Choosing a Therapist, Part 2: Making The Call

photo by Clemson CC

Deciding to seek help is often the hardest part of actually beginning therapy.  In my last post, I addressed the mistaken stigma of seeking the help of a therapist, and doubts Catholics in particular might have about seeking therapy. Overcoming our own doubts, hesitations and preconceptions is hard enough.  After that, finding a therapist should be easy – just open the phone book, call someone and go.  Unfortunately, it is rarely that simple.  One aspect that often makes choosing a therapist more complicated is the intimacy of the work.  Going in, you know you are trusting someone to understand you, even the parts of yourself that you don’t usually share with others.  That can involve plenty of doubt and uncertainty.  Will the therapist really understand me?  Really get what is going on with me?  Really be able to help me?  For these reasons, those seeking help are often evaluating more than just credentials – they want to know if the therapist as a person is a good fit with them.

Because of my background, I am often asked to suggest a therapist or help in the process of finding one.  As often as not, the person who asks me is not the person going to therapy, but is someone who wants information to smooth the process for a friend or relative.   Regardless of who is asking, what I describe below is how I would approach the process.  There is no “right way” to choose a therapist, so my intent is to provide some information to help you ponder rather than laying out a perfect series of steps.

Therapy is not only for those with a mental illness.  Right up front, I want you to know this.  There are many situations in which therapists are well trained to assist that do not involve a diagnosis of mental illness.  Coping with the grief of losing a loved one.  Needing support in a difficult life transition.  Identifying your interpersonal patterns to improve your relationships or your own self-understanding.  Adjusting to the diagnosis of someone close to you, or living with someone with a mental illness.  In therapy, you can have someone who listens intently, with the benefit of training and experience, and can offer a steady support solely focused toward your benefit.  This can be a powerful aid for all types of situations.

Self-examination.  It is important to know what you want before you begin looking.  To me this is like making a list before I enter Wal-Mart.  If I don’t, then everything I see looks like something I want, and I end up having to return it all.  Clarifying your “must haves” in a therapist will help you target your search and be clear about what you are looking for.  What issues that matter to you?  How important is:

• A therapist who shares your faith?  What if they share important ideals and values, but do not belong to your religious tradition?
• A therapist with extensive experience?
• A specialization in the area you need help?  (e.g. eating disorders, healing from trauma, couples therapy)
• Where the therapist is located?  How far are you willing to drive, or do you need someone accessible via public transit?
• The training a therapist has received? Length of training, training in specific therapies, or with particular issues are all considerations.
• The kind of relationship with the therapist?  Do you want to be mainly educated and informed?  Challenged and coached through steps to a healthier life?  Listened to and understood on a deep level in a way that frees you to change?

Financial considerations.  There are a variety of financial arrangements with therapists.  Some are part of a particular insurance network, and accept that insurance and bill for you.  Others will give you the documentation you need to file a third party claim with your insurer, but do not directly bill for you.  In that case you pay the therapist, and file the paperwork to get reimbursed by your insurer.  Some agencies work with low income clients, and offer a sliding scale fee (which means they adjust your fee based on your income).  Before you contact therapists, evaluate the financial questions, and know which options you are comfortable with.

• Can you pay out of pocket?
• What does your insurance cover?  Which insurance do you have?
• Are you willing to take receipts from the therapist and submit to insurance yourself?  Does your insurance cover third-party services?  If so, what is the procedure?
• Do you need financial assistance or a sliding scale fee?

Gather options. Next you will need to find who is available in your community.  There are a variety of sources, and each conveys a different level of information about the therapist.  A personal recommendation may give you detailed information, a list from insurance answers financial questions, a Catholic listing vouches for the faith perspective, etc.

• Network with trusted sources.  Who do you know that might recommend a therapist?  Friends who have been in therapy?  Contacts who know therapists? College professors who have therapist colleagues? Your pastor or church staff may also have a list of trusted therapists.
• Many Catholic diocese offer some counseling, often through Catholic Charities.  Those that do not usually will have a list of therapists that they trust and refer to.
• There are also a few sites that exclusively list Catholic therapists.  I know of two: WellCatholic.com and CatholicTherapists.com.
• If you have insurance, you can contact them to get a list of all the therapists in the insurance network in your area.
• You can also check professional listings of therapists, which can be found in a number of places.  State psychology boards often list therapists, and professional specialty societies often list therapists as well.
• Many therapists have listings in the phone book as well, though often all you will get is a name and phone number.

Examine your options.  Once you have gathered a few names, do a little research to see what info you can find about them.  You may already have some of this info from the process of finding them – your friend may have told you they offer couples therapy, or you found them through the specialty society for play therapy.  Usually you are just looking for context clues here, little indications that suggest a better fit.  Oftentimes it is easier to rule out therapists with this info than definitively establish them as someone you want to work with.  For example, if their website mentions nothing about working with couples, and that is what you are seeking, that is a strong indicator to look elsewhere.

• Examine their online materials.   Do they have a page dedicated to the services you want?  Do they explain their approach to therapy, and if so, does it fit with you?
• In my experience, neither the academic degree (MS, MSW, MFT, Ph.D, Psy.D) nor the licensure (e.g. licensed professional counselor (LPC), social worker (LCSW) or psychologist) of the individual is a reliable indicator of the therapy experience you will have.  I have met excellent therapists with every credential.
• What training credentials do they have?   Indications of credentials in a specific practice area may be important to you.
• Do they use a specific therapy?  It can mean that they have specialized training and extensive experience in an approach that fits well for you.  Or it could mean that they will use that approach with you, even if you do not like it.

Make contact.  After finding a potential fit, you can call to set up a first appointment.  Others might want to call and ask a few questions first.  Either way, first contact helps you decide whether this therapist is a fit for you.  It is OK to ask therapists directly about the way they will handle issues that matter to you.  This is where putting in the work to identify your preferences really bears fruit in the ability to ask questions that identify a good fit.

• Call and ask questions.  How do they line up with the issues that matter most to you?
• Do you feel heard and understood?
• Are they able to articulate how they intend to work with you?
• How do they respond to your concerns?  Conceptualize your problems?
• Are you able to set and agree on goals for therapy?
• Do you feel that important values are respected and attended to in your care?

Evaluate, and if needed, try again.  You do not have to make a final decision on the first day you meet with a therapist.  It may be later that you decide that they are not the right fit for you, and it is OK to stop and look for someone else.  Generally speaking, however, I would encourage everyone to share any concerns with the therapist and discuss leaving before doing so.  It allows you to talk about the difficulty, opens the door to working differently with the same therapist, can often be a turning point in therapy, and helps lead to a healthy ending if you do decide to move on.  There is nothing unusual about meeting with several different therapists over the course of healing through an issue, or of needing to try one or two before finding someone who is the right fit for you.  I hope you find a great match right away, but if not, know that there is a great deal of diversity in therapists and therapeutic styles.  This diversity is what can make choosing a therapist hard, but it also increases the odds you can find someone who is well fitted to you.

So that’s my two cents on choosing a therapist.  Now its time to share your input:  comments, questions, tips to share with others!  Please leave a comment for us, and feel free to share or repost to help inform others!  If you would like to receive future posts via email, click here to subscribe.