How to build confidence as a therapist

Hands shaking, heart pounding, profusely sweating – these are some of the things I experienced when I was faced with my first patient ever.

I was sure she was going to judge me and think that I actually wasn’t supposed to be there; or that in the middle of the session, something would happen that would make me completely lose the grip of the situation.

But that didn’t happen!

Things went on great – not perfect, but certainly better than I expected!

And I’ll be sincere… this wasn’t even my first real patient; it was only a roleplay. So you can imagine how nerve-racking it was for me to get face to face with real clients.

In the middle of all this nervousness and insecurity, I try to keep one thing in mind: we’re simply humans connecting with other humans that need our help. This humanity lets us create meaningful relationships with the clients, and at the same time, it makes us open to mistakes and doubts – and that’s ok!

In this article, we’ll discuss how to keep this excruciating self-doubt as a therapist in check, and the ways that lead to a more confident practice.

Getting to know self-doubt

Self-doubt is a deeply uncomfortable feeling and, even though it’s not restricted to therapists, it’s especially distressing to feel incompetent as a counselor. There are plenty of reasons to choose from on why we feel this way: pressure to deliver the right interventions, fear that we won’t make a difference, desire to see concrete change…

It can sometimes feel like we’re alone in suffering from self-doubt, but it’s much more common than we think. For beginners, the lack of experience can affect the person’s confidence and make them feel like what they’re doing is not enough. For more experienced therapists, they may come across a more difficult case or situation where the feeling of not knowing enough comes back.

For therapists who are just starting, self-doubt is concerning when perceived as permanent and out of their control. This can negatively impact their brand-new practice, promoting feelings of hopelessness, detachment from the patient, and isolation. However, if the therapist perceives this feeling as temporary and controllable, it can become a powerful tool during the learning process, serving as fuel to obtain more knowledge. This checks out with the study ‘Feelings of Incompetence in Novice Therapists: Consequences, Coping, and Correctives‘, which further discusses the novice therapist’s challenges.

Still, what matters most when tending to a client is not how much experience or training a therapist has or how many certificates they have on their wall. Rather what is important is their personal and interpersonal qualities, such as a capacity for affirmation, responsiveness, genuineness, and empathy. This means that novice and seasoned therapists alike must grow their confidence with their interpersonal qualities in mind, rather than accumulating knowledge detached from reality.

Another comforting idea to have in mind is that sometimes, your clients never had someone that listens to them as a therapist does – so the simple act of being there for them plays a huge part in their improvement. If you’re not breaking ethical guidelines or harming the client in any way, there’s a big chance that they’re benefiting from therapy already. Being supportive and connecting with the client is one of the biggest parts of the job.

Imposter Syndrome is real – even for therapists

One of the ways self-doubt can paralyze you is through Imposter Syndrome, a term coined in the 70s by psychologists Suzanne Imes and Pauline Rose Clance.

APA states that “imposter phenomenon occurs among high achievers who are unable to internalize and accept their success. They often attribute their accomplishments to luck rather than to ability, and fear that others will eventually unmask them as a fraud.”

Not everybody that experiences self-doubt as a therapist has Imposter Syndrome, but those suffering from this phenomenon deeply doubt themselves. Especially for therapists, it can take the form of feeling incompetent or not feeling up to the task, leading to a sense of unworthiness or numbness. In some cases, it can even be accompanied by anxiety or depression.

Whether you’re suffering from low confidence issues or Imposter Syndrome (or both), learning how to overcome your worries and grow your confidence is central to a thriving practice.

This is easier said than done, so how can we do this? Well, let’s get to it!

How to gain confidence

Therapists know better than anyone the difficulty of changing a belief that has been cultivated over time, and managing self-doubt is no different. When you’re suffering from low-confidence, you believe that you’re not enough or maybe not capable of making a difference. While these are beliefs that take time and effort to change, the result of changing them definitely pays off.

To achieve this result, here are the main ways that you can face your self-doubt and build your confidence.

Be self-aware

To start, understanding that it’s possible to help others and still have problems of your own is a valuable lesson. This helps you realize that, even though you’re dealing with your own issues, your abilities and knowledge provide you with all the tools necessary to do a good job.

This way, it’s not expected that you live a problem-free, unattainable life- but rather that you’re aware of your own blind spots and work on them the best way you can. Odds are, if you’re reading this article, you’re already on a good path!

For example, a twice divorced therapist is sought out by someone who’s looking to solve their marital problems. In this case, the therapist may feel incapable of helping this client because of their own personal problems and, consequently, doubt their professional abilities.

The therapist might wrongly think: “who am I to help this person if I can’t even help myself?”

Now, if the professional is aware of where these negative feelings are coming from, they’ll keep their problems out of the setting or manage them better when they appear. Taking the example above, the therapist would be aware that these feelings of incompetence, when faced with a patient’s marital problems, were triggered by unresolved issues in their past.

Once the therapist knows what their triggers are, they’ll focus on the patient and feel much more confident in their professional abilities. This relates to keeping boundaries between your personal and professional life, making it much easier to concentrate on patients’ demands.

Practice self-compassion

Self-compassion is a big part of building confidence, as it means having the same compassion for yourself as you have for others. It involves embracing imperfection as part of the human experience and understanding that you won’t stop making mistakes, but rather do the best you can in the situations you find yourself in.

Self-compassion can help reduce feelings of self-doubt because it gives you the perspective that it’s okay if you don’t say the perfect thing or know everything there is to know about the theory- you’ll learn from these experiences and come out stronger and sharper because of it.

And, even then, you won’t stop making mistakes! What kind of therapist would you be if you encouraged clients to strive for perfection, for example? If it’s not healthy for them, it’s sure as heck not healthy for you either. Both of you are human, after all!

As an exercise, when you’re faced with situations where you feel incompetent or are heavily criticizing yourself, ask: “What would I say to a friend or colleague if they came to me asking for advice on this?”. I bet you’d be way kinder to them, than yourself.

Let’s say, during a session, you accidentally call a client by the wrong name. At this moment, a million things go through your head – most of them bad and self-accusatory. You chew on this moment for days, replaying it over and over in your head, assuring yourself that your client will hate you for it as much as you hate yourself for it.

Now, if this had happened to a colleague and they’d asked for your opinion, you’d probably be way more forgiving. You could’ve said: “Relax, you were tired that day!” or maybe “It’s not that big of a deal, mistakes happen!”

If you’d say things like that to other people, why don’t you say it to yourself?

You’re only a human being that made a mistake – apologize, learn from it, and move on! A good amount of self-doubt is released when you begin to accept your errors and view them as an opportunity for growth.

Make friends with doubt

Being self-confident is an amazing feeling; I mean, that’s why I’m writing this article in the first place! However, beware of a therapist that is 100% sure about everything – this suggests an arrogance that isn’t compatible with a good practice.

Self-doubt, when experienced in moderation, can actually be a great asset for your practice, keeping a therapist both humble and attentive. The study ‘Love Yourself as a Person, Doubt Yourself as a Therapist?‘ shows that.

Therapists that reported having more professional self-doubt than others presented a better patient outcome, according to these findings. The patient presented an even bigger change if, along with self-doubt, the therapist showed a strong self-affiliation. We’ve covered self-doubt already, but self-affiliation is a feeling of tolerance and care towards oneself. It’s believed to come from how a person was treated by their primary caregivers, and it influences how a person treats others. In more than one aspect, it strongly resembles self-compassion.

Back to the study, if a therapist were to present a high level of self-affiliation combined with a low level of professional self-doubt, the outcome wasn’t as successful. The authors theorized: “The findings imply that a healthy self-critical stance is an ingredient of successful professional role performance but that treating oneself as a person with care and nurturance but lacking capacity to critically evaluate (i.e., doubt) one’s therapeutic work, is not.”

For example, I had a college colleague who never revaluated his work or second-guessed his actions; he was always right about everything as far as he was concerned. In turn, he never got nervous during internships or practices, whereas I constantly revised protocols, questions I had to ask, all sorts of things, in fear of making mistakes.

One day, we had to apply a complicated test on a patient. We did it, then corrected and interpreted. It turns out, my colleague was so sure he’d do everything right that he missed a bunch of important rules when administrating the test. As for me, I was so afraid I’d administrate the test wrong that I had the manual memorized from start to finish, so when the moment came, I did everything I was supposed to do.

In conclusion: make friends with your self-doubt! Don’t let it be that toxic friend that jokes about you and steals your clothes, but rather go out to lunch with it from time to time and listen to what it has to say, because you might actually learn from it!

Perform practical actions

Practicing self-compassion, self-awareness, and learning about self-doubt is essential. Still, to achieve a high level of confidence, there needs to be a constant exercise of these skills, which implies taking practical actions.

Next are some important steps to take in order to face your professional insecurities.

Get professional support

It doesn’t matter if you call it consultation or supervision – having a place you can get together with an experienced professional and discuss your practice is an invaluable resource to any therapist.

Besides being an impartial professional that will provide a different perspective on the situations you face, they’ll also help you reflect on your thoughts and feelings regarding patients and your experience.

Are you having trouble connecting with a client? Did a topic come up in therapy, and you felt uncomfortable? Did the patient tell you something, and you didn’t know how to respond?

These are just a few of the infinite situations that have the potential of shaking up our professional confidence. However, consulting on these matters and discussing them with someone else, without fear of breaking confidentiality or shaming, can bring a sense of relief and security that we wouldn’t be able to achieve alone.

That’s why you shouldn’t be afraid to ask for help in these consults! The professional is there to hear your concerns and feelings and help you work on them; they won’t be able to do that if you omit them. So, don’t keep your problems to yourself just because you’re embarrassed or apprehensive. Make the most of the space you got!

Having someone there to discuss your worries and rely on when things get difficult will make you feel much more stable and confident in your actions.

Get your own therapist

I don’t need to explain to you the benefits of therapy, but this should be said: go to therapy!

This definitely relates to becoming self-aware, but therapy is where you’ll actually put in the work to manage your own issues and demands. Identifying these blind spots and bringing them to therapy is an essential part of the work you do as a therapist since certain situations might trigger you in a bad way, harming the therapeutic relationship.

Additionally, therapy is where you’ll get the chance to address confidence and self-esteem issues directly! So not only will you be dealing with a variety of issues (which will ultimately lead to improving your practice), but you’ll also focus on minimizing your self-doubt, with the therapist as your guide.

Get in peer groups

For me, one of the problems of feeling like I’m not enough as a professional – or of any concern, really – is to feel like I’m all alone in this experience, and that I’m the only one who feels this way.

Fortunately for me (and unfortunately for other people who feel this way), this couldn’t be further from the truth!

By taking part in peer groups, both virtually and in “real life,” I feel extremely validated and comforted every time I see someone discuss problems they’re going through and that resemble mine. I feel like I’m not alone in this, and that if they do it, I can do it too.

However, this is only one part of the benefits of joining a peer group, as you can also get amazing advice from the people that experience the same things you do, making for a consultation group. You can learn a lot from your peers’ experience since everyone has a different background and brings a different perspective to the table, and they can learn a lot from you.

Some ways to enter peer groups are through social media, especially when you look for Facebook groups and Subs on Reddit (my own indications are Facebook’s Thriving Therapists and Therapists in Private Practice, and Reddit’s r/psychotherapy) and groups in your city, maybe from clinics that offer meetups, or even create one yourself by getting in contact with therapists you know!


We’re way more inclined to take notes on the things we did wrong than the things we did right, but journaling invites you to invert this logic.

After each session, or whenever you have the time, journal what you did well in your day or the things you like about yourself. Did you notice an improvement in a patient? Did the client give you positive feedback? Have you noticed anything about your style as a therapist that you appreciate? Put it all down on the page (physical or digital, your choice).

By doing this exercise, you’ll be able to identify your strong points and realize that, even if you think everything you did was wrong, there’s always something to be proud of.

After writing it, you’ll be able to go back to it whenever you need a boost. Thus being able to read about the good things you’ve done and that you’re capable of doing.

Do trainings

Attending courses or training is a great way to sharpen your skills as a therapist and gain valuable knowledge. Especially if one of the things that make you insecure in the practice is feeling like you don’t know enough, identifying your weak spots and looking to trained professionals to teach you will surely give you a much higher level of security.

And even if you think you know everything there is to know, I suggest you go back to the “Make friends with doubt” section! Psychology is a field that is forever evolving and reinventing itself, so seeking knowledge needs to be a continuous process in your career path. For therapists, settling is not an option.

In here, you can find a number of different free/low cost trainings for therapists.


Self-doubt, in the extreme, can suffocate us. It can make us feel unprepared, unable, unqualified – all the worst “un’s” we can think of. Even so, there are many steps one can take to minimize that feeling and build our confidence, as long as we’re willing to put in the work.

However, even if you take all the steps I presented you in this article, you won’t become some sort of unbeatable therapist that never gets anything wrong or always has the answers to every question.

Freud, Skinner, Beck, Rogers – none of them had all the answers. I believe that’s part of why they were so successful – they identified what they were doing wrong and the gaps in their knowledge, and went after it.

My point is, being a confident therapist is not a synonym for a perfect therapist. Being confident in your profession is much more a matter of humility, self-compassion, recognizing your strengths, and strengthening your weaknesses.

Above all, it’s connecting with your client and entering their world for 45 minutes a week, being fully present, exercising empathy and genuineness the best way you can.


In this section, I gathered a number of resources, from books to websites and podcasts, that may help you in building confidence.


Motivo is a website that provides access to online clinical supervision of quality and affordable price. is a website run by self-compassion researcher Dr. Kristin Neff, in which it’s possible to find numerous resources, workshops, practical exercises, and research on this topic.


“Other People’s Problems”, podcast by Hillary McBride

Host and therapist Hillary McBride offer a whole new format of podcast, in which she, with the permission of her patients, offers a look into her sessions. Every episode shows a real patient of Hillary discussing their own life and the problems that come with it.

“Where Should We Begin”, podcast by Esther Perel

Where Should We Begin? is an enticing podcast by Esther Perel, a relationship counselor. In the show, we follow Esther as she counsels and listens to real couples and their real issues, leaving you reflecting on the problems we all face as people connecting with others.

“Psychology in Seattle”, podcast by by Kirk Honda

Psychology in Seattle touches on a wide array of recent topics, all related to mental health, with the objective of being just as educative as it is entertaining. The host is Dr. Kirk Honda, a professor, and therapist.


To keep this site running, we are an Amazon Associate where we earn from qualifying purchases. To keep this site running, we are an Amazon Associate where we earn from qualifying purchases. While these links are amazon affiliate links, the selection of books remains accurate and unbiased.

“Presence”, by Amy Cuddy

“Presence” is a book by Harvard professor Amy Cuddy, in which she shows the connection between body language, behavior, and mindset. She teaches us how to use this connection in a way that empowers and makes us confident when we need to.

“Self-compassion”, book by Kristin Neff

Self-Compassion is a transformative book that provides great insight into limiting self-criticism and achieving your highest potential every day.

“The Mindful Self-Compassion Workbook”, book by Kristin Neff and Christopher Germer

This workbook follows Neff’s theory on self-compassion and expands on the practical exercises that lead to the power of being as compassionate to you as you are to others. The guide provides guided meditations, stories, exercises, and more.

“The Gifts of Imperfection”, book by by Brene Brown

Living up to modern expectations is impossible; yet, we seem always to be seeking perfection when, in fact, we should be after self-acceptance and balance. This book by renowned professor Brene Brown explores that idea and teaches us that we don’t have – nor should – strive for perfection in everything we do.

Great posts about this on Reddit (from r/psychotherapy):

  1. “Advice for a beginning counselor/therapist who feels like they don’t know enough?”
  2. “Feeling like I don’t know what I’m doing…?”
  3. “New therapist struggling with confidence”

Great posts about this on Facebook:

  1. “Human Therapist Moments” (from Therapists in Private Practice group)
  2. “Do you have any advice on how to grow your confidence or how to minimize self-doubt?” (from Therapists in Private Practice group)
  3. “I got licensed in May and began fee for service with a company in July. It’s October and I’m still having such imposter syndrome.” (from Thriving Therapists group)

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Recent studies show that therapists’ personal and interpersonal qualities seem to be particularly relevant to psychotherapy outcome, for example, their facilitative interpersonal skills; their capacity for affirmation, responsiveness, genuineness and empathy with different types of clients —but also their being convincing and persuasive ; their ability to resist counter-aggression when confronted with devaluation and rejections by patients ; and their ability to manage countertransference reactions . As already mentioned, thus far, these factors seem more important than more professional factors, such as practice experience, training, as well as adherence and competence, in distinguishing between therapists

  • Why do we have self-doubt? (discuss how it normally happens to beginners, and why is that)
  • Will it always be like this?
  • Normalize normalize normalize!
    • Everyone’s been there, even the greats (maybe get quote from famous psychologist)

  • Thériault, Gazzola and Richardson (2009) found out that the feelings of self-doubt and incompetence can be considered an important feature when developing their professional identity. These feelings can trigger a wide range of negative emotions such as anxiety, discouragement, anger, frustration and the causes are multiple: permissible fallibility, professional process issues, pressure, and personal sources of stress. The authors also found that these issues can lead to positive outcomes in the learning process if they are perceived temporary and controllable. If they are perceived as permanent, they tend to have negative outcomes like hopelessness, professional detachment, and feelings of isolation and separation and potentially from the therapy career itself. (quote about the article above; read it in full later)
  • Just keep in mind that sometimes the client just having someone to listen to them goes a long way. As long as you’re not harming your clients, anything you’re doing (as limited as it may feel) is a big step-up from the client having no support at all.
  • Best advice I ever got in school: they don’t care how much you know, only how much you care. Rapport is the MOST important piece of psychotherapy. If you’re connecting & being supportive, you’re doing the right thing. —> many times, your patient never had someone listening to their problems like this
  • When you don’t know what to do or say, listen. Ask yourself what this person needs right now. From me? From others? Try and see it from their internal frame of reference. You can actively listen and reflect your understanding back until you get your footing. —> To add to this excellent advice – if you don’t know what to say, validate what the client just expressed. Often, they’ll add to their thought after receiving validation, which gives you more to work with.

  • Counselors must not live the perfect life but they need to be aware of their own issues, how they are being triggered, and how to professionally and ethically deal with them. Awareness and insight about oneself is an important step in becoming confident with counseling clients.
  • Supervision is key
  • So if counseling is a process, novice therapists should be worried about having all the answers after the first session(s). Therefore, if you are a novice counselor and think that you are not good enough and that you should be able to give more within less time; think twice and explore which feelings you are trying to avoid by overcompensating and discuss these fears with your supervisor.
  • If you don’t feel comfortable working with a certain client or a certain topic be professional and refer the client to a colleague. But be honest in debriefing the client in order to avoid any misunderstanding and thank the client for seeing you. Referrals do not indicate that you are a failure neither do they put your professional abilities in question. Instead responsible therapists refer clients all the time for a number of reasons – but always having the best interest of the client in mind.
  • Discuss self-compassion as a concept, and how it can help
  • Talk about how self-compassion is a big part of the process; it’s not that you won’t face difficulties, but being sure that you can handle whatever comes your way
  • What would you say to a fellow therapist if they came to you with this problem? probably would be kinder to them than to yourself
  • Discuss how self-doubt can be healthy in small doses; keeps you humble and sharp
  • Mention the article
    • professional qualifications (such as competence related to diagnostic assessment and technical skills) must merge in an optimal way with the personal and uniquely subjective aspects of therapists (i.e., their ways of being with others, attachment style, personality and non-verbal expressiveness) to create effective practice
    • Recent studies show that therapists’ personal and interpersonal qualities seem to be particularly relevant to psychotherapy outcome, for example, their facilitative interpersonal skills; their capacity for affirmation, responsiveness, genuineness and empathy with different types of clients —but also their being convincing and persuasive; their ability to resist counter-aggression when confronted with devaluation and rejections by patients; and their ability to manage countertransference reactions. As already mentioned, thus far, these factors seem more important than more professional factors, such as practice experience, training, as well as adherence and competence, in distinguishing between therapists
    • Due to the initially unexpected favourable effect of PSD (professional self doubt), the factor was interpreted as indicating a therapists’ healthy self-criticism and ability to be open, sensitive, reflexive and taking responsibility for relationship struggles in therapy, and not as a measure of justified concern about one’s actual competence.
    • Professional self-doubt had a beneficial effect on change in IIP, while self-affiliation alone did not relate to change
    • As can be inspected, the most change was obtained by patients treated by therapists who were high on both PSD and self-affiliation, while the least change was observed in those treated by therapists who combined low scores of PSD with high scores on self-affiliation
    • self-affiliation —> stable core of tolerance and nurturance in the personal self
    • On the other hand, as we hypothesized, the interaction between PSD and self-affiliation predicted change significantly —> not self-affiliation itself
    • The findings imply that a healthy self-critical stance is an ingredient of successful professional role performance but that treating oneself as a person with care and nurturance but lacking capacity to critically evaluate (i.e., doubt) one’s therapeutic work, is not
    • constructive coping strategies were associated with more reduction in global interpersonal distress, while nonconstructive coping (‘avoiding therapeutic engagement’) negatively affected the rate of change in patient symptom distress.
    • Based on these findings, we may infer that patients are better off meeting therapists who can allow themselves to report higher levels of self-doubt in their clinical work because of a more acceptant and less attacking way of treating themselves as persons. Also, when therapists generally cope with difficulties by dealing actively with the problem, in terms of exercising reflexive control, seeking consultation and problem-solving together with the patient, this seems to help patients in reducing their general interpersonal distress
    • Love yourself as a person, doubt yourself as a therapist
    • Healthy dose of self-doubt
    • Make friends with self-doubt. It is a friend. It keeps you humble. It reminds you how much you have to learn. It keeps you learning and growing and moving forward. Like everything else, it is a feeling and needs to be balanced with truth. Allow truth to help you see what is real mixed with self-doubt to keep you growing and you will always win (Facebook’s Thriving Therapists post)
  • Personal and professional growth may be maintained by attending to supplementary courses, supervision and personal therapy. Learning about laws, ethical and professional responsibilities, self-care and strategies to maintain good physical and emotional well-being might help in maintaining a balance between personal and professional life. Having access to regular peer support it’s a necessary activity in private practice. Even considering all of the above, a therapist cannot be constantly prepared for every possible encounter and having access to regular peer support is necessary in private practice.

  • First described by psychologists Suzanne Imes, PhD, and Pauline Rose Clance, PhD, in the 1970s, impostor phenomenon occurs among high achievers who are unable to internalize and accept their success. They often attribute their accomplishments to luck rather than to ability, and fear that others will eventually unmask them as a fraud.
  • Though the impostor phenomenon isn’t an official diagnosis listed in the DSM, psychologists and others acknowledge that it is a very real and specific form of intellectual self-doubt. Impostor feelings are generally accompanied by anxiety and, often, depression.
  • Most people experience some self-doubt when facing new challenges, says Lieberman. “But someone with [imposter phenomenon] has an all-encompassing fear of being found out to not have what it takes.” Even if they experience outward signs of success — getting into a selective graduate program, say, or acing test after test — they have trouble believing that they’re worthy. Instead, they may chalk their success up to good luck.
  • “Unconsciously, they think their successes must be due to that self-torture,” Imes says
  • Facing imposter syndrome: talk to your mentors; recognize your expertise; remember what you do well; realize no one is perfect; change your thinking; talk to someone who can help