by Rachel Porter, PsyD

To Catch A Therapist


RachelS1Rachel Porter, PsyD. is Clinical Director at Carolina House’s Residential facility in Durham, NC. In 2005, while in graduate school, Rachel obtained a job as a Counselor at The Renfrew Center and discovered her passion for working with individuals with eating disorders. Since then, she has worked tirelessly in the field of eating disorders, and has developed a passion for the Health at Every Size paradigm and Size Acceptance movement. She strives to help people discover that self-love and health are not size dependent. In her spare time, Rachel loves reading, yoga, hiking and spending time with her cat and her husband.


To Catch A Therapist: How to Find the Right Therapist for You and Your Body

Walking into a psychotherapist’s office can be an incredible and emotional experience. It can also be downright hard. Let’s look at all it takes just to get in the door:

First, you’ve got to choose to go get help. You’ve got to make a choice that, to a far-too-large part of society, is a bit taboo.

Then, you’ve got to actually select a therapist! And what a task – where to even start? Unfortunately, the first thing many of us have to start with is checking who is covered by individual health care plans… or who will work on a sliding scale or is most affordable for people who perhaps do not have health insurance. While this is not the most ideal way to select a psychotherapist (or, perhaps, any healthcare professional – but that’s another blog for another day), it’s the realistic way for the majority of people.

From here, you at least have a list of names, addresses, and, if you’re lucky, some specialties. At this point, it may feel like the best thing to do is throw a dart at the sheet of paper and see what you hit. Unfortunately, this method will probably not end up finding the best match for you. Instead, I’d suggest picking up the phone and starting to call around, asking questions that are important to you when selecting a therapist- someone that, ideally, you’ll feel safe to be extremely vulnerable with. Perhaps you have all kinds of questions on your mind as you consider taking this important step in self-care: Will s/he understand me? Will I feel able to be honest? Will I get the help I need? Will I be safe? These are all questions that exist for people the first time they go see a new therapist, and they can be quite scary.

But then add being fat (used here, and throughout, as a neutral descriptor, much like one might use the word “tall” or “blond”) to this experience, and a whole new world of uncertainties might open up. These can range from the logistical (“Will there be a seat in which I am comfortable?”) to the emotional (“Will this person accept me and see me for who I am at any size?”) and even to the semi-political (“Will this person stand for or against me?”). And when these are the questions swirling in your mind, those first and incredibly important quandaries (you know, the ones about understanding, safety, and honesty) suddenly become laden with even more meaning. For many, and especially for those who face weight stigma, the questions of safety become not just about their emotions or their words, but also about their bodies.

It is for these people that I write, and for these people that I suggest asking the following questions to find a therapist you can feel truly safe with:

  • Do you know about Health at Every Size®?
    1. If yes: Do you use it in your treatment?
    2. If no: Are you willing to learn about it?
  • Do you try to encourage people to change their bodies through weight loss?
  • Do you ever prescribe diets?
  • Do you work with a dietitian/MD who practices Health at Every Size/Intuitive Eating? (This question is particularly important for individuals who have eating disorders or disordered eating and need dietetic counseling & medical support in addition to psychotherapy.)
  • How will you work with me on my health goals?
  • Are you open to working with a team of other professionals (i.e., dietitian, psychiatrist, MD)?
  • I need X type of furniture/physical accommodation in order to feel comfortable. Is this going to be available to me? (This may be something along the lines of armless furniture, or furniture that will support over a certain weight, or a handicap ramp, or any number of other needs).
  • My partner/family member/supportive friend would like to get some education about how to help me. Can you recommend someone that will do this in a nonjudgmental, intuitive approach fashion?

These are just some of the questions you might want to ask. My strong encouragement to you is this: Do not be afraid to ask these questions. They are important, and your needs matter.

If the answer is any variation of “I can’t support you…”, that is OK- you can find another therapist. People often forget when they are selecting a medical professional that they are the customer, and these people can (and are encouraged to) “shop around” as much as needed to find just the right fit for them. You are worth the time this will take. I promise.

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