Mental Health Providers are like shoes… Finding the right fit is important.
Why does everyone talk about the “right fit” when it comes to therapy? What actually is this “therapeutic alliance” that is supposedly so important? Therapy is a different form of treatment, more intimate than any other treatment you will probably participate in. Sure, you want to make sure you feel comfortable and like the other providers you are seeing. However, how many other providers are you spending between 45 and 60 minutes with on a weekly basis talking about the tough stuff? The therapeutic relationship is unique and very different from any other relationship with will have.
Various research studies have shown that the therapeutic relationship (relationship between provider and client/patient) has more of an impact on positive therapeutic outcomes than treatment modality/theoretical orientation (e.g. psychodynamic, cognitive-behavioral-therapy, etc.). The treatment modality can assist with the symptoms you are experiencing, but if you don’t feel comfortable and safe with the person providing the treatment, therapy most likely won’t work.
How comfortable would you feel sitting across from someone, crying, and spilling the struggles you are going through? How comfortable would you feel talking to someone about the mistakes you’ve made, and the areas of your life that aren’t the most appealing? For most of us, our comfort level isn’t too high with any of those. Now, ask yourself if you could do all of that while sitting across from someone you dislike or didn’t click with. That comfort level probably dropped a few points. I know mine would.
As I mentioned above, the therapeutic relationship or alliance is a unique type of relationship. Although your therapist reserves the time for you, there is not an equal exchange of information being shared. You are not friends with your therapist. Your therapist is your treatment provider and there for you. However, just because it’s not an equal exchange of information doesn’t mean you could (or should) go to just any mental health provider.
Before reaching out to a provider to start or continue mental health treatment, explore who your ideal provider would be and what is important to you. Some helpful questions to ask yourself:
1) Would I prefer a provider who identifies as male, female, trans, non-conforming, or other?
2) Do I have an age preference? Would I prefer someone younger than me, older than me, or around the same age?
3) Does the provider’s religious affiliation matter to me? *Some providers might not feel comfortable providing this information to you.
4) Does the provider’s political affiliation matter to me? *This came up frequently over the last year as tensions were high with the election. Some providers might not feel comfortable sharing this information with you.
5) Does the provider’s credentials matter to me (e.g. LPC, LCSW, PsyD, PhD)?
6) Does it matter if they offer in-person or telehealth options? *New question added after
7) Are there certain topics or areas that are important to me that I would like my provider to
be sensitive to (e.g., kink friendly, LGBTQIA+ affirming/ally)?
One very important piece of information I tell all my patients is that you should not feel like you are “settling” for a mental health provider. Just like my shoe analogy in the title, if the shoes don’t fit right in the store, they won’t fit right when you bring them home and wear them to the event. If after the first, second, or even third session you don’t feel a connection, find a new therapist. The job of the mental health provider is to help. That help might also mean finding another referral option for you. Mental health treatment is an investment. It can be expensive and it is time consuming. Make that time, money, and investment count. Find someone you feel comfortable talking to, not just someone who you can check the box and say, “I am getting treatment.”
Dr. Nicole (Nikki) Lacherza-Drew is a Licensed Psychologist providing psychotherapy to children, teens, and adults throughout NJ, NY, FL, and VT. She has a physical office location in Northern NJ and provided online therapy prior to the COVID-19 pandemic. Dr. Nikki provides cognitive-behavioral therapy, although she is also trained in other evidenced-based approaches. Aside from providing individual therapy, Dr. Nikki also provides psychological evaluations and runs groups. When Dr. Nikki is not seeing patients, you can find her teaching undergraduate and graduate psychology classes at local institutions.