After the decision to seek therapy has been made, an individual may feel unsure about how to choose a therapist. People seeking therapy often find that they have no standards to use
in evaluating potential therapists. There are many competent therapists practicing therapy using different approaches.
The purpose of this guideline is to provide you with information that might be useful in selecting a cognitive-behavior therapist. No guideline can provide strict rules for selecting the
best therapist for a particular individual. We can, however, suggest questions you might ask and areas of information you might want to cover with a cognitive-behavior therapist you
are considering seeing before you make a final decision.
Questions to Ask When Deciding on a Therapist
A therapist will devote the first few sessions to assessing the extent and causes of the concerns you have. Generally, your therapist will be asking quite specific questions
about the concerns or problems causing you distress and about when and where these occur. As the assessment progresses, you can expect that you and your therapist will arrive at
mutually agreeable goals for how you want to change. If you can’t agree on the goals of therapy, you should consider finding another therapist.
The following are things you need to know about a prospective therapist:
Training and Qualifications
You should find out whether the individual therapist is licensed or certified by your state. If the person is not licensed or certified by your state or province, you may want to ask
whether the person is being supervised by another mental health professional.
The emphasis on cognitive-behavior therapy varies within each discipline. As such, the amount of training or type of professional discipline will not provide information on the
therapist’s familiarity and experience with CBT. Therapists with a strong foundation in CBT will not mind being asked questions about their qualifications and will freely give you any
professional information that you request. If a therapist does not answer your questions to your satisfaction, or refuses to answer your questions, you should consult another
Many people feel uncomfortable asking about fees. However, it is important information that a good therapist will be willing to give a potential client. The following are financial
questions you may want to cover with a therapist. This information may be obtained over the phone or during
your first visit. You will want to know:
• How much does the therapist charge per session?
• Does the therapist charge according to income (sliding scale)?
• Does the therapist charge for the initial session? (Since many therapists do charge for the
initial session, you should get this information before your first visit.)
• Is there a policy concerning vacations and missed or canceled sessions? Is there a charge?
• Will your health insurance cover you if you see this therapist?
• Will the therapist want you to pay after each session, or will you be billed periodically?
The following are other questions you may want to ask a therapist:
• How many times a week will the therapist want to see you?
• How long will each session last?
• How long does the therapist expect treatment to last? (Some therapists only do time-limited
therapy, whereas others set no such limits.)
• What are some of the treatment approaches likely to be used?
• Does the therapist accept phone calls at the office or at home? • When your therapist is out of town or otherwise unavailable, is there someone else you can
call if an emergency arises?
• Are there any limitations on confidentiality?
As Therapy Proceeds
Once the initial goals are decided upon, you can expect the therapist to discuss with you one or more approaches for helping you reach your goals. Central to cognitive behavior therapy
is home-based work. Many other forms of therapy do not involve exercises between sessions but it is an important part of CBT. As CBT is a skills-based therapy, people will be
required to practice these skills. This practice occurs at a pace that is individual to you. As you continue therapy, you can expect your therapist to consistently evaluate your
progress toward the previously established goals. If you are not progressing, or if progress is too slow, your therapist will most likely suggest modifying or changing the treatment
approach. At each of these points you may
want to ask yourself the following questions:
• Do you understand what the therapist has asked you to do?
• Do the therapist's instructions seem relevant to your objectives?
• Do you believe that following these instructions is likely to help you make significant
• Has the therapist given you a choice of alternative therapy approaches?
• Has the therapist explained possible side effects of the therapy?
What to Do If You Are Dissatisfied With Your Therapist
Talk With Your Therapist
People can feel angry or frustrated at times about their therapy. If you do, you should discuss these concerns, dissatisfactions, and questions with the therapist. A good therapist will
be open to hearing them and discuss your dissatisfaction with you.
Get a Second Opinion
If you feel that the issues and problems you have raised with your therapist are not being resolved, you may want to consider asking for a consultation with another professional.
Usually the therapist you are seeing can suggest someone you can consult. If your therapist objects to your consulting another professional, you should change to another therapist
who will not object.
Consider Changing Therapists
Many people feel that it is never acceptable to change therapists once therapy has begun. This is simply not true. Good therapists realize that they might not be appropriate for every
The most important thing you need to ask yourself when deciding to continue with a particular therapist is, "Am I changing in the direction I want to change?" If you do not feel that you
are improving, and if, after discussing this with your therapist, it does not appear likely to you that you will improve with this therapist, you should consult another