What should I look in a therapist?
First and foremost, find a therapist you feel comfortable with. Therapy is not an easy process and your therapist is not there to be your friend. You must be able to trust your therapist 100% and if you cannot and feel like you have to lie to your therapist or withhold important information, you are not going to get any real help. You must also feel, at some point in therapy, that actually going to your therapist is helping you. If you do not feel relief from your emotional problems, you may not be getting the best treatment available. Look for these types of warning signs as reasons to think about choosing another therapist if you are already in therapy, or signs to look out for during your initial few sessions with a new therapist.
Second, you should seek out therapists who have been practicing in the field for at least a decade, longer when possible. Research doesn't show much difference between the qualities of therapy outcomes based upon a clinician's degree or training, but it does show that the longer a clinician has been practicing, usually the better client outcomes. Ask point-blank questions about the therapist's experience in your first session with them. You're interviewing the therapist as much as they are interviewing you. Take the opportunity to ask about the therapist's experience with your issue. All questions related to their credibility are appropriate to ask in the first session. Listen to the answers and make your decision about whether this therapist will help you or not accordingly.
What difference does the therapist's degree make?
Psychologists are like the General Practitioners of mental health. They have a unique educational background grounded in research and science which helps to ensure that the techniques they utilize are the most effective and beneficial to you. Psychologists can refer you to a psychiatrist, a medical doctor specializing in prescribing psychotropic medications, if their professional assessment warrants it.
Next in line are licensed clinical social workers. They most often have some specialized training in psychotherapy and helping clients in very similar ways to most psychologists. Master's level counselors follow, with a little less training and supervision than most clinical social work degree programs.
You should likely avoid seeking help from a psychiatrist only, for almost all mental disorders. Emotional stress can be relieved temporarily through medications and may be an important adjunct to psychotherapy, but they generally are not used as a "cure."
What if I can't afford a psychologist?
If you cannot afford a psychologist, clinical social workers are the next best thing. They have less initial training and experience than psychologists, but after a dozen years in the field or so, this becomes a less noticeable and important difference. They are much more prevalent in giving psychotherapy as the managed care field has grown in recent years in America.
How to choose a therapist, regardless of their degree?
The answer to this question depends on tricky insurance question. Some HMOs and other insurance companies are setup so that you must first consult with their GP and get a referral from that person, before you can see a therapist (either within their system or outside of it). Consult your health benefits handbook for the procedure for this, or contact your HMO directly and ask.
Otherwise, the procedure is bit more difficult, since there is no easy way to choose any professional in any field. In many larger suburban or metropolitan areas in the United States , there are referral agencies set up to handle this problem. In smaller communities, this might be handled by a local professional association or the mental health advocacy association. The answer to this question is likely to be found in the Yellow Pages of your local telephone book under one of the following headings, "Mental health," "Therapists," "Psychologists," or "Psychotherapists."
What are the minimum qualifications?
Look for a therapist who is licensed or registered in the state or territory in which he or she practices in. Psychologists, for instance, likely will have to have a valid license before being listed under the 'psychologists' heading in the Yellow Pages. For clinical social workers, they will generally have an "L" in front of their degree (e.g.- LCSW). Some states may not license clinical social workers, or do not require they display licensure in this format. Ask the therapist is you are unsure. No professional or ethical therapist should mind being asked about their educational or professional backgrounds. If a therapist has a degree, it will almost always follow their names in the advertisement and may be required by law. Try to avoid counselors who don't have at least a Master's degree, little or no formal training, or titles that are not easily recognizable. For instance, in New York State, you need nothing more than a high school diploma to become a "Certified Addictions Counselor." While this sounds pretty impressive, it is misleading since the training required to receive this title is minimal.
What to expect on the first meeting?
The first session, sometimes called an Intake Evaluation, usually is very unlike what you can expect of all of your following sessions. During it, you will be asked to explain what brings you into therapy, what kind of symptoms you might be experiencing, and your family and general history. The depth of this history-taking will vary according to therapist and the therapist's theoretical orientation. It will likely include questions on your childhood, education, social and romantic relationships, current living situation, and career. When this history is completed, and the clinician has a beginning understanding of you and what goes to make up the important things in your life, as well as your current difficulties. If you have any question, feel free to ask them. This would be a good time to ask a few questions about the clinician's theoretical orientation, training, and background, especially in treating your specific type of problem. Professional and ethical therapists should have no problems in answering such questions. If your clinician does, that would be the first warning about that person's ability to help.
What is theoretical orientation?
Theoretical orientation describes what theories the clinician subscribes to in thinking about a person's problems and how best to treat them. Most clinicians subscribe to "eclectic" orientation. "Eclectic" orientation therapists try to tailor their treatment approach to your own way of relating and the problems. Other popular approaches to treatment are "cognitive-behavioral," "behavioral," and "psychodynamic." You should also be aware that some therapists theorize in one orientation, while they treat in another. The most common example of this type of merging of two different theoretical orientations is conceptualizing or thinking about your case in a psychodynamic manner, while treating in an eclectic or cognitive-behavioral approach.
How long should the therapy take and what should to expect in the course of therapy?
It is difficult to predict since individuals vary widely with their own backgrounds, severity of the problem, and other factors. For mild problems, treatment should be relatively brief or short-term and will likely end within 12-18 sessions. For more severe problems (especially chronic or long-term difficulties), it's going to take longer. Some therapy can even last up to a year or more. The choice is always yours, however, if you feel you've benefited as much as you'd like, you can tell the therapist and end therapy accordingly. A good therapist will respect your decision (questioning it a little to look at the reasoning behind it and make sure it is sound) and will seek to end the process with another session or two, to wrap things up and summarize progress made on treatment goals. An unethical or unprofessional therapist will attack your decision and seek to keep you in therapy. Be firm with this kind of therapist and leave whether the therapist wants you to or not. After all, unfortunately, not all therapists act appropriately in all respects in this field.
What is “treatment goal”?
All therapists should use treatment goals, but there is no standard in the field. Naturally, if you come into therapy with particular problems or difficulties in your life, you would like to have them solved (or at least begin working on them). Treatment goals, especially ones that are formalized and written down, ensure that both you and your therapist are on the same "track" and working on the same problems. Also, by occasionally reviewing said goals, you can chart your progress (or lack thereof) in therapy and work with your therapist to change therapy if need be. But, treatment goal is an individual therapist decision; if you'd like to have some goals set up, you can always ask your therapist to help you do so. Sometimes, treatment goals don't need to be formalized and written down. But if you feel more comfortable being concrete about your goals in therapy, let your therapist know.
What if the therapist conducted into an unethical manner?
It is best to report such violations to your state's licensing board as well as that therapist's professional association. It is not always easy to follow through on these charges, however, because these professions are generally "self-policed." This means that it is up to the profession (e.g. - the licensing board or professional association) to investigate the charges and follow-up on them. This is a slow process.
If your therapist has done something harmfully wrong to you during therapy, it really should be reported, or else the therapist may continue to harm others after you. Inappropriate behavior which violates your trust, including engaging in a sexual relationship with you or violating your confidentiality without your expressed written consent, should also always be reported. [back] [pick a state]