How to select a therapist who will help and not hurt. A project of Metanoia Communications


10 - A Professional Referral

The way you find out about your therapist might end up becoming an issue in your therapy.

Perhaps most important: Your therapist cannot have a close connection with any relative or friend of yours. It will be extremely difficult, if not impossible, to build a secure frame under those circumstances. It is unlikely that any competent therapist will accept you as a client if you are the friend or relative of a current or former client. Therapy is already too difficult (and too expensive) to intentionally handicap yourself in this way. A secure-frame therapy requires anonymity, confidentiality, privacy, and therapist neutrality. For best results, IF SOMEONE YOU KNOW IS SEEING OR HAS SEEN THIS THERAPIST, FIND ANOTHER THERAPIST.

The best referrals are professional referrals, from a professional who knows the therapist professionally, and who is not involved with you or the therapist socially. Your therapist may be suggested by:

  • your family doctor,
  • a professional organization (see below),
  • a counselor whom you have consulted for the purpose of obtaining a referral,
  • your minister or rabbi, or
  • some similar person who is in a professional position to have general feedback that this therapist's clients have worked successfully (and who is NOT themselves a client).

It should be unlikely that you will ever see your therapist outside therapy. Therapy works best when your relationship is confined to the therapeutic frame.

Less good are referrals in which you have no choice: therapists to whom you are assigned by an employer, court, HMO or clinic. These assignments may turn out to be good; but if they are not, you need the freedom to select another therapist. Also less good are therapists about whom you know something personal, or who you are likely to see outside of the therapy frame. These situations can be made to work, but they are much more difficult to deal with in your unconscious and so make therapy longer and harder.

Avoid selecting a therapist arbitrarily, say from the yellow pages. This gives you less guarantee of the persons competence. If you have no other choice, pay very close attention to the themes expressed in your dreams and narratives when you start seeing a therapist selected in this way, and discuss them with the therapist.

If you use a therapist referral service or directory, especially those online, keep in mind that most of them are commercial services. They may not have screened the therapists; any therapist who pays for a listing could be included, which guarantees you nothing. In other cases, the service could be restricted to only one variety of therapist, giving you less of a choice.

When you get the referral, you may find out about the therapists education, training and experience, and, if you know you have a particular need, the therapists specialty, if any (i.e. alcohol/addiction, depression, family or couples therapy, etc.) Keep reading to find out what you should look for.

Next: Therapist credentials: the truth revealed >>

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Table of Contents


  1. Why I wrote this article
  2. How to tell if a therapist is competent, or not
  3. What psychotherapy isand why you need to know
  4. The secret that you already know
  5. How a good therapist makes you feel safe
  6. The perfect therapist
  7. Privacy: the essential ingredient
  8. Non-judgmental acceptance: you deserve it
  9. How to choose a therapist to call
  10. How you find out about the therapist
  11. Therapist credentials: the truth revealed
  12. First contact. Watch out for these red flags!
  13. Your first session: what should happen
  14. Safety is in the details
  15. Now what?

Copyright 1991,1996, 1999 Martha Ainsworth. All rights reserved. Please refer to reprint information before reprinting or distributing all or any part of this text.


This resource is hosted by mental health information at Psych Central.