5 questions to ask when choosing a counselor

The most important thing to know about picking a counselor is this:  it's intensely personal.  

I always say that it's like shopping for blue jeans.  They all look the same on the rack, but they fit each person differently.  You've got to try them on to see if they work for you or not.  

That's a really bad thing to hear, I know.  When you need therapy, the last thing you want to do is shop around.  I completely understand that, believe me.  

In order to streamline the process as much as possible, here are some questions you can ask.  

1.  Do I feel safe and respected with this person?

Research shows that therapy is more likely to be successful when there is a good therapeutic relationship, regardless of the counseling theory being used. (You can check the source text, here.) 

A good therapeutic relationship simply means that you feel safe, respected, and heard.  You and your counselor can have difficult conversations.  You feel safe to say what needs to be said, and satisfied with the outcomes of those conversations. 

A good therapeutic relationship is not a friendship, though.  While your counselor may tell you a little about herself at times, the counseling sessions should be about YOU:  your story, your pain, your processing, your way forward.  You should never feel burdened by your counselor's emotions or experiences.  If that is happening, let your counselor know what's happening for you, and talk it through to your satisfaction.  If it continues to happen after you've talked it through, you might want to find another counselor.

When you visit a counselor, if the relationship feels clunky and weird--or worse yet, painful--LEAVE.  You are under NO OBLIGATION to the counselor.  Counseling is for YOU.  It has to work for YOU.

2.  What kind of license does this counselor have?

Here's how the hierarchy goes in the therapy world:


A psychiatrist will be called Dr. So-and-So, and she will have the letters MD after her name.  This means that she is a medical doctor who has specialized in psychiatry.  Years ago, psychiatrists did therapy.  These days, they prescribe medicine, and THAT IS ALL THEY DO.  Now.  Many of us need prescriptions.  In fact, the research says that most mental illness is best treated with a combination of talk therapy and medication.  Just be aware, though, that while you can get a much-needed prescription from a psychiatrist, you won't get counseling there.


A psychologist will also, confusingly, be called Dr. So-and-So, but he will have the letters PhD after his name.  That means he has an academic doctoral degree in psychology (not a medical degree) and is probably a specialist in a particular area of testing or treatment.  This person is a counselor, at the top of the food chain, and you will probably pay more to see him unless your insurance is truly awesome.

Licensed Counselor

Most of the counseling work in the world gets done at this level.  Licensed counselors have Masters Degrees in counseling, psychology, social work, marriage and family therapy, etc.  They then go through a state-certified licensing procedure before being certified in various areas:  Licensed Professional Counselor (LPC), Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), etc.  Different states may have different letters for licenses that are similar.  Ask your counselor if you're curious or confused about what their particular letters mean.  Licensed counselors have a high degree of accountability in their training and practice because of the requirements of state licensing boards.  Also, you can report a state-licensed counselor to their board if they turn out to be a terrible counselor.

The Others

There are lots of other people out in the world using the term "counselor."  You may get really good help with counselors in these categories, and have a terrible experience with a licensed counselor.  There are no guarantees!  Just be wise about what kind of training you're looking at.  You may come across categories like Pastoral Counselor, Biblical Counselor, Lay Counselor, Life Coach.  You'll have to ask to see what kind of training process these types of counselors have been through.  

If you're worried about being Bible-bashed--and many of the folks who ask me about therapy are--then I'd recommend looking for a therapist in the state-licensed category, where you're more likely to find someone who is a Christian but has broad-based experience in their education, training, and experience. 

3.  Where do I even look?

The American Association of Christian Counselors and Psychology Today both have directories you could check.  You can also ask friends or family for a recommendation.  

Just remember, you're shopping.  Not every counselor will be a good fit for you, even if a close friend had a good experience with that counselor.  

I have, unfortunately, sometimes made recommendations that turned out to be a bad fit for the client.  I hate it when that happens!  

Ultimately, trust yourself to know if the counselor is right for you.

4.  What is "therapeutic orientation"?

"Therapeutic orientation" means the theoretical approach a particular counselor prefers. 

Therapeutic orientation is important because here are many, many different theoretical approaches in counseling.  There are cognitive approaches ("it's all about what you think/believe").  There are behavioral approaches ("changing your behavior will change your life").  There are cognitive-behavioral approaches ("let's work on your thoughts and behaviors together").  There are systems approaches ("family relationships need to be restructured correctly").  There are psychodynamic approaches ("it's about healing your pain").  

Different therapeutic orientations suit different issues better.  If you're wanting to deal with a phobia about spiders, that's a great fit for a behavioral therapist.  If your teenager is acting out, a systems therapist might be able to help the whole family move forward.  If you're grieving the loss of a loved one, processing the pain of abuse, or working through a life transition, you'll probably want a psychodynamic therapist.

I identify myself as an existential therapist, which is a little twig on the branch of the psychodynamic tree.  (You can read more on my Manifesto page.)

Ask your potential counselor about their theoretical orientation over the phone.  See what they have to say about how they work, and why. It may take a minute for them to recover from the shock of meeting up with a client who even knows to ask this question.  But you should be able to have a conversation that helps you understand who this counselor is, what motivates them in their work, and whether their approach is a good fit for you.

5.  How long will I need to be in therapy?

Here's what I always say to new clients.

"The length of time that each person needs for therapy varies.  I like to ask clients to think in terms of five to six sessions.  That gives me a chance to get to know you, understand your situation, and do some work together.  After five or six sessions, we'll talk about how things are going in therapy, and decide together if we've met our goals or not.  We may be done at that point, or we may want to continue.  Of course, therapy is for YOU, and you are under no obligation to me whatsoever.  If you wish to leave therapy at any time, for any reason, you are free to do so."

Some clients come into therapy having already done a fair amount of reading, thinking, and journaling.  They have clear ideas about the issues they want to work on; they're just finding themselves a bit stuck in their process.  Those clients are highly motivated, high functioning, and able to do a lot of homework between sessions. Their therapy may progress quite quickly to a point where they're satisfied.

Other clients come into therapy just pole-axed by life, suffering from severe anxiety or depression, or grieving over terrible losses.  Their goals are clear in my mind (symptom relief, support, emotional processing) but the client often feels like they're making little progress, just suffering slowly along.  Those clients often need and want to stay in therapy longer.  

Sometimes, other issues surface over the course of therapy and those issues require a referral to a specialist, which adds to the length of therapy in unexpected ways.  

Like everything else in the therapy process, the length of therapy is a highly individual issue.  If you feel stuck or confused or frustrated about the pace of therapy, or if you feel like you're not making the kind of progress you'd like, talk to your therapist about that.  If you don't feel satisfied by the conversation, you can move on to another counselor who might be able to help get you unstuck.  Sometimes a counselor who's a good fit at one time may not be a good fit later on.  That's okay.  I realize it's frustrating and difficult to move on, but sometimes it's necessary.

So there you go, friends, a few questions to ask as you're looking for a counselor.  Hope that helps you find a good fit with a minimum of frustration--or at least to recognize a bad fit when it happens to you.

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