How to Choose a Therapist: What to Ask in Your First Consultation
The Consultation Is a Job Interview. You're Not the One Being Interviewed.
How many times have you tried therapy?
How many therapists did you go through until you found one that was a good fit for you?
The first time I went to therapy, it took me, if I recall correctly, about five therapists before I landed on one I actually connected with. The upside: I found a therapist I connected with, felt comfortable with, and who helped me. The downside: I paid for several intake sessions before I found that therapist.
Enter the era of free consultations (with caveats), video introductions on therapist marketing platforms, and picture layouts to “get to know” your therapist before you ever book a session. The videos and pictures are cool. They can give some nice insight into a therapist, and frankly, some people are just so genuine that you can tell almost immediately you’d connect with them, or even like them. Overwhelmingly, though, I’d say video intros and pictures are a lot like social media: mostly polished, reflecting the good things people want you, the viewer, to see.
Initial consultations are different. Done right, a consultation tells you a lot, some of it out loud, some of it between the lines.
Here’s the thing: Think of the consultation less like a power differential, where the therapist is elevated and in charge, and more like a job interview. For them. Not you. You might need a therapist. They probably could use a client, or they wouldn’t be consulting with you. So, you’re the interviewer. They’re the ones trying to get the job.
In this post, we’re going to walk through that interview: what to ask, what to listen for, and, perhaps more important than any specific question, how to read the answer you get.
Let’s get into it.
The Question Almost Doesn’t Matter. The Reaction Does.
Here’s the thing nobody tells you about vetting a therapist: you don’t need a perfect list of questions memorized. Instead, pay attention to how the therapist responds when you ask any reasonable question about their ability to help you.
A good therapist can be questioned without getting defensive. That’s the whole test.
Ask about their credentials and notice whether they explain them plainly or become bothered or defensive. Ask how a treatment method works and see whether they walk you through it or dismiss you with something about how long they’ve been a therapist or encourage you to “trust the process.” Ask something more direct, like “How can you help me?” and listen for or watch whether they treat it as a fair question or a personal insult.
The specific question is just the trigger. What you’re actually measuring is whether this therapist can tolerate being evaluated by the person they’re supposed to be helping. If they can’t handle that in a fifteen-minute consultation, that tells you something about what session three, for example, is going to feel like when you disagree with them about something that actually matters.
Credential Alphabet Soup
You’ve seen it. LPC, CSAC, ICS, CCPT, LCSW, LMFT, NCC, CADC, PhD, PsyD, ACS. Then, there are the pay-to-play certifications (which we will touch on here and will be more fleshed out in a full blog post in the future), like the CCTP, CCTS, CCFP, CCATP, C-PTSD-S, ASDCS, CTC, TLC. And about a thousand legitimate, and perhaps questionable or borderline fraudulent, more. Just strings of letters after a name that reads like a keyboard smash. But what do they mean?
You are allowed to ask exactly that. What do they mean? How did the therapist acquire them? How, exactly, will they be helpful, specifically for you? All of them. Every last acronym. And a good therapist will walk you through it all without sounding rushed or annoyed.
Here’s a distinction worth knowing before you even ask: licensure is state-mandated; it’s the legal permission to practice, backed by a state board, exams, and supervised hours.
Certifications are additional, typically optional, training in a specific approach or population. Some certifications require extensive coursework, supervised cases, and ongoing consultation. Others require a one-day or weekend seminar and additional payment for a certificate (i.e., “pay-to-play”). They are not the same thing, and a therapist who’s up front about which is which is honest.
- Green flag: They explain what a credential required, how long it took, and what it actually qualifies them to do, without treating the question as an attack on their competence.
- Red flag: A vague answer, a defensive tone, or “I’ve been doing this for 20 years, I think I know what I’m doing” in place of an actual explanation.
Certified vs. Trained
This one’s small, perhaps, but it matters more than most people realize.
Let’s use EMDR. Being certified in EMDR and trained in EMDR are not the same thing, even though they sometimes get used interchangeably. Certification means a defined number of documented sessions, supervised or consulted cases, and a completed process with a certified trainer. The entire process is recognized by an approving organization, such as EMDRIA. “Trained” can mean anything from a full certification track to a single afternoon webinar.
Ask the therapist where they did their training. How many hours or sessions did that involve? If they use acronyms, ask them what those acronyms mean.
A therapist who’s done the work, certified or not, should be glad to tell you exactly what that involved, because it’s specific, and specific things are easy to talk about. A therapist stretching the truth tends to stay vague because vagueness is easier to hide behind.
Here’s the nuance worth adding, though: don’t assume “not certified” means “not competent.” It often doesn’t mean that at all.
Many modalities, like EMDR, come with their own required post-training consultation built into the base training. That part isn’t optional, certified or not. Some modalities and trainers offer ongoing consultation groups that might or might not count towards overall certification hours—almost always paid—but it’s still qualified ongoing consultation.
Certification is a separate track, and it exists for a few reasons. Ostensibly, it exists to help clinicians become more competent in specialized types of therapy. I say ostensibly because there is an ongoing (somewhat heated) debate in the field about the monetization of therapy modalities. Trademarks and money have, sadly, seeped into therapy. Or maybe it’s always been there. By monetization, I mean certain people make a lot of money—like new house money—by creating organizations, rules, certification tracks, and charging money.
My word choice of “ostensibly” a couple of sentences back is meant to say certification is supposedly to ensure clinicians are using the modalities correctly. But then, what is the training for? And why, for some good modalities, is there already post-training consultation built into the training format?
See what I mean?
So, many therapists who choose to do the paid consultation hours for certification choose to do so, largely (in my estimation) for two reasons: i) they believe it helps with marketability, and/or ii) they want to increase their revenue by becoming a trainer in that modality.
That said, if a therapist isn’t using the certification to attempt to boost their marketability or if they never intend to train other clinicians, certification might not add much clinically that consistent practice and ongoing refreshment training might not already add.
For example, a therapist can complete Brainspotting (BSP) Phases 1 through 4, One-Eye BSP, David Grand’s master class, a retreat or two, and rack up years of real, effective clinical use of the model…and still never pursue certification, simply because they had no reason to.
Meanwhile, someone can complete Phases 1 through 3, log the required sessions, get certified almost immediately, and still not have a real grasp of something as fundamental as dual attunement or how to build the kind of therapeutic alliance that actually makes a modality work.
All this is to say: “Certified” might not guarantee that someone is highly trained and effective any more than the absence of “certified” disqualifies someone.
Hence, questioning the potential therapist about qualifications and experience is always in your favor. So, ask the questions and listen for substance behind the answer, not just the label.
“I trained through Phase 3 and have been using it for six years. Here’s how I approach it” is a perfectly fine answer. So is “I’m certified, here’s what that process looked like.”
What should give you pause is someone who can’t describe their own competency with any specificity either way, and can’t do so without incredulity and defensiveness.
How They Ask You Questions Matters Too
The interview goes both ways, and that’s a good thing. A therapist should be asking you about what’s bothering you and how they might help. But pay attention to what kind of questions they ask.
Are they trying to understand your goals, or just filling out an intake form? Are they curious about what didn’t work in previous therapy, or do they brush past it? A good therapist treats your history, including your therapy history, as useful information. A therapist who’s only half-listening for the next scripted question is telling you something about the kind of attention you’ll get once you’re their client.
It should be a conversation. And an easy one at that. Not a sales call.
Reading Tone on the Harder Questions
Some of the most useful questions you can ask aren’t really about facts. They’re about fit.
There’s no script a therapist can memorize that makes this question necessarily easy to answer, and there shouldn’t be. What you’re listening for isn’t a perfect answer; it’s how they carry the question.
Do they get defensive? Do they minimize it (“we’re all human, aren’t we”)? Or can they speak concretely about their training, their consultation, and their own awareness of what they don’t know from lived experience? A therapist who can sit with the limits of their own perspective, without getting prickly about being asked to name them, is showing you something important about their character.
This isn’t a post about identity-competent care specifically; that topic deserves its own space and a fuller discussion than a few paragraphs here. But it’s a clean example of the bigger principle: how someone handles being questioned about their limits tells you more than the content of the answer itself.
Available by Phone or Video
If this is a proposed telehealth therapist and you’re offered a choice, take the video consultation over the phone call when you can. Video gives you a chance to see a therapist’s face, eyes, and body language. An enormous piece of what actually gets communicated in a therapy relationship isn’t verbal, and you can start reading that from the very first conversation if you do so via video. That said, whatever feels most comfortable for you is the right choice. This is your process, not a test you have to pass.
The Bottom Line
You’re allowed to ask questions. All of them. The credentials, the training, the boundaries, the hard ones about identity and fit, and confidentiality. A good therapist won’t just tolerate that. They’ll welcome it because they know exactly what it is: your due diligence before hiring someone for one of the more important jobs a person can take on.
Go into your next consultation like the interviewer: not pushy, firm but polite. Ask what you need to ask. Watch how it lands. Then, trust your instinct and what you now know from this post more than any fancy word choice, credential, or polished video.
Jason L. Fairweather, M.A., LPC, CSAC, ICS
Jason L. Fairweather is a nationally board-certified psychotherapist and clinical substance abuse counselor, licensed in Wisconsin. Before pursuing formal education and licensure as a clinical therapist, he served in the United States Marine Corps for eight years and as a sex offender agent and in correctional forensics for over eighteen years.
He lives and works in Wisconsin, where he spends his time with his wife and their roommate, Mazie, a red-nosed pitbull who’s so intelligent they swear she trains them. When he’s not working, Jason’s typically spending time with his wife and their dog, reading, writing, or working on apps like the bilateral stimulation tool on this site.
Jason’s a published author and an active member of the American Mental Health Counselors Association (AMHCA), the International Society for the Study of Trauma and Dissociation (ISSTD), and the International Society for Traumatic Stress Studies (ISTSS).