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Things to Consider When Starting Therapy

Therapy can often be a nerve-wracking or overwhelming experience that is deeply personal, and can be accompanied by a range of emotions, particularly for individuals who are entering therapy for the first time.

A common question many people have once they have decided to pursue therapy is “where do I start? and how do I find a therapist who is good?”. These questions alone can be overwhelming, bringing up more nerves and questions about where to look for a therapist and how to gauge success in the therapy process. In this blog we will break down the steps for starting therapy, what to consider, and what to look for in a new therapeutic relationship. Ultimately changing the question from “how do I know if a therapist is good” to “how do I know if a therapist is the right fit for me and my needs”.

Breaking Down the Steps to Starting Therapy

1. What is Your Budget for Therapy?

The costs associated with therapy, particularly for individuals with a fixed or limited budget, often serve as a significant reason why it may not be a viable option for many people. Understanding the available alternatives can be beneficial in such cases. Some insurance plans offer a yearly coverage amount for therapy, which can help cover part or all of the expenses. Additionally, many therapists provide a sliding scale, which offers a reduced fee based on your income and specific circumstances. Community not-for-profit organizations can also offer pro-bono or reduced-cost services, although there might be substantial waitlists for these services.

2. What are Your Goals for Therapy?

Knowing how to choose a therapist that suits your needs can feel overwhelming. A good starting point is to identify your specific problem and establish your therapy goals. It is crucial to select a therapist who possesses relevant experience and knowledge in addressing the specific issue you seek support for. To make this decision more tangible, a helpful question to ask yourself is, "If I woke up tomorrow and my problem was resolved, what would my life look like?" This can provide clarity regarding your goals and specific problem or skills you would like to build. This might help in narrowing down the type of therapist you prefer to work with.

3. Delivery and Therapist Style

The next question can be how do you want therapy to look? Do you want therapy to be in person? Would you like to do telehealth, or would you like a therapist who offers both? Do you prefer to work with a therapist who is a specific gender, race/ethnicity, sexual orientation, has a disability or is a certain age? Are you looking for a specific modality of therapy, such as Cognitive Behavioural Therapy, Relational Therapy or a counsellor who specializes in Trauma Focused Therapy etc. It might be helpful to know that research suggests that having the right fit of therapist and a strong therapeutic relationship can be a strong indicator of success regardless of the counsellor’s therapeutic orientation (1). Cognitive Behavioural Therapy might work well for someone you know, but maybe you find Relational therapy aligns better with your personality and needs.

Starting your Therapist Search

After gaining a clearer comprehension of your therapy goals and identifying the type of therapy and therapist who would be suitable for you, you can start your search. A helpful starting point often involves seeking referrals from family members, friends, or co-workers who have had positive experiences with therapists. Your doctor or primary care provider might also provide valuable recommendations, and mental health organizations may offer comprehensive directories of therapists currently accepting clients. Online therapy directories, such as Psychology Today or Affordable Therapy Network, can also serve as effective starting points, as many therapists offer free 15-minute phone consultations to determine if you are a compatible match.

What to Expect in Your First Session

In the first session, your therapist will explain the therapy process, explain informed consent, confidentiality, and its legal limitations, and ask you to sign forms. Depending on the therapy you are entering your therapist may do an intake with you to get a comprehensive view of you including questions about your medical history, family history or childhood. Other therapists may ask specific questions about your presenting problem or have a more client directed approach. Think of the first session with a new therapist like a consultation. You both are getting to know each other and building trust and safety. This is where you can ask questions about their credentials, expectations for the process and how you will achieve your goals. If after the first session you also decide you don't want to work with a therapist, you are under no obligation to continue services with them.

How to Tell if the Therapist is a Good Fit for You?

Paying attention to how you feel in session and your interactions with the therapist can help you gauge if you have a connection. Does the therapist create a space where you feel comfortable sharing? Do you feel safe, respected, and understood? A skilled therapist will prioritize creating a supportive, nonjudgmental atmosphere where you feel encouraged to openly express yourself. Does their communication and therapeutic approach work for you in session? Do you feel like they are attentively listening to you and understand your specific problem? Do you feel like they are working with you collaboratively, and providing you with treatment that is uniquely tailored to your life and needs? Overall, it may take a few sessions with a new therapist to decide if they are the right fit for you. Sometimes after the first session we realize that a therapist may not be the right for us and it can feel awkward to tell them you want to “shop around” until you find someone with a better connection. Therapists have these conversations often and may even be able to direct you to a therapist who may be a better match for you. The work you do in therapy can be difficult, uncomfortable at times and involves a great deal of vulnerability. Therefore, you’ll want a therapist who you trust to be professionally competent, who maintains trust and confidentiality and who creates a space where you feel safe, seen and heard.


(1) DeAngelis, T. (2019, November 1). Better relationships with patients lead to better outcomes. Monitor on Psychology, 50(10).

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