Why it’s so Hard to Find a Good Therapist

Written by Steve Rose

Steve Rose, PhD, is an addiction counsellor who assists those struggling with substance abuse, gambling, gaming, and internet addiction.

If you recently met with a therapist and felt let down by the experience, you are not alone. Working in the field, I have seen far too many clients finally reach out for help, only to be met with an ineffective, unprofessional, or inexperienced therapist. These experiences destroy trust and reinforce a sense of hopelessness, making the problem worse.

There are many good therapists, but they are often hard to find. The field of counseling and psychotherapy is filled with many different types of professionals, specializing in many different areas, with a wide range of quality and skill. So why is it so hard to find a good therapist?

It can be challenging to find a person who specializes in a specific area of concern. Also, there are many ineffective therapists, so persons seeking therapy need to be critical of the support they are receiving. 

This article dives into this important issue, helping you understand why it’s often challenging to find the right therapist, in addition to offering practical suggestions on how to find a good therapist.

Not all Therapists are Specialists 

One of the primary reasons many people have difficulty finding the right therapist is due to a lack of specialization. Many practitioners focus primarily on anxiety and depression.

According to a survey by the American Psychological Association, just over 40% of practitioners say they “very frequently” treat anxiety, compared to around 5% for addictions, and under 5% for Obsessive-Compulsive Disorder.

Finding someone who specializes in your specific area allows for better-targeted treatments, easier rapport regarding the specifics of your experience, and potential referrals to more relevant resources such as peer-support groups.

Although generalists can be helpful when using evidence-based treatment approaches, a specialist has developed a keen eye for spotting specific useful details. For example, someone who specializes in addiction may have a better sense of the particular types of denial and have more practice in the art of effective communication when dealing with resistance or fluctuating motivation.

I recommend finding a specialist who has a strong track-record helping people with your specific type of issue. In the past, it could be difficult to find a specialist in your local community, but in a world of ever-expanding online options, specialists are becoming increasingly more accessible.

Online counseling is an effective way to access specialized treatment. The scientific literature also confirms it is as effective as face-to-face counseling, as I shared in my article on online counseling. If you are looking for online support, I have provided a list of resources here.

Choosing the Right Specialist 

Not understanding the different forms of specialization is another reason why it can be so challenging to find the right support. This is usually a result of lacking familiarity with the field of psychology and the other helping professions.

I’ve often heard people say they tried seeing a therapist but was simply only handed a bunch of pills and didn’t feel genuinely listened to. When I hear prescriptions are involved, my first question is usually, “did you see a psychologist or a psychiatrist?” Although they sound similar, they are very different types of specialists.

Here is a quick and simple breakdown of the various types of specialists. Since regulations vary by country and jurisdiction, I will provide a broad overview of the field:

Psychologists: These are persons with a doctoral degree in psychology who are licensed to diagnose mental disorders and treat them with psychotherapy. They are generally specialized in a specific form of therapy, focused on specific types of issues, and they do not prescribe medications.

Psychiatrists: These are medical doctors who focus on diagnosing and treating mental disorders with medications. Distinct from psychologists, their interactions with patients are far more evaluative and focused on selecting the proper medication to fit the disorder. Although the majority do not, some may offer therapeutic support.

Both psychologists and psychiatrists can use “Dr.” in their prefix, but psychologists hold a PhD (Doctor of Philosophy) or a PsyD (Doctor of Psychology), whereas psychiatrists hold an MD (Medical Doctor).

Mental Health Counsellors: These are persons with at least a Master’s Degree in psychology who are licensed to practice psychotherapy and treat issues similar to a psychologist. Mental health counselors offer therapeutic treatments similar to psychologists and may also specialize in a particular area.

Marriage and Family Therapists: These are professionals who generally hold at least a Master’s Degree, specializing in psychotherapy for couples and families. They focus on relational issues and look at family systems.

Social Workers: These are professionals who generally hold an Undergraduate Degree or Master’s Degree in social work and may receive licensure or registration by a governing body. There are a wide variety of social workers.

Those with an Undergraduate Degree who are licensed or registered can deliver counseling services but often work for public agencies as case managers delivering social services including assistance with employment, housing, and protecting vulnerable populations.

Those with a Master’s in social work who become licensed or registered generally specialize in an area and can offer psychotherapeutic treatment, similar to a Psychologist.

Addiction Counselors: These are professionals who generally have a college certificate in chemical dependency, in addition to having several years of experience working in the field, focusing specifically on treating addictions.

This is a broad overview of the main types of therapists and counselors. Although each type of professional focuses on slightly different areas, it is possible to benefit from using many at the same time.

For example, you may see a psychologist to treat trauma, while seeing a psychiatrist to address chemical imbalances in your brain. You might also see a social worker who specializes in housing while seeing an addiction counselor to help cope with an addiction.

Knowing the difference between each type of professional helps manage your expectations, in addition to knowing which form of support best fits your needs.

In terms of my own background, I fit into the addiction counselor category. I received a PhD in sociology, which does not allow me to practice as a Psychologist. My career path is relatively unique since most Sociologists stay in research rather than working with people directly. To read more about my own unique path into the field, I tell my story here.

There are many Ineffective Therapists

Sadly, this is one of the biggest reasons why people find it so hard to find a good therapist. I’ve heard of too many cases where people had terrible experiences with therapists, leaving them feeling hopeless and destroying their trust.

Each time I hear these stories, I feel deeply sad for the individual who perhaps took their first step toward recovery, trusting another person with the most private details of their lives, only to be confronted by accusations, a lack of empathy, or the use of ineffective practices that do not suit their specific issue.

There are effective and ineffective practitioners at all levels. Someone’s role, specialization, education, and experience does necessarily make them an effective therapist. There is actually a study in the Journal of Counseling Psychology showing that a practitioner’s amount of experience does not predict positive client outcomes.

The most ineffective therapists can do active harm to clients. As Cris Reed shares on Quora:

I have seen A LOT of psychiatrists/psychologists/therapists/what-have-yous. Sadly, the vast majority of them just didn’t give a shit. I had a therapist that started checking her watch two minutes into an hour long therapy session, before we’d even talked about anything.

She continues, sharing the following regarding her medication:

…the psychiatrist who took me off meds that were working, put me on ones that didn’t work, refused to listen to me, or my husband, or my THERAPIST that the pills were making me suicidal, just kept increasing the dose… I know someone else who saw him for some very serious issues and he told her she just needed to pray.

Although these may sound like isolated incidents, they are not. Situations like this are far too common. I’ve heard of many instances where mental health professionals have been actively destructive to their clients.

Fortunately, I have seen more examples of effective therapists than ineffective ones. It may be difficult to find the right type of practitioner with the right level of skill and compassion, but it is possible with a bit of effort and insight into what to look for in a good therapist.

How to Find a Good Therapist

Ask someone you trust. If you know someone who has sought support for mental health or addiction issues, it could be helpful to inquire about their experiences with therapists. If they had a positive experience with a particular person, this does not guarantee you will also connect the same way, but it increases the odds of finding the right fit.

See if you can schedule a free consultation. Many therapists offer free 10-15 minute phone consultations. This allows you to get a good sense of their interpersonal style and whether or not this is someone you will feel comfortable with.

Ask questions about their approach. Although merely feeling comfortable with this person is a significant factor in therapeutic success, you also want to know if they use evidence-based practices. Some of these may include Cognitive-behavioural Therapy, Acceptance and Commitment Therapy, Dialectical-behavioural Therapy, and various mindfulness-based techniques.

Trust your instincts. If you feel like something is not right, take a step back and follow your gut feeling. A therapeutic relationship should feel very comfortable, despite the difficult subject matter. The therapeutic process will feel like a challenge, but the relationship needs to be based on comfort, mutual respect, and trust. If there is any question of whether or not you can fully trust this person, it is time to reassess your therapist.

Notice red flags. If you’re not familiar with therapy, these may be easy to overlook. Some red flags include the following:

  • They form a description of your issue that does not feel accurate
  • Blaming, shaming, or judging you
  • They share too many personal details, rather than focusing on you
  • They seem inexperienced in your area of concern
  • You feel pressured to accept their version of reality
  • They are not open to feedback
  • They seem distracted during the session
  • They give too much praise and reassurance

Although this last point about positive feedback may seem counter-intuitive, praise and reassurance can sometimes serve as a way of making the client dependent on the therapist for external validation, rather than dealing with deeper issues regarding self-esteem.

An over-reliance on positive affirmations may also be a red flag since research demonstrates they are not generally effective. For more on this topic, see my article: Do Positive Affirmations Work? A Look at the Science.

Use clear and assertive communication. It is okay to say you disagree with your therapist. If they interpret your situation in a way that doesn’t feel right, it is okay to correct them or share that you feel misunderstood. You are in control and can decline to discuss specific topics until you are ready. Also, if something is not working, you can request trying a new approach. If your therapist is not receptive to appropriate feedback, it might be time to reassess the working relationship.

Switch therapists, if you’re not feeling supported. It is perfectly normal if you do not find the right therapist the first time you reach out for support. I have seen several instances were people have sought help from three or more therapists before finding one suitable for them. Like dating, you may not find the right fit early on in your search, but if you are persistent, finding the right person makes all the difference.

Where to Find a Therapist

Ask Local Service Providers. If you are not familiar with the services available locally, try reaching out to a local agency to inquire about the type of services they offer, in addition to other services available locally.

Persons who work in the field will generally have a strong understanding of quality services that might fit your needs. Another benefit of local agencies is that many are government-funded and therefore offer support for free or at a reduced cost. One drawback to receiving government-funded support may be long wait times.

You can find local mental health agencies by doing a quick google search, or you can check out MentalHealth.gov if you are in the US.

Use the Psychology Today Directory. This is a listing of therapists and counselors who offer private support, meaning their services are generally not publicly funded. If you have health insurance, a portion of their services may be covered.

The main benefit of using this directory is the ability to search for a local specialist, in addition to filtering results by type of insurance coverage. Another advantage is the lack of wait times and the ability to immediately reach out to several different professionals who may provide a free phone consultation.

If you are interested in checking out the Psychology Today Directory, you can find it here.

Try online counseling services. Online counseling services such as BetterHelp.com offers online support via text, audio, and video calls. They are not publicly funded, nor do they generally accept insurance coverage.

The main benefit of online counseling services is their accessibility, ease of access, lower cost, and the ability to switch counselors any time with a simple click of a button. Like any service provider, the range of counselor quality varies widely, so it is essential to look for red flags and change counselors until you find the right support.

Conclusion 

No amount of education, training, or certification can weed out every ineffective therapist. I cringe every time I hear horror stories, hoping these experiences don’t cause people to give up hope.

With enough persistence and a bit of luck, you will likely find the right support. Ask someone you trust, reach out to a local organization, or use online directories to search for specialist support.

If you have any questions, feel free to contact me or leave a question below this article, and I will personally do my best to assist.

Want to Try Online Counseling?

I offer virtual addiction counseling to persons residing in Canada. If you are interested in learning more, you can contact me here

If you reside outside of Canada or are looking for general mental health support, check out the following resources:

BetterHelp.com is like the Tinder of online counseling. Their main benefit is lower costs, high accessibility through their mobile app, and the ability to switch counselors quickly and easily, until you find the right fit.

This is huge, since it’s not usually so easy to quickly switch counselors before finding the right one for you. 

For persons struggling with anxious thoughts, depressed moods, low self-esteem, low motivation, or loneliness, check out Better Help here to learn more.

If you want a free trial, complete their online application here, then select the option stating you are unable to afford counseling, before entering your payment information. 

Online-therapy.com also offers support for persons looking to optimize their mental toolbox. Click here to learn more about their program based on the evidence-based practice of Cognitive-behavioral Therapy (CBT).

*As an affiliate partner with Better Help and Online-therapy.com, I may receive a referral fee if you purchase products or services through the links provided.

If you are looking for a specialist near you, use the Psychology Today therapist directory here. Although prices are generally higher on this directory, many of the practitioners accept insurance. 

As always, it is important to be critical when seeking help, since the quality of counselors are not consistent. Also, one of the most important factors in successful treatment is the quality of the therapeutic relationship. If you are not feeling supported, it is important to seek out another practitioner. I wrote an article on things to consider here.

Curious if online counseling works? I wrote an article here, looking at the evidence.


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12 Comments

  1. Richard

    Great comprehensive article on the counseling and therapy exploration process. I hope you will share your thoughts on the burn-out rate, stress related problems and counselors who have emotional challenges themselves (latent addictions,etc.). I know from personal experience (retired crisis and suicide counselor) there are some therapists who should have retired or move onto other professions only to become a disservice to those they are trying to help. This is an “all-too-common” problem especially in our challenging environment of present. I suggest you may want to share the other side of the crouch perspective of this highly stressful helping profession. Thank you Dr. Rose, for your thoughtful, insightful and compassionate articles – helping us to feel informed and connected in difficult times.

    Reply
    • Steve Rose

      Thanks, Richard! What a great idea! I would like to share someone’s experience with burnout. I can’t share any, personally, since I have not experienced it yet, but I will reach out to others. Glad you are enjoying the articles!

      Reply
  2. fritzdenis

    Thank you for this article. It’s good to hear that some in the profession should be avoided…I saw a psychologist at a university guidance office while in the process of changing majors. She found ways to trigger a lot of mental pain. It was useful to find out how much I carried around with me, but she didn’t give me any way of dealing with it. I stopped going as I had begun to fear our sessions.

    Reply
    • Steve Rose

      It looks like they were able to bring up a lot of the pain underneath the surface, but it’s also necessary to help clients learn new coping skills to help deal with that pain. I hope you have been able to find more support after that experience.

      Reply
  3. paidiske

    The other big barrier is simply cost. I found that highly specialised therapists often have rates far above what many people can afford. I don’t begrudge them earning a living, but it’s true that for some people, the therapy they need is out of their reach, financially.

    Reply
    • Steve Rose

      This is very true. Hopefully the range of resources I offered can help people find someone who is both effective and affordable.

      Reply
  4. sofidial

    nice post keep it up

    Reply
  5. Deb

    I was violated (psychically and emotionally) and abandoned by my psychologist of almost two years. It’s been a year now. Honestly one of the hardest things to have ever gone through. I ended up having to report him, not my wish, but he would have hurt others. Still hurts. Thanks for shedding light on “red flags” in therapy.

    Reply
    • Steve Rose

      Hi Deb, I am sorry to to hear about this terrible experience. I can’t imagine how difficult that would be. I am glad to hear you ended up reporting him and hopefully preventing him from continuing this behaviour.

      Reply
  6. Deborah

    Do you know, or have any any helpful resources or articles for people that have been sexually, emotionally, or physically violated and abandoned by their therapists?

    Reply
    • Steve Rose

      I haven’t written anything on this particular issue, but I found a potential resource for you here. I wish you all the best and hope you have been able to find the right type of compassionate support after the abuse.

      Reply

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