What is Psychotherapy and How Do I Choose My Therapist?

People choose to enter into therapy for various reasons. Sometimes it is to alleviate emotional pain, enhance functioning in school or work, be effective in their relationships, or when they are struggling with life problems or need to make decisions. The safe space created in the counseling room and a strong therapeutic relationship can be beneficial to a persons personal growth. People who seek counseling services are not crazy, insane, ill or sick. They are people faced with undesired symptoms, and challenges that are accompanied with stress.

Therapy offers a space outside the norms of ones social self to discover, explore, and build their desired self. Therapy has different connotations in different parts of the world. In 2010 I was interning at a psychiatric ward at PIMS Hospital in Islamabad, Pakistan. I remember how the assistant psychologist and myself struggled with referring patients to commit to outpatient therapy. Patients would say,"Why do we need to talk to them when we have our family?", and then return home with their problem. While talking to someone helps, therapy involves a more complex process of becoming self-aware, and rewiring the brain to replace automatic patterns of thought and behavior- at the very least. Therapists do not do things haphazardly in the room. Trust me, it is more than just "talking to someone."

The process of finding a therapist can be very overwhelming. My clients share with me their experiences of finding the right therapist and often describe this process as confusing. While therapists differ from each other in their approach to therapy, what remains constant is that they are all in the practice of helping their clients produce change. How they arrive at this would depend on the their theoretical style. If you have seen different therapists in the past, you have probably noticed that some were talkative or direct, others quiet and non-directional, some spent time building a relationship, while others went straight to the problem and taught you skills. This was because they were practicing a unique therapeutic orientation amongst the various counseling theories that exist in the field today. The theory your therapist chose is what was congruent with their view of psychopathology. So, always ask your therapist what their therapeutic orientation is so that you understand what type of therapeutic experience you can expect to have in the therapy room and over the course of your therapeutic journey with them. Here are a few approaches that you may consider:

Psychoanalytic Approaches 
Expect your therapist to talk less, and focus more on past experiences to increase insight into the developmental origins of your unconscious psychological conflicts, making them more acceptable to the ego. Cultivating a therapeutic relationship is not the focus of your sessions together. This style may appear less warm to some clients while it can be the perfect fit for others.

Humanistic Approaches
Expect your therapist to be more engaging, and focus more on building a therapeutic alliance with you. The therapeutic relationship is important for your work together. This style may appear more warm compared to the psychoanalytic approach. Your therapist works on creating a safety net in the therapy room, and helps you achieve congruence with different facets of yourself, thereby promoting self-acceptance. 

Cognitive/Behavioral Approaches
Unlike psychoanalytic and humanistic approaches that are based on the assumption that targeting distressing thoughts, feelings, or behaviors directly would be ineffective and counterproductive to the client; behaviorists take on a more direct approach to their clients presenting problems. They focus on making changes to the environment in addition to targeting distressing thoughts and feelings. 

Integrative Approaches
Therapists who practice under this approach are usually eclectically trained. They use a multi-faceted approach, and use different interventions from all theories that make most sense to the presenting concern, and that fit the clinical profile of their client. It is more of an individualized approach whereby the therapist is not committed to use only one approach alone. 

Holistic Approaches
Therapists who practice holistically tend to look at you as a whole person. This means they are not treating your mind alone, however taking into account other factors that may be affecting your psychological health, such as what you eat, how well you sleep, your daily activity levels, your current health condition (etc.) is important to your work together. 

What other considerations or hesitations do you face when searching for a therapist? What have you found helpful, or not very helpful in the search process? What would you like to know more about?