Choosing A Therapist: A Patient'S Guide
A brief consumer guide to choosing a therapist. Questions to ask regarding treatment orientation, clinical specialties, modalities.
When you're in the middle of major life transitions, it's often valuable to visit a therapist to help you sort out issues. Unfortunately, the task of finding one presents most people with one more decision to make on top of many others. There is no easy way, but what follows is a brief guide to help you sort out your preferences and make an informed choice.
Comfort level. The fact that you should choose someone you feel comfortable talking with may seem obvious, but its importance is almost impossible to overstate. Often when people walk into a professional's office they get intimidated on seeing all those diplomas and certificates on the wall, particularly if they belong to a psychiatrist with "MD" after his or her name. More important than credentials, however, is rapport. If you feel as though someone's not listening, asking for intimate details too soon, or expressing negative judgments about you, make it known--and choose accordingly.
Clinical orientation. Find out about a therapist's clinical orientation--the approach they want to take in treating you. For example, a psychoanalytic therapist will want to explore unconscious conflicts that may be connected with the immediate problem for which you seek help. They look primarily at what you do in session and allow the treatment to take its own course. On the other hand, a cognitive-behavioral therapist is interested in more limited goals. Such a therapist will work with you, usually on a short-term basis, to help you overcome specific problems, often by looking at them in a new way. They are usually interested in what happens between sessions as well as in session, and a good one will give you assignments and other work to complete between sessions. There are many other types of orientation; feel free to ask, and expect a good, coherent answer.
Specialties. Therapists sometimes specialize in work with a specific type of problem. Eating disorders, bipolar disorders, and substance abuse issues are examples of these. In addition, some therapists specialize in work with a specific population--i.e., adolescents, children, women, or gays and lesbians. You don't necessarily need a therapist with a clinical specialty in your problem or population to get help, but it's sometimes valuable, especially if you've been disappointed in seeing others with a more "generalist" practice.
Modalities. One-on-one therapy is not the only type of treatment available. There are many other modalities which may be more appropriate for your type of problem. Some other modalities besides individual include group therapy, family therapy, and couples therapy. Many therapists specialize in one or more treatment modalities as well--as usual, be sure to ask.
Professional Associations, Publications, Awards. None of these achievements by themselves constitute a recommendation, but if you have an eating disorder and you walk into the office of a therapist with that clinical specialty, who gives frequent talks on the subject or who has published about it, chances are that this person will do a good job treating you. Therapists depend a lot on their reputations to generate new referrals, so they will probably take an interest in seeing you get the best treatment possible.
Choosing a therapist can be difficult, but a clear understanding of what you want and what makes you comfortable, together with an appreciation of treatment modalities, orientation, and specialties, will help you make a wiser choice.