Finding a Good Therapist: A Personal Journey Aided by Books, Experience & the Internet

I’ve wanted to write about this topic for a long time, but it’s back on my mind after reading a currently-trending book called “Maybe You Should Talk to Someone.” The book is authored by journalist-turned-therapist Lori Gottlieb, and it offers the single most comprehensive, unique perspective I’ve ever read on how therapists think about their work and interactions with various patients (from the wonderful to the difficult) and how therapists experience crisis and professional counseling themselves. 

It was one of those 400-page books that I got from the library and finished in a week. Human vulnerability is perhaps one of my favorite topics to talk and read about, and this book is bursting with raw, honest portrayals of both human suffering and connection. 

Another motivating factor in writing this: I feel like I’ve finally met “the one” when it comes to my personal search for a qualified therapist. I’m about two and a half months into my therapy with her, and it finally feels easy, right. I’m so grateful, because as Gottlieb says: 

Study after study shows that the most important factor in the success of your treatment is your relationship with your therapist, your experiences of ‘feeling felt.’ This matters more than the therapist’s training, the kind of therapy they do, or what type of problem you have.

Finding a good therapist takes work

I know it’s not easy. I’ve been looking for over three years. I’ve tried going through my insurance, through my company’s EAP program, through Psychology Today, through word of mouth references, and finally, through my company’s connected health program, where I’ve been able to see someone for an hour every week at very little cost.  

I’ll be the first to say that I’m extremely fortunate to work for a company that puts employee health and happiness before almost everything else. Most people will not have access to something quite like it. However, I think the tips below will help you take your first steps to finding someone that works for you and your life. 

Research before anything else 

Before you start shopping around, consider training, treatment, and your current resources. Not all of these things will weigh in equal proportions for all people, but they’re factors to be aware of.

Types of therapists

You’ll encounter a number of different trained professionals by a number of different names during your search (along with their confusing abbreviations). GoodTherapy.org outlines the four you’re most likely to work with:

• Licensed Clinical Social Workers (LCSWs)

• Licensed Marriage and Family Therapists (LMFTs)

• Psychologists (PhD or PsyD)

• Licensed Addiction Counselors (LACs)

I’ve worked with social workers, therapists, and psychologists with PhDs. With the specific challenges I’ve faced as a mid-twenties female living in a big city working for big companies with a (blessedly) strong support system, I’ve found the most success with LMFTs. It’s possible that this is a coincidence, and that type/training is far less important than the connection you feel and forge with any given mental health professional. I don’t remember feeling like anyone I saw was incompetent, so consider keeping your search broad in the beginning. 

Something to consider is the difference between therapy and life coaching; I’ve done both and written about my experience with life coaching if you’re unfamiliar.  

Types of treatment

There are many different schools of thought when it comes to treating the human mind, with the following being some of the most common: 

• Cognitive behavioral therapy (CBT)

• Psychodynamic therapy

• Client-centered therapy

• Existential therapy

Funny enough, the type of treatment has never come up as a focal point in any of my experiences with therapy. No therapist has ever looked at me and said, “Ah, I know what you need -- 5 sessions of existential therapy and we’ll finish you off with a little CBT.” It’s always been much more fluid and relational, which is perhaps one of the central points of this post. The relationship always matters more than the type of training or treatment. 

At a minimum, though, I’d recommend you look for someone who specializes in your particular issue(s), whether its relationships, anxiety, identity, or something else. It’s very comforting to know that your therapist has seen people in your shoes before and can speak to what’s worked well for others (and what hasn’t). 

Therapy is a journey; keep walking until you find the right path. Others don’t want to see you stop in the middle of the trail :)

Understand your resources 

By “resources” I mean --  what in your life can you draw on to make therapy more affordable? Before finding an inexpensive, insurance-backed rate with my current therapist, I was tapping my company’s limited EAP program or paying $160 per week out of pocket for a lame 40-minute session with a guy that I really didn’t like.

I dream of a day when regular, insurance-backed, preventative therapy is viewed as an integral part of our healthcare system. Until then, I’ve broken down the resources you can try, whether you’re in a position similar to mine or flying financially solo on your journey to mental health. 

Employer-sponsored resources

For anyone who has access to employer-sponsored mental health benefits or programs, I strongly urge you to take advantage of them. If you don't know, send a quick email to your HR team to find out - companies don't always do a good job advertising these benefits: 

• Company-sponsored program. Pay close attention to your various healthcare options to see if your company offers one of those rare, magical options of free or discounted therapy. I get my very-affordable therapy through a clinic that only takes one type of insurance that my company offers, so it’s important to understand the details here. 

• Through insurance: Most insurance plans offer some form of mental health coverage, so the co-pay for an in-network therapist can be $50 or less. However, in the US, some therapists are only legally allowed to bill your insurance if they have diagnosed you with a mental health problem, which is something that concerned me -- what if I wanted to run for public office one day and a mental health diagnosis prevents me from gaining a security clearance? I know that’s a little extreme, but something to be mindful of. Find someone in-network on your insurance provider’s website or on PsychologyToday.com (recommended by Gottlieb and many other therapists in my research). 

• Employee Assistance Program (EAP): Most big companies offer some version of an EAP, which gives employees access to free or discounted short-term counseling for work or life challenges. At my last company, I got 8 free therapy sessions per issue through the EAP. So I could keep calling to let them know I had a new “issue” and they’d refresh my session count. At my current company, I get three free therapy sessions per qualifying issue. It was a lot easier to take advantage of at my last company, so I haven’t at my current. I’ve also never felt a strong connection with therapists I met through the EAP. 

Flying solo 

If you are self-employed, a student, or working for a company without mental healthcare coverage, fear not. There are options for you, too. 

Know that, off the bat, most 50-minute therapy sessions without insurance will set you back $100-250 per session. Always ask your therapist about their sliding scale, which determines your rate based on your current financial situation.  

Whitney Goodman, LMFT and owner of The Collaborative Counseling Center in Miami, offers great advice on finding budget counseling options:

• Local universities: Goodman suggests looking into local universities and seeing someone who is going for their masters or doctorate in psychology. “The clinicians are really good. They’re being supervised by really respected people in the community, and sometimes the services are as low as $5.”

• Open Path: Another option might be to look into Open Path, where you pay $49 for a lifetime membership and gain access to a directory of therapists who charge between $30-$50 per session.

A quick word of advice: Look for a therapist who will give you a full 50-minute session (rather than 40 or 45), if that’s what you want for your time/money. It’s a more than reasonable expectation (in my experience), and the extra ten minutes goes a long way.  

Communicating with your therapist 

Take a seat, let’s talk.

Before the consultation

Although prep work isn’t necessary before your initial consultation, I’d recommend coming prepared with a list of ~5 questions that really matter to you. Keep it to no more than five, because you want to make sure the bulk of the conversation is focused on you and your therapist making a connection. 

In the past, I’ve asked some of the following: 

1. What style of therapy do you practice the most and why? 

2. What issues do you specialize in and why? 

3. How recently have you been in therapy yourself? 

4. How often do you consult with peers?

5. How will I know I’m progressing? 

For a more robust list of questions you can consider asking, check out this great article in the Washingtonian: The 14 Questions You Should Ask a Therapist Before Your First Appointment.

The initial consultation 

Much like a first date, you’re using this time to understand whether you and the therapist sitting across from you have chemistry. Chemistry is an intangible phenomenon, something most people know when they feel it. For me, I knew that I’d found the right person when they radiated warmth, were quick to smile and shared words of affirmation early on.  

During this time, you’ll also want to be wary of some common red flags that signal a less-than-qualified therapist, including: 

• The therapist is talking more than you

• The therapist is interrupting you often

• Any inappropriate behaviors from the therapist (sexual or otherwise)

• The therapist has violated your confidentiality (this would come after at least one session)

If the initial consultation is an enjoyable experience and you sense that the therapist is equipped to help address your issues, schedule a follow up. If you’re not sure, you can always ask for time to think about it and be transparent about the fact that you’re exploring a number of options. A good therapist will encourage you to look for the best fit. 

The first few weeks 

After you’ve started seeing a therapist for a while, you’re looking for a special bond to form called the “therapeutic alliance.” This term “refers to the relationship between a healthcare professional and a patient. It is the means by which a therapist and a patient hope to engage with each other, and effect beneficial change in the client.”

A 2011 meta study published in Frontiers in Psychology found that:

The emerging picture suggests that the quality of the client–therapist alliance is a reliable predictor of positive clinical outcome independent of the variety of psychotherapy approaches and outcome measures.

Based on their research, the definition has evolved over time, but a strong therapeutic alliance is most often characterized by:

• Support

• Collaboration

• Congruence

• Empathy

• Reciprocal positivity

Something else to be mindful of is your level of comfort during each session. There’s a tricky line between feeling uncomfortable with some of the conversations that you’ll have with a good therapist and feeling uncomfortable with the person themselves. If you don’t feel like you connect - like this person doesn’t see or feel you in the way that you need - that is an appropriate reason to politely move on to a better fit. 

Finding a therapist is a lot like dating 

Goodman, in the same Greatist article referenced above, solemnly states:

In some ways, finding a therapist can be like the worst parts of dating: You find someone you think might work and take time out of your schedule to go meet them, only to find out it’s a bad fit.

During my three-year search, I spent far too much time with therapists that were a bad fit. 

One very-feminist therapist hated President Trump and would launch into an impassioned speech on how he was ruining the lives of women everywhere whenever I mentioned an instance of female inequality in my life. Though we shared values, she didn’t feel objective. 

One woman was between my mom and grandma’s age, and I had a hard time respecting her advice for an early-twenty year old. When I expressed discomfort about my drinking habits around age 22, she suggested that I get new friends. That felt extreme and unhelpful at the time; what I really needed was to dig deep into my personal values and understand that my worth in a given social situation was not predicated on the fact that I drank or not. 

Another - the only male therapist I’ve seen - came off as slimy. His sessions were just 40 minutes, and he always spent the first 5-10 trying to corner me into another session. He had little empathy for the financial hardship that consistent therapy would impose and his pushiness irked me to no end. His insights were helpful, but I always left feeling gross about him.  

A good therapist is worth the wait

I’m finally in a position where I can say that the three-year search was worth it. I adore the therapist I’ve been seeing for the last two months. She’s young and in-touch, well versed in my set of challenges, warm, empathetic, and connection-oriented. Perhaps most importantly, she’s someone I can afford to see weekly. 

Something I read in “Maybe You Should Talk to Someone” stands out to me; there’s a passage in which a patient is telling Gottlieb how he hears her voice in his head throughout the week in between their sessions. She’s deeply satisfied to hear this, knowing that a goal of therapy is to get the patient to start doing their own line of questioning and self-soothing, both inside and outside the therapy room. 

I hear my therapist’s voice all the time now, and it’s become a source of both comfort and strength throughout what’s been a very painful period. I look forward to our session each week and am bummed when our schedules don’t align. But I always know she’s a quick email away and would bend over backwards to be there for me in a time of need. Look for a therapist who makes you feel like that. 

What’s your advice for finding a good therapist? Anything I’m missing? Please share in the comments! 

Positive Psychology and Relationships: What the Research Says About Happiness & Healthy Relationships

When I reflect on the happiest moments in my life, people are always part of the story. Not necessarily strangers - though their presence is welcome - but close, intimate relationships. I think about college, where being in a sorority meant I was constantly surrounded by my best friends. I think about glasses of wine shared with coworkers after a long week, where we end up laughing ourselves to tears. I think about small, sweet moments spent cuddled up next to the person I love, watching our newest favorite show and basking in the sense of easy closeness. 

Relationships have always been the most important and fascinating things in my life. Particularly romantic relationships, and why it’s so difficult to find and stay in a happy one. This fascination has led me to seek out endless books, articles, videos, movies and conversations on the topic. Now, I’m excited to start the conversation on Blue Sky Mind. 

Positive psychology and relationships 

It turns out, my interest is not unfounded. People and organizations that study well-being unanimously conclude that relationships are a core factor -- if not the most important factor -- to living a happy life. This is a topic so central to Blue Sky Mind’s core mission to educate the world about positive psychology -- what it is, why it’s helpful and how to practice it in a realistic and sustainable way. Because your happiness is more influenced by your relationships than anything else in your life. 

To introduce this topic on the blog, I wanted to draw the very clear connection between positive psychology and well-being, because the research is voluminous and conclusive on the subject. 

Let’s dive in. 

Researchers consider healthy relationships to be the single most important factor in happiness 

From the man who’s credited with inventing the field of positive psychology, relationships are considered the “single most reliable” of the five elements to well-being. Martin Seligman identifies all five in his book on positive psychology, Flourish. The researched-backed elements of well-being include positive emotion, engagement, meaning, accomplishments, and relationships. In Seligman’s own words, “other people are the best antidote to the downs of life and the single most reliable up.”

For a great primer on Seligman’s book and five elements of well-being, check out the following video: 

To add additional evidence to this idea, the Harvard Study of Adult Development -- a longitudinal study of 268 Harvard sophomores starting in 1938 and running until the end of each participant’s life -- found that:

“Close relationships, more than money or fame, are what keep people happy throughout their lives . . .[Close relationships] protect people from life’s discontents, help to delay mental and physical decline, and are better predictors of long and happy lives than social class, IQ, or even genes.”

So not only are relationships key to your present-day happiness, they’re instrumental in helping you live a long, healthy life.

A study out of Berkeley's Greater Good Science Center, which surveyed 2,500 people, found that:

“Being more pro-social—engaged in meaningful, authentic relationships, showing kindness and generosity in the world and being part of a supportive community—is the most promising route to sustainably increasing our well-being.”

Let’s pause on a few of those words: kindness, generosity, authentic, supportive. Collecting acquaintances is not enough. True happiness requires that your relationships feel authentic and supportive, that you express kindness and generosity in order to warrant that treatment in return. 

Additionally, research from one of Berkeley’s positive psychology fellows, Brett Ford, suggests:  

“This kind of approach to pursuing happiness may work better than striving for continuous pleasure, success, and power.” 

What this means: Stop prioritizing your job or your next sexy fling if you’re looking for lasting well-being. Start prioritizing authentic connections with people you enjoy. This idea is reinforced by everything I took away from Yale’s Science of Well-Being course (which I highly recommend). 

Quality and quantity count, but so does time spent engaged in said relationships 

At age 25, I already feel like there aren’t enough hours in the day, so I’m very keen to understand which daily activities I should be investing in for my happiness. Three different studies I found map the link between how we spend our time and life satisfaction, with all signs pointing to socializing as the best thing you can do on a daily basis to increase your happiness. I’ve quoted two below.

Another longitudinal study out of Berkeley’s Greater Good Center found that when people spent more time socializing over the course of a year, they became more satisfied with their lives. Here’s the key quote for me: 

“They were the people who committed to teach their son to swim or be more understanding of others, to go on a trip with their partner or meet new people . . . What seems true across cultures is that social connections are key to well-being. For example, very happy people are highly social and tend to have strong relationships; kids with a richer network of connections grow up to be happier adults; and socializing is one of the most positive everyday activities.” 

One interesting point about this study is that the researchers acknowledged that social goals are easier to attain than, say, weight loss or getting a new job. To socialize with others, you simply have to pick up the phone or attend an event, whereas other goals require repeated, long-term effort to attain. This doesn’t diminish the positive effect of relationships by any means; in fact, it should motivate us all to take the few easy steps required to socialize more.

Another study by Nobel Prize winner Dan Kahneman, titled “Characterizing Daily Life Experience: The Day Reconstruction Method,” shows that intimate relations and socializing are the two most positive activities you can do in a day in order to increase well-being (defined by feeling happy, experiencing warm or friendly feelings, or simply enjoying yourself). 

I was fascinated by the finding that participants got the biggest boost from friends and relatives, followed by their significant other and children; I would have thought that your SO and kids would be the happiest interactions of your day — food for thought. The most negative social interactions tend to be at work, with your boss, coworkers, or customers, which surprises approximately no one. 

The three studies combined represent some of the most powerful data for me, because I tend to really value my alone time. In fact, I will specifically avoid making plans with people in order to pursue other goals that I think will make me more happy, like working out or writing for my blog. I continue to seek the right balance of socialization and working toward my various personal goals.

Just because relationships aren’t your “thing” doesn’t mean they can’t be a priority

If it’s not obvious already, relationships were something I cared about before I knew about their link to positive psychology. In fact, it's likely a huge part of what attracted me to the field. 

Before, though, I was guilty of looking for all my happiness in the romantic affection of another human being. Now, I see it more as an essential component to a well-balanced well-being portfolio. 

For those who aren't naturally drawn to relationships and don’t believe that they need human connection in order to live a happy life, my hunch is that past negative experiences have caused them to cordon off that part of their heart's desire. This might be due to their fear that the desire for connection won’t be adequately met and therefore lead to intense disappointment, perhaps for what seems like the umpteenth time. 

I want to persuade anyone with this mindset that relationships are worth investing in and getting right. Even if they're not perfect, their healthy presence in your life will buffer so much of life's negativity. Even if you are the type of person whose goals fall far outside the realm of relationships, strong ones will invariably make you more successful in accomplishing the goals you do have.

Relationships and happiness are a self-reinforcing duo 

I love this closing thought from an organization called Action for Happiness, which aggregates positive psychology research into a digestible website for folks who want to learn more about well-being:  

“Just as relationships are a two-way thing, it seems the connection between happiness and relationships is too. Not only do relationships help to make us happier, but also happy people tend to have more and better quality relationships.”

Even knowing how important relationships are to your happiness, you can’t rely on other people to do the heavy lifting for you. It’s important to seek personal satisfaction in other areas of your life, so that you’re bringing joy to your relationships, rather than weighing them down with the heaviness of your unhappiness. 

In a few weeks, I’ll be sharing two posts from a couple that has inspired me all my life with their easy and loving partnership. One is an interview with a licensed marriage counselor with 30 years of practice under her belt on the secrets of a happy relationship. The other is something of a love letter from a husband to his wife of 30 years, inclusive of advice for young people seeking the same affection and stability.

So that you don’t miss a thing on positive psychology and relationships, make sure to subscribe to Blue Sky Mind.  

Thankful Journal No. 4

San Francisco has seen a goood last few weeks. The sun has re-emerged, and the feeling of joy it gives me is indescribable. I’ve spent so much time outdoors, basking in the glow of the blue sky or delighting in the first flowers of the season. The air is thick with musky, spring-heavy floral scents, even more so after the occasional burst of rain. Spring rain is different than winter rain; it leaves the air warm and thick, and I love walking home wrapped in its woolen touch.

With the coming of spring, I’ve spent more and more of my weekend time exploring and delighting in new places. And by new places, I mean new views and new food. This is what brings me joy. This is me as my own heaven. Sunshine, greenery and a glass of chilled wine. Stopping to admire city flowers on my walk to the library. Ripping into a matcha croissant or wafting freshly baked bread to the point that it’s become my personal aura.

Below you’ll find images of my personal delights of late. I hope they bring you joy like they do me.

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Up Next: Read Thankful Journal No. 2