Choosing a therapist is an important decision. It is not as important as choosing who you marry, but it is more important than which restaurant you go to for dinner tonight. Finding a good enough therapist for you can have a profound impact on the course of your life. Whether you are struggling with debilitating anxiety and depression or you simply want to learn more about yourself and the way you operate, here are a few thoughts to help guide you through the process.
1. Ask people who know you well for a referral. The best referrals I get for psychotherapy are from people who know me well professionally and who know the potential patient well personally. Research repeatedly supports the idea that the therapist/patient match is one of the most important factors in predicting a successful treatment outcome.
2. Shop around (but not too much). It is fine and common practice to call a few therapists and even meet with them in person before making your decision. Going alphabetically through the phone book and calling every single therapist in town, however, won’t serve you well (and it might also be part of your problem!). Keep in mind that “the best therapist in town” might not be the best one for you.
3. Rapport and fit is more important than degree or title. You should feel relatively comfortable with your therapist. Educate yourself on the types of degrees (e.g., Ph.D., M.D., M.S., LPC, LMSW, etc.) but don’t use that as a main criteria. Stick with someone who is licenced by the State in their field of practice. This information is easily obtained from online State government websites. Keep in mind, for example, that in the State of Michigan the titles “Psychotherapist” or “Therapist” are not state licensed ones. Many practitioners might refer to themselves as psychotherapists out of convention, but they also have the licensed title of “Psychologist”, “Psychiatrist”, “Licensed Master Social Worker”, or others.
4. Pay attention to first impressions, but consider second impressions as well. If you are on the fence after a first meeting go back for a second or even third one and try to keep an open mind. Going to therapy can be difficult and people often find reasons for it to not work out. That said, if your first impression of the therapist is a strong negative one don’t be afraid to abandon ship.
5. Consider the cost of therapy, but also consider the cost of NOT going to therapy. The cost of therapy can range from zero to substantial depending on your insurance and the therapist’s status as either an in-network or out-of-network provider. The cost of not going to therapy could be: a failed marriage, a lost job, an estranged relationship with a parent, or anything in between. If you find yourself in a situation where your insurance won’t pay anything for the therapist you want to see (or you have no insurance) it is okay to ask the therapist to negotiate a reduced fee. Be prepared to hear “No”. Not all therapists are able or willing to do this, but few would find this question inappropriate. If you drive up in a luxury sports car or have a vacation estate in the South of France I would skip this step. Ultimately, if the therapist’s fee is truly prohibitive there are places to get quality treatment on a sliding fee scale. Contact me and I will help you locate them.
6. Don’t be afraid to call it quits. If you have concerns about the direction of an ongoing therapy, talk to your therapist. This can be difficult or uncomfortable, but it might actually be an important part of your work. If your therapist seems unwilling to consider your concerns or “blames” you for the lack of progress in treatment, it is probably time to call it quits. While occasionally even really good therapists get defensive when things aren’t going well (we are human after all), this shouldn’t be the therapist’s prevailing mood. Give your therapist, and yourself, a chance to collaborate and creatively address a therapeutic impasse.