Every therapist may not be a good fit for every client

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For therapy to be effective there needs to be a match between what the client needs and what the therapist has to offer. I mean this in terms of three factors:

  1. The type of therapy the therapist can provide;
  2. The problem the client has;
  3. The fit of the personality – though you may be surprised when I say it’s the least important issue.

It’s the therapist’s job to help the client think through these factors, since most clients who are starting to see a therapist don’t have the expertise to identify or consider them.

Here’s a common situation:

An individual is struggling in some way. He or she finally gets to the point of making a call for help. But to whom? A random name from a Google search? Someone a friend mentioned?
People who don’t have professional training or a lot of personal experience in therapy simply don’t know what questions to ask. Is the therapist on their insurance panel? Does the therapist have expertise in diagnosing and treating their particular problem? What’s the problem that needs to be treated in the first place? What are the different treatment options, and why is one likely to be more effective than the others? Do I like and feel comfortable talking to that person?

How can someone who has never studied the range of available treatments hope to select the right therapist on the first call?

It happens; people get lucky. But the odds are against it. (As a side note, I can’t count how many people tell me they’ve left messages at a therapist’s office and never even received a call back. How disheartening.)

Here’s another common situation:

Someone has been in therapy and is not seeing the progress he or she wants. I often get phone calls from friends or family members who will say something like, “Sue has been seeing Dr. So-and-so for several months and she isn’t getting better.” Often, it turns out Sue is receiving supportive therapy rather than an evidence-based treatment that has been studied for its efficacy on her specific problem.

For many people, just talking about their problems to a nice, smart and validating person is not enough. They need skills that match their problem.

Who is there to help? Sue is suffering, perhaps dysfunctional and surely vulnerable. Who can guide her through all the variables to find the therapist who can help her right now? I don’t know of any match-making services that do this (though I’ve often thought it would be valuable).

So it falls to us. People call therapists because they’re in need, and we’re supposed to help. That means taking the time to figure out Sue’s issue – whether it’s social anxiety, depression, substance abuse or anything else – and match her with a therapist who has the expertise to help her get the problem under control. Even if it’s somebody else.


About the Author:

Dr. Lucene Wisniewski is an internationally recognized leader in eating disorder treatment and Dialectical Behavior Therapy, with more than 25 years of clinical and training experience. She may be reached for consultation through the "contact" page on this website.