There are four major factors you might want to consider when choosing a therapist: Personal comfort, specialization, theoretical orientation, and education. I will discuss each of these four below.

Personal comfort

The most crucial of the three is the personal relationship between the client and the therapist. Studies have shown that the most important predicator of a client's success in psychotherapy is the relationship that is formed with the therapist—more important than the theoretical orientation or the education of the therapist. You have to choose a therapist to whom you can relate, and someone that you trust. If you dislike your therapist, or do not trust him or her, therapy is not likely to be effective.

Specialization

Human thought and behavior is a vast subject; no single individual can be an expert in every aspect of it. Therefore, psychotherapists usually specialize in a handful of specific areas. It is important that the client know whether or not a therapist specializes in his or her particular area of concern. For example, an individual with a psychotic disorder, such as schizophrenia, may not want to seek treatment from someone who specializes in grief counseling.

A psychotherapist may advertise what his or specializations are. If you have any questions about a particular therapist's experience or specialization, feel free to ask him or her.

Theoretical Orientation

This is a trickier subject than the other to areas of consideration, because it requires some education on different types of psychotherapy. Simply put, there are many different ways to do psychotherapy, and therapists usually practice one or two types of therapy more than others. Many therapists will pursue post-graduate education and certification in different types of psychotherapy, and some therapist will go one to create new ways of practicing therapy.

There are many, many different theoretical orientations. Some of the most common are Cognitive-Behavioral Therapy, Psychodynamic Therapy, Interpersonal Therapy, and Family Systems Therapy. There are also many therapists who practice "Systematic Eclecticism," which seeks to borrow techniques from different schools as they are helpful for the client. Each of these schools of thought has a different way of conceptualizing a client's concerns, and different ways of treating these concerns.

Making an informed choice about a therapist's theoretical orientation may involve becoming familiar with the different therapeutic schools, and deciding which is the most likely to have positive results. This can be a lot of work for a client, though. To make things a little easier, feel free to ask a therapist exactly what kind of therapy they practice, how that school views particular concerns, and what kinds of results they have seen in their practice.

Education

This is the last concern that I list because in many ways it is the least important. It is essential to find a therapist who is qualified to practice and who is educated in human thought and behavior; beyond those basics, the choice of what degree a therapist has is more related to the client's preference. Research has shown that the particular degree that a therapist has does not influence the outcome of psychotherapy.

Broadly speaking, there are four fields of education that produce psychotherapists: Psychiatry, psychology, social work, and counseling.

A psychiatrist is a medical doctor who has training in psychiatry. This requires four years of college, four years of medical school, and then an additional four years of psychiatry residency.

Psychiatrists are the only mental health professionals who can prescribe medications. Often, a psychotherapist will send a client to a consulting psychiatrist for medications while providing psychotherapy.

Doctors of psychology can hold a Ph.D. or a Psy.D. The Ph.D. is the traditional degree, where as the Psy.D. is a more modern degree that focuses on practice instead of research. There is also a Master's degree in psychology, which is usually a M.A.

Perhaps the most important distinction between psychologists and the other professionals listed here is that doctors of psychology can administer certain tests that other mental health professionals cannot.

There is one other concern that a client may want to consider: In the State of Michigan, anyone who practices psychotherapy with a master's degree in psychology (M.A.) must be supervised by a doctoral level psychologist (Ph.D. or Psy.D.). If you are seeing someone with an M.A. in psychology, he or she is required to disclose information about their supervisor to you.

Most of this country's mental health services are provided by individuals trained in social work.

A psychotherapist trained in social work will probably hold a master's in social work (M.S.W.). There is a social work Ph.D., and also a doctorate of social work (D.S.W.), but the vast majority of clinical social workers have an M.S.W.

Counselors will most likely hold a master's degree in counseling (either an M.A. or an M.S.) Counselors often specialize in a particular area, such as children, addictions or marriages and families.

So I've made my choice… now what?

Call the person that you've chosen and speak with him or her. Ask about scheduling an appointment and about fees. Many clients are surprised to find that the majority of private practice psychotherapists do not accept insurance—because of this, discussing fees in advance is essential!

You may also want to consider the amount of time between calling the therapist and the initial session. Some therapists will tell you that they are "fully booked"—this means that they are not taking on new clients at the moment. Some therapists will ask if you want to be put in a waiting list, which means that you are willing to wait until the therapist has an opening before you schedule an initial appointment. Other therapists will offer you a referral to another profession who has a similar practice.

Conclusion

It is essential that you feel comfortable with your therapist. I hope that this guide will be helpful to you as you negotiate the (somewhat) complicated world of psychotherapists. Of course, if you have any questions, feel free to contact me.