How Do I Choose a Therapist for Counseling?

    You may be therapist shopping already: glaring into your smartphone or computer monitor entering keywords into a Google search with the hope that you will happen upon someone who will listen to you and understand.  They need to get you and your situation.  Further, they need to be affordable, or better yet, part of the mental health provision of your health insurance plan.  A simple query yields so many different people with so many different qualifications.  They all seem to want to help and their websites offer such kind and supportive words.  How do you choose?

Like buying a house, picking a partner, or selecting a pet, choosing a therapist for someone to talk to is a very personal decision.  And if you are seeking couples therapy, that choice must please both parties–a daunting task indeed!  You are right to discriminate because if you find someone with whom you connect, profound change and personal growth in your life can occur!  In short, that is the strategy to picking your therapist:  he/she is the person with whom you connect.  Virginia Satir, one of the most prominent therapists in the 1960’s and 70’s, is often quoted saying:

I believe the greatest gift I can conceive of having from anyone is to be seen, heard, understood and touched by them. The greatest gift I can give is to see, hear, understand and touch another person. When this is done, I feel contact has been made.

This is your target, your vision, when choosing a therapist:  to make contact with your therapist and your therapist should make contact with you while you are meeting together.  Here are some considerations when making this selection:

• Like buying a new car, know what you are looking for in a therapist before you start searching.  Basically, what is the issue that you want the therapist to help you with?
  • Do you want a psychiatrist, a psychologist, a marriage & family psychotherapist, or a licensed professional counselor?  All are educated with the same basic training in mental health. A good clinical psychologist has a doctorate, therefore more years of education and research with the degree.  That extra education may come at a price when it comes to the fee you pay.  A psychiatrist is a medical doctor and is often sought for psychotropic medications.  Psychiatrists are highly educated in medicine and very well versed in the function of the brain as an organ in the body.  Unless you are paying out of pocket or have health insurance, psychiatrists are difficult to find.
  • A marriage and family therapist and licensed professional counselor have basically the same mental health training.  Not all marriage and family therapists (MFT) specialize in marital or family counseling–many do have particular specialties (e.g. play therapy with children, teens and adolescent problems, gay clients, depression, anxiety, anger management) but are all trained to work with couples and families.  Many licensed professional counselors (LPC) are very competent in marriage and family counseling.  LPC’s can specialize in particular areas of mental health just like MFT’s, hence the reason you want to know what you want to solve or improvewhen looking for a therapist.

• Expand your search for a therapist BEYOND the health insurance provider directory.
  • Most people will constrain themselves with the health insurance directory because they want to find an in-network therapist whose fees are covered by insurance.  All the client has to do is show up, pay nothing out of pocket, and billing is handled by the therapist.  Sure, you may find a therapist this way, but are you able to make contact with this person?  If not, cheap therapy fails to be good therapy.  You may be able to find another provider in your insurance plan’s directory, but always make sure you can make contact with this person if you agree to services with them.

• DO NOT rely solely on the content of Google ads and searches to find a therapist.
  • A Google ad or search result will answer the following questions for you:  Who is this person?  What are their credentials (psychologist, marriage and family therapist, psychiatrist, professional counselor)?  How long have they been in practice?  Are they located near me?  What do they specialize in (e.g. depression, anxiety, autism, substance abuse, bipolar disorder, etc)?  How can I contact them (e.g. phone call, email, text, etc)?  Basically, how do they practice therapy (what is their therapy theory)?  Are the session fees affordable?  Do they take health insurance?  If not, are there other payment options?
  • All of this information tell us you many facts about the therapist, but the facts alone do not enable you to know the therapist.  A personal phone call can tell you a lot!  If they don’t return your call, they may be too busy to take you on as a client or it may say something about their level of professionalism.  If they do return your call, ask them questions about your situation and how they may be able to help you.  You don’t want to tell them the whole story–just the necessary facts that you would be willing to share with anyone.  If you go into the situation too deeply, you may be attempting therapy over the phone, which you don’t want to do!

• Make it a point to meet the therapist in person.
  • Just because you have met them in person does not obligate you to see them for the long term.  You want to meet them to determine if you can make contact with them and they can make contact with you.  Even if you completed a mountain of paperwork and assessments, you can still walk away.  Bear in mind, simply because a recommended therapist helped your best friend does not necessarily mean the same therapist will work for you!  Going weekly to a therapist you dislike is like subjecting yourself to a repeated bad date.  Meet them in person and size them up.  If he/she works for you, great!  If not, keep looking!

• Once you select a therapist, prepare for a mountain of forms and paperwork!
  • “What is all this?” you may ask.  You need to be warned: the mental health field is like the medical field: there’s paperwork. Sometimes these forms are combined into a single document, but here are the basics of what you will receive:
    • The first form you will encounter is the HIPAA Notice of Privacy Practices.  This informs you of the therapist’s promise to keep your personal (protected health) information and therapy records private and secured, but also discloses the various ways your information can be shared, sometimes without your knowledge.  Surely, you get this form from your doctor and it ends up in a pile on your desk or round-filed.  But it is in your best interest to read it and understand what it says because the circumstances in which your records can legally be released may surprise you!
    • The second form you will encounter will be Informed Consent.  It explains the therapeutic process, what you can expect, and defines the therapists obligations for confidentiality, as well as the exceptions to confidentiality.  There are exceptions?  Yes!  Read the document.
    • The third document you will encounter will be the Practice Policies.  This document explains how the practice does business with the client.  It explains the appointment and cancellation policies, specifies the fee, identifies the therapist’s availability to the client throughout the therapeutic relationship, means of communication (telephone, video conferencing, texting, email, etc), and the means by which treatment can be terminated (e.g. no-shows, not responding to calls, etc).
    • Finally, you may be asked to complete an assessment.  The therapist’s primary concern at earliest stage of therapy is life-threatening risks.  Is there a history of suicide, suicide attempts or ideations?  Is there a history of self-harm, like cutting or hair-pulling?  Has there been a history of mental health hospitalizations?  Are you currently taking any meds?  How are you eating, sleeping, exercising?  Do you have any hobbies?  Are you in a relationship, and how is that going?  Do you smoke or use drugs/alcohol?  By getting this information before the first session, the therapist will be in a position to know what specifically needs to be targeted that may very quickly alleviate your pain and suffering.  The more complete the information provided in the initial assessment, the more therapy will serve you right out the gate.

In summary, therapy is a life-changing decision since what you learn about yourself in therapy will affect how you live the rest of your life.  Choosing a person to guide you in this learning process is very important because you are trusting their knowledge, skills, and experience to help you relieve suffering and achieve your goals.  Once you have narrowed your selection of therapists to specific individuals, meeting them will help you determine if, together, you can make contact with each other.  Once contact is made, the therapy process can begin.