How to Select a Competent Therapist. 50 Essential Skills

Looking for a potential therapist? Whether your mental health conditions make you look for a mental health counselor, family therapist, professional counselor or other mental health expert, here is a list of 50 essential therapist skills to look out for. The skills are grouped by theme.

TL;DR

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Where to start

You can use the initial appointment with your mental health provider to assess their treatment approach. Obviously, there is a wide range of licensed therapists and other mental health service providers to choose from; not only psychologists and psychotherapists, but also medical doctors, primary care providers, social workers in mental health clinics and/or private practice.

Level of expertise and educational level (masters level clinicians, doctoral degree and advanced training) measure a certain level of knowledge, but the only way to find out if there is that click is to see the therapist in person - in a room or through one of the online therapy platforms.

I. Foundational Counseling and Therapy Skills

Possessing an attitude of respect and acceptance

Mental health professionals should demonstrate an unconditional positive regard for clients, accepting you as you are without judgment. I aim to have an approach to therapy that values your inherent worth and potential, fostering a safe and supportive environment where you feel comfortable exploring your thoughts, feelings, and experiences. In my experience, respect and acceptance lay the foundation for a strong therapeutic alliance. This leads to therapy sessions that facilitate trust and collaboration in the counseling process.

Understanding the client’s internal frame of reference.

This involves the therapist's capacity to perceive the world from the client's perspective, appreciating your values, beliefs, and cultural background. By stepping into your shoes, I can gain a deeper understanding of your experiences and challenges, fostering empathy and strengthening the therapeutic relationship. This skill enables me to tailor interventions that resonate with your unique worldview (and, as we have learned from the Internal Family Systems approach, with the unique worldview of your parts), promoting more effective and especially meaningful outcomes.

Building a collaborative working relationship.

A therapist should seek to establish a strong, cooperative partnership with the client. This involves open communication, mutual respect, and shared decision-making to create a personalized plan with clear goals for treatment. By working collaboratively, I see as my role to empower you to take an active role in your own healing and growth. The more you feel a sense of ownership and commitment to therapy, the more effective treatment will be. Evidence-based treatment protocols are essential, but they are only useful if they match your goals of therapy.

Ethical practice:

All therapists must adhere to ethical codes and guidelines to ensure client safety and well-being. Licensed providers are required to follow specific procedures, as defined by their licensing boards, including maintaining confidentiality, obtaining informed consent, avoiding conflicts of interest, and practicing within the licensed professional's scope of competence. Ethical practice builds trust and protects clients from harm, upholding the integrity of the therapeutic profession. So what to do if your mental health journey brings you to someone who is not a licensed therapist? I have learned a lot from the therapy process approach from a number of excellent alternative therapy providers and life coaches, so if you want to follow the alternative psychiatric practice route, make sure to do a good preliminary assessment of your potential therapist.

Diversity sensitivity:

Therapists need to be aware of and respect clients' diverse backgrounds, including culture, ethnicity, gender, sexual orientation, and socioeconomic status. This involves understanding how these factors may influence clients' experiences and tailoring interventions accordingly. Binary and nonbinary person alike, we all deserve a sense of safety. And when you experience that sense of safety, the sense of hope is just around the corner.

II. Communication and Active Listening Skills

Active listening:

This involves the therapist paying close attention to your verbal and nonverbal communication, demonstrating empathy and understanding. As a qualified therapist, I do my best to listen attentively, summarize key points, and ask clarifying questions to ensure I accurately grasp your message. My act of active listening helps you in your individual therapy to have a sense of being heard and validated. Common sense and evidence-based therapy research both show that this strengthens our therapeutic alliance. Better alliance, better psychotherapy outcomes.

Receiving voice messages accurately:

This involves paying attention to your vocal cues, such as tone, pitch, and emphasis. I often tune in even more to these nuances than to the actual words, in order to understand the emotions behind the words being spoken. Accurately receiving the meta communication behind the words enhances empathy and enables me to respond in a way that acknowledges your underlying feelings.

Receiving body messages accurately:

Therapists need to be skilled at observing clients' nonverbal cues, such as facial expressions, body posture, and gestures. These cues can provide valuable insights into clients' emotions and experiences, even when they are not explicitly expressed verbally. To me, the advantage of online sessions is that I can really zoom in on your facial expressions.

Paraphrasing:

Therapists should be able to restate clients' messages in their own words, demonstrating that they have understood the content accurately. Paraphrasing helps to clarify misunderstandings and ensures that both you and I are on the same page. Hearing your own thoughts through my voice can help you and your parts to better connect to your inner world.

Reflecting feelings:

This involves identifying and expressing the emotions that clients are conveying, both verbally and nonverbally. Therapists should accurately reflect clients' feelings to demonstrate empathy and create a safe space for emotional exploration. In Internal Family Systems reflecting feelings is an important part in the process of Parts Mapping.

Summarizing:

Therapists should be able to synthesize the main points of a session or a series of sessions, providing clients with a clear and concise overview of their progress. Summarizing reinforces learning, highlights key themes, and helps clients integrate new insights. Me as a therapist accurately summarizing helps you experience a sense of safety by seeing that I am actively engaged and attentive to your needs.

Questioning skills:

As part of compassionate care, a psychiatrist like me, a clinical psychologist, or any other type of individual therapist for that matter, should be able to ask open-ended questions that encourage you to elaborate on your thoughts, feelings, and experiences. Questions should be relevant, respectful, and designed to facilitate deeper exploration and self-discovery. Effective questioning skills help therapists gather information, clarify understanding, and guide you toward meaningful insights.

Challenging skills:

Therapists should be able to gently challenge your maladaptive thoughts, beliefs, or behaviors, encouraging you and your parts to consider alternative perspectives. Challenges should be presented with empathy and respect, aimed at promoting growth and change. Effective challenging skills help clients break free from limiting patterns and move toward healthier ways of thinking and behaving. IFS has taught me that it is important to realize that some of your parts may not be ready for change, and we should not force any part of you to adapt our way of thinking if they are not ready for it.

Providing feedback:

As a therapist I provide clients with constructive feedback on their progress, strengths, and areas for improvement. Feedback should be specific, honest, and delivered with sensitivity. Ideally I become your temporary mirror and you gain self-awareness and a sense of safety so you can reinforce positive changes, and address challenges yourself.

Self-disclosure:

A therapist should use self-disclosure judiciously to build rapport, normalize experiences, or provide encouragement. Self-disclosure should be genuine, relevant, and focused on the client's needs, rather than the therapist's. Appropriate self-disclosure can strengthen the therapeutic relationship and foster a sense of connection and trust.

III. Skills for Understanding and Assessing Clients

Assessing feelings and physical reactions:

You come to me to better identify, explore, and understand your emotions and bodily sensations. This involves creating a safe and supportive environment where you feel comfortable expressing your feelings without judgment. Assessing feelings and physical reactions provides valuable insights into your experiences and informs your conscious self about parts of you that may experience pain, loneliness, anger issues or confusion.

Assessing thinking:

This involves helping you to identify and evaluate your thoughts, beliefs, and cognitive patterns. A CBT therapist focuses on recognizing how your thoughts influence your emotions and behaviors, and in challenging maladaptive thinking patterns. Alternative therapy approaches such as schema therapy, ACT, mindfulness and Internal Family Systems try to influence this triad as well. What I like about these types of treatment is that they by definition incorporate previous life experiences as well, whereas cognitive-behavioral therapy (like exposure therapy for social anxiety disorder) has a tendency to stay in the here and now.

Assessing communication and actions:

Since we plan to spend our future time together as pleasant, safe, effective and efficient as possible, in the initial session and beyond, you and I should get an understanding of each other's communication styles and behavioral patterns. I can help you understand how you interact with others. In cognitive-behavior therapy you would then identify areas for skill development and behavioral change. In Internal Family systems we will try to match communication issues with behavior learned during previous life challenges, unburden parts involved, and find new roles for those parts and your self.

Forming hypotheses:

Therapists should be able to formulate informed hypotheses about the underlying causes and maintaining factors of clients' problems. This involves integrating information from assessment, clinical observations, and relevant theoretical frameworks. Together we will formulate a life story (how did you get to where you are now?) that guides treatment planning and helps us tailor interventions to address your specific needs.

Goal setting:

Therapists should collaborate with clients to establish clear, achievable, and measurable goals for therapy. Goals should be specific, relevant to your needs, and aligned with your values. Effective goal setting provides direction for therapy and helps us track your progress. Obviously, goals are not set in stone, and during the discovery process that is mental health counseling we may adjust the goals temporarily or permanently.

Problem clarification:

A therapist should be able to assist you in defining your problems in a clear, specific, and manageable way. This involves breaking down complex issues into smaller, more concrete components and identifying the key factors contributing to the problem. We want a clear focus for therapy and help you develop targeted solutions.

IV. Skills for Facilitating Change

Intervening:

This involves implementing therapeutic techniques and strategies to help clients achieve their goals. Interventions should be evidence-based, tailored to the client's needs, and delivered with competence and sensitivity. Effective intervening skills facilitate change and promote positive outcomes.

Cognitive restructuring:

A therapist should assist clients in identifying and challenging their negative or distorted thoughts, replacing them with more realistic and adaptive ones. This involves teaching clients cognitive techniques, such as thought records and cognitive challenging, to modify their thinking patterns. Cognitive restructuring promotes emotional well-being and helps clients develop a more balanced perspective. In many clients including trauma survivors, distorted cognitions have a role to protect against underlying pain. That is why I always focus both on the distorted thought and the reason why its there in the first place.

Behavioral activation:

As a therapist (and as a fellow human being!) I do my best to encourage you to engage in activities that are enjoyable, meaningful, or provide a sense of accomplishment. Scientific research confirms what our hearts tell us: behavioral activation increases positive reinforcement, improves mood, and promotes a sense of agency and control.

Relaxation techniques:

A therapist should train clients in relaxation techniques, such as deep breathing, progressive muscle relaxation, or guided imagery, to reduce stress and anxiety. This involves teaching clients how to activate their relaxation response and use relaxation techniques in their daily lives. Relaxation techniques promote physical and emotional well-being and enhance coping skills. They will also help you recognize the signs your inner emotional world sends you through your body.

Exposure techniques:

Cognitive-behavior therapy is used to gradually expose clients to feared stimuli or situations, helping them to overcome their anxiety and avoidance behaviors. This involves creating a hierarchy of feared stimuli and systematically exposing clients to each item, starting with the least anxiety-provoking. Exposure techniques help getting used to scary situations, reduce anxiety, and increase clients' confidence and ability to cope.

Mindfulness techniques:

One of the most profound changes in my life happened when one of my colleagues introduced me to mindfulness skills. This involves practicing techniques such as mindful breathing, body scan meditation, or mindful movement. It is such a mind blowing experience to be able to be aware of the present moment without judgment. Research shows that mindfulness promotes emotional regulation, reduces stress, and enhances self-awareness and acceptance.

V. Skills Specific to EMDR Therapy

Understanding EMDR therapy:

Therapists should have a thorough understanding of the theory and practice of EMDR therapy, including the Adaptive Information Processing (AIP) model, bilateral stimulation (BLS), and the eight phases of EMDR therapy. This knowledge is essential for effectively implementing EMDR and guiding clients through the process.

Applying Adaptive Information Processing (AIP):

The brain has a built-in system to transform disturbing information into adaptive resolution. Traumatic events disrupt this system, leaving traumatic memories stored without processing. EMDR therapy facilitates the processing of these memories, connecting them with adaptive information. This leads to a reduction in negative emotions and the emergence of positive insights and learning. Understanding AIP is critical for EMDR clinicians

Utilizing bilateral stimulation (BLS):

Therapists must be able to administer bilateral stimulation (BLS), such as eye movements, taps, or tones, to facilitate the processing of traumatic memories. Proper BLS technique is crucial for activating the brain's natural healing mechanisms and promoting adaptive resolution. While most therapists are trained waving our fingers in front of our clients' eyes, many of us practice using other BLS techniques as well.

Implementing the eight phases of EMDR therapy:

Therapists should be trained in implementing all eight phases of EMDR therapy, from history-taking and preparation to desensitization, installation, body scan, closure, and re-evaluation. Each phase plays a critical role in the EMDR process, and therapists must be able to guide clients through them effectively.

Processing present triggers:

Therapists should help clients identify and process present triggers that activate disturbing memories or emotions. Processing these triggers can reduce startle responses, avoidance behaviors, and other negative reminders of the traumatic experience.

Creating future template:

Before treatment is complete, I always try to assist my clients in creating a future template for each present trigger. As the name implies, the future template helps to use desired responses for coping with triggers in the future.

VI. Skills Specific to IFS Therapy

Understanding IFS:

Obviously, therapists should be well-versed in the core concepts of IFS, including parts, Self, and the non-pathologizing approach. This knowledge is essential for effectively applying IFS principles in therapy. It is impossible to learn IFS without experiencing IFS from the client perspective, either in a group or in one-on-one therapy with an experienced IFS therapist.

Applying a non-pathologizing approach:

In IFS, therapists view parts as protective rather than pathological. This non-pathologizing approach fosters compassion and acceptance, creating a safe space for clients to explore their inner world. All part have the intention to do well, but the behavior they have learned to reach that goal may not suit you well in your current life.

Helping clients differentiate parts:

Therapists should guide clients in identifying and differentiating their various parts, recognizing their unique roles, motivations, and perspectives. This process helps clients understand the internal system and develop a more compassionate relationship with their parts.

Facilitating access to Self:

Therapists should help clients access their Self, the core of wisdom, compassion, and connectedness within each individual. This involves creating a safe and supportive environment where clients can unblend from their parts and connect with their Self-energy.

Working with challenging parts:

Therapists should be skilled in working with challenging parts, such as protectors and exiles, using compassion and understanding. This involves validating the parts' concerns, addressing their fears, and negotiating for more adaptive roles.

Trusting the client’s Self:

Therapists express complete trust that the client will know what to do once they have accessed their Self.

VII. General Therapist Qualities and Skills

Empathy:

A therapist should demonstrate empathy by understanding and sharing the feelings of their clients. This involves actively listening, reflecting emotions, and validating clients' experiences. Empathy fosters a strong therapeutic alliance and creates a safe space for clients to explore their vulnerabilities.

Authenticity:

A therapist should be genuine and authentic in their interactions with clients. This involves being honest, transparent, and congruent in their words and actions. Authenticity builds trust and allows clients to connect with the therapist on a deeper level.

Cultural competence:

A therapist should demonstrate cultural competence by understanding and respecting the diverse backgrounds and experiences of their clients. This involves being aware of one's own cultural biases and assumptions and adapting interventions to meet the unique needs of each client. Cultural competence promotes equity and ensures that all clients receive culturally sensitive and effective care.

Flexibility:

A therapist should be flexible and adaptable in their approach, tailoring interventions to meet the changing needs of their clients. This involves being open to new ideas, theories, and methods and being willing to adjust the treatment plan as needed. Flexibility allows therapists to provide personalized care and maximize the effectiveness of therapy.

Intuition:

A therapist should trust their intuition and use it to guide their clinical decision-making. This involves paying attention to subtle cues and hunches and using them to inform their understanding of the client and the therapeutic process. Intuition, combined with clinical knowledge and experience, can enhance the therapist's ability to connect with clients and facilitate meaningful change.

Maintaining boundaries:

Therapists must establish and maintain clear professional boundaries to ensure client safety and prevent exploitation. This includes avoiding dual relationships, maintaining appropriate physical and emotional distance, and adhering to ethical guidelines. Maintaining boundaries protects the integrity of the therapeutic relationship and fosters trust and respect.

Self-awareness:

Therapists need to be aware of their own thoughts, feelings, and biases and how these may impact the therapeutic process. This involves engaging in self-reflection, seeking supervision, and addressing personal issues that may interfere with their ability to provide effective care. Self-awareness promotes objectivity and helps therapists avoid projecting their own issues onto clients.

Continuing professional development:

I love engaging in ongoing learning and professional development to stay up-to-date with the latest research, techniques, and ethical guidelines. For most therapists, licensing procedures require attending conferences, workshops, and training programs, as well as seeking supervision and consultation. I depend on continuing professional development to provide competent and evidence-based care. But at least as important, staying in touch with colleagues and being able to learn from role models keeps the job fun and engaging.

VIII. Skills for Online Therapy

Computer literacy:

Therapists must have a minimal level of computer literacy to provide safe and confidential services online. They should be able to troubleshoot technical problems, edit, and manage online platforms effectively. As we all work with online medical records, calendars, communication devices and billing tools, the same skills are essential for those seeing clients in office.

Excellent writing skills:

Online therapists must possess good writing skills to communicate effectively in text-based formats. They should be able to convey tone, mood, and empathy through their writing, creating a supportive and engaging online environment.

Text-based bonding:

This refers to the ability to establish a therapeutic alliance with clients through written communication. Therapists should be skilled at engaging clients, hearing their concerns, and providing guidance and support in a text-based format.

Managing misinterpretations:

Texting and email can be easily misinterpreted especially when messages are taken out of context. I have learned that as a therapist I have to be extremely aware of the potential for misinterpretations in online communication, especially with humor, sarcasm, and with the current political and societal sensitivities.

Assessing online environment:

Therapists should use appropriate assessment tools to determine which online environments are best suited for specific client needs. This ensures that clients receive the most effective and appropriate care in the online setting.

These are some of the essential skills for therapists to provide effective and ethical care to their clients. I see it as my task to keep developing and refining these skills, so I can create positive change in the lives of my clients. Now how to develop and refine those skills is another great question, and if time permits I will come back to that question later.

Now that you've come this far

Let's get in touch. I will send you my list of 50 essential therapist skills in a neat pdf.

Michiel Bosman MD PhD

EMDR- and IFS-trained Psychiatrist