How can I find a therapist for individual counseling? Feminist Advice Friday

A reader wants a feminist therapist who practices quality, evidence-based therapy.

A reader asks…

I recently moved back to my home town, and am interviewing therapists. I’ve decided to get counseling to help me heal from domestic abuse, which has happened to me on and off throughout my life. (Including emotional and psychological abuse by my mother when I was growing up). I want to make sure I get a feminist therapist who isn’t inclined to make excuses for men, and I will definitely ask about this in the interview process.

Is there any specific writing of yours you’d recommend I send to a potential therapist, so I can help make sure we are on the same page?

My answer

I’ve written some negative pieces about therapy lately, which might lead some readers to believe that I am anti-therapy. I actually think therapy is a great tool for healing, transformation, and even community liberation. The challenge is that it happens in private, which allows bad and unaccountable therapy to proliferate.

I’ve spent most of my writing career as a science and mental health journalists. One of my longest standing clients was an organization that advocates for ethical, effective, evidence-based therapy. Writing for them was eye-opening, because I saw that bad therapy is the norm. I’m talking here about therapy that just doesn’t work, as well as therapy that is outright abusive. That experience has made me much more skeptical of therapy—a skepticism that I think is both warranted, and a useful tool for quickly weeding out bad therapists.

I don’t think you should necessarily send a therapist a bunch of my writing and ask them to react. Therapists, like most professionals (doctors, lawyers, etc.) have very little time, and often have to contend with clients and prospective clients who do not value their time. It’s asking a lot to get them to read me as a condition for taking you on as a client.

Instead, I think a lot of the questions I pose in this piece are also useful for interviewing individual therapists.

Ultimately, though, what’s most important to ask is what you care about. For example, some people very much want to discuss spirituality in therapy, while others do not. Asking how a therapist handles this is important for these folks.

Therapist interview 101

In general, you should ask about topics such as:

• their experience with your specific challenges

• how they generally handle issues like yours

• how long therapy takes, and how you’ll know therapy is working

• when they would consider referring you to someone else

• if they partner with other professionals, especially doctors who can prescribe medications

• what they do to protect your privacy and safety, and in what situations they might breach this privacy

• the specific methodologies they use, and the evidence base supporting them

• their beliefs about gender, race, and other sociopolitical locations

What is good therapy, anyway?

The hallmark of a good therapist is this:

They rely on clinical, scientific judgments and recommendations rather than personal, emotional ones. They learn your values, understand and interrogate those values, then help you live in accordance with them.

This means that a therapist draws upon a base of evidence when making recommendations and interacting with you, rather than relying on personal feelings or beliefs.

A Christian therapist might truly believe that praying is helpful, but they should only recommend interventions that are scientifically proven for your condition and which are consistent with your stated values. So if you’ve said you have a religious, political, or personal opposition to a specific modality, they should not encourage that modality even if it’s helpful. There’s space for pushing back on some beliefs and on resistance to some modalities, but that goes well beyond the scope of this post; the general rule is that a therapist should honor your values and work within the scientific method.

One thing we see a lot with problematic therapists is that they react rather than anticipate and plan. So they respond emotionally to your emotions rather than putting your emotions into a scientific framework. As a result, people end up endlessly talking about feelings and making no progress.

You won’t really know how effectively your therapist uses clinical vs. emotional judgments until you have seen them for a while—though if a therapist pontificates about unsupported theories or pseudoscientific nonsense in your first session, that’s a red flag.

Once you are established in therapy, some things to look for include:

• Consistency. Does the therapist’s understanding of your challenges remain relatively consistent, shifting only as new information becomes apparent? Or is it constantly changing? A consistent therapist is much more likely to be using scientific judgments.

• Structure. The therapist should listen to you and support you to discuss what is important to you. But they should also impose some structure. There should be a plan beyond endlessly talking about your emotions.

• Progress. You should be making progress, should be talking about progress, and should have clear metrics for what counts as progress.

• Defensiveness. Therapists who get defensive are not qualified. A good therapist wants you to tell them when they miss the mark, because then they have more useful and actionable information.

The role of feminism

To be a good therapist, the therapist must be a feminist. This does not mean that feminism is sufficient. Lots of therapists claim to be feminists, but pay little attention to power dynamics. So get specific about the therapist’s feminism and how it manifests in therapy. Remember that they should be challenging you to live in accordance with your values.

Therapy as an ongoing relationship

Therapy is a relationship. While some therapists are objectively terrible, it’s more common for a therapist to be ideal for some people and less-than-ideal for others. A therapist who is great in the beginning might lack the skills to handle a new issue. Over time, they may lose objectivity and perspective. Sometimes you just need a new person.

So continue to evaluate your therapist for as long as you see them. As with any other relationship, there is no finish line at which everything will forever be perfect.

Some other links you might find helpful

This is a new feature I’m testing out, to connect people to useful educational material. Let me know if it’s helpful, or if it’s just clutter!