Finding a therapist can feel a little like online dating. You read their profile. You overanalyze their photo. You wonder if you’re going to have anything to talk about. You have an initial conversation.
And afterward, you’re left wondering:
“Was that good?”
Finding the right therapist isn’t always easy. And when you’re already anxious, choosing someone to talk to about your deepest fears, intrusive thoughts, or struggles can feel like a lot of pressure. But how do you actually know if a therapist is a good fit? Do you need to immediately feel comfortable? Should you leave every session feeling better? Is it a bad sign if your therapist challenges you? The answer is a little more complicated than simply asking whether you “like” your therapist.
You Don’t Have to (and should not be!) Be Best Friends With Your Therapist
This might be controversial, but you don’t need to want to invite your therapist over for dinner. You also don’t need to have the same personality. Your therapist can be quieter than you. More direct than you. Less direct than you. Older or younger than you. What matters more is whether you feel respected and whether you can communicate honestly. A good therapeutic relationship doesn’t require you to agree on everything.
In fact, you should feel comfortable enough to say:
“I don’t think that helped.”
“I’m not sure I agree.”
“I feel like we’re missing something.”
“Can you explain why we’re doing this?”
If you can have those conversations, that’s often a very good sign.
Feeling Uncomfortable Doesn’t Mean It’s a Bad Fit
This is especially important when treating anxiety and OCD. Good therapy can be uncomfortable. Talking about things you’ve avoided can feel uncomfortable.
Changing long-standing patterns can feel uncomfortable. Exposure therapy is literally designed to help you approach things that make you uncomfortable.
So if you leave a session thinking, “Wow, that was hard,” that doesn’t necessarily mean your therapist is doing something wrong. The question is whether the discomfort feels purposeful and collaborative. Do you understand why you’re being challenged? Does the treatment approach make sense? Do you feel pressured or forced? There’s a difference between a therapist helping you stretch outside your comfort zone and a therapist ignoring your boundaries.
You Should Understand What You’re Working On
You don’t need a detailed treatment manual in your inbox.
But you should understand:
What you’re working toward
Why your therapist is recommending a particular approach
What progress might look like
What you’re expected to practice outside of sessions
If you’re receiving treatment for anxiety, it’s reasonable to ask: “What approach are we using?” “How does this help anxiety?” “How will we know if I’m improving?”
A good therapist should be able to answer those questions. Therapy shouldn’t feel like showing up every week, talking for an hour, and hoping something eventually changes.
Look at Whether Your Therapist Understands Your Actual Problem
This is a big one. A therapist can be wonderful and still not be the right therapist for your particular concern. For example, a therapist may be excellent at treating generalized anxiety, but not have specialized training in OCD. OCD requires a different treatment approach. Similarly, someone who specializes in anxiety may
not necessarily understand how ADHD-related executive functioning challenges or autism can contribute to someone’s distress. That doesn’t make them a bad therapist. It just means specialization matters. If you’ve been in therapy for months and feel like you’re repeatedly explaining your symptoms, or feel like the therapist is trying to fit everything into a treatment model that doesn’t make sense, it may be worth asking more questions.
Your Therapist Should Be Willing to Reevaluate
Therapy isn’t supposed to be: “Well, this is what we’re doing forever.” If something isn’t working, it should be okay to talk about it.
A good therapist should be willing to ask:
Are we making progress?
Are we focusing on the right goals?
Is there something we’re missing?
Would another approach make more sense?
Is another type of support needed?
That doesn’t mean treatment should be abandoned the moment something becomes difficult. Sometimes progress requires sticking with something uncomfortable.
But if you’re genuinely not improving, the answer shouldn’t always be: “Just keep doing the exact same thing.”
You Should Feel Respected
You don’t have to agree with your therapist all the time. But you should feel respected. That means your therapist shouldn’t shame you for struggling. They shouldn’t make you feel stupid for asking questions. They shouldn’t dismiss your concerns. And they shouldn’t act like they’re the unquestionable authority on your life. Good therapy is collaborative. Your therapist brings clinical knowledge and experience. You bring expertise about your own experiences. Both matter!!!
Progress Matters, but It Doesn’t Always Look How You Expect
Progress in therapy isn’t always obvious. You might not suddenly wake up one morning feeling completely different.
Sometimes progress looks like:
Recovering from anxiety faster
Avoiding fewer situations
Asking for less reassurance
Recognizing patterns sooner
Being willing to try something difficult
Having fewer compulsions
Handling emotions without immediately reacting
Feeling more confident making decisions
And sometimes therapy gets harder before it gets easier. This is particularly true when you’re changing behaviors that previously helped you avoid discomfort. The goal isn’t necessarily to feel amazing after every session. The goal is to gradually build skills and make changes that improve your life outside the therapy room.
Red Flags to Pay Attention To
Not every uncomfortable therapy experience means something is wrong. But there are situations worth paying attention to.
Consider asking questions or seeking another opinion if:
You consistently feel judged or shamed
Your therapist dismisses important concerns
You don’t feel safe discussing disagreements
Boundaries feel inappropriate
Your therapist repeatedly practices outside their area of competence There is no clear explanation of the treatment approach
You have significant concerns about confidentiality or professionalism You repeatedly raise concerns about lack of progress and they’re ignored
You don’t have to convince yourself to stay in a therapeutic relationship that genuinely doesn’t feel right.
Give It Enough Time to Know
One session isn’t always enough to know whether someone is the right fit. First sessions can be awkward. You’re talking to a stranger about personal things. Your therapist is gathering information. You may not leave feeling dramatically better. That’s normal. During first sessions I have with clients, my goal is to give
them hope that we are going to figure this out. You should leave your first session with hope. Give yourself enough time to get a sense of the relationship and treatment approach. But don’t fall into the opposite trap either, staying for years because you feel guilty about leaving or it feels hard to start over again with someone new. You are allowed to change therapists. You are allowed to ask for a referral.
You are allowed to say: “I don’t think this is the right fit for me.”
A good therapist should understand that finding the right match matters. It is a problem in the therapy field that not all therapists speak up when they do not know how to help someone. That is where it can be helpful for the patient to be say, “This is not working for me.”
What if You’ve Tried Several Therapists and Nothing Has Worked?
This can be incredibly discouraging. After multiple unsuccessful therapy experiences, it’s easy to conclude: “Maybe therapy just doesn’t work for me.” But before giving up, it can be helpful to step back and look at the bigger picture. You can look at: What type of therapy were you receiving? Was it evidence-based for the problem you were experiencing? Were you working on behavioral change or primarily talking about your feelings? Was OCD recognized? Were ADHD or autism-related challenges contributing to the problem? Did you have clear treatment goals? Were you able to practice things outside of therapy?
Sometimes the problem isn’t that therapy doesn’t work. Sometimes the treatment wasn’t targeting the right thing.
Trust Yourself, but Ask Questions Too
Your instincts matter. If something consistently feels wrong, pay attention to that. But also remember that anxiety can sometimes make anything unfamiliar feel unsafe. The goal isn’t necessarily to find a therapist who never challenges you or makes you feel uncomfortable. The goal is to find someone you trust enough to work through discomfort with.
A good question to ask yourself is: “Do I feel like this person understands what I’m trying to work on and has a thoughtful plan for helping me get there?” That’s often more useful than: “Do I feel comfortable every single minute?”
The Bottom Line
The right therapist doesn’t need to be (and should not be!) your best friend. You don’t need to leave every session feeling amazing. And therapy doesn’t have to feel comfortable all the time to be effective. What matters is that you feel respected, understand the general direction of treatment, and trust that your therapist understands the concerns you’re working on.
A good therapeutic relationship should give you space to be honest, ask questions, disagree, and talk openly about whether treatment is helping. And if something isn’t working? You are allowed to talk about it. You are allowed to ask why. And you are allowed to explore other options. Finding the right therapist isn’t about finding a perfect person. It’s about finding someone who understands the problem you’re trying to solve and can help you move toward meaningful change.
Looking for an Anxiety or OCD Therapist?
I provide virtual therapy for children, teens, and adults throughout Connecticut and New York. My approach is collaborative, practical, and grounded in evidence-based treatment for anxiety and OCD, including CBT, exposure-based therapy, and ERP.
I also believe that therapy should involve looking at the bigger picture. Anxiety doesn’t always exist in isolation, and understanding factors such as ADHD related challenges, autism, social difficulties, executive functioning, and previous treatment experiences can be important when determining the right approach.
If you’re unsure whether therapy is the right next step, or you’re trying to figure out why previous therapy hasn’t worked, Care Navigation consultations can help you organize your questions and explore potential next steps.
Your cheerleader, Andrea