Psychiatry / therapy

Choose Your Therapist

 

The one thing that has made me the most self-aware, insightful, and empathetic towards others, especially my patients?  Psychotherapy.  Everyone can benefit from going to therapy.  I probably refer 80% of my patients to a psychotherapist, especially since I believe that the best treatment plans consist of more than just medications (or may benefit from therapy alone, depending on the case).  When choosing a therapist for myself, I was fortunate to have a trustworthy former supervisor refer me to two great therapists since I first started therapy during residency, though I realize that most people don’t have the luxury of having a go-to person to help them navigate their local mental health resources.  I pride myself and put effort into referring my patients to therapists whom I believe will be a good fit.  If you’re wondering whether or not you’re ready for therapy, I wrote a previous post that addresses that question here.

The following are some guidelines/tips that I use when choosing a therapist for my patients or suggestions I would give friends/relatives if they were looking for one themselves:

  • Keep in mind that the most crucial factor for effective therapy is the connection you have with your therapist.  The connection is important for feeling safe, developing trust, and creating a mutual understanding of your goals in therapy.  Even if the therapist listed trained at the most elite programs or was Dr. Phil himself, if the connection doesn’t develop over time, then it’s best to move on to a different therapist.
  • If you see a psychiatrist and feel that he/she knows you pretty well…Ask them for a therapist referral based on your history and goals in treatment.  Note: if your psychiatrist does NOT know you very well and solely focuses on medications and symptoms, then see bullet points below.  I work part-time for a Health Maintenance Organization (HMO) where we have designated therapists/case managers (who may or may not know the patient/client) make the referral, yet I’ve made efforts to connect with the contracted therapists so that I have a sense of their therapeutic style to gauge which therapists would work best with my patients.
  • If you have a friend or family member currently in therapy…Ask if they’d be open to inquiring with their therapist to provide any recommendations for you (Note: make sure your friend/relative actually likes their therapist and trusts their recommendation).
  • Nuts & Bolts:
    • if it’s important to see a therapist who accepts your insurance:
      • take a look at the in-network provider list, or search online directories such as Psychology Today (there’s a section under the profile of accepted insurance plans) and research information on the therapists online.  I recently gave a close friend the gift of psychotherapy sessions as a birthday present (yes, I try to be both creative & meaningful with my gift-giving ideas) and since I didn’t live in the area, I resorted to an online therapist search.
    • Whether or not you need to see an in-network provider, when narrowing down your list, consider the following:
      • Gender preference
      • Photograph – this is not intended to be superficial.  Since having a connection is important, you’d likely want your therapist to appear like someone you can feel comfortable sitting across from and opening up to.
      • Location – if transportation is a crucial component, then limit your search to local therapists.  I personally drive one hour to see my therapist in Los Angeles, but I’m okay with the distance because I’m willing to drive further in order to see my therapist, who came highly recommended, versus seeing someone questionable, yet closer.
      • Cost – if on a budget, there are several therapists who offer discounted fees on a sliding scale dependent on your income.  If you’re a student, be sure to look into your school’s counseling and psychological services (usually covered if you pay for student health benefits).  If you work for a large employer, they may have Employee Assistance Programs (EAPs) that provide confidential counseling services for their employees.  However, if choosing to pursue out-of-network providers, mental health professionals in private practice may charge anywhere from $50 to over $200 a session depending on location, credentials, and experience, though cost can be greater in larger, metropolitan areas (for example, in Los Angeles, a psychiatrist who provides both medication management and psychotherapy may charge around $400/hour).
  • When in doubt, try it out.  Yes, I’ll admit that some of my referrals haven’t worked out, but for the most part, the initial experience may solidify even more which qualities you prefer in a therapist.  I’ve even had a few patients request to see a a different psychiatrist other than me for specific reasons (usually because I look too young) and that’s okay because this is your treatment and we each have our preferences.  When you meet for the first time, take note of how you feel while interacting with the therapist (do you feel invited to share, does the therapist have a genuine interest in understanding you, does the therapist seem invested in working with you to help determine the issues impacting you the most?).  Keep in mind that just like any relationship, building the therapeutic relationship may take some time, but as long as there’s forward movement in the process, then I hope you commit and stick with it!

Any other comments or suggestions??  If any of you are in therapy, I would love to hear of tips/information you found helpful when choosing a therapist, or, if you’re a mental health professional, I truly welcome your thoughts on how to choose a therapist as well!

 

 

13 thoughts on “Choose Your Therapist

  1. Awesome post! You definitely covered the most important points to consider. I’ll add that, at least for me, the office environment is extremely important. For example, whether the therapist has a desk between myself and her (I could never have a male therapist), or whether the waiting area makes me anxious (difficult to get around that one in my case), or if the therapist has a dark/bright office or a big/small office (smaller makes me feel safer while talking about such difficult stuff).

    As an aside, I panicked a bit with the part about having patients asking for another psychiatrist due to your looking young. I look ridiculously young so that’s always in the back of my mind. I don’t mind patients seeking someone who they feel more at ease with, I just hope they don’t all run as fast as they can as soon as they see me haha!

    Take care!

    • great point about the therapeutic environment. i tend to be more psychoanalytic in my thinking, therefore pretty much anything from the placement of a desk, location of frames, color scheme, room temp, etc can play an important role. I hear ya about the concern with the age/looking young thing…i’ve honestly only had a few who requested a transfer, but for the most part the overall therapeutic connection and the perspective i bring to the table allows most to trust in me as a provider. Sometimes my older patients call me sweetie or hun, which i’m okay with also (took me awhile though) because i believe some relate to me as a daughter/granddaughter type. so you’ll probably encounter a few situations, but working with the transference & building your professional identity is part of this fun process 😉

  2. These seem like good, sound, practical suggestions. However, there may be other, more eclectic criteria. For instance, can the therapist find metaphors in photographs? Does he/she enjoy time (a LOT of time) spent at the beach? Just a couple that occurred to me at random.

  3. I’ve been on both sides of this issue, mostly in terms of being the client, although I have had the opportunity to informally counsel more than one person who was themselves a trained mental health professional.(grief issues and parenting issues).. a lot of times its just finding someone who will listen and validate what you’re struggling with..that goes a long ways in terms of instilling home. Just knowing someone cares…I knows there’s more to it than that, but it is a huge component. I think your suggestion about compatibility and trust are key for me personally. Wife and I just sat down with a young woman w/ several certifications behind her name who was young enough to be our daughter..that was a little surreal, but she was awesome and we were able to make some excellent progress.

    As far as finding someone, I know several people in the mental health field, so any more my first choice is get a personal recommendation. great post! DM

    • Thanks DM…and good to hear that you had a positive experience with the young therapist (i’d hope my patients view me in a similar way!). a good listener & someone who understands are extremely important qualities to have in a therapist. you understand a lot about the mental health field, so i’m sure you make great recs to your friends!

  4. Good post, I wish I had known four years ago. I would “add” to ask for a “spiritual position or belief system”. Some people need it some don’t

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