Once you have decided to look for help, finding the right person to work with is a very important, and challenging, next step. Coming to the conclusion that somebody is the right therapist for you is a highly personal matter, but having a guideline on how to approach this difficult task may make the journey easier.
A good psychotherapeutic relationship is a crucial aspect of any type of psychotherapy. If you decided to buy a house and you didn't like your real estate agent, you would find a different real estate agent. You wouldn't give up on the whole idea of buying a house. But still, too many people give up on therapy altogether after they go to a therapist that doesn't meet their expectations. A constructive approach is to envision this process as a journey, not as a one-time attempt to see if "therapy is for you."
There are three major areas that are important to consider when looking for a good CBT therapist: Hope, Technique and Relationship. It is essential to find a therapist that helps you feel hopeful, that has solid knowledge and experience with CBT and to whom you can relate well. These three general elements are inter-related, but different. We'll explore them in more detail here:
Finding a therapist, finding hope:
Most people in search for a therapist are ambivalent about hope. If you have decided to find a therapist to help you, you may believe things are unlikely to get better without help, you may be rather pessimistic about the future or you may feel that overcoming a problem on your own is too hard. At the same time, you are likely to have hope that with the right help things will get better, or that you will be, at least, better able to endure them.
If you are meeting a therapist for the first time and there is ambivalence in your hope, it is very important that the therapist makes you feel hopeful. A therapist that conveys a more positive outlook on life, and is optimistic about your potential to overcome your problems, is more likely to help you.
It is critical that the therapist's hopefulness is believable and clear. Not simply a cheerful attitude, but a clear vision of how things will get better.
Therapists are more likely to succeed in making their clients feel hopeful if they understand them. The more a therapist understands your specific situation and how you are reacting to it, how you feel, how you think about it, the more likely it is that his/her hopefulness will have an impact on you. Good therapists are sometimes able to relate back to you what they have heard from you and make it very clear both that they have a good grasp on the problem, and that they care about helping you. Great therapists may understand what you are going through even better than you do. Hearing an explanation or a connection that makes sense can be very comforting and bring faith in the outcome of the treatment. "This person really understands what I'm going through and thinks there's a way out!" The factors Hope and Relationship are rather inseparable. A therapist to whom you can feel close and that cares is more likely to make you feel hopeful. It is important that you trust the person that is giving you hope. Hope from therapists usually doesn't come in the form of "You have a good prognosis", but something closer to "Trust me and I'll show you a path forward." Therapists that elicit trust are usually flexible, honest, warm and alert; and they get you.
Hope is also closely related to the next factor we'll discuss: Technique.
It's not only understanding you that gives hope, but the concomitant knowledge of techniques and experience that will help you feel better.
Technique - finding out if your therapist does CBT
Finding a therapist with knowledge and experience is also crucial for effective treatment. A positive attitude and a caring and warm person can be comforting, but when you are looking for professional help you want to find somebody that is good at what s/he does.
We'll explain here a few basic components of what good CBT usually involves, but CBT is not the only valid approach and it may not be the best approach for you. Furthermore, many therapists use some CBT techniques, but they may also incorporate other approaches.
Don't hesitate to ask your therapist about their approach. There are no good reasons to keep any secrets on how therapy works. The more you know about how therapy is supposed to help, the better.
Here are some characteristics of what CBT visits look like:
Focus on specific problems or symptoms
Deal mainly with the present
Goal-oriented, problem-solving approach
Focus on exploring and understanding distorted or erroneous thinking patterns by practicing balanced rational interpretation of situations and thinking in general
Sessions are usually scheduled weekly, for four to six months
Sessions are rather structured, with an agenda that ensures the therapeutic process stays focused and productive
Homework assignments (CBT exercises) are an essential component of CBT and an important portion of the visits are dedicated to planning and reviewing homework
It is important to have a good relationship with your CBT therapist and to trust him/her, but the therapeutic relationship itself is not a focus of the treatment.
To see some examples of what CBT in general and CBT exercises may be like, visit cbt-examples.com
The Therapeutic Relationship - What constitutes a good one?
We've discussed how Hope is an essential component of good therapy and how Hope depends on a good therapeutic Relationship. Here are some more details about what a good therapeutic relationship consists of.
Finding a good therapist implies finding somebody that you can relate to. A successful psychotherapeutic relationship is not only comforting or pleasant, but most importantly, it is a relationship that facilitates therapy. A good therapist will try to establish a relationship with you that fosters your change and growth, the processing of your problems, and the achievement of your therapeutic goals.
When evaluating if you have, or could build, a good therapeutic relationship with a given therapist, consider the presence of these three factors: Positive Regard, Genuineness, and Empathy.
Positive Regard: As your therapist learns more about you, your history, views and preferences, she should have a consistently warm acceptance and appreciation of who you are. Your therapist should fully immerse herself in seeing the world from your point of view without any room for judgement. This doesn't mean your therapist needs to approve of everything you've ever done. It means that your therapist abstains herself from approving or disapproving. She is simply on your side, no matter what. Anything you've done, feel, think or plan to do. You should be able to discuss with your therapist with no fear of being criticized. Your mind and hers should work as one in order to process things better and to figure out the best path forward. Your therapist should understand your moral codes, not assume you share hers. Considering the whole of your mind content and capacities, she should help you overcome your problems.
Genuineness: Human beings are complex and marvellous creatures. If you are looking for help from another human being for very personal, important and often intimate problems, you really want the other party - the therapist - to be a real, genuine human being. The whole purpose of trusting and opening to another human being becomes impossible if you feel like s/he is playing a role. What does a lack of authenticity look like? You may have a sense that s/he is saying things without conviction, perhaps in the attempt to fulfill your expectations, or out of a wish to fit into a general model of how a therapist should behave.
Being genuine doesn't mean that your therapist will share her personal life with you. Therapy should focus on you and your problems. Therapists should disclose only the personal information that is in your best interest to hear about. A therapist should truly be there for you, and not try to make the therapeutic relationship into a friendship in which sometimes it might be your turn to empathize with her suffering.
Clients often become curious about their therapists' personal lives. In psychodynamic therapy this interest could be further explored. In CBT it is most important not to lose focus on the therapeutic goals.
Empathy: Empathy is the ability to understand what the other person might be thinking or feeling. Being capable of putting ourselves in somebody else's shoes is crucial to the success of any relationship. In therapy it's especially important that the therapist has a unique talent at grasping and even anticipating your perspectives, needs and intentions. A great part of the understanding of another human's suffering happens at an intuitive level. A therapist may be able to perceive or imagine a lot more than you ever had the chance to say in words.
The act of empathizing is not static. Empathic therapists will frequently check with you to confirm that what they are understanding and sensing is actually correct.
Finding a good therapist is not easy, but it is important. Knowing what to look for is empowering and makes the experience interesting and manageable.
Finding a therapist that is genuine, empathic, non-judgmental, that gives you hope and has a solid expertise in CBT may not be that easy, but the rewards make the search certainly worth it.
MindQuire offers a list of therapists that work with our CBT tools. We confirm that they are licensed to practice psychotherapy in their state, but we don't interview them or assess their interpersonal skills or knowledge of CBT.