find the right therapist

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I get all sorts of questions about therapists and the counseling process from friends and family. I am thrilled about the decreasing social stigma surrounding therapy, whether for the individual, couple, or family. Finding a good therapist can be difficult, but it can also significantly help you and your relationships. I thought it would be helpful to create a webpage to help you find the best therapist for yourself, your relationship, or your family.

where to look
First, I suggest asking people you know who to contact (or who to avoid). There’s no better reference than a first hand account from someone you trust. Ask your family, friends, preacher, teachers, or doctors. I got lucky the first time I went to therapy – I asked my doctor if she knew of anyone and she recommended a fabulous therapist who was a near perfect fit for me. But many counseling stories aren’t all that rosy. I know people who have had lukewarm to terrible experiences with therapists, but we’ll get to more of that later.

If your contacts are coming up dry or if you’re simply too embarrassed to ask about counseling from people you know, there are many places you can find therapists online. Here are the two I trust the most:
Psychology Today
Goodtherapy.org

You can also look on your insurance company’s website for approved therapists, or look through a professional counseling association’s site, like the therapist finder at AAMFT.org (American Association of Marriage and Family Therapy) or the psychologist locator at apa.org (American Psychological Association).

If you need low cost or no cost therapy, there are places to find that, too. Open Path Psychotherapy Collective has a directory of therapists who will see you for just $30 – $50 a session. Many towns have various pro bono (free) options as well. For example, here in the Baltimore area we have the Pro Bono Counseling Project. Both of these options will pair you with a private practice therapist who can meet your financial needs. I am a member of each of these organizations and recommend them highly.

No matter what, trust your gut. If you can relate to what the therapist writes about or specializes in, and if she or he looks like someone you would be comfortable talking to, you may have found a good match!

letters

Once you think you’ve found someone, look for licensing or certifications. An LMFT, LGMFT, or LCMFT is a licensed couple and family therapist, LCSW means a licensed social worker, and an LPC is a licensed professional counselor. We all know what M.D. or PhD means, but some might not be familiar with the PsyD moniker, which indicates a “doctorate of psychology.” Licensed counselors and therapists have usually all attended graduate school and spent a considerable amount of hours counseling (usually at least 2000) in order to achieve their status. In addition, most states require that licensed therapists obtain a certain amount of continuing education credits each year. This is to, hopefully, ensure that we counselors are up to date on the most recent research and training in our chosen field (a little secret: a lot of us do a ton of research and reading on our own because we’re really interested in our jobs.)

Look to see if your potential therapist is a member of one or more national or international associations, such as the aforementioned AAMFT, APAIAMFC (International Association of Marriage and Family Counselors), ACA (American Counseling Association), or AMHCA (American Mental Health Counselors Association). These organizations, and there are many more, each have their own code of ethics their members must abide by in order to remain in good standing. If you believe your therapist is not behaving ethically, you can report to his or her association and/or to the state licensing board.

coaching or counseling
Coaches are there for you when you’re having trouble getting clear on what you want, when you want to achieve a goal, but don’t know where to start or maybe how to finish, or when you just need some extra motivation and encouragement.

Here is a helpful chart on some general differences between coaching and therapy, given to me by my coach, Brenda Bomgardner:

In short, if you’re having trouble functioning in your everyday life, seek out a therapist; if you’re having trouble setting goals for yourself or achieving those goals, seek out a coach.
 
If you’re seeing a life coach, which I highly recommend if you are looking for someone to help you move forward in your future life or career goals, try to find one that is board certified or has training in a human services field, such as counseling. Being a board certified coach means the person has gone through some training, which is especially valuable since anyone can legally wake up one day and say “I’m a life coach.” If you’re working with a coach and find yourself stuck or wanting more emotionally focused work (ie. you want to work on feelings of anger, anxiety, or depression, or issues in your relationship), ask yourself if perhaps therapy is a better, or an additional, option for you.

call

When you pick up the phone – or write an email – to contact a therapist, you’ll want to be as honest as you comfortably can about why you are looking for counseling. This helps you and the therapist to know whether or not you’ll be a good fit. Go into a bit of detail, but not too much. There will be more time for the full story once you’re in the therapist’s office. It can be nervewracking contacting a therapist, so here’s a basic checklist you can use:

  • What sort of education or experience do you have with my/our specific problem(s)?
  •  What are your fees?
  • Do you take my insurance?
  • Hours? Location? Parking? Public transportation?
  • Anything else you want to ask! There are no dumb questions.

1st appt

It’s the 1st session. You’re nervous, asking yourself questions like “What will she be like? Will he think we’re crazy? What have I gotten myself into?” If you’ve never been to a therapist before, it’s like walking into a small room with a stranger who has agreed to take your money to provide you with a product you know little about. It can be weird and feel awkward. You’re taking a big risk entrusting someone else with your problems, with your life. And kudos to you for your courage! I want to try to make it all a little less daunting, so here’s a brief guide of what to expect when you walk into a therapist’s office for the first time:

When you get there, you will be greeted with the usual pleasantries and a bit of small talk, but eventually you’ll have to get serious. Your therapist will soon ask “what brings you here today?” You may have talked about it on the phone prior to your appointment, but some version of this question will be posed to bring the focus to exactly why you’re paying to be there. Attempt to be as honest as you comfortably can be. It’s natural to feel strange about telling someone you’ve never met your most hurtful problems. You don’t have to say everything, just try to be truthful. This can be extremely difficult when you’ve come to therapy with a spouse and it’s the therapist’s responsibility to help you feel as safe as possible in his or her space. This is YOUR time. Use it wisely.

When you come to therapy for the first time, at some point in the session you will be asked to sign confidentiality agreements and other documents. Your therapist should verbally describe the important points of the documents to you. If you do not understand certain parts of the document, be sure to ask. Again, this is for you, not the therapist. Good questions to ask include:

  • Does anyone else have access to your files?
  • What do I do in an emergency?
  • Who will take over for you when you go on vacation or if something were to happen to you?
  • Will I/we have a diagnosis?
  • Can I/we give feedback?
  • What theories do you use? – I, for example, am quite interested in emotionally-focused therapy. Common approaches are cognitive-behavioral,solution-focused, and systems theory (for couples or families).
  • What sort of education or experience do you have with my/our specific problem(s)?

The therapist may also administer certain assessments or tests, depending on what your complaint is.

If you’re going with your spouse or partner, it’s also important to ask who the client is. Is it the person who called or is it the couple as a whole? You might also want to ask about confidentiality if you have individual sessions. Will the therapist keep secrets or is everything out the open, no matter what? (My advice here, don’t put your therapist in the position of keeping secrets from your spouse. You’re in therapy – be honest. This is probably the one place in your life where you won’t be judged for what you do, within reason.)

NOTE: A therapist MUST report to the authorities if a person presents a reasonable threat to him/herself or others or if child or elder abuse is evident. There is also no statute of limitations on sexual abuse, so a therapist must report a living or dead offender even when the abuse occurred many years ago. This should be discussed in your first session, as well. The therapist does not have a duty to report domestic abuse.

A really good therapist will likely have you feeling safe and heard within the first one to two sessions. If after the second session, you’re not feeling this way, speak up! I hear stories all the time about people sticking with a therapist who they feel “did me no good” for long periods of time or who “liked my partner better than me”. My first response is always: “Did you say anything?” or “Why did you keep going??” Again, it’s weird – you’re telling this person so much about your life. It’s SO personal. Keep this in mind, though: your therapist is not your friend. You’re paying this person to provide you with a service. You have the right to complain or seek help elsewhere (you can even ask your therapist for a referral) if you don’t feel like your needs are being met. Do this, and you’ll get the most you can out of the therapeutic process.

money

I know, therapy is expensive. Like I said: it’s helpful to think of it as an investment. You’re investing in your self or your relationship or your family. You’re giving your life a tune-up. It all costs money. You’re putting yourself in the hands of a professional in order to do so. Someone who has been educated and trained for, at the very least, 5 years if he or she is licensed. This person should know their stuff and that can be intimidating. BUT, it doesn’t mean your therapist should be telling you what to do and it doesn’t mean you can’t trust your gut. In fact, your counselor should be encouraging you to trust and depend upon yourself. Here’s a short  list of advice on getting your money’s worth from therapy:

1. Ask questions, debate points, and give feedback
Ask for what you need. If you don’t understand something your therapist says, ask. If you disagree with something she says, say so. This doesn’t mean you shouldn’t listen to her, but when something feels inherently wrong, just way off from who you are, SAY SOMETHING. It doesn’t help you at all to stay mute on the subjects that really rile you up. Again, your therapist is not your friend; she is providing you with a service. Having said that, however you must understand that you also have to…

2. Do your homework
Many therapists gives little assignments to their clients. You might be asked to journal something or to complete a questionnaire online or to notice a behavior or thought process during the week. Try your best to do these activities. They’re given to you for a reason and completing them shows your therapist how committed you are to working on yourself or your relationship. If you don’t complete your homework, let your therapist know why. Perhaps something needs to be changed about it or perhaps it’s telling you something about yourself or your counselor.

3. Listen
Listen to what your therapist has to say, the questions he asks, and the insights he might have. He may have some very valuable points to make or inquires. However, your counselor should not be doing most of the talking. If this is the case, speak up. You’re there to talk about your life, not listen to your therapist drone on because…

4. You’re the expert
I know this sounds strange, but you’re the expert on your own life and relationships. A good therapist should never act as if she knows what’s best for you. A good therapist does not give advice. I repeat: A good therapist does not give advice. A good therapist asks good questions, gives good insight and good suggestions. The point of therapy is to give you (or you and your partner or you and your family) the ability to make the right decisions for yourself, not to make you dependent on your therapist.

5. Work through the discomfort
Part of any therapy, whether it be individual, couple, or family, is building self-awareness. With this comes the uncomfortableness of dealing with emotions you’d just rather not feel. Things like sadness, anger, guilt, and hurt. Things that make you feel vulnerable. I can say this from my own experience with therapy: Lean into the discomfort. Because when you come out the other side you’ve learned more about yourself, more about how you affect others, more about what works for you and what doesn’t, and more about the joy you can have. Be gentle with yourself, though. Handle what you can at the times you can. Take it slowly.

I know we hear this all the time, but it is a worthy adage: Take risks. It’s the best thing you can do for your brain and for your heart. You’ve taken the risk to go seek help, now take the risk to make the most of it.

dont give up

Again, finding a good therapist is not always easy. I know this seems like a lot to consider. But take this into account: you (or your insurance company) are probably going to spend a lot of money on therapy. Think of it as a worthy investment. You don’t buy an expensive television, computer, musical instrument, or appliance without doing a little bit of research, right? So why wouldn’t you take the time to find a good therapist? My best advice: don’t give up. Even if you go through a few counselors that just aren’t right for you or who are just plain terrible, remember that you and your life are worth it.