Since I’m currently looking for a new therapist, I figured I’d share my thought process, since I get asked all the time how I pick a good person to work with.

This is personalized to me, but maybe it helps you think on your situation.

1. Insurance and cost. This is usually my first filter, though there have been times when I just wanted the best fit or a specialized service no matter the price. Remember many therapists do sliding scale if you don’t have insurance or are on a budget.

2. Similar lived experience, at least doesn’t seem like it’d clash with mine. For instance, a much older, straight, heavily religious man is likely to have experiences that lead him to have clashing interpretations on research compared to me. Psychology still has a long way to go

It’s not all about demographics and background though. Sometimes I’ll just read an “about me” and get a bad vibe, knowing we won’t work, other times I’ll feel like we’ll gel even if our backgrounds differ. LGBT support is a big plus.

3. Similar treatment philosophies. For instance, I want medication to be seen as an absolute last resort, I don’t like people quick to diagnose, I don’t like treatments like EMDR and exposure therapy. I do like talk therapy, nutrition/supplements/lifestyle changes, and body work.

I also don’t like it when a therapist is too evangelical about one treatment philosophy, which relates to another point: I like it when my lived experience is believed, even if it clashes with research. Patient coming first. I need to be respected & feel that, not talked down to.

4. They specialize in the right things. For me, domestic violence experience is a major bonus because there’s a lot of bullshit about that topic and I need someone who understands the nuances. PTSD/trauma specialty is a must for me.

5. Are they open to phone appointments? I prefer in person 1000% but during times like these or times when I’ve traveled a lot, it’s good to have as an option. Not all therapists are open to it.

6. What’s their availability like? How flexible are they? Are they open to impromptu calls? Some therapists are always very busy, others surprisingly flexible, and that flexibility can be really nice.

7. Most importantly, how do I feel about our first interaction? As painful as it is, my gut instinct is usually spot on after just one chat. We don’t need to be best friends, but I need to feel aligned with them and not put down or feeling bad about myself.

Research actually shows that how well you get along with your therapist is the #1 indicator of success, above everything else. Kind of shocking if you think about it, so do take that point seriously.

I recommend treating the first session like an interview, not like therapy. I try to emotionally detach and not get too invested in the relationship, just laying out the facts about my background and asking questions, then thinking on it when I go home before making a decision.

8. I think about my goals for therapy and reasons for doing it, a few bullet points, and bring those to the session. I’ve found the initial feedback I get on them can say a lot about what the therapist’s focus is and if their approach will work for me.

9. Someone asked specifically what questions I ask at a first therapy session and how I'd personally approach that, which is far too long for a tweet but worth answering, so wrote it up here: https://pastebin.com/Wcd9D3s7