Finding the Right Therapist for You

by Carol Campbell, MFT, and Nancy Farrar, MFT

The process of finding a therapist can be highly anxiety producing. Frequently when people decide they would benefit from seeing a therapist, they are experiencing significant upset in their lives — not the ideal moment to be dealing with the stress involved in finding someone with whom it feels safe and right to be vulnerable. All sorts of people may hold themselves out as competent professionals to assist with emotional and mental issues, but, just as in any field, discrimination is called for. A sweet personality is no guarantee of ethical or effective skills, and a therapist who is just perfect for one person may not be a good fit for the next. One size does not fit all!

By following these tips, the psychotherapy consumer can greatly increase the probability of finding a therapist who will help the client reach his/her therapy goals in a highly satisfactory manner:

THE SEARCH FOR NAMES

• Word of mouth is a good starting place. If someone you know and respect has had good success with a particular therapist, it is possible that you might, too.
   
• Referrals from other professionals are a good bet. Doctors, lawyers, massage therapists, clergy, teachers, etc. often hear about the work of therapists and can assist in your search.
   
• Remember that virtually anyone can take out an advertisement or create a website. But a professional who bothers to participate in his/her professional organization is demonstrating an investment in being affiliated with colleagues who strive to uphold high standards of care. For example, Marriage and Family Therapists in California are likely to be members of the California Association of Marriage and Family Therapists (CAMFT).

All therapists listed on CAMFT's website are members in good standing. Take a look at www.therapistfinder.com. You can search there for a therapist by name or location and also by treatment modality and by clinical issues.

QUALIFICATIONS

Before interviewing a therapist, be familiar with the various options available. In California, and most other states, the law requires that anyone providing professional services to diagnose and treat mental disorders must be licensed, or be in pursuit of a license and working under the supervision of a licensed clinician. All licensed clinicians in California have passed rigorous state exams and are required to regularly complete continuing education. These are the pertinent licensed professions in California:

• Licensed Marriage and Family Therapists, also known simply as MFTs or LMFTs, are clinicians with a minimum of a master's degree in psychology, clinical psychology, counseling psychology or marriage & family therapy. They are trained to understand family systems, and they work with individual adults and children, couples, families, or groups. MFTs generally focus on assisting the client/patient to achieve more satisfying relationships in their lives, thereby alleviating the emotional or mental issue that bring them to therapy. The underlying assumption is that psychic or emotional pain is rooted in relationship troubles, either current or from the family of origin.
   
• Licensed Clinical Social Workers have a minimum of master's degree, and are skilled in matching individuals and families with social services. They often work in hospitals, clinics, and agencies, but may also work as therapists in private practice.
   
• Psychologists have a doctoral degree in psychology, or clinical psychology. Psychologists often have advanced training in research methods, testing of brain functioning, learning disabilities, and other aspects of psychology.
   
• Psychiatrists are medical doctors with advanced training that allows them to prescribe psychotropic medications, i.e., medicines to treat emotional or mental problems. Some psychiatrists only prescribe medications, and some do talk therapy as well. They frequently collaborate with the other professions to manage medications while another type of therapist does the talk therapy.

INTERVIEWING A POTENTIAL THERAPIST

• Interview more than one possible therapist, and be wary of any therapist who discourages this idea. No one therapist is ideal for everyone.
   
• Tell the therapist what you are wanting from therapy. Notice what happens then. Do you come away feeling as if the therapist heard you and responded appropriately?
   
• Inquire as to the potential therapist's education, training, licensure status, and membership in a professional organization for that license. You may check online with the appropriate licensing board to see if the therapist is licensed, and if there has been any disciplinary action taken against the license.
   
• Ask the therapist what it is that happens in his/her office that helps one feel better. In other words, ask what is the therapist's theoretical orientation? Does the therapist focus on helping to change how you think (cognitive therapy)? Does she/he focus on working with the unconscious (psychodynamic therapy). No single approach to therapy has been proven more effective than any other, and hundreds of approaches have been developed. Many therapists assert that problems you have had for a long time are more likely to require longer term treatment, while you can get relief fairly quickly with short-term treatment for a recently developed problem.
   
• Notice how you feel in the presence of the therapist. Is this someone you can imagine seeing repeatedly and feeling respected by and comfortable with? Does the therapist pay attention to you? Is he/she too distant? Too cold? Too effusive? Sufficiently empathic? Too sure of herself/himself? Is she/he defensive about your questions? Does the office have an atmosphere that is appealing to you? Regardless of a therapist's training or philosophy, the therapist/client relationship is largely what determines whether you will think the therapy is effective or not.
   
• Is the therapist experienced in working with issues similar to yours? While it is certainly not necessary for a therapist to have personally experienced whatever you are going through, you need some reassurance that what you are bringing to the table is not beyond the scope of competence of the therapist.

YOUR EXPECTATIONS

• Therapist's have a duty to tell you before you begin treatment how much the services will cost. Fees vary widely according to expertise and market factors, including whether the therapy is offered through an agency or in private practice, and whether a third party payor is involved (insurance).
   
• Therapist's often offer treatment agreements that address what you can expect from the therapy, how to get help in emergency situations, the limits of confidentiality, etc.
   
• An ethical therapist will uphold clear professional boundaries. Generally speaking, therapy is best served when the therapist does not have more than one kind of relationship with a client. For example, therapists do not treat their own relatives, close friends, or people with whom they have another personal, professional, or business relationship. Under no circumstances is it appropriate for a therapist to have a romantic relationship with a client in treatment. A good question to ask a prospective therapist is how he understands and observes professional boundaries.

ASK QUESTIONS ALONG THE WAY

• As an informed consumer, you should ask the therapist questions throughout your treatment about the process of therapy. You have a right to know what is happening and why.

In summary, choosing a therapist right for you calls for common sense. This article has outlined some simple ways to minimize the hassle and maximize your satisfaction. Resources abound in your own neighborhood and on the Internet to help you find a good match. Do yourself a favor by advocating for yourself when it's time to find a therapist. The results will be worth the time and energy invested.

FREQUENTLY ASKED QUESTIONS

Where should I look to find a good therapist?

• Ask for a recommendation from someone who has had a good experience.
   
• Get a referral from your doctor, attorney, clergy, etc.
   
• Go to www.therapistfinder.com to search for a therapist near you who is licensed in California and who currently belongs to the world's largest professional organization for MFTs, the California Association of Marriage and Family Therapists (CAMFT).
   
• It is a fact that therapists who are members of professional organizations have fewer disciplinary actions than those who are not members.

Is it OK to say I am shopping for a therapist?

• Absolutely! Interview several.
   
• Be wary about the therapist who dismisses the idea of you interviewing more than one.
   
• Many therapists will expect payment for initial interview.

How much will therapy cost me?

• Many healthcare plans cover treatment for mental disorders; plans vary widely.
   
• Private practice fees will vary according to the clinician's location, expertise, and level of experience.
   
• Work done by a registered intern under the supervision of a licensed clinician may be more economical.

What should I ask the potential therapist?

• Inquire about the therapist's training, licensure status, and ongoing education.
   
• Ask what it is that the therapist does that is supposed to be helpful. How is this different from how other therapists work? What should you expect?
   
• Does the therapist have a treatment agreement? This should cover fees, appointments, cancellation policy, limits of confidentiality, termination procedure, etc.

What should I ask myself?

• What do I hope to gain from therapy? Can this therapist help me do that?
   
• Am I comfortable with this therapist? Would I like to come back?
   
• Remember: The most important factor in securing effective therapy is a good relationship between you and your therapist.
   
• Did the therapist assure me that he/she is qualified to help me with whatever it is that is bringing me to seek therapy at this time?

Will therapy work for me?

• Research supports therapists' assertions that therapy works.
   
• Many report relief from depression, anxiety, relationship problems, and other common complaints.
   
• Many also report seeking therapy as a means of personal growth and exploration.
   
• Developing a therapeutic relationship with an individual trained in assisting others to find their own answers and solutions is a path to change-that is well-documented in the professional literature.

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Calls regarding appointments are welcome at my private voicemail: 650-325-2576.

Carol L. Campbell, MFT, is a licensed marriage and family therapist providing psychotherapy and psychoanalysis for individual adults and couples in Palo Alto, California. She has degrees from Brown University and Santa Clara University and has been licensed since 1991. Carol is a graduate of the Palo Alto Psychoanalytic Psychotherapy Training Program sponsored at Stanford by the San Francisco Center for Psychoanalysis and was a candidate at the Psychoanalytic Institute of Northern California in San Francisco from 2010-2011. She is also a clinical member of the California Association of Marriage and Family Therapists and the Northern California Society for Psychoanalytic Psychology.