How to choose a therapist: license, competence, fit and switching

By CBT Guide USA editorial team · Updated 2026-11-08 · Editorial policy

Choosing a therapist comes down to four checks: are they licensed, can they legally see you where you live, do they have experience with your problem, and do you work well together.

Step 1: Verify the license

The National Institute of Mental Health notes that most psychotherapy is delivered by licensed mental health professionals, including psychologists, social workers, counselors, marriage and family therapists, psychiatrists and psychiatric nurses. It also notes that it does not evaluate individual practitioners, so the check is up to you.

Licenses are issued by state boards, usually one board per profession. To look one up:

1. Get the details. Ask for the therapist's full name, license type and license number. Many list them on their profile. California, for example, requires telehealth providers to give clients their license or registration number and type.
2. Find your state board. Search for "[your state] board of [profession] license lookup", for example "Texas board of social work license verification" or "Ohio counselor license lookup". Make sure the result is a state government site (often ending in .gov).
3. Check the record. Confirm the license is active, the name matches, the license type allows independent practice (some titles are for supervised trainees), and look for any disciplinary actions.

Titles and board names vary by state; the table is a general guide.

Step 2: Check they can see you in your state

For telehealth, what usually matters is where you are during the session. In general, the therapist must be licensed, or otherwise legally permitted, to practice in that state. California's Board of Behavioral Sciences, for example, requires a California license or registration to provide therapy to clients located in California, and says its own licensees may only treat clients in another state if that state allows it.

Interstate compacts are expanding cross-state practice for some professions. The Counseling Compact lets licensed professional counselors in member states apply for privileges in other member states, and lists which states are live. If you move or travel, tell your therapist; it may affect whether they can keep seeing you.

Step 3: Check competence for your problem

A license shows a therapist is qualified to practice. It does not show they are experienced with your specific issue. Ask:

• "How often do you work with people with [depression, panic, grief, trauma...]?"
• "What approach would you use, and what is the evidence for it?"
• "What training do you have in that approach?"
• "How will we measure progress?"

NIMH suggests similar questions. For common problems like depression, several therapies have good evidence. CBT is the most studied, but a 2023 meta-analysis found its advantage over other psychotherapies for depression was small and not robust (Cuijpers et al., 2023). So a well-delivered, evidence-based approach that suits you matters more than a brand name. Some problems, such as eating disorders, OCD or trauma, often benefit from therapists with specific training. Learn more in what is CBT.

If you may need medication, you also need a prescriber (a primary care provider, psychiatrist or psychiatric nurse practitioner). Most therapists, and most online therapy subscriptions, do not prescribe.

Step 4: Judge fit

Fit is personal. After the first one to three sessions, ask yourself:

• Do I feel listened to and taken seriously?
• Do we agree on what we are working on?
• Do I understand the plan and what I am supposed to do between sessions?
• Can I disagree or give feedback without it going badly?
• Are practical things working: times, response speed, format?

Use our first session checklist to prepare questions in advance.

When and how to switch

Consider switching if, after a few sessions, you still do not feel understood, there is no clear plan, or you are not seeing any change and your therapist does not adjust. For depression, NICE recommends that treatment progress is reviewed 2 to 4 weeks after starting. That review is a natural point to raise concerns.

• Tell your therapist first if you can. Sometimes a direct conversation fixes the problem.
• On an online platform, you can usually request a new therapist from your account. Online-Therapy.com, for example, says you can switch therapist at any time from your dashboard; it assigns therapists rather than letting you pick a named one up front. Read more in our Online-Therapy.com review.
• In private practice, ask for referrals, and ask for your records to be shared if useful.

Red flags

• Will not give a license number, or the license is not active.
• Promises a cure or guaranteed results.
• Pressures you to buy extra services or long commitments.
• Crosses personal boundaries, or dismisses concerns about safety.
• No clear plan for emergencies.

If you have concerns about a licensed professional's conduct, your state licensing board handles complaints. If you are in crisis, do not wait for an appointment: call or text 988 in the US, or call 911. See crisis resources.

Next steps: if you are looking for help with low mood, see online therapy for depression. If cost is a concern, see what online therapy costs and our lower-cost care options. For how sessions and messaging work, read how online therapy works.