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Choosing a Therapist- Part 1

Updated: Mar 27, 2019

Deciding to take the plunge and reaching out for help is a monumental step. Wouldn't it be nice if there was a manual on how to do it? Say no more.

When prospective clients connect with me, I always wonder "why is it that out of all the therapists on X website or through Google, they chose to contact me?" I'm pretty sure it's not because I take good pictures. But in talking with them, I've come to see that there are a variety of different things that people look for in a therapist, whether they are aware of it or not. Some are very specific about their needs, others like the amount that you charge or where you are located, some like the way you present yourself, and yes, some like the pictures.

Have any questions about what to ask or say when first reaching out? Feel free to connect with me to get some tips.

As someone who has experience being in both the therapist chair and the client couch, I've spent time looking at various aspects of a counselor and comparing the types of clients they tend to attract. It's backed up by research that liking your counselor promotes better results in therapy than what the counselor actually does, and so it merits a look.


What types of traits or aspects of a prospective counselor can you think of that might help or hurt your time together with them? This blog series hopes to highlight some aspects to keep in mind when selecting someone to see.


Demographics


There's always two ends of the spectrum relating to the topic of counselor demographics: some believe that counselor background doesn't matter as much as their ability to be open and understand matters, and some believe that a counselor background means everything and precludes their ability to understand.

My personal stance is that it boils down to two major points:

  1. When a client comes to me with an issue, will I be able to actually understand their perspective based on my own background?

  2. If I do seem to understand it, can I convey it in such a way that client believes that I understand it (or am trying)?

If I cannot satisfy both points, then I have failed that client.



Culture is highly underestimated in the western world, such to the extent that our sense of multiculturalism is incredibly biased and racial, religious, and sexual orientation persecution continues at an alarming rate. So when a client comes into my office for an initial assessment, I tend at some point to ask how both the similarities and differences between us manifest in our session.


There are many demographic factors that play into what a client presents with in session as well as how it's handled by the therapist. Some key ones:

  • Age: Taking my own age as an example, will a 20-something be able to understand what's it's like for someone to be going through retirement? Losing parents? Having grown children? If my client is 15-20 years my senior, will they associate me with their child and feel like the position of power is too reversed? If a client is younger, will they think that I'm too old and unable to understand them where they are? There's all kinds of approaches to these arguments, but it is reasonable to say that when going through phase of life type concerns, it's more comforting for a client to seek out a therapist of similar age or older (so, I tend to get a lot of 20-somethings and college students.)

  • Gender/Sex: This relates to things like sexual orientation, gender expression, and gender roles. It might also relate to things like sexual dysfunction, gender stigma, and sex specific problems. Relationship problems play out hugely different depending on the physical bodies present. In the past, I've dived more into men's issues, partially because men already have major stigmas stopping them from seeking services and because some men feel like it is less threatening to talk to another male. I've also referred men to female therapists because I felt like they would do better with one, too. It can be difficult as a women to discuss reproductive health or things related to pregnancy with a male (although, strangely enough, a lot of clients I saw during my school internship struggled with post-partum depression and had really bad ovulation cycles, but you would never assume that!) Similar things reign true with LGBTQ+ individuals: it can feel incredibly relieving to know that the person you are talking about things like gender expression and sexual orientation with is supportive and understanding of those struggles.

  • Race/Ethnicity: Where someone comes from, the color of their skin, and their cultural heritage and understanding contribute immensely to the dynamic seen in session. Work through aspects

of privilege and power differentials that play out in session compared to the real world between different cultures can be a powerful tool the therapist uses to connect with the client. Dominant culture vs. minority culture also plays a huge role, and must be addressed when that dynamic is present. One way to help alleviate some pressure here is to always question, wonder, and learn more about the different cultural backgrounds of clients. This is one of my favorite parts of my assessment, and often catches people off-guard when I say something like "so, tell me what your culture means to you and how you value your heritage."

  • Socio-Economic Status: Working in community mental health clinics, you see the difference here. Clients who are not as well off financially are often less likely to seek out services. This applies to other types of care, not just mental health. As a therapist, you want to meet your clients where they are as much as possible. The US often categorizes financial success as overall success, so clients from varying SES backgrounds also have their own ideas of what success means and how they relate to others.

There are just a few examples; there are many more. Being mindful of counselor demographics puts you one step ahead of the game when picking out the type of person you want to undergo change with.


In my next blog post, we will go over some aspects of personality when choosing the right clinician for you.

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