The ultimate guide on how to find the right therapist for you
[Updated December 2020]
Medically reviewed by Carl Fleisher, M.D., reflect head of clinical
At reflect, we know the process to find a therapist can feel intimidating. You might not want to ask all your Facebook friends, and combing through online directories or outdated insurance lists can be overwhelming. What do all the terms mean? What’s the difference between a therapist and a psychologist? What kind of therapist is right for me?
Please don’t let that stop you from getting support to become your best self or to improve your relationships. Whether you’re looking for individual or couples therapy, we’re here to answer these questions and more! In this post, we will demystify the process, break down the most common terms, and share our learnings on what matters when choosing a therapist. Don’t worry -- we got you covered.
Do I need a therapist?
In our humble opinion, no matter who you are, the short answer is: yes!
In the past, therapy was stigmatized, but all that is changing. Our understanding of the benefits and role of therapy is also expanding.
Anyone can benefit from therapy. Just like how some people go to the gym to improve their physical fitness, while others may need help recovering from injury, so too are there different reasons to consider therapy. Some folks are dealing with a mental issue, whereas others are building mental fitness or resilience. Regardless, it’s good to make mental wellness a priority.
There are many reasons someone may want to get in better mental shape: to achieve a personal goal, to gain a competitive edge (individually or as part of a team), to feel good about yourself, to get better sleep, or to be more attractive to potential (and current) partners. Sometimes it is nice to get another perspective in areas where even the most successful people can face challenges: career stress, relationships, parenting, etc.
Besides, life isn’t always perfect; having additional support can be helpful, even if you also have great friends and family. Who doesn’t want to have someone really listen to them for once?
Therapy can give us a space to process our experiences and feelings and help us learn concrete skills to handle stress and navigate interpersonal relationships more effectively. Because no two people are the same, a counselor can work with you to tailor a program based on what you might need. Think of therapy as having a personal coach for your mental health.
For those in relationships, couples therapy can be a great proactive way to maintain and improve intimacy, communication, and understanding. In some religions, couples counseling is a custom before marriage.
No matter what the reason, we believe therapy should be an essential part of everyone’s life! And we have seen firsthand the transformative power of therapy.
If you’ve read this far, you are probably already curious about therapy or at least open to giving it a try. That’s a great first step! Now you may be asking yourself, “But how do I choose the right therapist for me?”. Read on!
Different types of therapist licenses
We know the landscape of therapy can feel confusing. There are so many terms and acronyms for different license types. MFT, LCSW, PsyD, PhD -- what do they mean, and do they even matter?
First, it’s important to remember that licenses and accreditations serve an important purpose. Going to see a therapist is very different than talking to a friend -- the education and training a counselor receives allows them to better engage with clients to understand their full perspectives and pull appropriate tools to address those needs and create lasting change. A rigorous licensing process ensures practitioners have the appropriate training to best serve your needs. Plus, it’s important to know that this (or any other) medical professional has been properly evaluated and adheres to your state’s regulations in the field in terms of competency, qualifications, ethics, and business practices.
There are a variety of ways someone can become a mental health provider, each involving different degrees and training and having slightly different specializations or scopes of practice. And many degree types can work with individuals and couples therapy.
Across most states, clinicians must hold a Master’s degree (Master of Science or Master of the Arts) or Doctorate (PhD, PsyD) in a mental health-related field such as psychology, counseling psychology, marriage or family therapy, among others.
This is where things get complicated. Licensing and customs can vary significantly by state, but in practice, most clinicians have a great deal of overlap. In other words, there’s more similarities than differences between these professionals.
The National Alliance on Mental Health explains that many types of mental health care professionals can help you achieve your therapy goals. They operate under a variety of job titles—including counselor, clinician, therapist or something else—based on the treatment setting.
The most common in California, where reflect is headquartered, are Marriage and Family Therapist (MFT), Licensed Clinical Social Worker (LCSW), Psychologist (PsyD or PhD), and Psychiatrist (MD). There are also Licensed Professional Counselor (LPCC) and Licensed Clinical Alcohol & Drug Abuse Counselor (LCADAC), depending on the setting. Given the high variability, we recommend you also look up the requirements and standards in your specific area.
Confused? Let’s take a closer look at some of the most common acronyms and what they mean. Then we’ll discuss how to choose the right therapist for you (hint: it’s not as much about the degree!).
Marriage and Family Therapist (MFT)
Marriage and Family Therapists (MFTs) have a Master’s level degree in Marriage and Family Therapy and/or Psychology. They have one year of coursework, then have training experiences that are focused on psychotherapy. While they cannot prescribe medications, many will work with a psychiatrist (M.D.) who does medication management as part of the overall treatment plan.
Those that are licensed (indicated by the titles MFT or LMFT) have also completed a minimum of at least 1,000 hours of supervised experience depending on the state and passed the state board licensing exams. California requires 3,000 hours of supervised training, which can take 3 to 5 years -- or more!
Marriage and family therapists (MFT) who have finished their coursework but who are not fully licensed are called Associates (AMFT). They are required to be supervised for a certain number of hours in order to get their license and practice independently. As we will discuss later, Associates can be as skills and effective as licensed therapists, due to this rigorous training process.
Licensure is required for an individual to work independently as an MFT. Upon licensure, MFTs have the freedom to establish their own private practices.
With California, MFTs are the most common type of counselors in private practice. You can learn more about California MFT’s through one of the state’s most popular organizations, CAMFT which helps support its more than 32,000 members and educate the overall community. We have many CAMFT therapists in the reflect network.
Mental Health Counselor or Professional Clinical Counselor (LPCC)
Mental health counselors are among the most common types of therapists nationwide, although they are less common in California than Marriage and Family Therapists. Their education and training are on par with MFTs; they are trained to work with individuals, families, and groups. Also known in some areas as a Professional Counselor or Licensed Professional Clinical Counselor (LPCC).
Mental health counselors receiving supervision (pre-licensure) are called Associates, though the word “Licensed” still appears in their title, Licensed Mental Health Counselor - Associate (LMHCA). Pre-licensed professional clinical counselors are called Associate Professional Clinical Counselors (APCCs).
Social Worker (LCSW)
Another way for someone to become a therapist is by pursuing a career in clinical social work. Social workers are trained in psychotherapy and help individuals address a variety of mental health and daily living issues to improve overall functioning.
Social workers usually have a Master's degree in Social Work, though some have a Doctoral degree. They have two years of coursework (four for Doctorates) involving sociology, growth and development, mental health theory and practice, human behavior/social environment, psychology, research methods. Note, those who have a Bachelors in Social Work can work in organizations and community centers, but they cannot pursue licensure and work in private practice without a graduate degree.
There are a wide variety of specializations the Licensed Clinical Social Worker can focus on. These include specialties such as: working with mental health issues, substance abuse, public health, school social work, medical social work, marriage counseling or children and family therapy.
Social workers interested in becoming psychotherapists have training experiences focused on psychotherapy. They are required to be supervised for a certain number of hours after attaining their degree in order to practice independently. Social workers have an alphabet soup of titles: independently licensed social workers may be called LCSW, LISW, LICSW, or LASW depending on state and speciality. Associate social workers may be called ACSW, LSWAIC, or LSWAA.
Psychologists (Ph.D. or Psy.D.)
Psychologists have Doctoral degrees which allow them to provide professional services such as specialized assessments or making formal diagnoses of mental illness.
Psychologists take three or four years of coursework focused on a variety of areas, plus two to three years of training experiences. They are required to be supervised for a certain number of hours after attaining their degree in order to practice independently.
Psychologists may have one of two different degrees, a Ph.D. or a Psy.D. In Ph.D. (Doctor of Philosophy) programs, the focus is tilted more towards research. A Psy.D. (Doctor of Psychology) degree focuses more on clinical practice and less on research.
Ph.D. degrees are awarded in social work, counselor education, and marriage and family therapy. A Doctor of Philosophy degree (Ph.D.) in Psychology prepares the mental health care provider to conduct independent research and to provide professional services (consultation, assessment, diagnosis, therapy).
A Doctor of Psychology degree (Psy.D.) focuses more on clinical practice and less on research. Like a Ph.D. in Psychology, the Doctor of Psychology degree (Psy.D.) prepares students to practice psychology in a wide range of clinical settings. However, this particular degree requires fewer research and statistics courses and thus takes less time.
To use the title "Psychologist," individuals must have graduated specifically from a Psychology program and meet their state requirements and obtain a license to practice Psychology.
As part of their professional training, they must complete a supervised clinical internship in a hospital or organized health setting and at least one year of post-doctoral supervised experience before they can practice independently in any health care arena. Clinicians undergoing this post-doctorate experience are called Psych Assistants until they become licensed.
It's this combination of doctoral-level training and a clinical internship that distinguishes psychologists from many other mental health care providers. Psychologists must be licensed by the state in which they practice, though some states offer reciprocity. Licensure laws are intended to protect the public by limiting licensure to those persons qualified to practice psychology as defined by state law. In most states, renewal of this license depends upon the demonstration of continued competence and requires continuing education.
Psychiatrists are doctors who specialize in mental health. The main difference between psychiatrists and the other types of providers is that psychiatrists can prescribe medication. Psychiatrists can also evaluate people and provide diagnoses, like psychologists.
To become a psychiatrist, doctors go to medical school where they earn an M.D. or D.O. degree. They then have at least four years of training called residency. Residency is primarily focused on prescribing medications, but some psychiatrists also get introductory therapy training. After completing residency, psychiatrists are tested periodically for competence by a professional Board; those that pass the test are considered “Board Certified.” Some psychiatrists practice psychotherapy in addition to prescribing medication. Those who are interested in therapy often pursue additional training.
Psychologists and psychiatrists hold the highest levels of education and certifications due to the rigorous requirements of the medical field. The American Psychological Association explains that after graduation from college, psychologists spend an average of seven years in graduate education training and research before receiving a doctoral degree.
Licensed vs. Associate vs. Psych Assistant
Therapists who have not completed their licensure process and are still working on their training hours (typically 1,000 to 3,000 hours total) are called Associates, designated with the letter “A” rather than “L” in their credentials (except an LASW, or Licensed Advanced Social Worker). Associates can be found in each type of degree (e.g., MFT, PCC or MHC), though psychologists who are associates are called Psych Assistants. Without licensure, a person can still provide counseling under the supervision of a licensed professional.
It’s important to note that partly because of extensive licensing requirements, associates and licensed therapists may provide equally good care (our founder, Jonathan, actually works with an AMFT under supervision). Studies also show that therapy outcomes, as rated by clients, do not vary based on years of experience or whether a therapist is an associate or is licensed. Outside of reflect, the hourly rates of many associates can be equal or greater to that of licensed therapists.
Does it matter?
All clinicians who go through this education and certification process can potentially help you. The degree type alone is not a good predictor of who will be helpful for your specific circumstances, and in many cases a Master’s level therapist can be as good or better than someone with more training. The same is true for an associate vs. a licensed therapist or even someone who has been practicing for 5 years vs. 15 years.
It’s essential that you ultimately find the right fit with the person who will be helping you manage your mental health. Fit is less about education and more about how the present in the room and their specific style. A lot more on this below
What kinds of therapy are there?
Regardless of the degree type, any therapist with any degree is allowed to practice any type of psychotherapy, and there are hundreds of different types of psychotherapy they can focus on. Several of the most common types of therapeutic orientations and modalities are listed below.
Some types of therapy require additional training and certification, for example Dialectical behavior therapy (DBT) and Eye movement desensitization and reprocessing (EMDR) (see below). It also can be common for a clinician to pull from different orientation types. There may also be specific therapy types for individual vs. couples therapy.
Psychodynamic psychotherapy helps people find more satisfaction in their lives and relationships, by bringing to light how the mind works. Psychodynamic psychotherapy explores current and past situations, across both the conscious and unconscious mind. Understanding and healing come from the process of examining and talking through situations.
Psychodynamic psychotherapy discusses all mental activity including feelings, wishes, innate drives (such as for connection, power, admiration, etc.), attachments, dreams, and habits of coping (“defense mechanisms”).
Psychoanalysis is an intensive form of psychodynamic psychotherapy in which people see their therapist three, four or five times per week over long periods of time. The point of having such frequent sessions, as with training in other fields like athletics or in the arts, is to maximize progress by putting in extra time and effort. Not everyone can afford such frequent sessions, of course, but for those who can, the benefits can be substantial.
Could psychodynamic psychotherapy be right for me?
Psychodynamic psychotherapy can be useful for people seeking greater satisfaction in their relationships or career, or those simply wanting to be their best selves. It may help people seeking help coping with chronic health problems. Psychodynamic psychotherapy is also a proven, durable treatment for depression, anxiety, and other issues. This therapy is a good fit for people who can get by day-to-day, but want to tackle an important issue or are interested in how their past influences them in the present. Therapists who practice psychodynamic psychotherapy may take an active role, or a more passive one, depending on their particular style. Psychodynamic psychotherapy traditionally goes on for a year or more, but modern variants like STDP are meant to be completed in a much shorter period of time.
While psychodynamic is less “solution-oriented” than other orientations, it can still have very powerful and lasting positive impacts for clients. For those clients who work with therapists who are psychodynamic, it is still important to be thoughtful about why you’re coming to therapy and what you want to get out of the experience -- and to check-in regularly with your therapist to help them understand how the experience is sitting with you.
Cognitive behavioral therapy (CBT)
Cognitive behavioral therapy, or CBT, helps people set clear goals and use practical strategies to find solutions to life’s challenges. It has roots from Albert Ellis in 1980 in Rational Emotional Theory, but Aaron Beck was the developer of cognitive behavioral therapy. It has now become one of the most popular forms of therapy worldwide. The basis of cognitive behavioral therapy is the concept that automatic negative reactions trap us with unpleasant emotions that can lead to self-defeating actions.
Cognitive behavioral therapy teaches new ways to think and react, which people can then use to control their emotions and actions better, ultimately leading to behavior change. In a way, cognitive behavioral therapy is like having a mental coach: CBT therapists often start by teaching clients how the brain works in predictable patterns, like learning the rules of a game. They then help clients set specific goals, assign exercises to practice what is learned, and measure progress.
A more recent version of cognitive behavioral therapy takes the client’s important values as a basis for goal-setting. This version is called acceptance and commitment therapy, or ACT.
Could cognitive behavioral therapy (CBT) be right for me?
Cognitive behavioral therapy is an excellent choice for people who want tools to deal with stress and make concrete changes. While it can work well for many people, it is especially helpful for clients who are rational-focused because it separates us from our thoughts. CBT is a well-established treatment for anxiety, insomnia, phobias, obsessive compulsive disorder and depression. Over the years, the uses of cognitive behavioral therapy have been extended to include trauma.
In cognitive behavioral therapy, the therapist actively structures and directs therapy. It is usually relatively short in duration. It can be completed in as little as 12-16 sessions, though more often takes between six to nine months.
There are even versions of cognitive behavioral therapy that can be completed online with little to no input from a therapist; however, CBT therapists can be an important partner to help them stay on course. They can also help people with difficulties that range from the very mild to the severe.
Dialectical behavior therapy (DBT)
Dialectical behavior therapy, or DBT, is an off-shoot of cognitive behavioral therapy that has grown increasingly popular over the years. Dialectical behavioral therapy was originally designed to help people diagnosed with borderline personality disorder. Its main goals are to teach people how to live in the moment, develop healthy ways to cope with stress, regulate their emotions, and improve their relationships with others. Dialectical behavior therapy has evolved to become an evidence-based approach to treat a variety of conditions and presentations.
Dialectical behavioral therapy offers a structured way for people to frame their experiences and deal with mood and emotion regulation issues, whether it's depression, anxiety, impulsivity, etc. It integrates structured elements from cognitive behavioral therapy and adds mindfulness and other skills that are particularly effective with managing stressful situations and interpersonal dynamics.
Rigorous training is required to become a fully-certified DBT practitioner. Group therapy can also accompany individual work for serious cases. However, due to its effectiveness, it is increasingly common for therapists who have attended a DBT workshop or two to incorporate aspects of dialectical behavior therapy into an eclectic, or non-specific, approach. Be sure to ask any potential therapist who purports to offer dialectical behavior therapy just how much training they have.
Could dialectical behavior therapy (DBT) be right for me?
Dialectical behavioral therapy is a useful approach for anyone who wants to learn effective skills and strategies to manage strong emotions or who notices themselves getting into frequent interpersonal issues.
The word "dialectical" means making space for seemingly incompatible ideas, which can help reframe black and white thinking and rigidity. DBT can be especially useful for people who have been confused when they have been told to "just get over it" or "stop thinking negative thoughts.”
For those clients who have hard time getting through the day or who engage in unhealthy or unsafe behaviors, dialectical behavioral therapy can be particularly effective since it is concrete and skills-based. Certainly, if you have been diagnosed with borderline personality disorder, or suspect you may have it, it’s a good idea to seek out a certified DBT therapist.
Research also supports using dialectical behavioral therapy to help people deal with traumatic experiences, whether or not they have post-traumatic stress disorder or other co-presenting issues such eating disorders. It is important to remember that trauma may also present over time (sometimes called “little t” trauma), such as with an overbearing parent, childhood bullying, an unhealthy relationship, and intergenerational trauma. Like cognitive behavioral therapy, dialectical behavioral therapy can be useful for people with mild to intense difficulty.
DBT therapists are quite active in conversation and engaging in the client-therapist relationship. Therapy may last from 6-12 months, or more, depending on the goals.
Humanistic therapies (Gestalt, person-centered, experiential)
Humanistic therapy takes a holistic approach that emphasizes people’s strengths and their innate ability to heal and grow. Humanistic therapists assist people in reaching their full potential (“self-actualizing”). Therapists act as facilitators, while clients choose the direction of the session to solve their own problems.
Several therapies are based on the humanistic approach and incorporate slight variations. In Gestalt therapy, for example, the therapist takes an active role in getting people to experience their emotions here and now, but may otherwise let the client lead. In client-centered therapy, the therapist focuses on creating a supportive environment for the client to lead the conversation. Other humanistic therapies include person-centered therapy and experiential therapy.
Studies suggest that humanistic therapies are probably effective at helping people reach their goals. However, it has been hard to prove that completely because research depends on having measurable actions, while humanistic approaches are by definition unstructured and unique - not only in how each therapy works but also in how each therapist carries out that therapy with a particular client.
Could humanistic psychotherapy be right for me?
Humanistic therapy is a good fit for people who are clear about what they want to explore, who don’t want to be taught skills or strategies, or who prefer a therapist who mainly listens. These therapists are less active in conversation and tend to ask questions or offer reflections, rather than advice.
Humanistic therapy has not been studied explicitly as a treatment for mental illness, but might still be helpful. This type of therapy is best suited for people who don’t need help day-to-day, but who are seeking gradual change in themselves or in their relationships.
Like with psychodynamic, therapy in this style can go on for months or years, depending on what the person wants.
Eye movement desensitization and reprocessing (EMDR)
Eye movement desensitization and reprocessing therapy (EMDR) was developed as a treatment for survivors of trauma. It is based on the idea that traumatic experiences interfere with the brain’s normal memory formation process, causing unprocessed, harmful information to be stored as if we are “frozen in time.” This unprocessed information then leads to dysfunctional reactions long after the traumatic event has passed.
EMDR therapy helps the brain process these memories and allows normal healing to resume. It is believed to help people by using movement to relax people and stimulate their learning. It does not require talking in detail about the distressing issue or completing homework between sessions. Rather than focusing on changing the emotions, thoughts, or behaviors resulting from the distressing issue like other therapy orientation, EMDR enables the brain to resume its natural healing process and is designed to resolve unprocessed traumatic memories in the brain.
Could EMDR be right for me?
Research supports EMDR as a treatment for PTSD. Since survivors of trauma suffer greatly, yet only a minority of them go on to develop PTSD, then EMDR may also be a useful approach for trauma survivors who do not have PTSD. EMDR is considered an active therapy. EMDR is also brief; it can be completed in 6-12 sessions, or in some studies, in as little as 3 sessions.
Eclectic and other types of therapy
There are hundreds of different types of therapy and offshoots of existing orientations like psychodynamic therapy and psychoanalysis or CBT and DBT. Many therapists may combine several types of therapy into a more “eclectic” approach, like how a skilled craftsman might use different tools for different situations.
Lastly, keep in mind that how different providers interpret each orientation may also vary -- so one person who works with CBT techniques may look very different from the counselor right next door to them.
What should I look for in a therapist?
While all these terms may make anyone’s head spin, rest assured that you don’t need to be an expert to find the right therapist for yourself. In our experience of doing tens of thousands of matches, there are several key principles you should keep in mind on how to find the right therapist:
Tip #1: all types of therapists are good
Research has shown that no one type of therapist is inherently better than any other. Ditto for experience. Data comparing therapists in training to licensed therapists tends to show only slight differences; we also see minimal differences between seasoned therapists and those early in their career. So, you have as good a chance of feeling better working with an associate therapist as with a licensed one, whether a social worker, an MFT, or a psychologist.
Tip #2: all types of orientations can be effective
Certain types of therapy are designed to tackle certain issues, but outside of CBT for anxiety, it’s honestly not clear that one type of therapy is really all that much better than any other according to the research.
This is why everything you just read about types of therapies may not matter that much -- and why your friend may have success with a type of therapy style that you don’t find very useful. Of course, we invite you to use the guide above to explore which type of therapy may appeal to you. Just don’t get stuck trying to pick the perfect orientation -- because there isn’t one!
What does matter is that the therapist is skilled in whatever type of therapy they provide. This is why reflect requires all of our therapists to undergo a rigorous screening process, which includes a license check and live interview with a member of our team. We are not just a listing service or paid “directory.” In fact, we have a long waitlist of providers who want to join our network.. That’s because we want to help you screen for quality that you can trust.
When choosing a therapist, especially if you aren’t in an area where we serve and can pre-vet providers, make sure you interview your therapist and ask them to articulate how they practice. Feel free to push them on areas that you don’t understand. That conversation should five you confidence and make you excited to want to try working with them!
Tip #3: fit matters the most!
Research shows that, by far, the most important factor to predicting successful outcomes in therapy is “therapeutic alliance,” or the fit between you and your therapist.
As such, it is also essential that you ultimately find the right fit with the person who will be helping you manage your mental health. One of the best questions to ask yourself is this: do you feel comfortable opening up with this particular individual? When talking with potential therapists, you should feel a level of ease, even with difficult or awkward topics.
If you are in an area reflect serves, our goal is to help take all the guesswork out of the search. In addition to pre-vetting every provider in our network, our data-driven matching algorithm finds the right fit for you based on a short matching survey. We use data from thousands of previous successful matches and tens of thousands of successful therapy sessions to predict fit and set you up for success.
To make sure our matches work for you, we also offer free intro sessions for you to try any of your matches before choosing one. Satisfaction is guaranteed. In fact, eighty percent of those who try reflect find a therapist they like -- which means that you can find a great provider quickly and focus your energy on getting the support you need.
If you are interested in giving us a try, please click the “Get Matched” button above.
And finally, remember you are not alone. reflect's mission is to make mental health more accessible. Our team is always here to answer any questions, even if you’re not in an area where we service. Simply tweet us @joinreflect or email firstname.lastname@example.org.
The fact you are doing this research and embarking on this journey to become your best self is so commendable. Once you find a great therapist and see the amazing work you can do together, it will be worth it. Just keep going!
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