What Should You Look For in a Therapist? An Interview with Ryan Howes, Ph.D.


taylorenglish.comWhat should you look for in a therapist? I asked one of my favorite psychologists that question. Ryan Howes is a clinical psychologist in Pasadena, California. He writes the “In Therapy” blog on Psychology Today and is the coauthor of “What Wives Wish Their Husbands Knew About Sex.” He shares what he knows as a therapist himself.

What should someone look for in a therapist (or what are 5 qualities that good therapists have)?

Most people look for a therapist who is a fit for their financial resources, has some expertise in their particular issue, is licensed and has a sufficient degree or credential, and seems like a caring person. These basic elements are a great start, but successful therapy often requires a little more. Since most issues that bring people to therapy are relational in origin, it’s important that you’re able to form a good relationship with your therapist. In fact, research has shown that the strength of the therapeutic relationship is the single most important predictor of therapy success, regardless of their training or expertise. Given this, here are five qualities that help clients build a trusting, healing relationship with their therapist:

Patience – Growth and healing take time. Most clients have spent months or years dealing with their particular issues, and they aren’t likely to transform overnight. A helpful therapy relationship will move at the pace that is comfortable for the client and respects the time needed for growth. Clients don’t thrive when they feel pushed or feel a need to please their therapist.

Listening – Therapists are human and can’t be expected to recall the names of everyone in your life. But they should know your goals, your primary issues, and what you’re trying to achieve in therapy. Therapy is called the “talking cure” because it’s healing for you to put words to your thoughts, feelings, and behaviors. It’s also important for you to speak these revelations to someone who is able to take in and process this information.

Acceptance – Most clients have a harsh critical voice that is alive and well in their brain. The last thing they need is another critic sitting in the chair across the room. A wise therapist will listen without judgment and help clients accept and adjust their behaviors, not scold and criticize them.

Knowledge – One of the elements that sets therapists apart from friends and family is the fact that they’ve spent several years in graduate school learning how to treat mental, emotional, and relational problems. They have hopefully become adept at sharing this theory and research in a way that activates practical changes in your life.

Self-awareness – I believe every therapist should spend a substantial amount of time in their own therapy to help them distinguish their issues from their clients. In fact, I intend to be in my own therapy for as long as I see clients (at least!). A therapist who is willing to acknowledge his/her own blind spots or areas of potential conflict is worth their weight in gold, as far as I’m concerned. Asking a therapist if they’ve done their own work may feel awkward, but may help you avoid pitfalls.

How do you go about finding a good one?

Most people find a therapist from a personal referral – often from a trusted physician, religious leader, family member, or friend. Online resources are also helpful, as it answers some questions about experience and training.

The best thing potential clients can do is develop a list of three or four therapists and take them on a “test drive.” They have a telephone consultation or initial interview, tell them a little about their issues and ask what the therapist would do about it. While the data of the treatment plan is important, they really need to focus on how they feel in the presence of the therapist. Do they feel like they can open up? Do they feel guarded for some reason? Do they feel the need to impress or “win over” the therapist for some reason, or did they feel relaxed? In the end, trusting your gut is more important than the age or experience level of the therapist. Go with the therapist with whom you were best able to be yourself.

What are some red flags that the therapy relationship isn’t healthy?

If your therapist is talking more than you. If you feel the need to take care of your therapist. If your therapist is suggesting your relationship extend beyond the time and place of your therapy sessions. If you feel like you’re talking to a brick wall. If you feel a romantic advance from the therapist. If you feel like the financial practices are shady. If you have any sense your confidentiality is being compromised. If you’ve read this (http://www.apa.org/ethics/code/principles.pdf) and feel like some boundaries are being crossed.

When should you stop therapy?

When it’s successful, when you can find better help elsewhere, or when it’s harmful.

Success – The ideal end of therapy comes when you feel you have conquered the issues you brought to therapy as well as any you’ve uncovered in the process. Sometimes people enter therapy with one issue and soon realize they have several more, this isn’t uncommon. Success means you have learned how to overcome or cope with the symptoms and underlying issues that contribute to the distress in your life. Clients often report that they are able to “hear” the voice of their therapist in their head, recommending the positive course of action that is healthy and helpful. When you’ve internalized this positive perspective, you have less need for the actual person of the therapist. In this situation, I like to make sure the client and I have a good ending to the therapy, where we’ve taken the time to have a complete “exit interview”, where we have good closure and tie up all the loose ends.

Find help elsewhere – I’m experienced at helping people find relief from anxiety and depression. Many clients come to me for help with these issues, but some of them reveal they also have an addiction that contributes to this problem. Chemical dependency and addiction isn’t an area of expertise for me, so I’ll refer these clients to colleagues who have expertise in these areas. This often ends our work together, which is sad, but I know they will be in better hands with people who specialize in their particular problems.

Harmful – Physician’s hippocratic oath “Do no harm” applies to therapists as well. Sure, it’s common for people in therapy to feel a little worse before they get better, and they don’t always feel good following a therapy session. This kind of discomfort is normal in therapy. But when clients feel a dramatic increase of their symptoms, feel an increase in shame about their problems, or feel their privacy, dignity, or sexuality have been exploited, it’s time to look for the exit.

Originally published on Sanity Break at EverydayHealth.com.


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Therese Borchard
I am a writer and chaplain trying to live a simple life in Annapolis, Maryland.

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