So you have finally made the decision to go to therapy, however, once you started the process you found out that all ‘shrinks’ are NOT created equal. The search for a therapist can be daunting, since most people do not know what they should be looking for and the industry does not provide a simple manual to navigate through its vast world. Here are five helpful tips to consider before beginning the therapeutic process.
1. What should I look for first?
Surprisingly, the biggest factor in client success is not choosing ‘the right therapy,’ it is choosing the right therapist. An extensive amount of research suggests that positive treatment outcomes are most closely connected to the relationship with your therapist. Credibility, skill, empathic understanding, affirmation of the client, and ability to engage/focus the client on their issues and emotions are the most crucial attributes of a therapist that contribute to patient success (Orlinsky et al., 1994).
2. What kind of therapy is right for me? One of the most important developments
in the field of psychology has been the growth of numerous theoretical perspectives. At present, no single theoretical perspective dominates the field. However, major differences exist depending on the therapeutic orientations. This article discusses only two popular types of therapy, but know that many others exist, ie. DBT, ACT, Gestalt, holistic.
- Psychoanalytic therapy, or traditional “talk therapy,” is based on the work of Sigmund Freud. Psychoanalytic therapists generally listen to patients talk while looking for patterns or significant past events that may contribute to the root of the client’s current difficulties (often stemming from childhood events and/or unconscious feelings).
Pros: Provides a nonjudgmental environment where clients can explore deep feelings. Cons: Expensive, time consuming, and can last years before finding ‘the root’ of the
issue. Also, lacks a scientific basis backing its effectiveness.
- Cognitive-behavioral therapy (CBT) is based on the concept that feelings and behaviors are caused by thoughts, not external things, like people, situations, and events. Thus, the ability to change the way we think, act, and feel is based on our behavior and perspective. CBT therapists are generally solution-based and short-term focused, meaning that they help clients to achieve goals in a collaborative environment and timely manner. CBT therapists are directive, often asking questions and encouraging their clients to ask questions of themselves.
Pros: CBT’s effectiveness is empirically-based for depression, anxiety, and eating disorders. Rapid results can occur with skill learning and homework assignments.
Cons: For certain individuals, focusing on positive thinking may feel like it minimizes the importance of personal history.
3. Should I find a social worker, a mental health counselor, a psychologist, or a psychiatrist to help me with my problem? The good news is that there are a wide range of professionals who work with mental health concerns. The main differences between these professions are the educational background and training.
- Social workers (LSW) primarily do case management and/or psychotherapy counseling to improve the wellbeing of an individual, group, or community through research, community organizing, and practice. Requirements: a masters’ degree, internship hours, and the passing a licensing exam.
- Mental health counselor (MHC) is another masters’ level counselor whose counseling is a holistic orientation grounded in prevention and wellness. Requirements: masters’ degree, internship hours, and certification process.
- Clinical psychologists (PsyD or Ph.D) require a doctoral level degree and are experts at psychotherapy and psychological testing. Psychologists require over three thousand hours of supervised clinical practice, internship and research experience, passing a licensure exam (EPPP), and individual state requirements to practice.
- Psychiatrists (MD) are physicians who have gone to medical school and specialized in psychiatry. Psychiatrists often rely on prescribing psychotropic medicine and interpreting laboratory findings of blood work or brain imaging tests as their main methods of addressing mental health problems. However, they may also do therapy as well.
4. How long does therapy take? The most general answer is: the duration of therapy depends on the client. Client issues, problems, disorders, or goals are often dependent on both internal and external factors. Thus, there is no mathematical equation to predict the amount of sessions needed to successfully complete therapy. Clients may attain their goals in anywhere from ten to hundreds of sessions. Typically, when a client says, “Hey things are pretty good for me right now, I don’t have a lot to talk about anymore,” is when the therapist considers decreasing the frequency of therapy sessions in a way that clients can still maintain their therapeutic goals. However, some people enjoy attending weekly, bi-weekly, or monthly therapy sessions indefinitely.
5. How do I find a therapist? One of the easiest ways to begin your search is to ask a professional with whom you already trust, a doctor, dentist, lawyer, and/or nutritionist, those who are bound by confidentiality. Many professionals are already connected and commonly refer to one another. Asking family members or friends can also be very helpful. Just be sure that you are comfortable with the person you are asking. Thirdly, if you happen to know a therapist, they are great resources to ask for recommendations. Therapists commonly refer close friends to people that they trained with, trust, and/or respect in the field. The internet can also be great tool. Sites like the PsychologyToday.com or APA.org are extremely helpful in researching psychologists in your area and often include biographies, practice areas, pictures, and contact information for the psychologists. Additionally, universities are great sources of psychology information, especially for programs with ‘sliding scale’ fees, cheaper therapy from graduate students that are supervised by their professors.
6. Do not be afraid to speak up. Therapy is a service and you should be comfortable speaking up with the person you are working with. Would you continue seeing a hair stylist who cut your hair in a way you did not like? If you disagree with your therapist, share your concerns. If you continue to feel uncomfortable, it is OKAY to terminate and
continue the search to find the person that best suits your needs.
- Jan Weiner, PhD
References:
Orlinski, D. E., Grave, K., & Parks, B. K. (1994). Process and outcome in psychotherapy. In A. E. Bergin & S. L. Garfield (Eds.), Handbook of psychotherapy(pp.
257-310). New York: Wiley.
1. What should I look for first?
Surprisingly, the biggest factor in client success is not choosing ‘the right therapy,’ it is choosing the right therapist. An extensive amount of research suggests that positive treatment outcomes are most closely connected to the relationship with your therapist. Credibility, skill, empathic understanding, affirmation of the client, and ability to engage/focus the client on their issues and emotions are the most crucial attributes of a therapist that contribute to patient success (Orlinsky et al., 1994).
2. What kind of therapy is right for me? One of the most important developments
in the field of psychology has been the growth of numerous theoretical perspectives. At present, no single theoretical perspective dominates the field. However, major differences exist depending on the therapeutic orientations. This article discusses only two popular types of therapy, but know that many others exist, ie. DBT, ACT, Gestalt, holistic.
- Psychoanalytic therapy, or traditional “talk therapy,” is based on the work of Sigmund Freud. Psychoanalytic therapists generally listen to patients talk while looking for patterns or significant past events that may contribute to the root of the client’s current difficulties (often stemming from childhood events and/or unconscious feelings).
Pros: Provides a nonjudgmental environment where clients can explore deep feelings. Cons: Expensive, time consuming, and can last years before finding ‘the root’ of the
issue. Also, lacks a scientific basis backing its effectiveness.
- Cognitive-behavioral therapy (CBT) is based on the concept that feelings and behaviors are caused by thoughts, not external things, like people, situations, and events. Thus, the ability to change the way we think, act, and feel is based on our behavior and perspective. CBT therapists are generally solution-based and short-term focused, meaning that they help clients to achieve goals in a collaborative environment and timely manner. CBT therapists are directive, often asking questions and encouraging their clients to ask questions of themselves.
Pros: CBT’s effectiveness is empirically-based for depression, anxiety, and eating disorders. Rapid results can occur with skill learning and homework assignments.
Cons: For certain individuals, focusing on positive thinking may feel like it minimizes the importance of personal history.
3. Should I find a social worker, a mental health counselor, a psychologist, or a psychiatrist to help me with my problem? The good news is that there are a wide range of professionals who work with mental health concerns. The main differences between these professions are the educational background and training.
- Social workers (LSW) primarily do case management and/or psychotherapy counseling to improve the wellbeing of an individual, group, or community through research, community organizing, and practice. Requirements: a masters’ degree, internship hours, and the passing a licensing exam.
- Mental health counselor (MHC) is another masters’ level counselor whose counseling is a holistic orientation grounded in prevention and wellness. Requirements: masters’ degree, internship hours, and certification process.
- Clinical psychologists (PsyD or Ph.D) require a doctoral level degree and are experts at psychotherapy and psychological testing. Psychologists require over three thousand hours of supervised clinical practice, internship and research experience, passing a licensure exam (EPPP), and individual state requirements to practice.
- Psychiatrists (MD) are physicians who have gone to medical school and specialized in psychiatry. Psychiatrists often rely on prescribing psychotropic medicine and interpreting laboratory findings of blood work or brain imaging tests as their main methods of addressing mental health problems. However, they may also do therapy as well.
4. How long does therapy take? The most general answer is: the duration of therapy depends on the client. Client issues, problems, disorders, or goals are often dependent on both internal and external factors. Thus, there is no mathematical equation to predict the amount of sessions needed to successfully complete therapy. Clients may attain their goals in anywhere from ten to hundreds of sessions. Typically, when a client says, “Hey things are pretty good for me right now, I don’t have a lot to talk about anymore,” is when the therapist considers decreasing the frequency of therapy sessions in a way that clients can still maintain their therapeutic goals. However, some people enjoy attending weekly, bi-weekly, or monthly therapy sessions indefinitely.
5. How do I find a therapist? One of the easiest ways to begin your search is to ask a professional with whom you already trust, a doctor, dentist, lawyer, and/or nutritionist, those who are bound by confidentiality. Many professionals are already connected and commonly refer to one another. Asking family members or friends can also be very helpful. Just be sure that you are comfortable with the person you are asking. Thirdly, if you happen to know a therapist, they are great resources to ask for recommendations. Therapists commonly refer close friends to people that they trained with, trust, and/or respect in the field. The internet can also be great tool. Sites like the PsychologyToday.com or APA.org are extremely helpful in researching psychologists in your area and often include biographies, practice areas, pictures, and contact information for the psychologists. Additionally, universities are great sources of psychology information, especially for programs with ‘sliding scale’ fees, cheaper therapy from graduate students that are supervised by their professors.
6. Do not be afraid to speak up. Therapy is a service and you should be comfortable speaking up with the person you are working with. Would you continue seeing a hair stylist who cut your hair in a way you did not like? If you disagree with your therapist, share your concerns. If you continue to feel uncomfortable, it is OKAY to terminate and
continue the search to find the person that best suits your needs.
- Jan Weiner, PhD
References:
Orlinski, D. E., Grave, K., & Parks, B. K. (1994). Process and outcome in psychotherapy. In A. E. Bergin & S. L. Garfield (Eds.), Handbook of psychotherapy(pp.
257-310). New York: Wiley.