Finding the right psychotherapist: What are the top things to consider?



Psychotherapy in Ontario is legally defined in the Psychotherapy Act, 2007:

“The practice of psychotherapy is the assessment and treatment of cognitive, emotional or behavioural disturbances by psychotherapeutic means, delivered through a therapeutic relationship based primarily on verbal or non-verbal communication.  2007, c. 10, Sched. R, s. 3.”

Maybe you are wondering how to find a good therapist for yourself or a loved one. Looking for a therapist can be overwhelming. Here are a few things to consider as you search.

PROFESSION. Currently in Ontario, Psychotherapy is legally regulated. This means that in order to practice psychotherapy here, one must be a member of a professional college that grants the license to practice psychotherapy. There are several professions that can practice psychotherapy: Registered Psychotherapists (RPs), Social Workers, Psychologists and Psychological Associates, Physicians, Occupational Therapists, and Nurses.  If you are seeking psychotherapy, you will look for one of these kinds of professionals.

EXPERTISE. Expertise is about knowledge and skills. You should consider what a psychotherapist’s training has been to practice psychotherapy, and also whether they have expertise to help your specific case. Psychotherapy expertise is developed through a combination of training and experience. Training often involves graduate-level coursework in psychotherapy theory and technique, a significant amount of supervision and supervised clinical practice, and a degree of specialization. Psychotherapists will advertise themselves based on their training and experience, and should be open to explaining their expertise to you.

For example, in my case I have a graduate degree in clinical psychology, specializing in adults, and a considerable number of  supervision hours and supervised client contact hours as part of my professional requirements.  Based on my expertise, I practice clinical psychology with adults from an Integrative psychotherapy orientation.  Further, psychotherapists will often list more specific areas of specialization based on specific issues that people seek therapy for (e.g., ‘anxiety,’ ‘trauma,’ ‘building more satisfying relationships,’ etc.). It is always a good idea to ask a psychotherapist to clarify how their expertise can apply to your specific situation, and whether your specific issues fall within their scope of practice. The psychotherapist should be willing to fully explain this to you as part of their referral intake process. 

THERAPIST DIRECTORIES. Therapist directories such as Psychology Today can be good starting points. You can look up psychotherapists in your geographical area or by name, and then read through their profiles to get a sense of expertise, psychotherapy approach, and profession. If interested, you can contact the therapist directly through the directory to ask more questions or book a first appointment.

REPUTATION. Perhaps a friend or colleague has recommended a psychotherapist for you. Or perhaps a therapist has a PhD, has won multiple awards, lectures at a university or college, or has written a research article or book. Although there is no sure way to determine that a good reputation will translate into a good therapy experience for you, a good reputation suggests credibility.

COST AND COVERAGE. One of the first things to find out in order to plan your treatment is the hourly rate a psychotherapist has. These rates can vary between individual psychotherapists and also between professions. Often highly experienced psychotherapists cost more per session than less experienced ones. Consider how much expertise you are willing to pay for.

Some psychotherapists are open to discussing a sliding scale, for example if you are a student or currently unemployed. There is no harm in asking if the therapist offers a sliding scale. An important consideration in calculating cost is to know your extended health benefits plan, if you have one. What is your plan? What is your co-pay and annual limit for psychotherapy? What professionals are covered for psychotherapy with your plan? Knowing these things can help you coordinate your treatment with your therapist and help you know what to expect financially.

YOUR PREVIOUS EXPERIENCE. Your previous experiences with psychotherapy matter. Have you been in psychotherapy in the past? What was it like? This is very valuable information as you move forward to your next experience. Would you like a therapist who is similar or different from your previous one(s), and in what ways? Was your previous therapy a positive or negative experience overall, and what do you see as the reasons?

YOUR IMPRESSION OF THE PSYCHOTHERAPIST. There is no substitute for your personal experience in determining whether a therapist is right for you. Although there is financial investment, meeting several times with a therapist and beginning psychotherapy is the most definitive way of knowing if the therapist is the right fit. Are you comfortable with this therapist, even though what you talk about can be difficult? Do you feel hopeful that this therapist has the expertise and knowledge to help you? Do you feel like the therapist is making an effort to understand you and your therapy goals? Psychotherapy is a complex human experience, but by engaging in a few sessions, you will have your own impression of a psychotherapist and can use this to make a decision about a more regular commitment.

Finding a good psychotherapist can be a life-changing experience. It is my hope that this article can help you get closer to what, and who, you are searching for.