Choosing a Therapist

I wrote about how to choose a therapist on my website over 10 years ago and, although I think most of my points are still relevant, I have some new  comments, which I will add here.  I underline some of the further ideas about this important topic  I’ve had.

Taking care to choose the right therapist for you is very important.

Successful therapy can help you to transform your entire life.  I have had many, many clients throughout the years who have changed their existences in dramatic ways.

 

1. First, talk with people you trust.

Get recommendations from friends, relatives, your family doctor, your clergyman or your local professional association.  But be aware that one size does not fit all.  All therapists are limited in some ways as to the type of client with whom they’re  most effective.  I’ve had some ex-clients who did great work for and made referrals to me that didn’t work out because we were not a good “fit.”

2. Next, call to get a sense of each therapist as a person.

Call the recommended therapists on the phone and take a few minutes to talk with them. Get a sense of what they’re like as people.

If they’re successful therapists, they may be very busy. But they should be willing to spend five or ten minutes on the phone, answering questions.  If they don’t have time, ask for some other therapists they might recommend to you.

A) Be prepared to tell them a little about what your problems are and ask them if they’ve dealt with those kinds of issues before.

B) Ask about their fee so you’re not surprised when you arrive. If you have insurance, make sure your sessions will be covered. They may not be providers on your plan.

C) Make sure their credentials are good, that they are professional in the way they talk to you, and that they are licensed or certified to provide psychotherapeutic services.

D) If they seem impatient or defensive about answering your questions, write them off your list. They would probably be the same way if you were in therapy with them, and you don’t want a defensive or impatient therapist.

3. Then, go for a test drive, and trust your own impressions.

If you can afford it, it’s very helpful to make appointments with a few therapists with whom you feel some rapport on the phone.

A) Be prepared to pay their regular fee or even a bit more for this evaluation session, which they may charge more for because it may be longer than their regular sessions.

B) Being in their presence and seeing how they relate to you is an invaluable test of how you and they will get along. After all, committing to working with a specific therapist is a very important decison.

C) You are going to spend quite bit of time with this person, entrusting some of your most important, perhaps painful, issues with him or her, so you should be careful about making the decison to see that therapist.

D) Above all, trust your own impressions. Your friend who referred you might swear by a particular therapist, but that doesn’t mean he or she is right for you.

E)  And by the way, clinical experience and theoretical orientation doesn’t seem to make much difference in effectiveness.  Research indicates that it’s the quality of the therapist that’s most important, not how many years he or she has been practicing.

4. Agree on a Trial Period.

Even if you do feel comfortable with this person and think that he or she can be of help to you, I suggest you talk with the therapist about this being a trial period.

A) If you’re only interested in short-term treatment for a specific problem, you probably won’t be going to the therapist for more than a couple of months. If, however, you’re interested in a more long-term therapy, in which you can deal with major issues in your life, I would suggest telling the therapist that you want a trial period of around two months.

B) At that point, you and the therapist will take stock of how things are going and whether or not you’re getting what you want. You can then either continue or stop and switch to someone else.

C) It takes a couple of months to see if you’re making any progress. But remember that you should feel that you’re getting something out of each session.

5. Feeling “connected” to your therapist is very important.

In fact, much research studies on the results of psychotherapy show that feeling comfortable with and understood by the therapist is more important than the therapist’s theoretical orientation or even amount of experience.

A) It’s not that your therapist should be chummy with you. He or she should be professional, interested, concerned.

B) There should be clear rules about how much notice must be given if you have to cancel an appointment, and the sessions should start and end on time.

C) Be particularly wary if the therapist starts to act at all seductive with you. This type of therapist is being very unprofessional and should be avoided like the plague!

6. But different people need different things from a therapist.

Some people want a therapist who is very professional and aloof, others want someone who is warm and friendly.

Some people are best working with a man, others with a woman, for others the sex of the therapist doesn’t matter. The most important thing is that you’re comfortable with your therapist (not that you should be too comfortable and relaxed). It’s not like being with a friend or a relative; if you’re too comfortable, your therapist may not be the kind of person who can help you deal with painful things. and you might not get anything out of the therapy. But avoid any therapist who seems cold, hostile, impatient or sarcastic. The research shows that clients of this type of therapist also don’t get much out of therapy.

7. What about the sex of the therapist?

In recent years, many women have chosen to work with women because they don’t feel a man can understand them.

Or they may have a past history of sexual or physical abuse with men and are afraid to trust any man. For this type of woman, seeing a female therapist may be the right thing to do for her first therapy experience. When, however, the woman works through some of her fears of men with the female therapist, it might be a good idea to see a male therapist to work through the rest of her issues. Relating directly to a male therapist can be more effective in working through fears of men than just talking about it with a female therapist.  For example, some years ago I was working with a woman who had been sexually abused by her father and consequently had problems relating to men and achieving a good love relationship with a man.  She had even tried romantic relationships with women, but realized that solution was not for her.  There were seemingly innocuous events that occurred with me that scared her–for example my running my fingers on the rough bottom of my coffee cup.  She interpreted that as seductive.  I noticed her discomfort, explored it with her, and we accomplished a bit more unravelling of her traumatic relationship with her father. She was then able to separate me from her inappropriately seductive father and feel safe with me again.  

8. The same issues apply to male clients.

Having had a poor or very conflictual relationship with one’s mother or sister can make it difficult relating to women, but a female therapist might be the best person to see later on after they have done some significant work with a female therapist.

But I’ve seen situations that a male prefers a female therapist because he thinks that she won’t be as threatening as a male therapist.  This is especially the case if he had an overbearing, dictatorial, punitive father and tends to have difficulties with male authority figures in his life because he hasn’t worked through his father issues.  He’s afraid or belligerent or avoidant of males whom he sees having positions of authority.  So working with a male therapist might enable him to deal with these issues because they are bound to come up in therapy.  

 

9.  What about theoretical orientation?

This is a tricky issue because, as I said above. the research doesn’t seem to indicate that theoretical orientation is that important, but who the therapist is as a person.   At the present time, Cognitive Behavioral Therapy is the most popular form of treatment.  Part of the reason is that, because there is a clear methodology that is used with practically all clients. it’s relatively easier to study in research, tends to focus on behavior or conscious thought and can seem shorter in duration. But the CBT therapist is dealing mostly with conscious issues and many, perhaps most, of the issues clients have are things of which they are almost completely unaware.  So to some, CBT can appear somewhat superficial.  So, for many clients, being with a psychodynamically oriented therapist who deals at least some of the time on the relationship between him or her might be preferable.  But one of the better therapists I’ve known in the past was a CBT therapist, who was very sensitive to the therapeutic alliances he had with his clients.

 

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Comments (2)

manfieldOctober 6th, 2014 at 11:59 am

I liked this very much! Nice overview.

StephTobinNovember 10th, 2014 at 1:04 pm

Glad you liked it. Thanks for your comment.

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