All About Therapy—Do I Need a Therapist, How Do I Find One, and What Type of Therapy Works Best?

Today, we're talking allll about therapy. I've gathered up the big questions people ask and we're tackling them head-on. Remember, therapy isn't just for crises-it's for clarity, growth, and understanding. So if you're curious about the process or wondered how in the world to get started, this episode is for you.

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Here's what we cover:

1. The most important predictor of success in therapy (18:36)

2. Different types of therapy (29:33)

3. How to find a therapist (12:35)

4. Breaking up with a therapist (42:42)

5. My top tips for finding affordable therapy (12:59)

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Music by Andy Luiten

Sound editing by Kelly Kramarik

While Dr. Cook is a counselor, the content of this podcast and any of the products provided by Dr. Cook are not specific counseling advice nor are they a substitute for individual counseling. The content and products provided on this podcast are for informational purposes only.

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Resources

• ‍DrAlisonCook.com/podcast
• ‍dralisoncook.com/resources
• ‍Psychologytoday.com
• ‍Adverse Childhood Experiences Test

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Transcript

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Alison: Hey everyone. And welcome back to this week's episode of the Best of You Podcast. I'm so glad you're here. I'm so glad you're tuning in for this series, these foundational building blocks of psychology. And today's episode is probably the topic I get asked about the most. 

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It's “what kind of therapist do I need and how do I find a good one”? Honestly, I get asked this question multiple times a day. Every single day. back in episode 63, I promised you an episode all about therapy. And this is that episode I've gathered together the top 10 most asked questions. These are the questions I get asked the most about therapy, about how to find a therapist, about how to find a good fit, about all the things, 

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And we're answering all of them in this episode. This is an episode to save and to share with your friends and loved ones. Now there's a lot of information in this episode, a lot of practical information, and websites.

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To make it easier for you to get the information you need out of this episode, as well as every episode we're going to do a couple of things. Number one, every episode is transcribed completely and it has its own webpage. Go to DrAlisonCook.com/podcast and on that page you will see a list of every single episode we've recorded.

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If you click on the episode you're interested in, it will take you to that episode's webpage. You will find a list of all the resources. From that episode and at the bottom of that page, if you scroll down, you will see a button that says view transcript, click on that transcript, and you will see this whole episode transcribed.

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That's an easy way to scroll through and get information that you might have missed while you're listening. Secondly, starting with last week's episode 70, that was a dense episode. There was a lot in it, including a lot of practical exercises for managing emotions. Starting with that episode we're going to add a timestamp feature so that you can easily find the portion of the episode you most want to pull out to share with somebody.

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Look for that timestamp feature to return to the part of the episode you really want to go back to, to grab that information. I'm trying to make it easy for you to get the resources you need and to share those resources with your friends. All right. Without further ado, we're going to dive into the top 10 questions I get about therapy. 

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Question number one, when should I go to a therapist? I want to start off with some stats. First of all, a recent study found that around 20 percent of Americans in any given year are seeing a therapist. Now that doesn't account for the people who saw a therapist last year, who aren't currently seeing a therapist right now.

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That's folks who are currently seeing a therapist. And the number is only increasing, especially since the pandemic, the number is only going up. Bottom line, a lot of people are turning to therapy for support. And of those people who are turning to therapy, over 75 percent find it to be beneficial. I want to normalize if you're thinking about seeing a therapist, if you've seen a therapist, it's really normal, no longer is there a stigma attached to it. Most people are going to see a therapist at some point in their life.

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There are a lot of different reasons that people see a therapist; some people have been diagnosed with an ongoing mental health issue, such as a mood disorder or an anxiety disorder. There are numerous types of anxiety issues that people deal with on a regular basis. Many people are seeking therapy as a part of their wellness regime as a way to grow, as a way to become a more whole person, mind, emotion, body, and soul. 

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It's simply another tool in the toolkit to help you improve different areas of your life. There are a lot of reasons that people go to see a therapist. You think about the medical model–most people see a doctor in their life. Hopefully you're seeing a doctor at least once a year to check in on your health. In many ways, this new mental health model is more of a health model versus a mental illness model. This idea that we are all dealing with something at some point in our lives would suggest that at some point you're going to want to enlist the support of a therapist to help you out. It's normal. 

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In many ways, most of us at some point in our life will have a mental health issue that we need to resolve. Here are some reasons that you might want to seek therapy. Number one, if you're dealing with overwhelming emotions–maybe you notice a disproportionate response to things. This could be new or this could be something you've noticed for a while. 

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For example, if you notice that you get disproportionately angry when someone does something annoying. Let's say your kids or your spouse or a friend does something that may be annoying, but you have a big response. You go right into fight mode, you go right into anger. And then later you're aware, oh man, I overreacted. I had a big emotion. Or if you get really big sad emotions. Again, there's no shame in this, but that might be a cue that there's some pain in your life or there might be a wound in your life that needs some healing.

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It's a cue that you might need some attention and you might want to enlist the support of a therapist. Another reason people seek therapy is during significant life changes. What we call adjustment periods. It could be anything from adjusting to having.

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A new baby or adjusting to your children, leaving home, or an empty nest. It could be adjusting to marital life. It could be adjusting to single life, adjusting after a divorce. It could be adjusting after the loss of a loved one. These are normal season-of-life changes, but they stir up a lot of emotions inside of us, and it can be so helpful to have someone walk you through that life change. A third reason, probably the biggest reason that people seek therapy, is for ongoing anxiety or depression that isn't self resolving. 

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It's one thing to feel anxiety, and then to have that anxiety resolve over the period of a couple of days. But if you're dealing with anxiety regularly, for example, if you go back to episode 54, where I talked with Curtis Chang about his anxiety and how persistent it was, that's the time to see a therapist who can help you. Or if you deal with chronic feelings of sadness or depression, that's the time to see a therapist.

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Another reason is if you're aware of traumatic events from the past. Maybe you dealt with emotional abuse, physical abuse, sexual abuse, emotional neglect, and you're aware of that, and you've never really processed it. It's so helpful to have a trained therapist. Someone who is trauma-informed to help you heal some of those wounds. 

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Maybe you're doing as best you can. Maybe you're even doing really well, but you have this awareness of, I've never really talked about that thing that happened. This is so common and it's so wise to say, you know what, I'm going to enlist the support of someone who's trained to help me work through that and help me gain a deeper layer of healing, 

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I like to think of it this way: if you had a twisted ankle and it was hurting you and it wasn't self resolving, maybe you're walking pretty well, you can even go on hikes, but you're always dealing with a form of pain. Why wouldn't you go to a physical therapist to help you heal that pain, to help you restore that part of you to its proper function?

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That's what a therapist does. If you're noticing that you walk with a little bit of a limp as a result of a trauma, or an injury that maybe even happened years ago, a therapist can help you heal that and restore that part of you to the way that it's designed to function. Another reason people seek therapy is relational issues.

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It might be that you're dealing with a relational problem in a marriage as a parent, as a friend, or maybe you're dealing with persistent loneliness. It's hard for you to establish healthy relationships, or you feel unsatisfied with the quality of your relationships. Great time to seek the support of a therapist.

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We have all different ways of getting support. We go to church communities for spiritual support. We go to medical doctors for physical support. 

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At some point in our life, we all need to look back because there's not one of us that arrived where we are right now without a wound or two. Every single one of us has something in our past that's worth taking a look at. We all need to look at where we are right now and see how we are doing mentally.

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How are we doing emotionally? How are we doing spiritually? How are we doing physically? And who is attending to me in each of those categories? Again, it doesn't have to be a therapist, but a therapist is a great resource to help you, especially in that mental and emotional domain. 

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And then where do I want to be? How am I doing toward pursuing the goals that I have for myself, am I the parent I wanna be? Am I the friend I wanna be? Do I have the types of relationships I wanna have? Am I growing? A therapist can help you in all of those ways.

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When is it time to get a therapist? When you've talked with friends, when you've maxed out your community, or if you don't have a lot of friends or community to talk with, and you're struggling in any of these ways, a therapist can help. 

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And what I like to say to people is don't wait until you're in crisis to find a therapist because it's really hard to find a good fit when you needed one yesterday.

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I encourage people to proactively locate a therapist that you like, that you build a rapport with. You can meet for a few sessions and they are there for when you need a therapist. When that crisis comes, whether it's for a family member, a loved one or something in your own life, you know who that person is that you're going to call.

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I think it's wise. Just like how you usually have a medical doctor on file, you know who you'll call when you need to see a physician. Similarly, I think it's wise to have identified a local therapist or someone virtually that you can turn to when you're going to need mental or emotional support.

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Number two, (12:35) how do I find a therapist? I get asked this question every single day. I'm going to run you through some really practical ways to find a therapist. Ask people you trust. Referrals are a great way to do it. If someone you love and trust liked working with a particular therapist, there's a good chance you might like that therapist.

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Ask people you can trust. (12:59) You can contact local churches, local seminaries, local universities. Many of them have counseling centers and most of those counseling centers have referral lists also. Ask them for lists of people who provide discounted counseling services.

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If you have local counseling programs, local seminaries, or local universities who are training counselors, oftentimes those institutions offer discounted counseling for people who are working with their counselors and training. That's a way to get low cost counseling. 

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Also ask your primary care physician. Most physicians offices have counseling referral lists for people in your region. On my resources page, dralisoncook.com/resources, there are several links to different online platforms. There's a growing number of virtual counseling platforms that tend to be a little bit more affordable and a little bit more easy to come by for those of you who live in places where there are not a lot of counselors practicing in your local zip code.

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Lastly, there's a huge database called psychologytoday.com. I linked to that on that same website. It's a huge database of licensed therapists of all different types in all different regions. And I'm going to walk you through how to search for a therapist using that database. When people reach out to me and say, hey, can you help me find a therapist in Nevada, and I don't know any therapists in Nevada at this moment in time, this is exactly what I do to help that person find a therapist.

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I'm going to walk you through how to do that for yourself right now. Go to that timestamp or go to that transcript and share this with friends who are trying to figure out, how in the world do I find a therapist? Number one, you go to psychologytoday.com and the first thing you'll see is this big search bar, “find a therapist”, and it wants your city or zip code. You put in your zip code and it's going to pull up a list of all the therapists who are licensed and registered with the Psychology Today database, which is one of the biggest databases there is.

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Now underneath you're going to see these filters and it's amazing–you can filter by the issue that you're dealing with, whether it's anxiety, addiction or maybe it's an issue with one of your children, depression, an eating disorder, grief. You're gonna see a whole list so you can filter by the specific issue. 

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You're going to see an insurance filter. You can filter by the therapist that takes your specific type of insurance. You can filter by the gender of the therapist if you prefer to see a male or female therapist. You can filter by the type of therapy. We're going to get into these different types of therapy, but if you're thinking, I want an IFS therapist, I want an EMDR therapist, I want a Christian therapist, whatever it is, you can filter by that. 

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You can filter by the therapist's age if you're aware that you want to see someone older or younger. You can filter by their price range. You can filter by their faith. If people have identified, I am someone who works with Christians or I am someone who works with Jewish clients. You can really get specific about what you're looking for. And it really helps narrow down the field.

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Question number three that I get is how do I know if a therapist is qualified? And right there on that database on psychology today, you're going to see the therapist license. You can also go to any therapist website. You can go to state licensing databases to look up a therapist's license. But what you're looking for is someone who is a licensed psychologist, a licensed professional counselor, an LPC, a licensed mental health counselor, an LMHC, a licensed marriage and family therapist, an LMFT, a licensed social worker, an LICSW. 

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You also might see that MDs, licensed psychiatrists, sometimes do therapy. Licensed psychiatrists, MDs, are the only type of therapist who can prescribe medication. If you're looking for someone who can prescribe medication, you're looking for that MD. 

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Here's the thing to remember for therapists and counselors and social workers and marriage and family therapists: these are broad terms for professionals who are simply trained in talk therapy. They come from a variety of educational backgrounds. Baseline, you want to look for someone who has an advanced degree and who is licensed by their state licensing board. 

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Beyond that, whether it's a PhD, or whether it's a social worker, or whether it's a marriage and family therapist, what matters most is the relationship, and we're going to get to that. You also might look for specialty certification. If you're looking to work with someone who is IFS trained or EMDR trained or DBT trained, you want to make sure they've been certified or trained in that modality. This is something you can ask a therapist as well.

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Question number four: how much does therapy cost? There's a huge range. It varies based on geography, based on their qualifications. That's one of the things about those different degrees. Typically, the more advanced the degree, the more the therapist is going to charge and that doesn't necessarily mean it's a better fit.

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You always want to ask, do you offer a sliding scale fee? Ask about insurance and check with your insurance. More and more insurance companies are offering a certain number of sessions every year to people as part of their coverage because it simply works. It improves your health. Always check with your insurance provider to understand the coverage before you go out and enlist the support of a therapist.

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(18:36) Number five, how do I know if a therapist is a good fit for me? And I love that people are asking this question. It means that you are thinking about therapy as a collaborative process. And I want you to think about therapy in that way. I don't want you to think about picking up the phone and calling an expert who has all the answers.

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Because there are a lot of therapists who are not going to be able to give you the help that you need. You need to be thinking about finding a fit, finding someone who is good for you. The number one predictor of success in therapy, the number one predictor, is the relationship between you and your therapist. There's no such thing as a perfect therapist. There's no such thing as a guru who will have all the answers that are proven for you. What matters to the effectiveness of therapy is the nature of that relationship that you develop with your therapist.

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The relationship is what heals. The relationship is the most important predictor of a therapeutic outcome. Is it based on mutual respect? Is it collaborative? Are you together moving toward goals? Is it a safe environment where you feel understood? Where you trust this person to be honest with you in a way that you can manage? Is this someone who will repair with you?

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A therapeutic relationship is a relationship. This person is not a guru. This person is someone you are bringing into your inner circle as a trusted advisor. Yes, they are trained. Yes, they are an expert in things that you are not. They know about certain aspects of psychology that you don't know. It is also a relationship where you get to go to that person and say, hey, I didn't like it when you said this, I didn't understand it and it didn't sit right. Can we talk about it? 

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And that therapist needs to honor that. And they need to say, tell me more. This is a collaborative relationship. We've talked a lot on this podcast about the ways we can get hurt by pastors or ministry leaders or parents. Therapists also are in that mix where there's a certain power differential. A therapist is not perfect. They are not going to be perfect. 

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And, they absolutely need to be someone that you can go to honestly and say, hey, I didn't understand when you said that, or this isn't working for me. Can we shift gears or I want to bring something new to the table? It's up to the therapist to be an adult and say, I love that you're asking me this. I want to help you. That's not in my area of specialty, so I can't help you with that, but I would love to help you find someone who can. 

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Can they be a real person with you and listen to an honor what you need out of the therapeutic process? You are unique and healing is relational. You are unique. Your situation is unique and healing is relational. That relationship that you form is really important. It's more important in my opinion than years of experience or therapeutic modality. It's, can I trust this person? 

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Much of therapy is providing a reparative experience for those early childhood wounds. My guest Cindy Gao talked about the importance of those corrective emotional experiences with safe adults in Episode 67. And a therapist is trained to do that, to provide that corrective emotional experience. 

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Now here's the thing. They're not perfect, but that's part of the beauty of a therapeutic relationship. They're going to be ahead of you on the journey. They're going to be trained in ways you're not trained. They're going to have an expertise that you don't have. They are there for you. And can you also go to that person and bring your own needs, your own desires, even sometimes your own feelings of, I didn't understand that. Can you help me understand? A good therapist is going to earn your trust and join you there.

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How do you know it's a good fit? Here's what I tell everyone. This takes a little bit of work, and this is why I encourage you to do this work before you're in crisis. Call or visit two or three therapists in your area. And do an interview. Many therapists will do a short 20 minute phone interview for fit. Take them up on that, or schedule an appointment and say, listen, I want to have this one session to get a sense of who you are and for you to get a sense of who I am and see if there's a good fit.

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If a therapist doesn't like that, you might not want to work with them because that's a really normal and healthy thing to ask for. And you might do that with two or three and see who is a good fit. You're going in, you're inviting this person into your inner circle.

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Take some time to vet the person and get to know them. You can also, after a couple of sessions, reevaluate. You can break up with a therapist. It's okay. If you're in a few sessions and are like, this is not working for me, you can let them know. Hey, you know what? I'm going to move on.

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I want to empower you to know that a good therapist will honor that. They won't gaslight you in that. They won't second guess you in that. They'll honor that. They'll ask you helpful questions and they'll help honor your needs. 

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Here are some questions I want you to think about before you call that therapist so that you can ask them questions strategically. Do you prefer a structured approach where you want homework and you want exercises and you want goals at the end of each therapy session? Or do you lean toward a more open conversation? You want to go in and explore and talk and get insight. Think about that and then ask the person you're interviewing how they work.

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Not every therapist gives homework at the end of every session. If that's something you want, let your therapist know that before you sign up to work with him or her. 

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Do you want a therapist who is more directive, meaning they're going to use techniques, they're going to use interventions, they're going to give you guidance, or do you want someone who's more reflective, who's listening, who's more reflecting back what they hear? People want different things and your therapist doesn't necessarily know that. You have to ask them what their style is based on what you think is going to be most helpful for you. 

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Do you want a therapist who remains neutral and you don't really get to know them, or do you prefer someone who shares a little bit more of themselves, who's a little bit more relational in their approach? Are you looking for someone to build a long term relationship over time, are you looking for someone who's solution focused? 

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You're like, here's the problem that I have. I want to get in. I want to get out. Are you willing to work with me on that? I want to be more goal-oriented. These are all valid types of therapy, but these are questions to ask yourself before you make those phone calls.

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And then think about certain characteristics like gender. Do you prefer working with a man or woman? Age: do you want someone older or younger? Cultural background: do you prefer to work with someone who can understand your unique cultural experiences? Faith: we're going to get to that's our next question, but these are things to consider. They're really valid. It's okay to give yourself permission to seek out the type of therapist you think is going to feel safest to you.

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All right, the next question, number six, should I work with a Christian or not? My answer to this is, will the therapist respect your beliefs in your worldview? That's what's most important to me. Now, there are some people who would say, if you have a Christian background, you should only work with a Christian therapist.

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I'm not going to say that. The reason I'm not going to say that is that I know some exceptional therapists who are not coming from a Christian background and they can be really helpful to you and they will honor your faith. 

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Just because someone is a Christian therapist doesn't mean they're a good therapist or doesn't mean they're the right therapist for you. For me, the answer to that question is, will they respect your faith system or will they try to change it, stigmatize it, or criticize it? The number one thing to ask someone, if they are not from your same faith background is to say, listen, I need you to know up front, this is important to me. And can you respect it and honor it? 

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Conversely, if you go to somebody who's a Christian counselor, you might want to ask them, listen, this is what's important to me, but if you start doing this, it's going to be harmful to me. I need to know how you work. 

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Whether the therapist has a faith background or not, will they respect your value system, your belief system and work within it without necessarily trying to impose their values or their beliefs on you? It takes time to build up trust with the therapist. You really want to discern, is this person going to meet me where I am? 

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(29:33) Number seven. What's their approach? What's their modality? Which school of thought are they working with? Now, this is one of those filters. When you go to psychologytoday.com there's a lot of information. You've heard about a lot of different types of therapy. You might be interested in a specific type. 

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The main ones you might consider are: 

1. Couples therapy: You go to a couples therapist if you want the couple to be the center of the therapeutic invention. It's not so much about your individual needs.

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2. Family therapy: A family therapist is going to meet with the whole family and look at the family and try to create harmony in the family system. Also not so much about individual needs

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3. CBT/Cognitive Behavioral Therapy: this is one of the most well researched types of therapy. It's going to focus on thoughts and beliefs and how those thoughts and beliefs influence your emotion and your behaviors. We talked in episode 51 about those thinking traps and how to change them. This is right out of CBT. 

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4. Psychodynamic therapy. These are therapies that delve into the past more. They're looking at unconscious processes, things underneath the surface that you may not be consciously aware of that are driving your present behavior. 

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5. DBT/dialectical behavior therapy, which is a form of CBT, which brings in mindfulness strategies.

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Now you also might consider somatic therapies. Those other forms that I was talking about, CBT, DBT, psychodynamic approaches, these are what we call top down therapies. They start with your thoughts, with your emotions, with memories, beliefs, and then they move down into the way you experience the world, your embodied presence in the world.

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These are more insight driven therapies, these top down approaches. In contrast, bottom up therapies begin at the body or the sensory level and work their way up to influence emotions and thoughts. And a lot of these therapies were developed specifically with regard to trauma because so much of trauma is stored in the body.

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They're going to start by helping you pay attention to what you're feeling in your body, where you're carrying tension, where you're carrying heaviness. You're going to start with grounding techniques to keep you in the present moment to help you contain big emotions.

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Instead of going after the emotions, we're going to learn to pace ourselves in these bottom up in these somatic approaches. We're going to learn how to be in the present moment. I went through a couple of grounding in last week's episode 70. You might start with that, and as you become more aware of how to ground yourself in your body, then you might begin to link to different emotions.

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That's something to think about. Am I wanting something more insight driven? Do I want a top down approach where I'm going to tackle my thoughts or painful memories from the past? I've done talk therapy and what I really need is one of these bottom up approaches where I'm learning how to be in my body and ground myself so that emotions don't overtake me, where I can really regulate myself in any given moment.

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And finally a note about trauma-informed approaches. Trauma-informed approaches are not necessarily relegated to one particular type of therapy. There are some therapeutic approaches like EMDR, like somatic therapies, like certain types of CBT therapy that are explicitly designed to address trauma.

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But a trauma-informed approach can, and I believe, should be integrated into almost any therapeutic approach. A trauma-informed therapist is going to really prioritize the trust and transparency of that therapeutic relationship that we talked about. They understand and are trained to understand how deeply important that corrective emotional experience is in the therapeutic process. They're going to work really hard to build trust, to ensure safety, to ensure the pacing of the process doesn't outpace where you are and what your body can tolerate. 

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They're going to work collaboratively and mutually with you so that the process of therapy does not in any way, shape or form provide further injury because that can happen. And I hate it that it does, but it can. You can go to a therapist, and if they're not using the right technique and if you're not getting contained in the proper way, more emotion can come out than you are ready to manage. And a trauma-informed therapist understands that, and they're going to work with the pace of your body.

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They're going to look at these adverse childhood experiences, these ACEs that we talked about. This is a study I will link to in the show notes where they're going to look at these experiences from the past that so many of us have these big T traumas, these little T traumas that are still living in our body. And they're going to incorporate that understanding of trauma into the therapeutic process.

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For example, EMDR, which was developed in the 1980s. It's a technique used specifically to treat traumatic memories and PTSD. And it's a really beautiful protocol that can be so helpful with trauma. 

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Many IFS therapists are trained with a trauma informed approach. IFS is the topic of a whole six week series starting with episode 39, Boundaries for Your Soul, How to Navigate Your Overwhelming Thoughts and Feelings. That whole six week series is based on my book with Kimberly Miller. It's a Christ-centered adaptation of the Internal Family Systems model, but there's a lot of pacing in that model. 

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We don't go after those buried emotions without permission from the protective parts of your system in IFS. If you're an IFS certified therapist, you understand that people have coping strategies for a reason. And we've got to work slowly and delicately to replace certain coping strategies over time, while honoring the needs of the system. You may have coping strategies that you need to have in place before we go ripping those coping strategies away. 

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If you are aware that you've got big T, little T traumas in your past, look for somebody who is putting themselves out there as a trauma-informed therapist and is trained in some sort of somatic therapy, EMDR, IFS, maybe this very specific trauma informed version of CBT so that you know that they're going to be honoring the pacing that your whole system needs as you heal.

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Question number eight. Where do I start? You start with what you're dealing with right now. A good therapist, as I went through, will know how to pace you, will know how to take you where you need to go. Your job is to focus on what's the thing right now that's getting the best of me.

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What's the relationship, whether it's a friendship, whether it's a parenting relationship, whether it's your spouse, whether it's one of your own parents, it's getting the best of me. It's making me crazy and I need help. Start there. Just start there. It might be thoughts that you can't shake. Self-defeating thoughts. You can't stop comparing yourself with others. You can't stop shaming yourself. You can't stop beating yourself up. 

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Start there. It might be overwhelming emotions. Start there. A good therapist will know how to help you start where you are, ground yourself, pace yourself so that you can get to where you want to go. Start with the thing that is bothering you and a good therapist is going to help you get to the root of that problem and help you develop a plan to get where you want to go. 

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Number nine, how often should I go to therapy? This is something you're going to develop in partnership with your therapist, but I want to give you the different categories that you might consider. Increasingly, they're more and more intensive. These are where you can go somewhere for a week or two weeks to get intensive therapy. If you've been dealing with something for a long time, intensives can be super effective. They're very effective for couples therapy, where you get away from everything and you get right to the heart of the matter.

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In that one week, two weeks, you might even go to a month long recovery center. Those are what we call intensives. And I want to mention that because a lot of people don't realize that those are increasingly popular and increasingly accessible. 

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They tend to be more expensive. Obviously, they tend to take more time, but they can be really effective. And then we go to the more traditional model of weekly therapy. Most therapeutic modalities suggest a weekly starting point or possibly a bi-weekly, every other week. If you've done some therapy in the past but you still want some regular support, you might consider a bi-weekly option.

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Also, it's a great option if your finances are limited and you can't afford weekly therapy. Going to a therapist every other week is really helpful. A lot of clients maintain monthly therapy. This is when you're doing pretty well. It's called maintenance therapy, where you're not really diving into the deep end of your problems.

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You've done some therapy, you've gained some success, but you want to have that monthly check in to make sure someone is continuing to check in on you each month. And a lot of therapists will offer this. And then finally there's that “as needed” category, and this is what I was saying at the beginning when you've identified someone in your local community.

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This is a therapist that I can turn to when I need support. I've developed a relationship, but I don't really need to be in therapy right now. You talk to that therapist and you say, I think I'm finished with this leg of the journey with this particular need, but can I call you again on an as needed basis? Can I call you when a need surfaces? That gives you that option to return if a specific issue arises or for a periodic check in. 

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Finally, last question. How do I know when it's time to end therapy? And I love this question. It really depends, again, that relationship with your therapist. And that's why I've tried to equip you with all of this information. Because maybe you could go to maintenance, monthly therapy. Maybe you could go to an “as needed” basis. That might help you think about how to end therapy.

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Ending therapy can be really hard. It's a loss in many ways. A lot of people might continue on because they're afraid of losing that support. And if you're feeling that way, talk about it with your therapist. Let them know, this has been really helpful for me. I also want to move out of therapy.

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Can we start to talk about that? A good therapist will help you navigate ending therapy. It can be really important to come to closure with a therapeutic relationship. In fact, that in and of itself can be a really reparative experience. I actually went through an experience like that a year ago.

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I had started to see a therapist after my stroke. It was a new trauma. I'd never dealt with it. I formed a relationship with a woman. She was super helpful to me. But there came a point where it was important to me to end that relationship. And I'm terrible with closure in general, in my real life. It's hard for me.

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I decided to use that as an experience to practice. And I went to her and I said, I think I'm doing okay. But it's hard for me to say goodbye. Could we talk about that? And we had a couple of sessions, beautiful couple of sessions, where we navigated saying goodbye, where we honored the validity of a healthy closure.

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And it's one of the most meaningful experiences and it was the right thing to do. I said goodbye to her, but it became a positive experience of closure. I want you to think about that when you go into a therapeutic relationship. 

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Listen, it's okay if you simply can't afford it anymore or it's not working for you and you need to ghost a therapist. It's okay. We're trained. We can take it. It's okay. Sometimes that's what you have to do. And especially if that person really isn't helping you and you feel like they're going to twist it, you can fire your therapist.

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Just do it in whatever way you have to do. But if you've built a really beautiful relationship with that therapist and the thing that's keeping you from leaving the relationship is simply that fear of loss, that fear of letting go, talk to your therapist about that. Talk about a healthy closure.

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Even if you move to an as needed basis, it's a really beautiful experience to get to say goodbye to somebody in a healthy way. And a lot of us haven't had that experience. I encourage you actually to consider that as you consider the process of therapy. With that being said, I'm going to close this episode out by saying, if you're thinking about working with a therapist, ask yourself, what if this is a gift I could give myself for a specific period of time? 

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Dr. Alison's equipped me, I feel empowered, I can dictate some terms. Maybe I'll try it for two months. Maybe I'll try it for a certain length of time. I can say goodbye when I need to say goodbye. I can move to a rhythm that works for me. I can look for what I need and give it a try. 

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You are worthy of healing. You are worthy of wholeness. You are worthy of repairing those painful experiences from your past. I hope for you to have a beautiful therapeutic relationship at some time in your life. I don't wish for you the pain that led you to it, but I am so happy in advance for you the joy of a healthy, positive, healing, therapeutic relationship.