On Choosing a Therapist

I am often asked how to choose a therapist. My answer: LET THE BUYER BEWARE.

Here are a few thoughts.

Therapy is not cheap, so it makes sense to begin by checking with your insurance to see if there may be some coverage for mental/emotional health services. If there is coverage, there is generally a provider list—a list of therapists that have contracted with the insurance company. If you don’t have any specific recommendation from someone you trust, start calling. It may take some time, but therapists should be willing to speak with you on the phone, briefly, to give you a bit of a feel for them. I would ask how long they’ve been in practice, what their areas of emphasis are, if they have any particular areas of focus, if they have worked much with your area of concern. You may also want to ask their approach. Members of the Church can ask if the therapist is LDS and if he or she typically incorporates LDS principles in therapy with LDS clients. If the therapist is not LDS, you should feel comfortable that your personal and religious beliefs will be respected and that therapy will be conducted within that framework. You may also want to have a super-brief synopsis of your situation already prepared and you can then ask them what sort of approach would be typical for that situation.

If you are choosing a therapist for a son or daughter, you may want to consider if your child would be most comfortable with a male or a female therapist. I would also ask what kind of communication the therapist maintains with the parent. Every client, even if underage, is entitled to confidentiality with a therapist. However, in my opinion, confidentiality does not mean the parent can’t know if the child is engaging in the therapeutic process willingly or reluctantly and at what level he is engaging. Personally, I prefer to meet with the parent(s), also, at or near the beginning of the process, usually, to get background, as well as the parents’ perspective and concerns. Then, I may continue to meet with one or both parents occasionally to help parents deal with their concerns and stress, to get parental feedback on how the child is doing, and to help parents made adjustments in their own part of the parent-child dynamic to help develop and support the changes that we want to see in the child. Change in a child is much more likely when the parents are involved in the process, in some senses, as co-therapists. When parents participate in changing the family dynamic, change is much more likely and lasting than if we just meet with the child for one hour a week.

So, the idea is to do a very brief phone interview with the therapist and often, that gives you a sense of who they are, etc. I know it can take some time but it’s worth it. However, in spite of doing a preliminary screening (with the phone call), I would encourage you to still be picky even after therapy begins. The therapist should be able to establish a good rapport very quickly with the client(s). Clients should feel listened to, understood, and cared for. Clients should also feel that they are gaining insight and learning things that can help him do things differently for a better outcome. Some therapists are good, sympathetic listeners but don’t offer much more than that. My husband calls that “Rent-a-Friend.” Therapy is too big an investment to settle for something that doesn’t lead to the change you’re seeking.

Although it can be a hassle, in my opinion, it is better to shop around and even better to do a bit of trial and error, as needed, to find the best fit. Therapy is a strange profession, I’m afraid. There are some very helpful therapists out there, but there are some pretty strange ones, too. Maybe we’re all a little weird :). The profession tends to be quite liberal in terms of social agendas, political correctness, and permissiveness, so you want to watch for that. Certainly, not all therapists follow that path, but that’s another reason it really is important to find a therapist that shares, or at least respects, your values framework.

Participating in therapy is an intensely personal experience. You have the right—and the need—to feel that you are in safe, caring, respectful, and skilled hands. Sometimes that can be found on a provider list, sometimes it can’t.

I am also regularly asked about choosing psychiatrists. Personally, although they differ, too, since psychiatrists mostly practice psychopharmacology (prescribing and regulating medications), with little counseling involved, I wouldn’t be as worried about choosing a psychiatrist.

Good luck.

Note: Just FYI, with today’s technology, I am taking more out-of-state clients than ever before. Phone call appointments have worked for many clients. Others prefer Skype or G-chat video appointments.