How to Choose a Therapist

You’ve decided that therapy might be beneficial to you. Odds are, this decision has been a long time coming. Well done. All the more power to you.

But… Now comes the (next) hard part.

What type of therapist/therapy should you be looking for? Where should you be looking? How can you trust the innumerable therapist profiles you come across as being authentic and honest? How often should you expect to go to therapy? And for how long? A month? A year? Longer?

If you’re living abroad or working across time zones, these questions get even harder. You’re navigating different licensing systems, figuring out whether to work with someone local or online, and sorting through options in a language that may not be your first.

Here’s the bad news:

These are difficult questions. Almost impossible to determine without trial and error (and, perhaps, a little luck).

Here’s the even worse news:

Many people give up before they really start. They are quickly overwhelmed by the seemingly insurmountable prospect of finding a decent therapist. They try a session or two with a therapist, find it a waste of time and money, and don’t bother looking for a better fit.

Fortunately, I have good news, too.

Below, I’ll give you a simple but comprehensive system to cut through the noise and find a therapist that works for you.

In step 1, I’ll introduce you to the two basic categories therapeutic modalities fall into. This will be a bit philosophical, but it is imperative that you know how therapeutic modalities differ from one another, so that you can zero in on the one that resonates with you.

In step 2, we’ll discuss how to find a therapist and how to accurately assess their effectiveness ahead of time. I’ll give you a list of actionable steps to help you find, narrow down, and choose the right therapist for you.

1. Two Types of Therapy

Some people work best with a therapist who helps them develop the courage and capacity to face hard truths head-on. Others need a therapist who offers supportive warmth and repair.

Don Carveth, a highly experienced psychoanalyst and teacher, describes these two approaches as “Disillusion” and “Illusion.”

As you read, think about (and feel into) the model that most resonates with you.

Therapy of Disillusion

In this approach, the therapist holds the view that the client’s natural expression of health is inhibited by inaccurate beliefs, false narratives, out-dated identities, and costly defenses.

The pathway back to health, therefore, is to clear up everything that gets in the way.

This is a therapy of removal.

This approach to therapy comes from Freud’s early thinking, where he saw psychoanalysis as a treatment for emotional disorders, and saw emotional disorders as the result of defenses that estrange the client from reality.

Therefore, to return the client to health, the therapist invites the client to ascertain and inhabit reality as fully as possible. To these ends, the therapy seeks to challenge and discard defenses.

Liberation is realized upon breaking free from the chains of illusion.

Therapeutic progress is based on the progressive disposal of resistances, defenses, illusions, and fantasies; or, as Carveth puts it, “through a never-ending process of eliminating errors and illusions.”

Therapy that falls under this category invites the client to discard anything that gets in the way of their health, distorts their reality, and perpetuates their suffering.

Ultimate responsibility for healing lies with the client. The therapist helps the client see what they cannot, tolerate what they could not, and invites the client to drop what no longer serves her.

The therapist doesn’t pretend to save the client; merely to assist the client in saving herself.

Therapy of Illusion

The other model of therapy sees the source of a client’s sufferings and symptoms as coming from a different mechanism entirely.

Instead of resulting from costly defenses and illusions, suffering is seen to be the product of psychological deficits and arrested development.

Childhood trauma and deprivation generate psychological deficits and arrests “that require the therapist’s provision of emotional nutriment.”

This, then, is a therapy of provision and addition, as opposed to removal and disposal.

What “cures” isn’t seeing through false narratives and discarding costly defenses, but is, instead, corrective emotional experiences and skillful coping mechanisms.

Therapy in this category is understood to be a means of filling-in for “pathogenic absences” (deficits and arrests in the client’s development) as opposed to being a means of removing “pathogenic presences” (illusions, projections, defenses, and fantasies).

Here, therapy might be understood as “reparative reparenting.”

The therapist has an active, all-important role in the client’s healing, providing the client with what they didn’t receive in childhood. The client must participate in their salvation, but it is, as it were, the therapist who saves.

Through the mechanisms of filling in and adding on, the client overcomes developmental traumas and employs skills that help them cope with emotions, manage life circumstances, and improve accuracy of thought and belief.

Therapeutic Modalities: Which Category of Therapy Do They Fall Into?

Next, let’s take a look at today’s major therapeutic modalities and see which fall under the category of removal (disillusion) and which fall into the category of repair (illusion).

Though good therapists will apply aspects of both disillusion and illusion regardless of their preferred modality, the modality itself will always lean more to one side or the other.

“Disillusion” Therapies

If you tend to prefer truth-telling and emotional honesty, you’ll probably resonate with the modalities listed here.

ISTDP (Intensive Short-Term Dynamic Psychotherapy): This therapy is highly focused and emotionally direct. The therapist actively identifies and challenges the client’s defenses as they appear in real time, helping the client face avoided feelings and reality itself. Healing occurs through exposure to truth, not comfort.

Classical Psychoanalysis (Freud/Klein/Bion): A long-term, interpretive therapy aiming to uncover the unconscious conflicts and fantasies shaping present life. The therapist’s neutrality and interpretations invite insight that dismantles self-deceptions and illusions over time.

Psychodynamic Psychotherapy: A briefer, more relational descendant of psychoanalysis. The therapist helps the client recognize repeating emotional patterns and unconscious defenses. Progress comes through insight and reality-testing rather than reassurance.

Lacanian Analysis: An uncompromisingly disillusioning form of psychoanalysis. The analyst confronts the client with the limits of knowledge, language, and desire — helping them relinquish fantasies of wholeness and accept the structural “lack” at the heart of being human.

Existential Therapy: Explores anxiety, mortality, freedom, and meaning. Instead of trying to remove suffering, it invites clients to face life’s givens directly and live authentically within them. Liberation arises from accepting reality, not escaping it.

RLT (Relational Life Therapy) Couples Therapy: Blunt, truth-telling, and skill-oriented. The therapist exposes each partner’s illusions about power, entitlement, and victimhood, then teaches new relational behaviors. It dismantles defenses while building mature connection.

Masterson Approach: Focused on personality disorders rooted in the conflict between the real and false self. The therapist exposes the defensive “false self” while offering a reliable relationship that supports the emergence of the authentic one. Disillusion first, repair second.

Buddhist-Based Approaches: Waking up to what is already true. The therapist helps the client turn towards discomfort, contradiction, and impermanence with awareness instead of avoidance. The work is to stay present with the raw reality of present-moment experiencing.

“Illusion” Therapies

If you find yourself drawn to gentleness and supportive empathy, these therapies will probably be more up your alley.

CBT (Cognitive Behavioral Therapy): Structured, skills-based, and present-focused. The therapist helps clients identify and reframe distorted thoughts, learn coping tools, and build behavioral mastery. Healing occurs through construction of new beliefs, not deconstruction of old illusions.

IFS (Internal Family Systems): Gentle and reparative. The therapist helps the client meet and re-parent inner “parts,” restoring harmony under the leadership of the Self. The work heals through compassionate inclusion and reconstruction rather than confrontation.

Humanistic/Client-Centered Therapy: Rooted in unconditional positive regard. The therapist provides deep empathy and acceptance so the client can grow toward self-actualization. Change arises from nurturance and presence, not from dismantling defenses.

Schema Therapy: Integrative and reparenting. The therapist helps identify maladaptive schemas from childhood and meets unmet needs through corrective emotional experiences and skill-building. The focus is on filling deficits rather than exposing illusions.

Gestalt Therapy (mixed): Experiential and here-and-now. Clients explore unfinished emotional business through dialogue and enactment. While it can confront avoidance (disillusion), its core is expressive completion and self-support (illusion).

Attachment-based Developmental Therapies: Emphasize secure attachment and emotional regulation. The therapist becomes a temporary attachment figure, offering corrective experiences that build capacities the client lacked early in life. A therapy of provision and repair.

Motivational Interviewing: Supportive and collaborative. The therapist strengthens intrinsic motivation through empathy, validation, and guided discovery. The work adds confidence and coherence rather than stripping illusions.

PACT (Psychobiological Approach to Couples Therapy) Couples Therapy: Attachment and neuroscience-based. The therapist coaches partners in co-regulation, attunement, and secure functioning. Healing emerges through modeling and practicing safety — the provision of what was missing, not the exposure of what is false.

EMDR (Eye Movement Desensitization and Reprocessing): A structured trauma therapy that helps clients safely reprocess disturbing memories through guided recall and bilateral stimulation. The therapist provides containment, pacing, and reassurance, allowing previously “stuck” experiences to integrate. Healing occurs through completion and reorganization — not confrontation or analysis.

ACT (Acceptance and Commitment Therapy): A pragmatic, skills-based approach that teaches mindfulness, cognitive diffusion, and values-driven action. Clients learn tools and metaphors to relate differently to thoughts and feelings, building flexibility and direction. Though it encourages acceptance of reality, the method itself is constructive and educative — adding psychological skills rather than stripping away illusions.

My Opinion

Much of modern therapy is focused on support and provision, often to the expense of challenge and removal. This is a marked departure from therapy up until the 70’s, which leaned more towards disillusion.

In my experience, therapists (and therapy modalities) that are disillusionist still employ a healthy amount of illusion (nurture, support, etc). On the other hand, therapists (and therapy modalities) that are illusionist by nature often lack the counter-balance of disillusion that is necessary to return the client to reality.

My bias, then, is to seek out “disillusion” therapies as a starting point.

On the other hand, if you know, beyond doubt, that what you need is reparative nurturing and comforting emotional experience, trust yourself and go for the illusion approach.

2. Finding a Therapist

Once you know whether you lean toward removal or repair, the next step is to find therapists whose therapeutic modalities reflect that orientation.

Search, “therapist in [my town], [therapeutic modality], [10+ years of experience].”

As you scroll through the websites, do the following:

• Copy the URL of any therapist who looks remotely qualified
• Paste those URLs into an AI tool like ChatGPT or Claude (or your own spreadsheet)
• Ask the AI to make a comparison of the therapists based on the following criteria (or do it on your own, of course):

Background & Qualifications

• Years of Clinical Experience — note both total years and years post-licensure.
• Supervisory / Teaching Roles — therapists who supervise others usually have refined clinical judgment.
• Advanced Trainings or Certifications — e.g. ISTDP core training, EFT certification, EMDRIA credentialing, etc.
• Continuing Education & Ongoing Supervision — signs of an active learning stance.

Therapeutic Orientation & Style

• Primary Modalities Used: which of your chosen modalities do they explicitly mention?
• Language on Their Website:
  • Disillusion-leaning therapists often emphasize insight, truth, reality, defenses, emotional honesty, growth through facing difficulty, or tolerating discomfort.
  • Illusion-leaning therapists often emphasize healing, compassion, safety, attachment, self-acceptance, regulation, inner child, or reconnection.
• Tone of Presentation: Does it sound more direct and reality-focused, or more nurturing and supportive?
• Population Focus: trauma, couples, high-functioning adults, personality structure, etc. (Some populations call for more provision, others for more disillusion.)
• Evidence of Reflective Thinking: do they publish, write, or articulate their philosophy clearly?

Practical Fit

• Fees and Policies — transparency and clarity usually signal professional maturity.
• Initial Consultation Style — do they offer a brief intro call (common among relational/illusion approaches) or a structured intake (common in analytic/disillusion approaches)?

Narrow It Down

Step 1: Filter Out the Non-Starters

Cross out anyone who clearly doesn’t fit your basic needs. Ask yourself:

• Are they too expensive?
• Do they have experience with people like me (e.g., couples, trauma, high-functioning adults)?
• Do they practice the modalities I’m drawn to?
• Are they licensed and practicing in my country or timezone?

If the answer is “no” to any of these, move on.

Step 2: Check for Credibility & Depth

From what’s left, focus on competence and presence. Ask yourself:

• Do they sound grounded and thoughtful, or more like they’re selling something?
• Do they show reflective depth e.g., writing, interviews, supervision experience, clear philosophy?
• Does their language feel solid and adult, or more soothing and generic?
• Do I sense aliveness in how they write about their work?

Cross out anyone who feels vague, overpromising, or disconnected from their own words.

Step 3: Book Intake Calls

Most (but not all) therapists offer brief intake calls, free-of-charge. I’d recommend speaking with at least three therapists.

During the call, tell/ask the therapist the following:

• Tell them what you are hoping to resolve through therapy
• Ask if they have had experience working with people who have symptoms/problems such as yours
• Ask them about how they work and how they help their clients heal
• Ask them for an estimated timeline of how long they think the therapy will last (a few months, a few years, etc.)

The Decision

You’re ready to decide. Will your decision be “right”? That’s hard to say. What you can, however, say with confidence is that you have put in the time and effort to find the right therapist and therapy for you.

Moving forward, think of this relationship as an experiment, at least at first. You’re not locked in. You didn’t sign a lifelong contract. You can leave at any time.

Conclusion

Good therapy will change you. It will free you of unnecessary suffering. It will help you break free of painful patterns. It will give you the emotional insight and awareness to live an authentic, open-hearted, fully-participative life.

Finding the therapist for you is a journey. This roadmap is designed to help you navigate that journey successfully, avoiding fatigue, exhaustion, and information-overload along the way.

If you get lost along the way, don’t hesitate to reach out. I’m always happy to help.