What Type of Therapy Do I Need?
TL;DR
Good question, but it’s probably the wrong one.
Better Questions might be:
What type of person do you connect best with?
What type of therapy style would you prefer?
What issue are you struggling with?
In the end - Make 3 educated guesses for possible therapists and test them out.
Therapists are Humans, Too.
Common factors account for 30-70% of treatment outcomes. “Common factors” are minor behaviors in therapy that are often related to a therpists’ personality and are a part of how they work. The way they look at you, nod their head, whether they make a joke or not, the words they use to ask follow up questions, and so on. “Common factors” also includes the therapeutic alliance and how much you and your therapist are sharing the same goal. Common factors are notoriously hard to measure, but you can feel them. Therapists give off vibes and people respond differently to those vibes. Just like you may like or dislike random people you meet, the same is true for your therapist. Because, well, it turns out your therapist is human too. So really you are looking for a therapist you can vibe with.
They just GET me.
It’s important that you feel your therapist understands where you're coming from, or at least can get there with a little effort. It may take a few sessions, but when your therapist says something, ideally you want to be able to say, “YES! EXACTLY!”. This is actually going to really be important if you hold a marginalized identity (or maybe several). It might be really helpful if you have a therapist who shares some of these identities, but it isn’t always necessary. It would be good to check and see if they are aware of common concerns/cultures associated with your biggest identities. It will just help everything go smoother. It doesn’t guarantee they will get you, but therapists that openly name they work with marginalized groups or use a social justice/intersectional lens might be a good start.
For those who need a refresher about marginalized identities or intersectionality, use the links.
Therapist Theoretical Orientation
This is a weird phrase therapists use a lot. It basically means - this is the lens through which I see the world/think about client concerns. Each therapist uses their own interpretation of counseling theories that we learn in school (and beyond). There are many theories in counseling. Read this article if you want an example of how my theory translates into how I do therapy. Many therapists use more than one theory to create a stronger, more well rounded mega-theory. This is often called an integrative or eclectic style. In general I think this is just good practice and shows critical thinking on the part of the therapist. It takes work to understand multiple theories so well that you can take them apart and put them back together to create a custom therapy hotrod. The weaknesses in one theory can be filled in by a different theory.
Therapy Styles
I’m sure some therapists would fight me on this but I generally think that therapy styles can be described as directive and non-directive. Here is a broad generalization. Of course because therapy is so specific to the therapist and person none of these are ALWAYS true.
Directive therapists are more likely to do the following:
Give you a summary of where you left off
Set agendas at the beginning of the session
Give you homework (or atleast co create it with you)
Give you more feedback
Interrupt you
Keep you on track if you’ve gone off on a tangent
Ask questions
Provide options for treatment/intervention
Make interpretations
Non-directive therapists are more likely to do the following:
Let you talk
Leave a lot of silence
Follows your lead
Asks questions
Rarely challenges
Trusts that you have the answers you need and you can find them
Different people might prefer different styles of therapy. Some people may even start out feeling directie styles are more helpful and over time they might prefer to move to a non-directive style if they have a good understanding of their internal landscape. To complicate things, most therapists are sometimes directive and sometimes non-directive. Although, most have a general leaning.
Therapist Specialties
Another possible question might be, what are you trying to accomplish in therapy? If you have a super specific issue you want help with, you should find a specialist. Some examples might include addiction, substance use/abuse, eating disorders, or sexual dysfunction. People who treat these issues generally received additional specialized training or experience after graduation. Therapists can specialize in just about anything: teens, LGBTQ issues, depression, existential concerns, life transitions, grief, anxiety, trauma, psychosis, dissociation, etc.. Maybe the therapist had extra training but usually we just figure out we are really good at working on a few things and we say that’s our specialty.
For example, I used to specialize in treating trauma and severe and persistent mental illness (SPMI). It’s work I love doing, but not all therapists do, so I ended up volunteering to take a lot of these cases when I was working in agencies. Now that I’m solo and often online, it’s not always ethical/possible for me to treat these concerns, but I have found that the same underlying existential and social justice principles that powered my work before have allowed me to help a different group of people with finding purpose, making connections, and increase self-awareness. It’s all the same things I was doing to improve the quality of life for my old clients, new client’s lives just look a lot different. So now I say my specialities are value alignment, existential questions, decision making, and general coping.
Specific Treatments
There are some treatments that are generally more helpful for certain diagnoses. So if you have one of these diagnoses, these treatments might be worth looking into.
Borderline Personality Disorder --> Dialectical Behavioral Therapy (DBT)
Phobia --> Prolonged Exposure Therapy (PET)
There has also been a lot of evidence that EMDR can be helpful for certain symptoms of trauma.
Now, these are treatments that generally work. Like chemotherapy generally works for cancer. There are no guarantees these therapies will work, but that’s a discussion between you and your treatment team.
Boy howdy, I bet you this is going to be one of my less popular blog posts, but I hope it helps some very detail oriented individual clarify their journey of finding a therapist. My recommendation is usually to interview three therapists and see if you feel that therapy spark. If you want a more step by step guide, check this out. If you think I might be a good fit for you, I encourage you to learn more about me here. I am happy to answer any questions you may have before making an appointment. To book your free 20 minute consultation, fill out the form on my Get Started page.
If you want to try and figure out a few things on your own, you can check out my online self-study course. Deepening & Developing Connections. It goes through how to find your values, set your priorities, discover your vulnerabilities, and evaluate your boundaries. It also guides you in how to connect with others deeply and genuinely by showing your true self and asking them about their true self. I also spend a whole lesson on conflict and how to use it to build your relationships rather than tearing them down. The Deepening & Developing Connections Workshop is available any time at www.ddcworkshop.thinkific.com
Dr. Fae
has a Ph.D. in Counseling Psychology. She lives abroad and offers online therapy & clinical supervision. In her individual therapy practice, she specializes in value alignment, existential questions, decision making, and general coping to increase overall life satisfaction. Her online self-study course Deepening & Developing Connections is always available.
—————————
You can learn more about her in all these places.
drfae.com | facebook | instagram | linkedin
Source:
Imel, Zac E; Wampold, Bruce E (2008). "The importance of treatment and the science of common factors in psychotherapy". In Brown, Steven D; Lent, Robert W (eds.).Handbook of counseling psychology (4th ed.). Hoboken, NJ:John Wiley & Sons. pp. 249–262. ISBN 9780470096222.OCLC 145942481.
*The content on online-therapy.net is not intended to be a substitute for professional medical/therapy advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical/mental condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.