As a therapist in New York City, I see patients from all walks of life: students, professionals, older adults, people of all genders, races, and economic backgrounds. Most of the time, a patient and I work very well together. Occasionally, however, the therapeutic relationship doesn’t jive. The reasons can vary. But after years of experience, I’ve come to understand some of the most important factors in finding the right therapist.

Before we talk about therapy and dating, let’s talk about the realities of our healthcare system. Health insurance plays a significant factor n overall therapy access. Many people can’t afford the out-of-pocket fees and need to use their insurance to pay for therapy sessions, limiting their options. Moreover, many insurance plans can have high deductibles or limit the number of sessions a person can have, making therapy expensive and limiting. This also means you don’t have endless sessions to burn in pursuit of your mental health match.

Additionally, the demand for therapists might, in some cases, exceed the supply in a given area. So many people find that the therapists they contact don’t get back to them. As a therapist, I can tell you that it is often hard to get back to all potential patients because of limited time and energy. But it can make a potential patient feel rejected. Overall it can be a detecting experience, one that you don’t need if you are struggling.

Because of these factors, a potential patient often chooses whatever therapist they can find, leading to mixed results. Like dating, it can take a lot of patience to find the right person for you. It can also lead you to feel like you’re stuck with whomever you’ve discovered, or your lack of connection is somehow your fault. None of these things are true, So how does one choose the right therapist? I’ve identified three factors that I think are crucial.

The chemistry you’re seeking is actually a therapeutic alliance

When I ask my patients what they are looking for in a dating partner, maybe the most common answer is chemistry. Chemistry is hard to explain. There is a je ne sais quoi quality to it. I’ve heard it described as a feeling that you and another person have connected on a deeper level. Finding a therapist can be very similar.

There is significant research on what makes a therapeutic relationship work, and studies show that alliance is the most crucial factor in a successful therapeutic relationship. What is therapeutic alliance? Most studies seem to point to the bond between the patient and therapist. However, I define the therapeutic bond as a shared understanding and connection between the therapist and you. Like a bad relationship, I’ve heard many current patients talk about how they did not like their past therapists but stayed in the therapeutic relationship because they didn’t know it could be different. While there’s value in talking through difficulties with your therapist before ending the interaction, it’s important to remember that, just like in dating, you can always leave and search for someone you bond with on a deeper level.

Empathy is also an essential part of alliance. If you don’t have a sense of empathy from your therapist, the relationship likely will not work.  Lastly, a shared understanding of the goals and directions of the therapeutic relationship is essential to making it work. Sometimes a therapeutic relationship can feel aimless. So it helps to come into therapy with a sense of what you’d like to work through.

Therapeutic orientation matters (and it’s not one-size-fits-all)

Many people understand therapy from movies or television, which generally show psychoanalytic sessions, but there are many alternatives to traditional Freudian, psychoanalytic treatment.

Figuring out what orientation works best for you is similar to swiping through dating profiles. Most people don’t choose a date at random. They look at a person’s profile to see if it connects to one’s worldview. Selecting a therapeutic orientation is similar.  For example, I consider myself an Acceptance and Commitment Therapist (ACT) who freely uses Cognitive Behavioral Therapy (CBT), Buddhism, and humanistic and existential therapies in his sessions. This may or may not appeal to you. Other therapists might be psychoanalytically trained or have Gestalt or Dialectical Behavioral Therapy (DBT) training. There’s no reason you should know anything about these orientations, but it helps to do a little research and reading to see what speaks to you.

It’s understandable if you’re not entirely sure what these things mean. If you’re struggling with the nuances of CBT, ACT, or any other therapeutic orientation, it’s OK to talk through the approach with your potential therapist and ask them what that means for how you will work together.

It’s important to remember that these orientations are ways of seeing the world. They are useful, but they aren’t written in stone. All of them can be effective. But it can help to research what therapeutic orientations are the most effective for the issues you’re dealing with currently. CBT, for example, has been shown to be very effective with many mental health problems, including depression and anxiety. However, if you look hard enough, there are studies to back up most kinds of therapy. Far more important is what speaks to you and what aligns with your worldview.

You can have identity preferences for your therapist

Have you gone on a date with someone you liked, but because of how they identify, you didn’t feel very comfortable with them? Maybe they voted for a candidate you didn’t like, had different tastes in food or movies, or they didn’t understand the culture you grew up in. When we are dating, we don’t necessarily question those choices. We often just trust our instincts about what feels comfortable about a person’s identity.

Similarly, the identity of one’s therapist can also play a significant role in how comfortable you feel with them. For example, I am an Asian American therapist. Because of my identity, many of my current patients are Asian Americans. When I ask them why they chose me as a therapist, the answer I most commonly get is because I’m “Asian” or “not white.” I think this is perfectly understandable. Many of my Asian American patients have found it difficult to discuss race with other therapists because of it.

So when looking for a therapist, it is essential to consider the kinds of people with whom you feel most comfortable. A man? A woman? A nonbinary person? A person who identifies with the LBGTQ community? A person of color? A person’s identity doesn’t necessarily speak to their competence, just like a person’s identity isn’t the only factor in finding the right partner. But it is often a baseline for most so they can feel comfortable with their therapist. Without feeling comfortable, real therapeutic change is hard to achieve. It is paramount to take your time finding a therapist you connect with because it can make or break how helpful therapy can be for you.

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