Tips for Choosing a Psychotherapist:
Choosing the right therapist for you.
What is psychotherapy and who are psychotherapists?
Where should I begin?
Are different credentials important?
How do I decipher those degrees?
Where else can I look for ideas?
Why is an interview important?
How do I set up an interview?
What should I ask?
Am I looking for certain qualities?
Making the final decision.
Choosing the right therapist can be like finding a needle in a haystack. And sometimes, it seems like the first step is even finding the haystack. There are so many choices, and so many therapists have different titles and letters behind their names. The prospect of choosing the one person who will fit your needs can be overwhelming.
Knowing just a few key points will set you on the right path. And having the right questions to ask can be a better starting place than trying to find all the answers.
At its core, psychotherapy serves to help clients solve problems. The wide range of approaches to this service is varied and diverse, but every good therapist has his or her clients' needs at the center of that approach.
Psychotherapists might be called "therapists," "counselors," "psychologists," or "psychiatrists." These terms might refer to the individual's educational background or a specific state licensing category. In fact, some states allow almost anyone to legally practice psychotherapy; at times, the quality and amount of academic education and professional training, or lack thereof, contrast wildly.
However, most states regulate the mental health professions, requiring a certain amount of education and training before allowing therapists to hang out a shingle and start working with clients. These states keep a database of licensed therapists and often provide information about the professional's license, education, and practice history. Certain states include a listing of complaints made against a license holder and the outcomes of those complaints. Generally, you'll find this information available through your state's department of professional regulation.
While this information is not necessarily a guarantee that each and every practicing psychotherapist is a competent, ethical, or effective professional, it does offer valuable insight into starting your journey to finding the therapist who best matches your strengths and needs.
Recommendations and referrals are often the best way to start tracking down your therapist. Start by asking other people who are in therapy or who have personal experience with it. You'll likely find that your family, friends, and neighbors can offer insight.
Certain community members, like the clergy, also tend to have in-depth knowledge of local therapists. Other health professionals, such as doctors and nurses, are also knowledgeable sources of information about psychotherapists they come into contact with while caring for patients. This might not always be the case, but doctors generally have nothing personal to gain when recommending a specific therapist or making a referral. So asking for personal recommendations as well as professional ones offers a wider base of information upon which to your well-informed decision.
Keep in mind the referrals and opinions that come from those who know you best. They are in a better position to understand your needs and personality. In the end, the decision will be up to you, and choosing a therapist whom you already know socially is not a wise choice. Having a dual relationship makes it difficult for both parties to separate the personal from the professional.
If your health insurance plan limits you to certain network providers, definitely take a look at the list of providers. Even though referrals based on an insurance policy will sometimes point you to the therapist who is simply the closest, your pool of choices is probably larger than you realize. Undoubtedly, understanding your insurance coverage is a big part of the first step.
Most therapists and counselors have pursued Masters or doctoral programs in psychology or related behavioral sciences. There are several ways to become a therapist, and licensed professionals must also meet state or national standards for post-graduate education, clinical training, and supervised field experience.
Professional organizations and academic institutions also offer certifications for more specialized training in certain areas. Evaluating the competency of an individual often involves evaluating the competency of the institution that awarded the diploma or license. Look for therapists who studied and trained at respected, established institutions.
Most states recognize five categories of licensed psychotherapists:
- Licensed Marriage and Family Therapists (LMFT)
- Licensed Psychologists (PhD, PsyD)
- Licensed Social Workers (LCSW, LSW)
- Licensed Professional Counselors (LPC)
- Licensed Psychiatrists
Doctors of Philosophy (PhD), Psychology (PsyD), or Education (EdD) complete at least four years of graduate school, and they are all eligible for state licensing exams. Psychologists can choose to specialize in a wide variety of non-clinical practice areas, including statistical research, industrial psychology, diagnostic testing, and evaluations. Only those who have passed the exams and been licensed can call themselves psychologists. You might also encounter PhD's from other academic fields who still practice therapy in some form without being licensed or clinically trained.
Usually, Licensed Clinical Social Workers (LCSW), Licensed Marriage and Family Therapists (LMFT), and Licensed Professional Counselors (LPC) have at least two years of graduate school and have earned a master's degree. Some may hold additional doctoral degrees.
Licensed Social Workers often have other credentials, including BSW (Bachelor's of Social Work) and MSW (Master's of Social Work). The ACSW (Academy of Certified Social Workers) distinction includes completing a two-year post-graduate national credential. And the BCD (Board Certified Diplomate) or DCSW (Diplomate of Clinical Social Work) is a five-year post-graduate credential. In addition to practicing in a clinical setting, social workers are also trained to specialize in a variety of areas, including community organization and development and administrative management.
Licensed Marriage and Family Therapists and Professional Counselors have other Masters degrees such as MA's (Masters of Arts), MS's (Masters of Science), or M.Ed.'s (Master of Education). These mental health professionals have received specialized training in the area of family systems.
The title of Licensed Professional Counselor applies to a wide variety of more generalized training in the area of psychology and counseling.
Professionals with other forms of training and credentials also practice psychotherapy in some form or another. This includes Pastoral Counselors carrying the credentials M.Div. (Master of Divinity) or ThD (Doctor of Theology), Psychiatric Nurses with RN (Registered Nurse) or MSN (Masters of Science in Nursing) distinctions, and Certified Addiction Counselors with CAC I, II, or III qualifications.
Medical Doctors (MD's) may also be trained as psychiatrists, and the title of psychoanalyst applies to professionals trained to practice the Freudian or analytical psychodynamic approach. Within any of these groups, you may find hypnotherapists, who have studied the clinical use of hypnosis and meditation techniques, and sex therapists, who specialize in sex therapy.
You'll always find lists of mental health professionals in the trusty yellow pages and local newspapers and directories. Just remember that advertisements selling a therapist are just like any other ad; they aren't always what they seem, and they don't provide any assurances that the person is truly qualified, experienced, or reputable.
Directories and referral services are great sources of information, but they typically only give out names of therapists who have paid for that service, and many referral companies receive a commission for those referrals. So they may be choosing the therapist with the deepest pockets, not the deepest insights.
Agencies and group practices, especially large ones, often assign patients to a therapist based entirely on schedule openings. Established practices usually hire reputable, experienced doctors, but they don't always make much of an effort to match compatibility.
There's no surefire way to know that a therapist is good at what they do. Credentials, diplomas, certifications, and licenses are good starting points, because they show that a therapist has pursued academic education and professional training. But they may not tell the whole story. Check into the universities and training programs where your prospective therapists learned to practice their trade.
Look for members of recognized professional organizations like the American Association of Marriage and Family Therapists, the National Association of Social Workers, or the American Psychological Association. These associations hold their members to ethical and educational standards and often maintain records of complaints against mental health professionals and the outcomes of those complaints.
After asking around, you may find that the same person was universally recommended. That's a good sign that you've found someone competent, but is this therapist compatible with you?
No matter what leads you to a therapist, a personal interview is essential, because it is the only way to know for sure that you'll be able to build a working relationship with this person. Meeting your prospective therapists and seeking them in action is part of gauging a personality fit. Besides an interview, a therapist's public presentation or workshop is a great way to learn about his or her personality or practice style.
Even highly recommended, experienced therapists and counselors aren't a perfect match for everyone. It's not always a matter of doing a good job; some personalities just don't mesh well.
As a patient, you need to be comfortable with your therapist. You'll certainly need to entrust your deepest emotions to this person. So you should take the time to interview a few choices. Ask questions, and get a feel for their personal and professional styles. After all, you wouldn't hire an employee without an interview.
The first step is a phone call. Most therapists are difficult to reach directly on the first call since a good therapist will be devoted entirely to the client during an appointment. Always be prepared to leave a message. Details such as how you were referred and how to reach you are important, and don't forget to leave your phone number. It's easy to get flustered, so try to remember to say your name and number twice, just in case.
You can expect a brief conversational interview over the phone with most therapists when they call you back. This is a good time to bring up what you're hoping to achieve through therapy and why you would like to interview them in person. Most therapists will also want to schedule an in-person interview. When you're setting up an in-office interview, be sure to ask about the charges for the visit. Payment arrangements for an interview session range from no charges to full fees. You might meet for a few minutes or an entire hour. Just remember, there's no harm in asking what to expect.
Ask any question that you might have about the therapist's process and polices, or really anything else you want to know about therapy. Here are a few questions to get started:
- When is your schedule open? How long is the wait for an initial appointment?
- Are you available for appointments on weekends or evenings?
- How long are your sessions?
- What is your theoretical orientation for practicing therapy? (Cognitive Behavioral, Solution Focused, Family Systems, Collaborative, Psychodynamic, Behavioral, Humanistic, Existential, or Transpersonal?) What's the difference? Is a combination better?
- How long have you been practicing psychotherapy?
- Do you have a specialty?
- Do you have a consulting supervisor?
- What kind of experience do you have working with others who have issues similar to mine?
- Is the expected time frame to treat my kind of problem a long-term or short-term course of treatment? What results can I expect?
- Do you prefer individual, group, or family therapy?
- Do you prefer to meet at certain intervals such as weekly or monthly?
- Where do you practice?
- Are you available for emergencies by phone? Do you charge for taking phone calls?
- Have you ever been in therapy yourself? If so, what did you learn about your own practice?
- Is it okay to contact you by e-mail? Do you charge to read e-mails?
- What is your policy for cancellations, rescheduling or missed appointments?
- Do you carry liability (malpractice) insurance?
- Do you charge for an initial appointment? How much?
- What is your regular fee? Do you accept reduced- or sliding-fee clients?
- Do you offer a cash discount?
- Do you accept checks, credit cards or PayPal?
- Will I be required to pay in full at the time of service, or can I set up payment arrangements?
- Are you in my insurance plan's mental/behavioral health network? Do you file my insurance claims for me?
The relationship between you and your therapist is of primary importance. A therapist's personal qualities, attitudes, expectations, beliefs, and values matters as much as their particular technique, approach or theoretical orientation in making therapy work. The following are questions you may ask yourself to determine how compatible you felt during and after your interview:
First of all, a good therapist should be comfortable answering your questions about therapy. Being a good therapist involves far more than listening to clients talk. During an interview, an experienced practitioner will convey warmth, genuineness, and respect for you and your concerns. He or she should be interested in your thoughts and may ask you to elaborate on certain things.
After the interview, ask yourself if you received specific insightful feedback. A good therapist should display a mutual trust and not be afraid to confront or challenge you and your notions when there's productive feedback to be offered.
Trust your initial instincts. Did you feel comfortable talking honestly with this new person? Could you be yourself? Could you voice your disagreements, and did you receive a perceptive response?
The right therapist will make you feel at ease and confident in them as both a person and a psychotherapist. Human wisdom and personal insight are just as important as understanding technique and theory. Ideally, you'll feel inspired and hopeful about your work together after the interview.
Even the most highly recommended, experienced therapist may not be the most effective partner for you. Qualifications are important, but you might click with a newly minted therapist with the natural ability to empathize and communicate.
The personal, human factor can make all the difference in your treatment, and the theoretical practice style or technique may not matter at all. That's why the interview is so important to making the final decision.
You deserve the opportunity to find a therapist who will help you make the decisions that will shape your journey and your future destination. Your ideal therapist should have a balance of professional credentials and training, a natural ability to communicate, and ethical, caring standards.