Jennifer S Bailey, MA, LMFT 

Top 5 Things To Consider When Choosing A Therapist

 

 

 

Usually people turn to a therapist when they are at a difficult point in their lives and need help to sort out what doesn’t make sense or feels overwhelming to them. While this can be a hard time to begin the search, hopefully some of the tips in this article will help make it easier and less stressful.

 

If you’re reading this, you may be thinking of finding a therapist—perhaps for yourself, or someone else. Great! I know I may be a little biased, but I happen to think that going into therapy is one of the best gifts you can give to yourself. That said, picking your therapist is not anything to do on an impulse. Oftentimes, people seek referrals through their health insurance plan. If you were to do this they will end up sending you a gigantic list of mental health practitioners in whatever area you request. Maybe you have such a list in your possession now. It’s huge, isn’t it? I bet it’s pretty overwhelming, too.

 

So what do you do now?

 

First: Take a deep breath. Many people find this process confusing, but it can be broken down into bite-sized pieces…

 

In the next few series of articles, I will continue to provide a few tips to help demystify the entire process. Next time, I’ll go over the top five ways to find a therapist. I’ll also do a run-down on the alphabet soup of mental health practitioners—what all those letters after our names mean and what the differences are. I’m also planning an article on what it’s like to be in therapy, to try and lower the anxiety threshold for those of you who have never been in therapy before.

 

One thing I say a lot here on my website is that this process is definitely NOT like showing up at your local HMO and taking whatever practitioner happens to be on duty that day! Choosing a therapist is a lot like finding a hairstylist. You have to feel safe with them; they have to feel like a good match for you. In fact, studies show that this is the most important factor in the effectiveness of therapy: The relationship between the client and the therapist--the alliance is the key factor--followed closely by the therapist’s personality and the client’s feeling that the therapist can help them. Everything else is negligible.

 

You’ve got to feel comfortable with them. You have to feel as though they “get” you.

 

So how does one choose a therapist like this?

 

1. Location, location, location

As that old saying goes, location is a factor. After all, what good would an awesome therapist do you if their office was 300 miles from you? Not too much good, right? So, where do they need to be to fit your needs? Firstly, consider when would you most likely need an appointment. Lots of people seek appointments during their lunch hour or after work/school. If this makes sense to you, you may need to look for a therapist closer to your work/school address rather than your home address. Or, perhaps your hours are more flexible, or you need to be seen on a Saturday? If so, doing a search by your home might make more sense.

 

2. Male or female?

This might not make a difference to you, but for some people this is very important. For example, if a male physically or sexually abused you, choosing a male therapist may be very triggering to you. Likewise, if you know you have a lot of anger towards your mother or generally distrust women, you might not do well with a female therapist.

 

One more thing: While it has nothing to do with the therapist's gender, it's as good a place to mention it as another--What about other languages spoken? I know lots of people who are immigrants from other countries, and while they may speak perfectly fluent English, there is admittedly something very powerful about conversing in one's native tongue. I've seen people say things in English and not bat an eye and then translate it into their own language and experience what they're saying on an entirely different emotional level. So if English is a second language for you, consider finding a bilingual therapist.

 

3. Insurance, Private Pay, or Sliding Scale?

Granted, this won’t do much in the way of helping you find a therapist who “gets” you, it is an important consideration in your choice. And it could be argued that nothing destroys a relationship faster than disputes over money, so nailing down your cost and payment options might go a long way towards your overall comfort in the room!

 

If you have behavioral health covered under your health insurance then you can call them and have them send a list. Look on your health insurance card and see if they give a separate number for behavioral health. Call that number and ask them to send you a list of covered therapists in the town that you’ve already decided would be best for you. Narrow the list by choosing if you’d prefer a male or female therapist. Also ask them to tell you how many visits they will cover, and if there’s anything they won’t cover. Keep in mind that many insurance companies will only cover 10 visits at a time. While 10 visits may seem like a lot, to many therapists, it takes more than 10 visits to establish the relationship. Also, know that the insurance company is obliged to know your diagnosis and can request access to your therapist’s records at any time. Some people may feel uncomfortable about that.

 

If you do, Private Pay is another option. This is how I currently work. You are seen by a licensed practitioner. Your diagnosis, treatment plan and session notes are private and confidential—there are no insurance companies involved to access your records. Your therapist has a standard rate and you pay it at each session. Also, some private pay therapists provide sliding scale rates--ask them about it if you aren't sure.

 

If your budget is tight, a third option is sliding scale. A little-known fact is that there are many Community Mental Health Clinics out there that are able to provide low-cost options to individuals, families and couples seeking therapy. These clinics are staffed with Trainees and Interns—men and women who are working toward their state licensing requirements. Trainees are still students in their Masters of Psychology (MA) programs while Interns already have their degrees and are anywhere between just out of school to having 6+ years of experience working with clients. In California, we need 3,000 hours of supervised experience working with clients before we are eligible to sit for our 2 licensing exams to become Licensed Marriage and Family Therapists (LMFTs). Believe me that can take a LONG TIME. Feeling queasy about being seen by someone still in/just out of school? Keep this in mind: As recent graduates they’ve just been taught state-of-the-art information. In this day and age, technology changes our understanding of neurobiology constantly, and Interns have access to the latest, cutting edge stuff. They also have lots of supervision—other, licensed people who are making sure they’re doing right by you. Don’t worry—these other people will never be in the room with you—but some clients like this, helping them to feel that they’re in good hands.

 

4. Do they treat your diagnosis or presenting issue? What are your feelings based on the info on their website?

You may already have a diagnosis that you know of from another practitioner, or you may have a pretty good idea yourself. If not, you certainly know why you’re seeking a therapist—and what you need help with. If you have that list from your insurance company and you’ve narrowed it down to gender and location, Google some of them and see if they have websites and if they treat what you’re coming in with.

 

You may also be seeking a specific kind of therapy. While “Cog-B” (Cognitive Behavioral Therapy) might be all the rage with insurance companies, it might not be for everyone. There are also some empirically proven treatments for specific issues (for example, Phobias have been shown to be helped in particular with Exposure Therapy).

 

If you don’t have an insurance list you can find tons of therapists via http://therapists.psychologytoday.com. From there you will see pictures, specialty lists, fees, treatment modalities and a brief statement about how they work. You can also see what kind of therapy they provide (e.g.: Cognitive Behavioral, Psychodynamic, Narrative, etc.). If you need more info you can find them on LinkedIn, but keep in mind that most of what you’ll find there may just be a rehash of what you find on psychologytoday.com. Once you get a small list together you can try Googling their website (or clicking through their links on their psychologytoday.com page), but keep in mind that many therapists—especially older, more experienced clinicians who get most of their clients via word-of-mouth—do not have their own websites.

 

But if they do, read it. Oftentimes they will provide a personal statement describing a bit of how they work and how they conceptualize struggle and change. Does it appeal to you? If you are strongly aesthetically minded you may also get a distinct feel from the design of the website itself. Is it clean and airy or cluttered, dark and hard to navigate? How do you feel visiting this therapist’s cyber-space?

 

The theory, of course, is that you may likely feel the same way in their office sitting across from them…

 

5. Call them and have a conversation with them.

You can do all the Googling you want, and read every page of info about them, but the real answer to the all-important question of  “Do they ‘get’ me, am I comfortable with them,” won’t come until you actually start to talk to them.

 

When friends ask me about finding a therapist, I usually give them the run-down of the first four items that I’ve listed above and then I tell them to call the therapist they’re considering and listen to their answering machine message. Most times when you call a therapist you’ll only get the message. This has always been standard industry practice (for the same reasons why you hardly ever have a direct line to your primary care physician).

 

But I digress…

 

Basically, what I’m encouraging you to do is to listen to your prospective therapist’s phone message: What’s your gut reaction? What do you think of the message? Is it professional? Do you like their voice? Yes, I’m being serious, here! You’re potentially going to have to listen to that voice a lot. Could you stand to hear it for the next several months at least once a week? You’d be surprised.

 

So good, you like their voice. Now leave a message: Tell them briefly what led you to call them, how you can be reached and what times/days are best to reach you.

 

Then they’ll call you back.

 

While a phone conversation isn’t the end-all in factoring if they’re right for you (only a couple face-to-face visits will do that), it is another opportunity to get an impression. Take your time to phone interview more than one therapist and then choose the one who fits best to conduct the first session. When you finally have them on the phone, try and be somewhere quiet where you will be undisturbed for the duration.

 

1. Ask if they’re currently taking new clients.

2. Recheck their fees or insurance (even if you’ve seen it on their website).

3. Briefly tell them what brings you to seek therapy.

4. Ask if they have experience with your presenting issue.

5. Ask what training they might have in a specific type of therapy if you're looking for something specific.

6. If you decide to move forward, find a time to schedule a session.

7. Get directions to their office, remember to ask about their parking situation—some offices (especially here in Los Angeles) have pay parking only.

 

Some therapists may also offer a free, half-hour consultation to help establish fit, too. This is a good time to ask the above questions in person, see the office, and evaluate your comfort-level with the potential therapist. Again, this is like sliding scale (it doesn't hurt to ask for it), although some therapists may prefer to do this over the phone instead--there is no industry standard here.

 

Whether you "interview" over the phone or in-person, you will get what you need to make a decision and schedule your first appointment; hopefully all will go well and you will get a lot out of your experience of therapy. However, if you find that after three or four sessions you aren’t really “feeling it,” you have every right to discuss this with the therapist and/or ask for a referral to another therapist. Remember, therapy works best when you feel safe, heard and understood. You are never stuck with someone. Yes, it could mean going through all of the above steps again—but in the long run you’ll be much happier with your choice and with your therapy!

 

Finally, I’ll leave you with this last tip: Just because someone seems to be just like you doesn’t necessarily mean they’ll be a good fit! I once had a client from a different culture who told me that they had originally gone to a lot of trouble to find someone who, on paper, had seemed similar to them. After a great search, they had finally found someone of the same gender, the same regional background, same ethnicity, etc.—but were shocked to discover they couldn’t stand this therapist! Going back to the drawing board, they found me—and were surprised to feel completely at home! I remember saying, “Yeah, who would have known that you’d bond with some crazy white girl from Boston?” We both had a good laugh at that, but it just goes to show you never know who you’ll do best with, you just have to feel it out and take a risk.

 

I hope this article has been helpful. Please feel free to subscribe to the mailing list (below) to receive all of my articles as they’re published here on my blog.

 

 

I wish you all the best in your search for a therapist—even if it doesn't turn out to be me.

 

 

Jennifer S Bailey, MA, LMFT