One of the most challenging and important steps in seeking treatment for yourself, a family member or a child who has mental health or trauma-related issues, is to find a therapist. Working with a practitioner who is experienced and competent but also offers connection, comfort, caring and understanding, can make all the difference.

Over the past 60 years, hundreds of studies on psychotherapy outcomes have determined that the factor most often associated with successful therapy is always the same—the quality of the client/therapist relationship. The therapeutic relationship is more important than the theoretical orientation or particular methods used.

Furthermore, research shows that it is the patient’s perception of the quality of the relationship that is the key predictor for treatment success and a powerful curative factor. Since interpersonal trauma is created by hurtful relationships, the “cure” requires a relationship that has the same ingredients as a healthy (“secure”) parent-child relationship:

  • Trust
  • Safety
  • Empathy
  • Emotional attunement
  • Limbic resonance
  • Support

In a good relationship, the therapist functions as a secure base for the client. They possess the same characteristics as secure attachment figures. For children, attachment figures provide a secure base so that they can explore, learn, and develop in healthy ways. Similarly, a therapist serves as a reliable and trustworthy figure who helps clients learn to acknowledge and discuss feelings and experiences that were denied and avoided, and to try out new behaviors, mindsets, and relational patterns. The therapist’s support and acceptance help reduce anxiety and distress, so clients can understand prior and current relationships and begin the process of change.

Many qualities make therapists a secure base. They are emotionally available, sensitive, and responsive in predictable and consistent ways. They are attuned to a client’s needs and emotions, both verbally and nonverbally. Therapists provide empathy, understanding, support, encouragement and positive mentoring. They mitigate anxiety, stress, and emotional pain, and facilitate new solutions and experiences.

When the relationship is good, the therapist and client establish a positive working alliance, a psychologically protective holding environment. They experience mutual respect and a general agreement on the goals and tasks of treatment, making decisions together and both having a sense of ownership for the treatment. The client should feel empowered to communicate openly and honestly about what is working and what is not.

Finding the Right Fit

It may take time to find a therapist who is the right fit and with whom you (or your child) can build a strong therapeutic relationship. There are some simple steps that you can take at the beginning of your search to facilitate the process:

1. Before meeting with a practitioner, research them. Make sure they have the experience and expertise you are looking for. Read their reviews.

2. Get an initial impression through a phone conversation before scheduling an appointment.

3. After a therapy session, ask yourself: Does the practitioner seem genuinely interested? Do they seem to really care about your (or your child’s) wellbeing? Are they listening and do you (or your child) feel heard? Do they appear to be a good communicator? Are they mindful of all aspects of your (or your child’s) identity? Are they easy to talk to? Are they open to input or feedback? How do you (or your child) feel after the session? Is there a connection?

4. Trust your gut. Although it is natural for initial sessions to feel awkward, if you continue to feel uncomfortable or unsettled, you may need to keep looking.

Studies show that you should give a therapist at least three opportunities before deciding whether a positive and helpful therapeutic relationship can develop. If the therapist does not seem to be meeting your needs, communicate your concerns. They may be able to make changes that improve the situation or they may recommend another mental health professional who they know would be a better fit for you.