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Sunday, February 10, 2013

Finding a Good Therapist (By Anshu Basnyat, LCPC)

     Finding a good fit between a therapist and the client can be challenging.  First, there’s the alphabet soup of PhDs, PsyDs, MDs, MSs, and MSWs. Then add the following labels to the mix: psychiatrist, psychologist, marriage and family therapist, family counselor, licensed clinical professional counselor, and social worker. That alone can create enough anxiety to avoid seeking help! 

     It is completely understandable why finding a good therapist can be daunting. It is true that all of these therapists are mental health professionals, but they each bring different training, experience, insights, and character into the therapeutic relationship.  Likewise, every client brings their own set of experiences, personalities, ideas, etc. into the dynamic. This is why the therapist and the client have to “click” for a successful therapeutic relationship.  This is true for other doctor-patient relationships as well. Unlike the typical doctor-patient dynamic, where you can easily switch doctors if you are dissatisfied; however, with therapists this is not that simple. Sure, the client always has the right to end the therapeutic relationship at any time, but since the nature of therapy is very sensitive, it may not always be in the best interest of the client to abruptly end a therapeutic relationship.  This is why it is very important to find out some information before entering into therapy aside from the logistical such as fees and schedules.

Here are some questions to ask a therapist on the first visit:

1.       What do you specialize in?  This will tell you what the therapist is most knowledgeable about. For instance, I specialize in children and families and focus on parenting.  I love working with this population and the bulk of my clinical training is with this group. Therefore, a client in their seventies will not be the best fit for me and the client would need someone who specializes in geriatric care.

2.       What is your theoretical orientation? The therapist should be able to tell you this information and explain what their approach in therapy would be. I will not get into these in details but some of the main theories therapists work from include cognitive-behavioral, behavioral, psychodynamic/psychoanalytic, humanistic, and eclectic.  I am a cognitive-behavioral therapist, which basically means that I believe how we think about our situations impact our behaviors either negatively or positively.  In turn, this affects our mental health. Cognitive-behaviorists also collaborate with their clients in finding solutions so it is an “active” way of doing therapy. They do not focus too much in the past, but really figure out how to move forward into a healthier place for the client. So, if a client wanted to explore their childhood to gain insight about the present, then a psychodynamic therapist would be a better fit than a cognitive-behaviorist. 
      Many therapists also have a more defined approach. I am a cognitive-behavioral therapist who uses positive psychology in my work.  This essentially means that I focus on people’s strengths and build on them to move forward in therapy.  For example, I often assign “homework” to clients and the very first ones involve clients figuring out what their strengths are, especially for those this may be challenging. In fact, I just did this with one of new clients the other day. When I asked her what her strengths were, she had a hard time responding. So, her homework was to make a list of her positive qualities or strengths for the next session.  The idea behind this is that when we feel good about ourselves, we are more likely prepared to handle the difficulties life presents us with.      

3.      How long can I expect therapy to be?  Although no therapist can predict how long therapy will be for a given problem because this is based on so many factors such as client’s motivation, presenting problem, other complicating conditions, finance, etc. However, therapists can give you an idea of how long they typically work with clients. This is important information because many people may steer away from therapy thinking that it will be a long, drawn out process. As a cognitive-behavioral therapist, I typically have 12 weeks in mind and depending on the client’s circumstances, it may be shorter or longer, but the point is that when clients have an idea of an end point, it seems less daunting and more approachable.  Personally, I know I would not engage in something of this nature that costs time, money and energy if there is no end in sight.     
4.       How much experience do you have doing therapy?  Experience is not everything since we know that there are therapists with many years of experience, but are so out of touch with today’s issues that this cannot possibly be helpful to the client.  Likewise, there are very good therapists out there with just few years under their belt.  However, experience does have value for the most part and you should have this information to be a well-informed consumer of therapy.  Also, have in your mind how much experience is "enough experience." 

5.      Do you collaborate with other mental health professionals?  This is important to know because every therapist cannot treat every problem so it is imperative to know whether they consult or refer clients to other mental professionals such as psychiatrists for medications, and other therapists who may have more knowledge about the client’s condition.  If someone gives you this idea that they can solve any problem, then I recommend you seek another therapist!

     There are many ways to find therapists such as through an insurance directory of providers or your primary care physician, but the best way is when someone you know refers a therapist to you. Due to the stigma, you may be embarrassed to ask people you know, but remember that getting over that fear will be well worth the outcome!  Everyone needs a therapist at some point in their lives!  

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