You wouldn’t buy the first car you saw at car lot and you shouldn’t hire the first psychiatrist, psychologist, or therapist you come across either. Deciding to see one of these specialists can be more of a life changing decision than that car; some caution and research on your part is highly recommended.
Therapy isn’t as expensive as buying a car but we should do more research when we think about choosing a therapist. Therapists, psychologists, and psychiatrists hold special areas of trust. They have the capability to really help you. They also have the capability to cause you significant harm.
Be willing to put in some time and effort to find and select one of these people. You are always the expert on you. No one else can get inside your head, your body, your emotions, your memories, and feel or experience these things except you. Remember, you are a consumer trying to make an informed choice about the person you’re hiring to work with you and for you. You are buying a service. You are the employer, the boss, and should be in charge of your own therapy.
- You have the right to determine the qualities you want in your therapist,
- the right to be treated with respect,
- the right to say no to any of the suggestions or recommendations a therapist might make,
- the right to be satisfied with the services you’re receiving,
- the right to freely discuss any problems that arise in therapy with your therapist,
- and the right to end a therapy relationship that isn’t working for you at any time.
Even if you are in crisis and feel you can’t make it through the week if you don’t get help, hold off on committing yourself to a long-term therapy relationship until you’ve looked around thoroughly. Ask for recommendations from friends and other sources.
Most of us have been to a doctor with 10 or so questions in our head we wanted to ask, and found when we left we’d only asked two. Write down a list of the things you’re looking for in a therapist and from therapy. When you talk with a therapist, psychologist, or psychiatrist you are actually doing an interview. Your list of things you’re looking for is actually your interview questions and the criteria you’ll use to hire that person.
Use your list to ask questions of each person you contact to get a sense of their attitudes, experience, and ways of working. Make sure you voice your needs and get answers about how they can help.
Psychiatrists are medical doctors, typically prescribe medications, and may or may not provide any talk therapy themselves. They focus on a medical model of mental illness and typically ignore trauma and other possible causes. Some therapists, psychologists, and psychiatrists may have training and experience in trauma and other areas while some may not. Psychologists have doctoral degrees while other therapists have master’s degrees with specialized licensing and skills.
You can save time and money by doing some preliminary screening on-line. “Psychology Today” and “Good Therapy” are two good on-line resources. Check the state licensing board for each person you are considering. The Resources page has links to check licensure status, complaints licensing boards may have received, as well as a means to file complaints. Most clinicians have Facebook pages, websites, and email so you can see what they do and send them your questions. Contact those you are interested in and talk to them via phone if at all possible. These people are busy and may not be able to take your call. They also have their own policies about taking phone calls, although many will talk to you for 10-15 minutes on the phone for free. Leave a voice or email message with your name and phone number and a brief description about what you are looking for. If they don’t respond in a reasonable amount of time scratch them off your list. If they do respond write down their answers to your questions.
Therapists should state what theories and therapy model(s) they use and why. Some theories to listen for or ask about in couples or marital therapy can include attachment, social and emotional intelligence, family systems, strengths, self-efficacy, hope, choice, trauma, gender, privilege, power and control, and domestic violence. Key, evidence-based models to listen for or ask about in couples or marital therapy can include emotionally focused therapy EFT by Susan Johnson, narrative therapy , Gottman marital therapy, and integrative therapy.
A good therapist will use several models and theories interchangeably as they work with you and will be able to explain why they use these models and theories, their benefits, limitations, and potential for harm to you in depth.
Steer clear of those therapists who say they use an “eclectic” style or focus, state they focus on communication, or are vague in their answer to this question.
If there is violence in your relationship, steer clear of a therapist who states he or she can stop that violence.
A therapist should not push for saving a relationship at all costs and should not push their own personal or religious views about relationships.
A therapist should meet with a couple (or family or individual) in a structured sequence such as:
- An initial meeting discussing the statements above and an agreement between you and your therapist to work together,
- Assessment to gain a sound understanding of your problem(s) and history,:
- First session with couple
- Second session with each individual
- Third session with couple to discuss recommendations, create a treatment plan, and go over rules
- Some sessions with couple, some sessions with individuals
- Therapist should state that couple is the client, not the individuals
- Therapist should never blame one party while protecting the other
- A therapist should state and abide by three specific rules in couples or marital therapy:
- If any form of physical violence within a couple surfaces during assessment or therapy the therapist should stop couple’s therapy and only individual work, possibly with other
therapists, should be done.
- The couple is the client, not each individual.
- There can be no secrecy between the therapist and either party in the couple.
Once you’ve interviewed several, compare the way you felt when you were talking with each of them. Who did you feel the strongest connection with? With whom were you most at ease, felt you could trust? How did each person respond to your questions and concerns from your list? Compare their expertise, availability, philosophies, and cost. Then make an informed decision for yourself and schedule an appointment.
After 3-5 actual therapy sessions take another look. Do you feel hopeful you’ll be able to resolve your problem(s) with this person? Remember, you are buying a service and paying a professional for expert help. Are you getting what you’re paying for? If not, say so. A good therapist will listen, explain themselves, and make changes in what they’re doing with you. And good therapists should be doing the same thing. If they don’t see their clients improving they should bring up their concerns -without blaming their clients.
When you’re evaluating potential therapists, there are some additional guidelines you should keep in mind. It’s important that your prospective therapist:
- thoroughly explains their recommendations for you and gives you full choice of whether to proceed or not
- never minimizes your experiences or your pain
- gives you room to explore your own history without trying to define it for you
- fully respects and encourages you to express your feelings (grief, anger, rage, sadness, despair, joy, etc.)
- encourages you to build a social support system outside of therapy
- teaches you skills for taking care of yourself
- encourages your contact with other survivors of abuse and/or neglect (if needed)
- keeps the focus on you, not on your abuser (if you were abused)
- has information (or is going to get information) about the healing process for adults who were abused or neglected as children
- is willing to discuss problems that occur in the therapy relationship (they will occur)
- is accountable for any mistakes that he or she makes within the therapy process or relationship (they will occur)
A good therapist is also one who:
- explains the techniques they use within therapy and why they would benefit you
- doesn’t force you to do anything you don’t want to do, yet encourages and at times pushes you in
- order for you to progress and to heal
- doesn’t blame you for lack of progress in therapy but instead re-examines their own behavior and
- efforts within therapy
- doesn’t talk with you about his or her own personal problems
- doesn’t blame you for or argue with you about your problems
- doesn’t push you for reconciliation or forgiveness
- doesn’t try to have a friendship with you outside of therapy
- doesn’t push their own religious views or values and respects yours
- doesn’t try to have a sexual relationship with you either now or in the future
- doesn’t search for or encourage you to search for forgotten or repressed memories
- doesn’t pressure you to say you were abused
Therapists should talk about their professional boundaries and ethical requirements about confidentiality at your first session, before the assessment begins.
Therapists should visibly display proof of their education, license, and additional certifications, and should give you a copy of their professional ethics if you ask for it.
Costs should be stated at the outset, as well as probable length of treatment and possible outside referrals as soon as possible after your assessment.
Some people, with good reason, do not want to be labeled with a mental illness. Your prospective therapist should be able to work with you on this. However, this will probably mean your insurance will not pay for your therapy.
Ask how much time in therapy your prospective therapist proposes. Be aware they won’t generally have an answer till after your assessment is completed. What specific and focused topics will be discussed? Some people find themselves having pleasant conversations for months and years with little improvement. That’s a waste of your time and your money. Your therapy must be focused and individualized for you.
This may seem like a lot of work for you, before you even sit down with a therapist. Remember, you are a consumer trying to make an informed choice about the person you’re hiring to work with you and for you. You are buying a service. Don’t sell yourself to an expert. Be in charge and take charge of your therapy