When someone reaches out for therapy services, I typically respond with a message asking if we can chat on the phone. I want to make sure that we are a good fit. It wasn’t until many months into working with one client that she revealed how nervous this made her. She was worried that she wouldn’t be a good fit and that would mean that her situation was hopeless. She didn’t want to face rejection again, not from a helping professional. Suddenly realizing what that felt like to her, I took the opportunity to express why, as a therapist, I like to have those conversations about “fit” up front.
What does it mean to “fit” with a therapist? Well, it can mean a lot of things, but here are a few:
Language
You understand the therapist easily. He or she doesn’t use clinical jargon (unless you like that) or have a language barrier that makes it difficult to understand.
Comfort
The therapist has made you feel welcome in his or her space, whether that is an office or computer screen. This is your time, and you should be as comfortable as possible. The work you are about to do in therapy is difficult.
Values
You have a basic understanding and appreciation of each other’s belief systems. For Christian clients, I encourage working with Christian therapists. There is a deeper level of connection and healing that can be accessed. However, regardless of your beliefs, it is important to find someone who can highlight the best parts of your value system as they support your growth and healing.
Personality
You like his or her personality. Humor is really important to me in my work. I love working with clients who like to laugh with me as well as cry. If your therapist’s personality bothers you, your best work may be stifled or delayed.
Scheduling
Logistical concerns are also important when looking for the right fit. If you gel together well but have opposite schedules, one or both of you will become frustrated trying to find a time that works.
Technique
The therapist uses techniques that are shown to work with the problems you present. For example, if you are healing from trauma, you may seek a therapist trained in EMDR (Eye Movement Desensitization and Reprocessing). If you suffer from depression, a CBT (Cognitive Behavior Therapy) or ACT (Acceptance and Commitment Therapy) approach may be helpful.
Loved Ones
If you’re part of a couple or family seeking therapy, you’ll want to know that your therapist will get along with other members of the family. For many wives seeking couples therapy, I have a conversation about how my personality and approach will fit for their husbands.
Style
The therapeutic style works for you. You may respond better to instruction and direction, or you might like someone who simply listens and empathizes. You might like the traditional “blank slate” therapist expression, or you might like someone who uses more self-disclosure. Only you will know the way you can grow best, and sometimes only after exploring some failed attempts.
Evaluating the Fit
If you can check “Yes” or “Probably” to the above criteria, you are one your way to knowing you have a good fit with your therapist. You’ll also know after the first few sessions if it’s going to work, at least for the short term. I usually encourage people to give a therapist at least three sessions to see if things are going anywhere. Of course, if you meet and realize that any of the criteria are lacking, or if there is something unprofessional or untoward in the therapist’s presentation, no need to subject yourself to a bad therapeutic fit. Next week we are going to talk about how to fire your therapist when needed!
The therapist will also be getting a feel for you in the initial conversations, and will be making judgements about whether she believes she can be helpful to you. If the therapist believes that it is not a good therapeutic fit, she may help you find someone else. She may pass on to you a few names of other therapists that specialize in your particular problem or demographic.
What if It’s Not a Fit?
During the initial phone call, here are some reasons the therapist may decline to work with you. And 99% of the time it’s nothing personal):
- She realizes that she knows someone that is close to you, but can’t reveal who it is because of confidentiality standards.
2. Similarly, she knows of a dual relationship (you cut her hair, so she can’t be your therapist; your kids play soccer together, and you’re likely to be on the field together).
3. She cannot accommodate your scheduling needs.
4. She doesn’t have the right training or experience to help with your problem.
5. The financial arrangements will be burdensome. (For example, she doesn’t take your insurance, but her fee is too high for you to afford weekly sessions.)
6. She has a personal trauma that your issue may trigger. (For example, you just lost a baby and she also went through a miscarriage recently.) She knows it will be too difficult emotionally to work with this issue at this particular time in her life.
None of the above reasons have anything to do with liking you or valuing you as a person. So keep in mind that if a therapist suggests that you work with someone else, the reason is not personal. It is in your best interest because she knows she will not be able to serve you well. The reasons might be ethical, practical, financial, or emotional.
Finding the Fit is Important
Lots of people who try therapy and report that “it didn’t work” may have either give up too early. Some simply did not find the therapist that was the right fit. I have seen several therapists in the course of my journey of becoming a therapist. There were times that it was joyful, painful, and growth-explosive. However, there were other times that I felt pretty ho-hum about therapy. Keep trying until you find the right fit. It’s ok to let a new therapist know that you are wanting to ensure a good fit. Suggest that you would like to evaluate after the first couple of sessions.
Finally, if you are a Christian seeking therapy, be prayerful in your decision. When Jesus promises abundant life in John 10:10, He assures us that He wants our growth and healing experiences to be significant and redemptive. There is a therapist out there who can help you move beyond pain and dysfunction and into your abundant life, as he or she partners with the Holy Spirit on your behalf. Trust that God has that therapeutic fit lined up for you and will lead you there.
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