Finding a Therapist: It Really Is About the Fit

Finding a therapist is strange.

We tell people to reach out when they are struggling. Talk to someone. Find a therapist. We say it as though finding that person is the easy part.

Then you start looking.

There are pages of therapists with letters after their names, descriptions of different kinds of therapy, specialties, insurance plans, fees, and promises about what therapy can help you accomplish. If you have never been in therapy before, you may not even know what half of it means.

And sometimes you are not looking only for yourself.

You may be a caregiver who realizes that you need a place of your own to talk about what you are carrying. You may be helping someone you support find a therapist. You may be an older adult looking for therapy for the first time, or returning to it after many years, while dealing with changes in health, relationships, independence, caregiving, grief, retirement, or simply what it means to be getting older.

However you arrive at the search, somewhere in all of those listings you are supposed to figure out who you are willing to sit down with and talk about some of the most personal parts of your life.

That part matters.

You Don’t Have to Know What Kind of Therapy You Need

People sometimes think they need to figure everything out before contacting a therapist.

You don’t.

Sometimes the starting point really is:

Something isn’t working, and I need some help figuring it out.

That’s enough.

For a caregiver, it might be something different:

I have spent so much time taking care of everyone else that I am not even sure what I need anymore.

For an older adult, it might be:

My life has changed, and I am trying to figure out who I am in the middle of all these changes.

What you probably do know is something about what you need from another person.

Maybe you need someone who will slow down and give you time to think. Maybe you need someone who doesn’t expect eye contact. Maybe you need telehealth because getting across town takes far more energy than people realize. Maybe you need someone who understands disability, neurodivergence, caregiving, grief, trauma, aging, chronic illness, changing independence, or what it is like to live in a body that doesn’t always cooperate with your plans.

Those things matter just as much as the letters after someone’s name.

When You Are Helping Someone Else Find a Therapist

Sometimes finding a therapist is a shared process.

A family member, caregiver, direct support professional, friend, or other trusted person may be helping with phone calls, searching directories, figuring out insurance, arranging transportation, or asking questions.

There is nothing wrong with getting help with those things. Navigating mental healthcare can be complicated.

But there is an important difference between helping someone make a decision and making the decision for them.

Whenever possible, the person who will actually be receiving therapy should remain at the center of the process.

Ask them what matters.

What would make them comfortable? Is there something they absolutely don’t want? Would they prefer telehealth or meeting someone in person? Do they want you involved in the first conversation, or would they rather speak to the therapist themselves?

A person may need support making a choice without needing someone else to make the choice for them.

That distinction matters.

You Get to Ask Questions Too

Therapists ask a lot of questions.

You get to ask some back.

Ask how they work. Ask whether they have experience with the things that are bringing you to therapy. Ask what happens if you disagree with them. Ask about fees. Ask about cancellations. Ask about accessibility.

If you are an older adult, ask whether they have experience with the kinds of transitions you are facing.

If you are a caregiver seeking therapy for yourself, ask whether they understand that caregiving can involve love, frustration, exhaustion, grief, humor, resentment, loyalty, and sometimes all of those things in the same afternoon.

And if you are helping someone else look for therapy, help that person develop their questions rather than only asking your own.

Then pay attention to how the therapist answers.

Do they actually answer the question?

Do they talk to you or at you?

If another person is present, does the therapist continue talking directly to the person seeking therapy, or does the conversation gradually shift toward the caregiver or support person?

Do you feel as though they are interested in understanding the person in front of them, or have they already started fitting that person into a box?

You may not know after one conversation whether someone is the right therapist. But you can learn quite a bit about how someone treats you.

The Therapist Is Not the Expert on You

This one is important to me.

A therapist has training. They may understand trauma, relationships, behavior, grief, anxiety, depression, aging, caregiving, or any number of other things. That knowledge has value.

But they have not lived your life.

You have.

Therapy should bring those two kinds of knowledge together.

That becomes especially important for disabled and neurodivergent people, people who rely on caregivers or support services, and older adults whose independence may be changing.

Many people have spent years in systems where somebody else was considered the expert on them. Doctors. Teachers. Case managers. Evaluators. Caregivers. Sometimes family members.

People can become very accustomed to being talked about rather than talked with.

Getting older doesn’t erase your right to make decisions about your own life.

Needing support doesn’t erase it either.

Therapy shouldn’t reproduce that experience.

You should be able to say, No, that’s not what I meant.

You should be able to say, That doesn’t fit my experience.

You should be able to say, Can we try this another way?

And sometimes you should be able to say, I don’t want to work on that right now.

None of those statements mean that you are failing at therapy.

They mean you are participating in it.

Sometimes It Isn’t a Good Fit

Not every therapist is going to be right for every person.

That doesn’t necessarily mean there is something wrong with the therapist. And it certainly doesn’t mean there is something wrong with you.

Sometimes two people just don’t work particularly well together.

Give yourself enough time to figure out whether you are simply uncomfortable because therapy is new or whether something about the relationship really isn’t working.

If you can, talk about it.

A therapist’s response to “This isn’t working for me” may actually tell you more about them than anything written in their professional bio.

And if you decide you need someone else, you can look for someone else.

You are allowed to do that.

You Are Not a Problem Someone Else Needs to Fix

I think this may be the most important part.

People often arrive at therapy believing there is something about themselves that needs to be fixed.

I don’t think that is a particularly useful place to begin.

You are bringing your history into that room. Your strengths. Your losses. The things that have worked. The things that haven’t. The ways you have learned to survive difficult situations. Your relationships. Your culture. Your disability or neurodivergence. The people you care for and the people who care for you. Your experience of getting older. Your questions. Your hopes for what might be different.

The therapist brings something too: training, another perspective, some tools, and hopefully a willingness to listen.

Neither person should be doing all of the talking or all of the deciding.

Therapy is something you build together.

So whether you are looking for yourself or helping someone you care about begin the search, don’t just ask whether that person fits what the therapist does.

Ask whether what the therapist does fits the person.