Choosing a therapist is an important decision but there are no hard and fast rules for picking a therapist that will best meet a patient’s needs. Because therapeutic alliance is such an important component of treatment outcome, it makes sense to pick a therapist with whom one feels comfortable. As in any relationship, this is to some extent a personal decision. A therapist may provide a perfect fit for one person, but not click as well with his or her friend. When seeking treatment for help with specific problems, it also makes sense to find someone with expertise in that area. As noted above, some problems are best treated with specific types of therapy, for example, anxiety disorders respond very well to behavioral therapy.

In many cases, however, the different types of therapy may be equally effective, so the theoretical orientation of the therapist (for instance whether they are psychody-namic, humanistic, or cognitive-behavioral) may be mainly relevant in terms of patient-therapist fit. For example, people might consider whether they want a therapist who is directive (structures the treatment) or exploratory (promotes open-ended discussion), who does or does not give homework assignments, who talks a good deal or who is more interested in listening, who delves into childhood relationships or who focuses on solving current problems, or who provides short-term or long-term psychotherapy (weeks to months vs. years).

The personality style of the therapist will also affect the type of therapy that is provided. Some therapists are gentle and supportive, while others tend more toward “tough love.” Some patients may prefer the first type of therapist, while others may find such a therapist too soft and prefer to be challenged.