Searching for your Therapist
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There is a whole slew of things you should look out for when on the market for a new psychotherapist. To get you started, take a look at the following attributes:
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Gender: Having a male or female therapist might be a silly question to some people. But sometimes it can make all of the difference in the world. Trauma, parenting practices, culture, identifiable influential figures in your life, and so on can definitely help or hinder what you think of or how you feel about your therapist. Some people incorrectly think that the same gender therapist is their best option; but the true test of course will be once you are in the room with the person. While those believe in gender equality are correct, the brain anatomy is often different between men and women along with cultural differences. Some examples including a larger corpus colosseum in women and a larger overall brain volume in men and for cultural differences perhaps having more of an analytical versus feeling provider. These presented facts are not hinting towards my preference but is showcasing to you that you might have one. These variables often lead to personality differences in your therapist, and the only thing that makes one better than the other is what you are looking for in a therapist.
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Age: This variable is often one either overlooked or marginalized by many clients. Yes, the goal of course is to choose a provider on their merits rather than their age. I suppose all of us on the outside want to appear to be politically correct and not choose what some might perceive as age discrimination. However, imagine a 74 year old prospecting client meeting a 34 year old clinician for the first time. Can you think of some cultural barriers? First, is the misnomer that age inherently breeds experience where the 74 year old might have a hard time envisioning how such a "kid" might be able to help them. Secondly, how has values and our environment changed over the past 30 years and ask yourself if that might be a problem for some people.
Role: Does your therapist think they have all the answers, work together getting the answers with you, or is there a therapist out there that wants you to evoke your own solutions to very unique problems? Generally these roles are broken up into three positions: Expert, Guide, and Student. Typically, visitors to treatment (clients not invested in treatment or think that they can't be helped) do better with Student-role therapists and persons what often seek advice would do well with the Expert variety. The Guide-role is sort of middle of the road, but generally this position does not fit everyone. A good therapist will alternate between these roles depending on the client or situation. Most therapists however do not posses this ability. When selecting a professional, a good possible hint towards their style of therapy would be the model(s) they practice such as Cognitive Behavioral Therapy (Expert position generally), Solutions Focused Brief Therapy (Student-Role), or Person Centered Therapy (more like a Guide).
Background: Does your therapist actually have experience treating children, have a degree to back up their specific population (e.g. mandated clients with a degree in criminal justice), or have any useful services that might come in handy in the future (e.g. drug testing for court reports). Some professionals you may meet may never have seen outside of a classroom and were a career student and "green" around the ears. Typically you will find most of these new or inexperienced professionals in cookie cutter nonprofit programs. However, there are a lot of good reasons to go with these programs still, they get special contracts and government grants for very specific programs that could be beneficial for you and your family. Often for low to little cost due to government allocations and donations from the general public. However, many of these programs these days have fee for service therapists which negates many of the benefits nonprofits once had and are often more motivated by feeding their family much like for-profit businesses.
Type of Therapist: Marriage and Family Therapists view pathology systemically or being influenced by a great deal of things in your life that forms various patterns. Social Workers are more numerous and typically are great at finding resources or what they call case management. Professional Counselors have advanced training in counseling and specialize in physical and mental disabilities with a strong foundation in vocational rehabilitation (work that you do), Psychologists typically deal in advanced testing and severe pathology, and Psychiatrists are medical doctors that can prescribe and only typically do nominal or no psychotherapy. Yes, there is also a ton of overlap between these professions, and typically (minus prescribing) many therapists can and do function in many of these roles and specialties. (e.g. a Professional Counselor can do a ton of case management)
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Insurance: A provider telling you that they take your insurance might make you feel good initially, but that is pretty much all it does. Minus state insurance such as Husky/Medicaid, many private insurance companies require costly deductibles to be reached first before they will pay anything or ask you to pay just your copay. For you unlucky ones with co-insurance (e.g. a 80/20 split) sometimes this becomes exponentially harder to comprehend. Paying full price for psychotherapy is either the negotiated rate of your insurance provider or an adjusted rate if you choose not to use insurance. With the exception of a couple insurances with children, most insurances do not cover case-management for adults (e.g., provider phone calls, etc.).
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In Person or Online?: Does your therapist have a security system? Is the space comfortable and clean? Do they use technology such as a TV or computer? You'll be surprised with the answers to some of these questions. Online or "teletherapy" is probably the most frequent question we are asked due to convenience and cost associated with the client. Change Talk LLC prides itself in NOT initially offering online therapy services due to our belief that most psychological problems stem from relational problems that most professionals will likely agree are exacerbated by the use of electronics and social media. More importantly encouraging you or your loved one to leave your home and see a professional is usually the first step towards breaking the habitual cycles of behavior associated with many disorders. Lastly, if substances are involved, it makes things very difficult for a therapist to help a person under the influence of drugs and alcohol due to said format having many exploitative opportunities for those struggling with addiction.
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Reviews: This section might certainly surprise you. DO NOT use reviews as your primary means of selecting the right therapist. If you do, make sure you attempt to ascertain the context surrounding the many possible reasons why that reviewer selected such a harsh review of a therapist. As one of countless examples, if a therapist is serving a client who is a child when it comes to a court proceeding, their agenda does not always lay favorably with the parent who has been drawn into court. Consequently, not taking responsibility for their own shortcomings, project their anger towards the therapist. Please also keep in mind that most psychotherapy-related professional associations discourage a clinician from actively soliciting for a favorable review from their clients. After all, it defeats the purpose of confidentiality if a client posts online both their experience while identifying themselves. Secondly, even negative reviews can be actively concealed or completely removed by reputation management companies. Lastly, please keep in mind the nature of the business we do. The best providers care less about political or advertising liability clientele and focus more on quality of care knowing the outside risks if that client relapses, cycles, or fails to follow their treatment plan. Oftentimes, most of the negative reviews for other practices I come across are associated with the provider maintaining clear boundaries to their previous clients.
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Other Info: How many times has your therapist been married? Did your therapist become a counselor to work out their own problems? Did they succeed? Does the clinician not take "special populations" that they are biased against (e.g. sex offenders). Does your therapist consume alcohol on a regular basis? Sounds like hard questions to find out answers too, but just looking around the office or their internet page can tell you a lot about a person that you are about to put a great deal of trust in. Some good examples of detective work are looking at family photographs, if they have a cork collection on their shelf, drinking merchandise, pictures partying, hanging their high school diploma, postings indicating that they specialize in gender specific issues, etc. Yes, answers to these questions by themselves may mean very little, but the more clues that begin to add up, the better idea of the direction you want to go. As part of a potential intake process, many good therapist offer referrals if you are not a good fit for their services, however, please don't call more than one therapist at a time and do what is called "therapist hopping." Give that therapist that's meeting you an equal shot by completing your initial intake and asking for their assistance towards finding the right counselor for you.
Just because you are beginning to use the therapist as your primary counselor does not mean that you have to stick with him/her. If he/she gives you bad juju, move on, but also realize that if the solution was meant to be comfortable or known to you, chances are there would no longer be a problem and the initial reaction for some clients is to over judge or even challenge their prospective therapist. Lastly, many therapists don't have receptionists. This is typically not a downside after meeting your clinician for the first time. Most insurance policies require to have some way of getting a hold of your therapist after hours. Once your intake is over many therapists will give you their business cell phone that you can call/text/email when they are still awake. Again, having access to your clinician 24/7 does not mean you should use that service. We ask that you reserve such availability for "urgent" cases. Not sure what might be considered an urgent case? Typically if it can wait during business hours, your next appointment, or if you are consistently asking yourself "Is this an urgent case?" that generally provides the answer. 211 (mobile crisis unit) and 911 crisis clinicians are your best bet for "emergency" cases that can't wait up to 24 hours. Clinician's are not robots and need time to unwind and not get burnt out!
