible with your life’s rhythm. While you are at it, explore the process for rescheduling or cancelling appointments. Will a change set you back several weeks, or does the therapist have some flexibility for life’s surprises? Notice how many appointments are being offered in a day, and ask yourself where you want to fit into that energy cycle. Personally, I love my massage therapist, but I don’t want to be their 6th appointment of the day. Likewise, your therapist also has an emotional capacity that has shaped their schedule. While we live in a society that tells us to hustle and grind, you might enjoy finding a window of time where you can intentionally ease into an appointment and ease out with some self-care practices, rather than rushing off to the next thing.
*Pro Tip: If you are constrained by work hours, you can explore with your employer if they have a policy regarding medical leave (which is normally for medical appointments) and or sick leave (which is used to recover). Taking care of your mental health is just as important as taking care of your physical body. Like oil changes or dental cleaning, investing in sustaining your mental wellness can make you more resilient to life's surprises and prevent larger disruptions or crisis later on. 8. Resources, we all need them.
Therapy shouldn’t feel like homework, but what you do between appointments is just as important as what you do during your appointment. Often, resources come up organically in conversations. You might see formal resources such as:
A list of helpful links on their website
Book, video, or podcast recommendations
Educational models to support your learning
Additional programs or events available in your geographical area
A referral to a specific service related to your area of concern, such as a dietician or perimenopause course
Sometimes the resources are supportive practices such as:
Journalling prompts
Nervous system regulation techniques
Creative invitations to explore at your own pace
A good therapist will usually be (1) well-versed in resources and often able to point you in a direction to access them, or (2) willing to look for resources that can support your process together. If you know your learning style (auditory, visual, kinesthetic/tactile, verbal, analytic, social or solitary), it can be helpful to share this with a potential therapist so they can adapt their approach to match your natural learning style.
*Pro Tip: If you are looking for something specific, like an assessment, diagnosis, or a report for a third party, ask if these are services that the therapist provides in advance. 