Choosing The Right Therapist
As you go through the process of choosing the therapist that will best serve your needs, trying to first decipher the confusing array of academic degrees, licenses, and certifications used in the psychology profession can seem daunting, to say the least. You may come across literally dozens of designations, such as Ph.D., M.D., MA, Psy.D., M.F.C.C., or L.C.S.W.
Click here for a complete list of therapist degrees and their descriptions.
Some will be "licensed", some "certified", and others will be "registered." They may also list a particular orientation like psychoanalytic, psychodynamic, cognitive/behavioral, gestalt, or solution-focused. Quite understandably, many people are confused about what all of these initials and titles mean. They may be unsure about just what they should be looking for, and they worry about making a wrong choice. These concerns can be heightened by the fact that when you're in emotional pain, you want help and you want it right away.
Wisdom, empathy, compassion and character are all attributes you'll want your therapist to have, but they aren't enough. Knowledge and good professional training are essential. You will want a therapist who has acquired all of the following:
- Intensive academic study in a field of mental health.
A good, competent therapist starts with a master's or a doctorate in a field of mental health (e.g., MA, MS, MSW, PhD, PsyD, MD).
- Supervised clinical experience.
It is important to know whether or not the therapist you are considering choosing has completed an extensive psychotherapy training program ("clinical training"). This could have been part of their academic degree, or it could have been a separate postgraduate program. Some MA's and PhD's have academic knowledge about psychological research or medication, but have never had actual training or practice in psychotherapy. Psychotherapy cannot simply be learned out of a book or in a classroom. You want a therapist who has also benefited from supervised training.
- Certification or registration or licensure.
Following their successful training, the therapist is pronounced worthy by an authority to which they will then be accountable. This can be a government licensing board, or some other credentialing organization. Some of the more common designations you might see include: LCSW, CSW, MFT, LMFT, MFCC, AAPC, LPC, NCC, or NCPsyA. The type of credential is not as important as some may want you to believe. For instance, a psychologist may not necessarily be a better therapist than a licensed professional counselor.
Individuals often wonder if they would do better with a female or a male therapist. Trust your instincts to determine if the gender of the therapist is a significant issue for you. It could be that the nature of your particular problem, as well as your own preferences, will lead to a decision that is best suited to you. For example, a woman who was sexually abused by her father may decide she feels more comfortable working with a woman therapist. While the therapist's age and cultural background are certainly not determinates of their capacity for empathy or their skill at providing effective therapy, these may also be characteristics that you have either an intuitive or preferential response to. Choose what feels right for you personally.
As you evaluate a potential therapist, there are some specific questions to ask that can provide valuable insight into how good a match they are for you. Information that's included in the 4therapy Therapist Locator will answer many of these key questions. You can ask for further details during the initial phone call to the therapist (usually the first phone call is quite brief and primarily focused on setting a first appointment), or during your first meeting.
Basic questions to ask that will help you decide if a therapist is right for you include:
- "What expertise do they have with my type of problem?"
Although the therapist doesn't necessarily need to have had experience in helping with your exact problem, she or he should be at least familiar with your type of situation and be prepared to tell you how they've helped others in similar circumstances.
- "What do they think is usually the cause of most people's problems?"
There are many ways to approach people's problems. Depending on their personal background, training, and preferences, therapists attribute problems to different sources. Some look to childhood events, some to the interrelationship of family members, others to faulty thinking, bad habits, or societal and cultural influences. Make sure your therapist's beliefs are at least somewhat in sync with your own views.
- "What is their fee?"
If you have no mental health insurance coverage, or you must pay a portion of the fee out of pocket, determine if you are able to comfortably afford the therapist's fee. During the first session, you and the therapist will determine an approximate length of therapy necessary to help with your particular issues and goals which will provide you with a "ballpark" figure for the total cost of therapy.
- "What would my appointment schedule be?"
If time is a factor (e.g., if your only availability for appointments is on Monday evenings, or every other week), you should make sure that the therapist can accommodate your requirements—and will be comfortable working with you on that basis.
When you feel confident that a particular therapist's overall criteria meets your needs, you're ready for the first phone call. Although you might be feeling nervous during this initial conversation with the therapist, it can still offer an opportunity to evaluate how clearly you are able to communicate with one another and how the rapport feels. Remember, you are the one doing the choosing.
During your first meeting with the therapist, pay attention to how you feel in their presence and in the therapeutic setting they've created. Note how "listened to" you feel and how their style of responding to you and sharing information makes you feel. Although making yourself vulnerable to another human being is always anxiety provoking, observe how you feel as the session progresses, including changes in your level of ease and shifts in the depth of information you reveal.
It's important to remember that therapy is a much, much richer experience than just problem-solving. The foundation of good therapy is the relationship you and the therapist build together. Because this relationship is going to be so crucial to the effectiveness of your therapy, it is essential you find someone with whom you feel a comfortable connection, someone who makes you feel understood and accepted, a therapist who creates and maintains an environment within which you can feel safe to explore even the most deeply felt sources of pain or conflict. Choose a therapist with whom it feels very right to establish such a life-changing and life-enhancing relationship. You deserve the best possible therapy experience.