We all have ideas or visualizations of what it’s going to be like to start therapy. If you’re familiar with therapy and the process, you might have more confidence sitting down with someone new and asserting your goals. Even if that’s the case, going to therapy can feel daunting, and nerves can make it harder to effectively express your thoughts, needs, and concerns.
What brings people into the therapy room is usually difficult and complex to open up about. It’s also fairly common for people to say, “This is my first time in therapy,” so it can be hard to know what to expect. Finding a therapist is not a one-size-fits-all situation, so knowing what to look for—and how to look for it—can greatly help you navigate the “let’s talk about it” terrain.
What Is a Therapeutic Alliance?
One of the first points of emphasis when meeting with a new therapist is this: just as every client is different, every therapist is different. The most important factor is what’s called the therapeutic alliance—the unique professional relationship between a client and therapist that plays a critical role in growth and development.
A strong therapeutic alliance is one of the biggest predictors of outcomes in therapy (Del Re, Flückiger, Horvath, Symonds, & Wampold, 2021). Here’s why: clients who feel connected to their therapist tend to stay engaged in the process, continue attending sessions, and feel safe being honest about their thoughts and feelings (Bordin, 1979).
The Three Elements of a Strong Therapeutic Alliance
According to Bordin (1979), the therapeutic alliance includes three main components: bond, goals, and tasks.
Bond
The bond consists of acceptance, trust, and emotional connection. While the relationship remains professional, it should also feel warm and supportive.
Goals
Clear goals guide and direct your sessions. Establishing them early helps ensure your therapist understands what you want to work on and gives you confidence in their ability to help you move toward those goals.
Tasks
Tasks are the means to achieve your goals. Every therapist has different modalities, training, and specialties, so treatment approaches vary. What matters is that your therapist keeps you informed about their methods and includes you in your treatment planning—key elements of a strong alliance and successful therapy outcomes.
It’s Okay to “Shop Around” for a Therapist
Because the client–therapist relationship is so essential, it’s perfectly okay to explore your options. If you have the time and ability, take advantage of free phone or video consultations, filter by specialty on psychologytoday.com, and pay attention to training and expertise.
I tell new clients that it’s most important they feel their therapist is the right match. If that turns out not to be me, it’s truly okay. Therapists are generally happy to help you find someone who may be a better fit. This is part of informed consent—you have the right to decline treatment, just as you would with a medical recommendation from a doctor.
You do not have to explain why you want to switch therapists, though sharing your reasoning may be helpful.
How Do I Know If a Therapist Is the Right Fit for Me?
There are several things to look for when choosing your therapist. Everyone is different, and those differences matter. It’s often recommended that you try a few sessions to get a feel for their style and build comfort, especially since trusting a stranger with vulnerable parts of your life can take time.
Before beginning your search, it can help to create a list of what’s most important to you—your goals, preferences, and the qualities you want in your provider.
A common question clients ask is whether therapists have personal experience with the issues they’re seeking help for. Therapists are trained to share personal information only when it is clinically useful. If your therapist doesn’t share their personal beliefs or experiences, it doesn’t mean they can’t help you. Instead, it can be an invitation to explore why it feels important that they share your experiences.
It’s also essential to know that therapists must stay within their scope. If your concerns fall outside their expertise, they are ethically required to refer you elsewhere.
Your Voice Matters
Ultimately, there is a reason you’re looking for a therapist. Providers want to support you in getting the help you need. Know that you have a voice—you can and should advocate for yourself when it comes to your mental health care.
References
Bordin, E. S. (1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory, Research & Practice, 16(3), 252–260. https://doi.org/10.1037/h0085885
Del Re, A. C., Flückiger, C., Horvath, A. O., Symonds, D., & Wampold, B. E. (2021). Examining therapist effects in the alliance-outcome relationship: A multi-level meta-analysis. Journal of Consulting and Clinical Psychology, 89(5), 371–378.
