I’m not a therapist anymore. I trained for it and practiced it for years before moving into my work as an executive advisor and coach to High Achievers and their organizations. Because of that earlier work, I still get referrals for therapy, and sometimes I help clients or loved ones screen potential therapists.

 A few years ago, someone sent me a set of questions they had as they sorted through therapists, and I’m publishing my answers so that they can help others as well.

 It also fits into a larger theme in my work of human due diligence — how to decide who you let impact your life, whether in personal or business scenarios. Most people frame this as how to choose a therapist, but the real skill is knowing how to assess one. The same discipline I bring to evaluating executives, advisors, and coaches applies here: you’re screening for competence, fit, and genuine care before you spend real energy and trust. Here’s how I’d do it.

 Start with the big directories, then widen your search from there.

Directories (start here). Go to Psychology Today (psychologytoday.com) and click “Find a Therapist.” You’ll see photos, profiles, and enough to get a feel for who you’re drawn to. Read a profile or a bio and go with your first overall feeling. I know that’s vague and not scientific. It’s still the right first step.

Can you use Google or AI to find a therapist?

Sometimes people won’t be on Psychology Today, so it’s worth searching directly to see what comes up. As AI evolves, it may become easier to search for the specialties or interests you’re looking for. One caution, though: I’ve received several reach-outs from AI referrals. The AI wasn’t wrong, but the people who reached out hadn’t thoroughly assessed the context of my website. AI will pull as much as it can, and it may become increasingly good at sorting nuance — but you’ll still want to look at the provider’s own information and assess fit the same way you would on Psychology Today.

One more note: read what people write, and don’t make instant assumptions based on website aesthetics. Sometimes excellent clinicians have archaic websites.

What about referrals from friends or family?

Clearly, it feels comfortable if you have a recommendation from someone you know. There is a caveat; a therapist who is the perfect fit for your friend may be the wrong fit for you. If someone gives you a name, it’s good to find out what they like about that person. When I was a therapist, I was active, goal-oriented, and I gave specific recommendations. This is the opposite of someone who wants a person to simply listen. The right style depends on personal preference.dd

Credentials. Look for an MS, MA, PsyD PhD. Some states now allow associate-level clinicians to do counseling, and in my view that’s simply not enough training for accurate assessment.

Years of Experience. Experience matters, and the research backs this up: the two ingredients that most affect outcomes are the relationship with the therapist and the therapist’s years of experience. Please remember, that experience by itself does not mean expertise. Mediocre people with lots of experience don’t become more excellent with time.  

Relevant Focus. Look for someone whose background matches what you’re bringing. On Psychology Today, you’ll see a list of “issues.” Even if you don’t have a name for what you’re dealing with, you’ll often see something that resonates — that’s your signal. A note on this: If you see someone who resonates with you, and you don’t see exactly what you are looking for, it’s okay to ask. Good therapists often have more expertise than what they list.

Two questions do most of the work — but first, know yourself.

Before you ask anyone anything, get clear on one thing: do you want someone who mostly listens and helps you arrive at your own answers, or someone who gives specific guidance? Both are legitimate. It’s a match question, not a quality one.

Then ask the therapist directly: “Do you tend to give specific suggestions, or do you prefer to be more of a sounding board?” And listen to the answer.

A second question: ask what kind of client they most enjoy working with. It’s harder than it sounds, and a seasoned professional will be able to answer it. The answer you don’t want is “I enjoy working with everyone.”

Set the bar high. You should come away feeling the person is easy to talk to, organized, and competent. I strongly recommend a short phone call before you ever book. You can send a simple message such as:

“My name is ___. I’m looking for support with ___ and ___. Do you currently have availability? If so, could we set up a brief call?”

When I do this on behalf of clients, I start evaluating immediately: Does the therapist respond? How long do they take? Is the response warm and professional? Your goal is to screen people out before you ever meet them.

After the first appointment. That’s usually the whole answer. 

Here’s why the phone call matters so much: it takes real energy to get yourself to a first appointment, and more energy to start talking once you’re there. If the experience is bad, most people won’t try again for months. So if you get to that first appointment and it doesn’t feel right — call it. Don’t give it a second chance. The more you invest in the wrong fit, the longer it takes you to go find the right one.

You should feel that the person genuinely cares and isn’t just doing a job. If you find yourself re-explaining, or sensing they don’t quite get you, that’s a flag.

If you like the first appointment but something stops sitting right later — that’s your other exit cue. When you start questioning it, that’s usually the signal. Normally the first appointment tells you what you need to know.

One of my executive coaching clients once asked me how he’d know if the work was helping. I gave him the most succinct answer I’ve got: you shouldn’t have to ask. When the fit is right, there’s no doubt in your mind.

Yes, there’s insurance coverage for anxiety, depression, and other mental health conditions. The upside is cost. The catch is that coverage requires a diagnosis.

A diagnosis isn’t a bad thing on its own. But if you’re doing reasonably well and want to keep seeing someone for maintenance and quality of life, ask up front how the therapist handles that with insurance. Also know that therapists who take insurance (I did, early in my private practice) tend to be swamped, so getting in with those providers can be more difficult. Be aware that it is unusual (and possibly a red flag) if someone cites years of experience, takes insurance, and has a lot of open slots.

If you can swing it financially, consider both insurance and private-pay options — and above all, choose what’s sustainable for your budget. People sometimes ask about doing a short, intense stint to “get traction” and ease the cost. The problem: if you truly click with your therapist, the last thing you’ll want is to start over with someone else. When it’s right, it feels like a relationship — and therapists are about as interchangeable as good friends or a spouse. Which is to say: not at all.

Less than you’d think. Gender, age, in-person vs. remote — all of these are fairly insignificant. Start with what feels comfortable and go from there. The real fit isn’t demographics; it’s that this person “gets you” and can give you information that’s actually helpful. And even though they get paid, you should feel like they truly care — that you are, as one of my clients put it, “more than just a source of revenue.”