How do you know psychotherapist is 'the one'?

[Orangesandlemons82]

I had a session with a psychotherapist yesterday. She was very nice and seems to have a lot of experience. But how do I know she is the right one? I don't know if I clicked with her, but it was only the first session. I have booked to go back again next week.

I'm a therapist and have seen two different therapists over the years for a long time too. I would say as long as you feel comfortable enough talking to them (keeping in mind it's always strange to talk to a new person about yourself at first so some discomfort is normal), they have a qualification and are members of a professional body (such as UKCP, BACP, BPC) and seem professional, then it's all good.

As above and also that you have a rapport with them. I went to a couple of therapists before my current one. First one was okay but she retired, second one I really didn't gel with. I felt very uncomfortable around her. Decided to see a male therapist next and immediately clicked especially when he announced "we're all fucking nuts!". It's like talking to a friend and I feel safe enough to tell him anything, even the cringey things.

It's early days for you. Give yourself a couple of months and see how you feel. For me, the first sessions were very painful because I let out years of stuff I had repressed and felt ashamed of (not my shame by the way, belonged to my crappy family, just didn't realise it). Therapy has been life changing for me. Hope it helps you too.

I don't think framing it as 'the one' is really helpful, as there will be potentially hundreds of 'the one's when it comes to a therapist. There isn't just one therapist out there that's perfect for you that you have to find. There will be many who are good enough to meet your needs. The pursuit of perfection in therapy is tricky because it can lead you to discount perfectly healthy and helpful relationships over a small conflict or disagreement, when in reality research shows that the therapeutic relationship is stronger after rupture and repair than before any rupture at all!

Generally though, it's in two parts. Credentials, and personability.

Do they have the correct credentials for your goals? What are you aiming for? If you're looking to process a bereavement then a person-centred counsellor trained in bereavement would be the one to look for. If you're after treating OCD, they won't be right for you and you need a CBT therapist. Going to someone for a problem they're not properly trained in working with can be futile at best, harmful at worst. Always make sure they are professionally registered and accredited as there are lots of people out there claiming to be therapists with no training. Check the professional register.

Personability: do you feel comfortable with them? Do you feel as though you could tell them anything and they would respond appropriately? If you question or challenge something they say (for example 'it sounds like you feel angry' 'no, not anger, disappointment') do they go with the flow and accept that or do they get defensive? Do you get the impression they care and are genuinely listening and feel positively about you, or are they disapproving and very clearly clock watching? Can you sense that they're fully 'with' you in the moment? Some people want a therapist who's a complete blank slate who'll say very little other than reflecting. Others find that infuriating and need back and forth!

I think one session is absolutely enough to discount a therapist, but it may not be enough to be certain that they're right for you. You can stop seeing a therapist at any time for any reason, so you can always stop and find someone else if you feel it isn't working. Sometimes relationships do grow, the first meeting can often be a bit awkward on both sides as it's such an artificial situation when you think about it, you're meeting a complete stranger for the very first time and expected to share your deepest emotions and thoughts, one sided, while knowing nothing about them. You're aware you're both only there because one is paying the other (if private). It can take time for it to feel relaxed and normal but you should feel empowered to trust your gut.

I wasn't that sure of my therapist for probably about 4 months. I have major trust issues and he is quite reserved so we had a spectacularly awkward first few sessions. But he was kind and I felt safe with him so I kept going and he's definitely the one.

But to be fair there will be several 'ones' I did have an NHS therapist for a couple of months who I clicked with too so I wouldn't get too hung up on the idea that there is one right fit for you.

You have to try a few sessions. My first therapist was “the one”. After six yrs I left. But needed to go back. I decided to try someone new. I had about 10 sessions when the pandemic halted things. She would only do telephone not online. I realised that I was feeling drastically worse, that I felt almost torn down by her even though she was nice. It just wasn’t working. I returned to my old therapist. Two years on and last session will most probably be today!

See how it goes. You can leave at any time if it isn’t working.

I also agree with not trying to find 'the one'. It just isn't helpful especially when most of us pursue therapy when we are in crisis and just need someone who is able to listen and show empathy and not be shocked by what we say. I was struck by how present my current therapist is and she was able to express her boundaries from day one, even if I was unclear about my own. She has stayed consistent to this. She isn't perfect for me but she is who I needed in my life. She is utterly lacking in bullshit.

Thank you for all your replies. She is well qualified and registered with BACP. She also seems nice. I think there is just perhaps a couple of concerns I have, the first that she doesn't have any regular appointments at the moment so is fitting me into cancellations she has had. She isn't sure when a regular appointment will become available so potentially some weeks I won't be able to have a session. The second is that she asked me to tell her about myself and I mentioned my husband in the first couple of minutes. She then directed the whole session to something I said there which isn't the main concern for me at the moment and changed the direction of the appointment - is that normal? I thought she would ask me if there was a particular reason for seeking therapy and look to work on that first?

You really need someone who can offer you a regular slot and not just cancellations, as that’s quite important for therapy to go well.

And no, that’s not normal or ideal. I’d have a look for someone else who can give you a proper slot and their full attention.

Oh, that doesn't sound good at all.

The cancellations thing isn't normal. You deserve consistency and to know when to expect your session and to know that you will be seeing her weekly or however often. Cancellations from either of you due to illness are fine and a normal part of being human, but her only fitting you into other people's cancellations is pretty chaotic and not very respectful of your time. It suggests she has over committed. Is this private therapy? If so I'd be really concerned about her workload/professionalism if she can't actually fit you in as a regular client but is agreeing to take you on anyway.

The second thing is a bit off, but also something that you might have to get used to dealing with upfront with various therapists. If you are unhappy with the direction things are going in you can say so! 'I know we're talking about husband here but what I really wanted to talk about was this'. As otherwise she might think she's on the right track if you don't say anything. On the other hand most therapists with a new client will ask why you've come for therapy, what you want to work on, and for an overview of your circumstances so it seems strange she hasn't done that. How can it be appropriate to start addressing your husband in depth when you've just met and she has no idea what your goals are?

Being nice and well qualified are prerequisites for being a therapist so I wouldn't worry about letting this one go and finding another one, there's so much more to it. The cancellation thing alone would be enough for me to not see this person. If you're dead set on her though you could try explaining that you can only go to someone where you have a regular weekly slot to rely on and see what she says. The vast majority of people wouldn't really be able to go along with this ad hoc approach.

Most private therapists have a cancellation policy where for example if you cancel with less than one week's notice you have to pay full price for the session. Cynically I wonder if she's trying to get double-paid for those slots by booking you in!

If she cannot commit to a regular slot with you she should not be booking you in at all, this is unethical.

Thanks everyone, I was concerned about how sporadic the appointments might be and the fact that they could be given with little notice. I think that was what was putting doubts into my mind about whether she was the right therapist for me. I have looked up a couple of local psychotherapists on BACP website and emailed them to see if they have availability any time soon.

@LindseyStauffer yes, it is private so now I think about it, it is likely the person who cancelled will have paid and then I also pay!

Yeah that isn't the norm at all. I'd look for someone else. The reason I went private over NHS was consistency. I wanted the same therapist for the whole journey. Not whoever was free, whenever they were free.

As a retired psychotherapist and counsellor who has had loads of therapy myself I don't think you can know if they are 'the one' or even 'a one' but you can definitely tell when they aren't the one. Follow your gut with this. She doesn't feel right to you so she isn't right for you.

I'm really sorry you had that experience with the NHS! I work as an NHS psychotherapist and once a client starts therapy they stay with the same therapist for the whole journey unless the client wants to change for whatever reason or something serious happens like the therapist goes on longterm sick. Usually I work with people for 5-8 months, weekly. That's such a crucial part of therapy that you don't have to keep building a new relationship over and over again, it's very jarring and not conducive to progress.