Choosing and Using a Therapist: Part One

  • Heading into Mental Health month: I wanted to write SharePosts about therapy and its role in helping us achieve peace of mind and potentially the resolution of problems we struggle with. This first blog entry will talk about how to choose a therapist and the follow-up will focus on working with a therapist and knowing when to continue or end therapy. The last SharePost in the trio will examine cognitive therapy in detail as a tool specifically used to treat schizophrenia.


    You don't want the added pressure of worrying about finding a good therapist when you are going through a hard time. It could be your first time in therapy or you could've had dismal experiences in the past. In the midst of your struggle the thought of having to talk to someone every week and detail the agony you're in could be more than you can bear.

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    Before I go into detail about how to choose a therapist I want to tell you my experiences with therapy in the past to give you an idea about how I conducted my own searches. My first therapist was the team leader of the social workers on the ward when I was hospitalized and he stopped by to talk with me because I had been a disc jockey in college and he wanted to know what that was like. We talked about music and some of what was going on in my head.


    Angelo gave me his business card and when I was released back home I called him up to make an appointment. He told me it was a wise decision to pursue therapy and was glad I had contacted him on the outside. I saw him for five years. He was in private practice and my mother paid for the sessions until I found work and my health insurance took over.


    My next experience with a therapist was five years ago when I sought to talk to someone one-on-one again. I was under a lot of stress being in a relationship with a guy and wanted to talk about what was going on. Before I chose Tim I interviewed him and another woman. I had one session with the female therapist and knew I couldn't continue with her. The tiny room she conducted sessions in was almost as dark as the night: there was a barely 40-watt light bulb glowing for the 50 minutes I spoke with her. I simply could not function in a room without light. As well: she had a perpetual smile pasted on her face throughout the session. It was possible she was using her smile as a way to put me at ease or show encouragement however it seemed unnatural to me.


    At my first session with Tim I felt more comfortable getting into things that left me with an uneasy feeling when I exited his room. I understood I would have to deal with these feelings and I decided he was the therapist I would work with. I saw him for four years and it was by my own choice that I decided not to continue. He agreed I would be able to go my own way. I felt I had achieved what I set out to and he gave me the option of returning if I felt the need. Most likely I would use another therapist if the urge to enter therapy struck again.


    So this is what I recommend: make one appointment with each of two therapists and use that meeting to decide whether you want to continue. Not only did I interview those two therapists, I interviewed three psychiatrists when I needed to find a new doctor. Let your intuition be your guide at the end of the session as to whether you want to sign on with that therapist for the long-term. It is not unreasonable to ask how long the therapist envisions your treatment will take. Some therapists believe in a life-long approach and others espouse a functional tactic: get in, solve the problem, and get out.


  • Before you set the time to meet you can ask the therapist directly over the phone some basic questions to rule him or her out or you can ask the receptionist these questions if the therapist has one. You can certainly ask how long the person has been in practice, do they take your insurance and if not can you work out a fee, and whether you can be seen in the evening or on a Saturday or in the early morning or during your lunch hour. You want to know if the therapist is licensed and how long he or she has been in practice and where he or she obtained the degree. 

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    Some professionals believe a therapist should have 10 years of experience before you consider signing on with him or her.


    In person: you could ask if the therapist has experience treating people with your kind of problem yet you also want to gauge if you will be treated as an individual instead of having cookie-cutter techniques and solutions applied to you.


    Some therapists set specific treatment goals in writing and others take it session-by-session. My SharePost on setting treatment goals talks about a process I use in my own life. The focus should be on relief of your distress so you need to expect that therapy could bring up a lot of intense feelings. Examine any resistance you might have to this. Your therapist is not a friend you're having an open-ended conversation with. Like with any goal you set: the problems you tackle in therapy will require a timeframe for completion with specific results.


    Note: peace of mind can be a specific result. It might not be easy for you to quantify your therapeutic accomplishments yet you will be able to judge how far you've come. We'll talk in the next SharePost about making progress in therapy and how to determine whether you should continue or end the sessions.


    The ideal therapist will be objective and empathetic and treat the nature of your session in confidentiality unless you disclose you want to commit an act of violence. Beware of a professional who talks about his problems or refers back to personal experiences when you describe what you're going through. Deflecting the focus from you isn't going to help you feel better however well-intentioned it might be. Merely Me at our sister site MyDepressionConnection.com blogged about bad therapy she's had over the years and talked about this in detail.


    I'll close here by saying that the psychcentral.com web site has a good primer on how to choose a therapist. As well, the choosingatherapist.net web site offers thoughts on choosing a therapist.


    Meet me back here in early May when I continue this discussion giving more insight into my own experiences and the nuts and bolts of the should-I-stay-or-should-I-go question.

Published On: April 27, 2010