More and more people today are seeing therapists for a variety of emotional, psychological and psychiatric problems. But how can the average consumer know how to choose a therapist and whether or not this therapeutic process is the right one for them? This can literally be one of the most important decisions an individual could make in their life and has the potential for far-reaching consequences -- positive or negative.
So what can you do if you have problems that require outside help? For starters, you need to be consumer savvy and remember to do your homework!
The following are some suggestions to help you find a therapist that is right for you and to know if you are being helped or hurt in the therapeutic process.
1. Get a referral from someone you trust. Do not be taken in by splashy ads or "likes."
2. Make sure that the therapist you choose specializes in your particular problem(s). It is not possible to be an expert in everything.
3. Check his/her license and make sure that there are no past or pending malpractice complaints filed against your therapist.
4. Expect that your therapist will ask you a lot of tough questions about your family background, relationship history, sex, previous psychiatric problems, including possible hospitalizations, suicide attempts and gestures, medications that you take (prescriptions and over the counter), possible addictions, traumas, sexual abuse, sexual assault, affairs and gender identity issues. Though many of these questions may be difficult for you to answer, it is vital for the therapist to know these facts so that she/he will be able to make an accurate diagnosis. This is only possible if the right questions are asked and that your answers are honest. Make sure that your potential therapist is on board with this process.
5. Ask yourself after the first few sessions whether you are comfortable with your therapist. Don't expect a strong level of comfort instantly. Like any relationship, it takes time for trust to develop. If you continue to feel uncomfortable after several sessions, remember that there are other therapists with whom you will be able to connect. And there should never be any inappropriate advances, sexual, verbal or otherwise that occurs between you and your therapist. If there are you should promptly leave and shut the door to that particular therapist.
6. Does your therapist respect your time and call you back within 24 hours including evenings and weekends if necessary? The fact that the health insurance companies often poorly reimburse therapists and psychiatrists for out-patient mental health should not be your concern. You are entitled to sessions lasting a minimum of 50 minutes. I find that longer sessions work even better and my patients find that 2-4 consecutive hour long sessions help achieve results faster. Make sure your therapist is doing his or her due diligence on this basic level. If they are not, it is an indication that your therapist is not fully involved with you.
7. Is your therapist in contact with your primary care doctor? This is necessary in order to rule out any physical problems or prescription medications that may be contributing or causing your problems. After a few sessions your therapist should be able to tell you your diagnosis, including a detailed treatment plan. I also believe that anything less than weekly sessions, at least in the beginning, will not enable you to have the best possible momentum to achieve success in your therapy. If money is a problem, try to negotiate your fee with your therapist or even suggest a payment plan. ASK FOR WHAT YOU WANT! Remember your therapist is not an all-knowing God or Goddess -- be assertive.
8. You should ask whether your spouse, parent, siblings or children will need to participate in your therapy. Clearly, if you are having relationship difficulties, it is essential (assuming that you feel safe) that your significant other participate at some point in your therapy.
10. In my opinion, your therapist should fully understand your family background and help you see how the past has affected your present situation and problems, helping you to understand how and why you have learned your self-destructive or destructive behavior. Unless this occurs your treatment will be a bandage for your issues at best, or a complete waste of time at worst.
11. On-going evaluation is necessary in order to determine how well (or how badly) your therapy is going. Expect that at times you will feel pain, since good therapy helps you take a hard look at yourself and deep introspection may make you feel very sad. Although you can't change the past, you can learn to understand and accept it, free yourself from your chains and move forward. Make sure your therapist is one that periodically evaluates with you how you're doing in the process. If necessary, ask them -- don't be shy about it!
12. Successful therapy depends not only on your therapist's expertise, but also on how much time, work and energy you are prepared to put into the therapeutic process. They can't do it alone --- a good therapist should make that clear to the patient.
13. The question of medication often comes up. Although no one likes to go on medication, there are certain clinical situations that absolutely require a combination of medication and psychotherapy.
Please don't beat yourself up if you have found that massage, acupuncture, energy healing,meditation, vitamins, exercise and healthy eating have not helped alleviate your symptoms. Brain chemistry is very complex, so let the experts do their jobs. And if you do need to go on medication, find a skilled psychiatrist (not an internist or dermatologist) who will work with you so that side effects are minimal. Make sure your therapist is open and up to date on medication possibilities.
Remember to spend at least as much time (hopefully a lot more!) researching your therapist as you would deciding on which car, computer and cell phone to buy. Making the time and effort to be a wise consumer will save you precious time, money and energy.
Good luck on your therapeutic journey! There are many paths to the journey -- these are some of the steps I believe will help you get started and continue in the process in a helpful, healthy and successful way.
Beatty Cohan, MSW, LCSW, AASECT is a nationally recognized psychotherapist, sex therapist, co-author of For Better, for Worse, Forever: Discover the Path to Lasting Love, national speaker, columnist and national radio and television expert guest. She is the host of ASK BEATTY on the Progressive Radio Network. She has a Master's of Clinical Social Work degree from McGill University in Montreal, Canada, post-graduate specialization in marriage and family therapy and sexual dysfunction and over 35 years of clinical experience. She has private practices in New York City, East Hampton and Sarasota, Florida.
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