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how to choose a therapist

Discussion in 'Therapy and Medication' started by ari, Jul 14, 2007.

  1. ari

    ari Staff Alumni

    Questions to Ask Your Therapist

    by Ben Martin, Psy.D.
    February 17, 2006
    Choosing the right therapist is important and often difficult to do simply by looking at ads in the Yellow Pages. Credentials can be important, but are not the whole story. Word of mouth is the best advertisement for the quality of a therapist.

    While people are still reticent about talking about mental health, experiences of friends or relatives can be valuable. You can also seek information from your primary physician.

    Although it may feel as though you are the only person with depression, millions of people suffer from the condition. Your physician has likely seen many depressed people in his or her practice and may be comfortable with particular therapists.

    Finally, you can consult referral hotlines of professional organizations, including your state or local medical society, association or other professional group. They often have a list of members who specialize in situations similar to yours.

    Questions to ask when choosing a psychiatrist or therapist:

    Are you licensed by the state?

    Licensure is important because it means that the provider has passed minimum competency standards for training and expertise.

    What level of education do you have?

    Psychotherapy is available from a number of different providers. Psychiatrists are medical doctors who have completed special training in psychiatry. They can prescribe medication in addition to providing psychotherapy. Psychologists usually have a doctoral degree in psychology. They can conduct psychological testing that may aid in the diagnosis of your depression and any associated conditions. Most other therapists have masters degrees in a related discipline including licensed clinical social workers (LCSW), advanced registered nurse practitioners (ARNP) and licensed mental health counselors.

    What are your areas of expertise?

    Most therapists are really good at a few things, not everything. What success in treating people have they had?

    How long have you been in practice?

    This can be a source of information regarding the therapist’s effectiveness. A therapist who is not effective will have a hard time maintaining an active referral base and staying in business.

    How much do you charge per session?

    Costs among therapists can vary widely and are often related to their number of years in training. A psychiatrist or psychologist will probably be more expensive than a social worker of mental health counselor. While this is clearly not a situation of “you get what you pay for,” you should be aware that training differences among these professionals may have an impact on your treatment. Usually, more severe symptoms or complex history and medication regimen, will require a psychiatrist, especially if this person will be primarily responsible for your care.

    What insurance do you take?

    Psychotherapy can be expensive and having your treatment covered by insurance will greatly help defray costs. Check that the person you are seeing is able to handle third-party billing (insurance) and that treatment is covered by your insurance plan. You can obtain this information from your benefits person or the therapist.

    If you are not a medical doctor, do you work with a psychiatrist or other physician who manages the medication?

    A “yes” answer improves the chances you will be prescribed medication if you need it.

    Do you have a cancellation policy?

    Some therapists charge for missed appointments or cancellations within a certain period of time. If you have inconsistent transportation or other issues that may affect your ability to keep appointments this will be important information.

    Are references available?

    Ask for recommendations or references from the professional’s other colleagues.

    In cases of emergency, do you have an ‘on-call’ system?

    Hopefully, the answer is “yes”.

    Probably the best method of choosing a therapist is to gauge your reaction to him or her. Research on the effectiveness of psychotherapy has consistently shown that the personal qualities of therapists and how they “fit” with the patient are at least as important as the type of therapy used to produce a positive outcome. If you feel uncomfortable with a therapist after several sessions, make sure you discuss this. If an issue cannot be resolved to your satisfaction, then seek another therapist. If the problem is with you, you will discover it soon enough.

    Keep in mind, too, that while the therapist may be recognized as being very effective and you can be an ideal patient, you just may not be able to work together. People are different and sometimes relationships do not work out. If that happens, find another therapist.
  2. ari

    ari Staff Alumni

    What to Expect in Your First Counseling Session

    by Steve Bressert, Ph.D.
    March 2, 2006

    Are you about to go to a counselor for the first time? Whatever your reason for seeking help, you will be more at ease and get better results if you know what to expect.

    In your first session, the therapist typically will ask certain questions about you and your life. This information helps him make an initial assessment of your situation. Questions he might ask include:

    Why you sought therapy. A particular issue probably led you to seek counseling. The therapist has to understand your surface problem(s) before he can get to the deeper issues.

    Your personal history and current situation. The therapist will ask you a series of questions about your life. For example, because family situations play an important role in who you are, he’ll ask about your family history and your current family situation.

    Your current symptoms. Other than knowing the reason you sought therapy, the therapist will attempt to find out if you’re suffering from other symptoms of your problem. For example, your problem might be causing difficulty at work.

    The therapist will use this information to better understand your problem. And, while he may make a diagnosis at the end of your first visit, it’s more likely that a diagnosis will take a few more sessions.

    Don’t just sit there

    Therapy is a team effort. If you don’t take an active part in the session, you won’t find the counseling experience valuable. Here are some things you can do to make your first session as successful as possible.

    Be open. Therapists are trained to ask the right questions, but they’re not mind readers. The therapist can do his job more effectively if you answer the questions openly and honestly.

    Be prepared. Before you get to the session, know how to describe “what’s wrong,” and to describe your feelings about your problem. One way to prepare is to write down the reasons you’re seeking help. Make a list and then read it out loud. Hearing yourself say it a few times will help you describe things more clearly to the therapist.

    Ask questions. The more you understand the counseling experience or how counseling works, the more comfortable you’ll be. Ask questions about the therapy process, and ask the therapist to repeat anything you don’t understand.

    Be open and honest about your feelings. A lot will be going through your head in this first session. Listen to your own reactions and feelings, and share them with the therapist. You’ll both learn from these insights.

    Be sure to go to your first session with realistic expectations. Therapy is not a quick fix for your problem, rather it is a process. With some effort on your part and a strong relationship with your therapist, it can be a successful tool toward resolving problems.
    Serein likes this.
  3. sami

    sami Well-Known Member

    great post! soooo helpful :biggrin:
    thanks ari!
  4. Rose24

    Rose24 Chat & Forum Buddy

    Thank you for this! I have been though large number of therapists, I always tend to leave after giveing my history to them, which is such a waste of time (and some what degrading). This will help me weed out the bad ones at the start, though i do like the therapist that i'm with at the moment :)

    Thank you!! *hug
  5. lostboy

    lostboy Well-Known Member

    Yeah great post cheers
  6. Stranger1

    Stranger1 Forum Buddy & Antiquities Friend

    Agood therapist is hard to find. Ask around, you'll find one. My therapist is good. She says I don't knows are not in her vocabulary. There is always a reason you think on those lines. She also says there are no should haves,could haves,can't, and a few others I can't think of right now. Once you get your meds right and get a good therapist things will look totally differant. It takes hard work.
    I hope this helps a little. I kind of feel like a hypricat. I am suicidal also. As a matter of fact I have a plan, and a time to witch I will try again. I didn't suceed last time.I woke up. Good luck.
  7. lavendR23

    lavendR23 Active Member

    Thank you for this post. It helped me verify something I knew about my
    last therapist.
    She didn't do any of these things. She just had me talk on and on once a weeks
    for a few months and didnt say anything!
    I mean anything!!!
    I think she was just milking my insurance....
  8. pinkpetals33

    pinkpetals33 Well-Known Member

    I point blank have asked therapist
    "Why do you want to listen to people's problems all day?"

    I think the direct and point blank honesty puts them on the spot and you can pretty much tell who is worth your time IF at all.

    Very few are.
  9. wastedmylife

    wastedmylife Well-Known Member

    I wish I had listened to my gut before sticking with some horrible therapists that I am with

    I think they just want to control you or they dont care and have prejudice feelings or they are just in it for the money

    I have seen some really shitty therapists including one who has led me to the shape I am in
  10. Aaron

    Aaron Well-Known Member

    Sorry to hear of your bad experience, i have been lucky to find two really good therapists...they are out there.
  11. fromthatshow

    fromthatshow Staff Alumni SF Supporter

    I'd say make sure your therapist is also in therapy. If someone is not working on themselves how can they help someone else?
  12. Zola

    Zola Antiquities Friend

    A wonderful post by ari above. His description of how to get a decent therapist is absolutely spot on. Print out his post and keep it handy. When you're going for an interview with a new therapist, be sure to read it over again.

  13. cloud9

    cloud9 Well-Known Member

    Thanks for this post!
  14. Mr Stewart

    Mr Stewart Well-Known Member

    thank you for this.

    I recently realized that it's time for me to seek professional help. Better late than never I suppose. The prospect of talking to someone without shielding the truth behind the usual framework of lies is terrifying to me. Knowing sort of what to expect will help motivate me to actually make an appointment, i hope. Soon.
  15. trevordd

    trevordd Member

  16. Depressed Since 1974

    Depressed Since 1974 Active Member

    From my own experiences, for your first visit to a therapist add the following questions:

    How long do you expect to continue your practice?
    Do you have any intentions to stop accepting insurance or certain insurance companies?
    Are you considering moving your practice to a new location and if so, when would you expect to move?

    I started therapy with one lady and six weeks into therapy she tells me "I'm taking a job with the school district for the medical insurance and I will only be seeing private patients on Wednesday nights and Saturdays in this office. I am subletting the office the rest of the week. I am also going cash only at $160/hr." That didn't work for me so I asked for a referral to another therapist and she said, "call your insurance company for a referral." I excused myself from the session to use the restroom and never returned. She never called me.

    I found second therapist and after three months of weekly visits she said she was changing offices but wouldn't give me the new address until two weeks before the move. Three weeks before her office move, I went on vacation and when I returned I called the old office and they didn't have her new address or contact information.

    I gave up on therapy for 10 years after these two pretend therapists.
  17. blackestocean

    blackestocean Member

    I was so desperate in august when i finally made myself find a therapist. i was grateful to find one yet i didn't feel like we connected. it's so personal dumping out your heart to a stranger. anyway, i missed my 2nd appt and they dropped me. i need to now find a new one. sigh, it's gotten really bad inside my head lately.
  18. green_fox

    green_fox Active Member

    I think it's always hard to choose right therapist. My advice: don't afraid to change it in any time.
  19. Elemteacher92

    Elemteacher92 Member

    Today I had my first evaluation and the therapist was very understanding. I also felt very comfortable which is very important since you are talking to a stranger. I believe that one should do the hw of finding someone experienced in the area you need help and also feel comfortable.
  20. Lovetolisten

    Lovetolisten Well-Known Member

    I would suggest to always listen to your gut, if something doesn't feel right. That's my biggest regret too. I would feel obligated to stay with a provider, even when I didn't feel like something was right. A therapist's body language and presentation can be obvious too. If you aren't making any progress within months or years, something may not be right.

    I used to think that it looked bad for clients to therapists shop, but it's okay to interview a few therapists and get a feel on who connects with you better.

    When I compare my current therapist now to previous ones, I can't help but think "wow, those people really were the wrong fit."