How to Evaluate Your Therapist: A 14-Point Checklist

Most people who go to therapy don’t like the idea of criticizing their therapist. They want to stay on their therapist’s good side. They want to be respectful. This is usually because they want to change, and they’re willing to try anything to get unstuck — from depression, anxiety, addiction, etc.

But therapy, at it’s best, isn’t a passive experience — like going to the doctor’s office for a physical. The truth is: It is what you make it. Therapy will either be your passive submission to another person’s way of looking at the world, or your active utilization of a professional for your personal benefit. The more you see therapy as a tool that you are using, rather than as a professional who is fixing you, the more you will be able to tell your therapist what you want, what you like and dislike about therapy, and whether therapy is really working.

TIP: Download the printable PDF based on this article: “Therapist Evaluation Worksheet.” This PDF scientifically walks you through every point explained here, helping you to ask diagnostic questions about your therapy experience.

Therapist Evaluation Worksheet:
Downloadable PDF


    Differences between therapeutic modalities have almost no impact on the effectiveness of therapy

    Most people shop for a therapist like they shop for wine — “Do I like the label?” Typically, the sleekness of website and Google reviews play a more prominent factor than what therapeutic modality the therapist uses. But this isn’t a tragedy. In fact, you should imagine picking a therapist like buying a bottle of wine. Imagine that by accident you signed up for a year-long subscription to a wine-a-week club, where they send you the same bottle of wine each week. However, if you asked for a different bottle, they would happily send you a different one. Here’s the catch: It’s $150 a week. A tragedy! They gouged you! Nevertheless, what’s done is done.

    How would you pick the wine? There’s only one responsible way to choose the right $150 bottle of wine each week: Try it, evaluate it, make an informed decision based on your experience. Did you like it? Does it have qualities that you enjoy?  

    Picking a good therapist is similar. You just have to start somewhere, and evaluate. Some people think that therapeutic method determines the effectiveness of therapy — is he a behaviorist, a Jungian, an existentialist? The truth is that differences between therapeutic modalities have almost no impact on the effectiveness of therapy for helping the client,[1] except for minor variances of effectiveness with regard to order-specific treatments.[2]


    Studies found that certain personal qualities determined the difference between therapists who were helpful for clients, and those who were not.

    However, counselors commonly outperform other counselors of the same approach — for example, while cognitive therapy (CT) on the whole has not been proven to be more effective than interpersonal therapy (IPT), certain cognitive therapists had consistently and significantly better results than other cognitive therapists, and likewise for interpersonal therapists.

    Studies found that certain personal qualities determined the difference between therapists who were helpful for clients, and those who were not.[3] You should be on the lookout for the presence (or absence) or these qualities in your therapist.

    The more they show evidence of these qualities, the more you are able to give them trust that is credible and integrous. The more they show evidence that they lack these qualities, the more you need to either speak up and express your need for them, or find another therapist.

    And remember, these aren’t just desirable qualities in a therapist. These traits are predictive of long-term therapeutic success. Here are the fourteen essential qualities of an effective counselor, which studies showed made the difference between ineffective and very effective therapy:

    1. Personable.

    There are a lot of socially awkward therapist out there. A lot of people get degrees in counseling in an attempt to work through their own psychological issues, so the professional landscape can contain a lot of kooks. But reliably effective therapists were strong in these six interpersonal skills:

    a. Articulating thoughts

    b. Reading people

    c. Controlling and expressing emotions 

    d. Warmth and acceptance

    e. Empathy

    f. Focusing on the needs of the counselee.

    These might seem fairly basic, but these traits are as rare among counselors as they are among regular people — that is to say, rare.

    2. Welcoming.

    During the first meeting, clients are often hyper-attuned to verbal and non-verbal cues like body language, tone, and breathing patterns. Effective therapists are mindful of the client’s experience from the moment they step in the door. Clients shouldn’t feel guilty for voicing a sense of unwelcome and distrust — a poor therapist will get defensive, and a good therapist will take these cues as information to use for the client’s good.

    3. Trustworthy. 

    A good therapist doesn’t assume their trustworthiness, but rather works from the assumption that trust must be earned. Even the over-trusting client should learn that their trust is not cheap, and the therapeutic alliance between counselor and client can be a place in which both the suspicious and the vulnerable learn to build firm but flexible boundaries that simultaneously cultivate safety and intimacy.

    A therapist that is either presumptive or detached is not building any social capital with the client, and is therefore climbing a therapeutic ladder that cannot handle the emotional load of a good therapeutic relationship in which wounded minds can be healed, non-judgmental exploration can be ventured, moral stances can be made, and secrets can be disclosed.

    4. Pedagogical. 

    Therapists have a tendency to use “psychobabble” when talking to clients — that is, they require the client to speak their language that they learned in school, and are unable to translate their psychological knowledge into a language that the client is comfortable with.  

    There is a legitimate place for psychoeducation — for example, in teaching trauma survivors what trauma is, its symptomatology, etc. Psychoeducation can be a tool of empowerment. But used carelessly, technical psychological vocabulary can be the therapist’s means of establishing a dominance hierarchy in which the client does not have sufficient education to subject the therapist’s speech to critical inquiry.

    The client should always feel as though they have the agency to say “No, that’s not what happened,” or “No, I don’t fall under that label” to the therapist. The issue can remain an active point of discussion, but the therapist should never appeal to psychological manner which implies to the client: “This is what you’re experiencing. I have a degree. Case closed.”   

    5. Straightforward.

    Therapists often get stuck in a long string of sessions that have no intuitive connection to any progress. At any given point, the client should be able to ask: “How does this contribute to my treatment plan?” and the therapist should be able to give a straightforward answer. With this information, the client has two options: (1) express dissatisfaction with the treatment plan’s purpose or pace, or (2) begin the process of finding a new therapist.

    6. Persuasive. 

    While the therapist should be generally non-judgmental for the sake of giving the client a safe place to speak openly about their experience, the therapist should take a stand on something. This stand should always be held in an open hand, but a therapist that is so fluid and open that they see themselves as facilitators of pure process will not be supremely helpful to a client who needs a dynamic relational environment in which to engage.

    In other words, the therapist will take a perspective. A good therapist isn’t a cold, neutral, removed scientist. At the very least, he is invested in his client’s wellbeing — and this wellbeing is defined a certain way. Practically speaking, a therapist who only asks questions may as well be “therapy software.” Therapists who feel more like computers than people will be handicapped in their ability to build a therapeutic alliance.

    More than that, persuasion is a matter of entering into discourse. If the therapist is unable to explain to the client in a persuasive way why his chosen treatment plan works for the client’s goals — why his plan will help the client achieve his expressed goals — then he will fail to give the client an important sense of operational control in his own treatment. Persuasion is not simply a matter of convincing the client— it is a matter of including the client in his own therapeutic process.

    7. Evidential.

    Good therapists make decisions based on evidence, not ideology. He will consistently monitor client progress and satisfaction to determine whether the treatment plan ought to be modified, paused, replaced, or scrapped. For this reason, the effective therapist will have from the outset means by which he will quantify the progress of the client. This may be in terms of self-report sheets, or his own evaluative sheets based on behavior, emotional experience, and thought patterns — their frequency, intensity, or profundity. When these metrics are in place and actively consulted (and re-consulted), the likelihood of the client reaching their goals significantly increases.

    8. Adaptable.

    A good therapist is willing to be wrong. He is willing to tell his client: “When you came to me six months ago, I thought this was the case. But after talking, I realize I was wrong. Now we shift our perspective and move forward.” A therapist who is always reluctant to admit that he may have been incorrect — or insists on his interpretation of your life — is likely trying to fit you into his picture of the world, rather than help you to transform your world into your desired outcome. 

    Some therapists will become fixated on a notion that you were abused as a child, that you need to resolve some lingering trauma, that you need certain medication, or that you fit a certain psychiatric label. If you express resistance to this, and it continues to remain a buoyant theme in your therapy, this is sufficient cause to change therapy.

    9. Non-avoidant.

    Therapists tend to be optimistic about the possibility for psychological self-improvement. However, much of therapy revolves around deep philosophical and personal issues with no resolution. If you sense that your therapist tends to avoid difficult topics by changing the subject, ask him why. A good therapist is willing to “go there” with his client, even if he doesn’t have the answers or explanatory tools to resolve the issue in that particular session.   

    Non-avoidance is particularly important, because it indicates that the therapist is not forcing the client to move in too quick or hollow a fashion through difficult situations. If something is important, and you need to linger there, tell him you need his help to work through the issue — maybe the issue is death, God, sexuality, a past relationship.


    If a therapist is redundant, shaming, or perpetually cliché in their optimism, there’s a chance they aren’t a good resource for you.

    Moreover, a good therapist is not scared of venturing proactively into difficult material. Sometimes, clients will feel a pressure to say positive things in therapy because of the stereotype that therapy ought to yield optimistic resolutions to difficult past issues. But a good therapist is not satisfied with the client’s avoidance of negative issues to the degree that it is hindering their own recovery.

    This is often a difficult line to walk, but a therapist who never invites you to investigate more deeply the more difficult issues of your mind is likely too comfortable and complacent to help achieve meaningful psychological goals.

    10. Optimistic.

    Most people hate themselves. They get easily frustrated with consistent relapse, moral failure, lack of change, or lack of progress toward their goals. While hollow optimism is obviously unhelpful (i.e., “You can do it!”), the most effective therapists are always looking for an organic way to advocate for a positive future in the midst of despair. What are legitimate, actionable, meaningful trajectories forward for the client in the midst of their struggle? How can you reignite, reexamine, and reformulate strategies for achieving goals that keeps the therapeutic journal live and fresh for the client?

    A client will often feel guilty and avoidant toward their persistent failures. They may even lie. But that’s why they’re in therapy. If they were naturally good at dealing with their issues, they wouldn’t need to pay someone exorbitant amounts of money to facilitate their mental health.

    If a therapist is redundant, shaming, or perpetually cliché in their optimism, there’s a chance they aren’t a good resource for you. Find someone who is willing to be more committed to and intelligent about your goals than you have been, and use their emotional energy to implement their treatment plan with rigor. If they can’t supply the optimism you need, ask for more — and if they can’t provide it, find someone else.

    11. Contextual.

    There are many reasons a therapist won’t be sensitive to your particular context. They may be dogmatic about their views on certain issues. They may have an over-inflated sense of their own therapeutic competence. They may think that therapy should be an isolated practice, divorced from other resources outside of the mental health disciplines.

    All of these postures are predictive of ineffective therapy. A good therapist will not only be sensitive to your familial, cultural, and religious context — they will be on the prowl for resources that will aid in your situation. Websites. Grants. Programs. Opportunities. They will be looking to help you get from where you are to where you want to be. And they will do this both by being a student of where you are, and becoming an expert at helping you shape the best possible future for yourself.

    Anything else is not only lazy — it is negligent.

    12. Professional.

    Therapists shouldn’t try to use you to legitimize their own perspective on the world. Therapy isn’t about the therapists. If you get the sense that your therapist is trying to get you to agree with them about issues like religion, politics, or philosophy, you need to recognize that this is not only unacceptable — it is unprofessional. 

    A good therapist won’t try to change who you are by inserting their story into your story. Instead, they help you to become the best version of you possible.

    13. Up-to-date.

    Most therapists fail to stay up to date on research related to their field. Psychological science is constantly self-correcting, and very few principles remain the same over time. Therapy consistently swells with fads.

    A good therapist will not only be up to date on the latest research, but will be critical of the latest research as well. There is rarely such a thing as a psychological certainty, and one way to pinpoint someone who hasn’t done their homework on an issue is to listen for dogmatisms — an attitude of “The science is settled.”  

    Apart from the general value of therapy, and the effectiveness of proactive psychological work, there is very little psychological knowledge that deserves a dogmatic tone. No one is more aware of this than the therapist who is saturated in the latest research.

    14. Self-improving.

    Every therapist is obligated to participate in “continuing education” (CE). But a good therapist will always be honing their skills for a specific goal — whether that is to become a more well-rounded therapist, a better grief counselor, more informed about the latest PTSD treatment research, gaining new credentials, etc.


    The more your therapist can answer hard questions, the less they will “cost” you in time, money, and potential for recovery.

    Don’t be shy about asking the question: “Do you do the minimum CE, or are you working actively toward bettering a particular therapeutic competency?”

    Inquire about your therapist. Ask hard questions. Ask what they’re learning. Ask how their perspective is changing. The more they have to say in response to these questions, the more likely it is that they are not the kind of person to “coast” in life or in therapy.

    FOOTNOTES

    [1] B. E. Wampold, The Basics of Psychotherapy: An Introduction to Theory and Practice (Washington, DC: American Psychological Association, 2010); B. E. Wampold, Z. E. Imel, K. M. Laska, S. Benish, S. D. Miller, C. Flückiger, et al., “Determining What Works in the Treatment of PTSD,” Clinical Psychology Review 30 (2010): 923-933; B. E. Wampold, T. Minami, T. W. Baskin, S. C. Tierney, “A Meta-(Re)analysis of the Effects of Cognitive Therapy Versus ‘Other Therapist’ for Depression,” Journal of Affective Disorders 68 (2002): 159-165; Wampold, The Great Psychotherapy Debate: Models, Methods, and Findings (Mahwah, NJ: Lawrence Erlbaum, 2001).

    [2] Although, even using PTSD as an example, these variances are statistically insignificant. See S. Benish, Z. E. Imel, and B. E. Wampold, “The Relative. Efficacy of Bone Fide Psychotherapies of Post-Traumatic Stress Disorder: A Meta-Analysis of Direct Comparisons,” Clinical Psychology Review 28 (2008): 746-758.

    [3] These qualities were found in the following studies: T. Anderson, B. M. Ogles, C. L. Patterson, M. J. Lambert, and D. A. Vermeersch, “Therapist Effects: Facilitative Interpersonal Skills as a Predictor of Therapist Success,” Journal of Clinical Psychology 65 (2009): 755-768; S. A. Baldwin, B. E. Wampold, and Z. E. Imel, “Untangling the Alliance-Outcome Correlation: Exploring the Relative Importance of Therapist and Patient Variability in the Alliance,” Journal of Consulting and Clinical Psychology 75 (2007): 842-852; The Heart and Soul of Change: Delivering What Works (2nd ed), ed. B. Duncan, S. D. Miller, M. Hubble, and B. E. Wampold (Washington, DC: American Psychological Association); M. J. Lambert, C. Harmon, K. Slade, J. L. Whipple, and E. J. Hawkins, “Providing Feedback to Psychotherapists on their Patients’ Progress: Clinical Results and Practice Suggestions,” Journal of Clinical Psychology 61 (2005): 165-174; Psychotherapy Relationships that Work (2nd ed.), ed. J. C. Norcross (New York: Oxford University Press, 2011); B. E. Wampold, “Psychotherapy: The Humanistic (and Effective) Treatment,” American Psychologist 62 (2007): 857-873.

     
     

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