How to Choose a Therapist
Once the intricacies of the various payment options for therapy have been cleared up, you may be wondering how exactly to choose a therapist now, as choosing the right one can be confusing at times. Even if you're not sure about therapy, it is always a good idea to just reach out and talk to some potential options; emailing or having an initial phone consultation with a therapist does not commit you to anything, and it can only help by allowing you to "test drive" therapy and get some more information. There is no harm in just trying it and reaching out for help, because we all need help sometimes, and what you learn in therapy can have a long-term impact.
Some helpful tips for the initial phone call with potential therapists:
- Introduce yourself and provide a 1-2 minute overview of issues that you're dealing with, or anything that would be relevant to the therapy relationship.
- Ask your therapist for an overview of themselves as well! Asking about what they specialize in, types of people they work best with, their therapy style (do they like to guide the conversation, or do they prefer to let the client lead?), etc. can be helpful for you to keep in mind when choosing the right therapist for you.
- Tell the therapist about one of your concerns or symptoms, and ask for an example of how they have worked with another client dealing with a similar issue in the past. Learning about their actions in past situations can help you realize how they will be inclined to help you with your concerns.
- Ask about payment
- The phone call is meant to help you gauge which therapist may be right for you, so just trust your gut reaction! If you don't think you will click with the therapist, it is okay to say so, and even ask for referrals to other therapists.
The phone call is meant to allow both you and the therapist to get to know each other's styles and personalities, but by hearing different therapists' approaches, it can also help you learn about yourself and realize what you are looking for in a therapist at the moment.
Types of Therapists
There are various types of degrees and licenses that a therapist can have. Here are the different types broken down:
- Doctoral-level. Those with Psy.D. and Ph.D. degrees have completed doctoral-level programs in psychology, and only they can legally call themselves psychologists. The main difference between the two degrees is that Psy.D. psychologists focused more on clinical work during their doctoral program, while Ph.D psychologists focused more on research work.
- Master's Level. Those with master's degrees in social work are often called therapists or clinicians, and these often include degrees such as Licensed Independent Clinical Social Worker (LICSW), Licensed Social Worker (LSW), and Licensed Clinical Social Worker (LCSW). Examples of other master's-level degrees include Licensed Mental Health Counselor (LMHC) and Licensed Marriage and Family Therapist (MFT), who focuses specifically on couples and family therapy.
- Other degrees. Those with Psychiatrist (MD) and Psychiatric Mental Health Nurse Practitioner (PMHNP) degrees focus on prescribing medicine, but some also conduct therapy. It is common to work with both a therapist and psychiatrist if you require medication as well.
Here are explanations of some of the popular approaches to therapy that some therapists may take:
- Cognitive Behavioral Therapy (CBT). This approach mainly highlights how our thoughts may affect our actions even when we don't realize it, and works to help consciously identify and revise thinking approaches that are unhelpful or inaccurate.
- Dialectical Behavioral Therapy (DBT). Focuses on mindfulness and interpersonal skills, popular for those with borderline personality disorder. Though DBT is often conducted in a group format with weekly meetings with a skills coach, some clinicians use aspects of DBT in their sessions.
- Acceptance and Commitment Therapy (ACT). Includes some aspects of CBT, but also emphasizes acceptance and mindfulness. The goal is to identify and accept your negative feelings, and help you observe yourself so that in the future, you can act differently in the moment.
- Psychoanalysis and Psychodynamic Therapy. In psychoanalysis, the focus is on the client's internal world and allowing the client to free-associate while lying on the couch. Psychodynamic therapy has more of a focus on the therapist-client relationship.
- Mindfulness-Based Therapy. Mindfulness exercises train you to notice thoughts that come into your brain and then let them go to focus on the present instead of the past or the future.
- Text-Based/Phone Therapy. Therapy is often reliant on being in the same space as the therapist, because body language and emotions can be hard to convey over the phone. As a result, many therapists do not provide text-based or phone therapy, or may only agree to do so after getting to know you better in person.
Myths About Therapy
There are a few myths and misconceptions about therapy.
One common one is that "happily ever after" myth. We often believe that therapy works much like dental care, for example, where you go to the dentist when you have a problem to get it fixed and you can then return to the way you were living before. However, toothaches have no bearing on your past or your future, and have nothing to do with who you are or the way you see life, while this is not the case with therapy. A therapist can't change your childhood, or your relationship with your parents, or other experiences you may have had that have led you to the point where you are today. Therapy allows you to talk about these matters so that you can have a better relationship with them and reframe other thoughts that may go through your mind on a regular basis. Even though therapy may not be the immediate "cure" that you seek, it allows you to manage your thoughts and relate to them more meaningfully so that you can move forward differently.
Another myth is that therapy is endless, or that going means committing for the long term. Therapy can last for any length of time, and it varies for each person. Some people may find that they still like having a third-person expert to talk to even after their initial problem has been resolved, and keep seeing their therapist for this reason.
One other common myth is that therapy just involves lying on a couch and talking about your problems. While this method is true for a method of treatment called psychoanalysis (as discussed earlier), for the most part seeing a therapist will not involve any lying down - often, you will be sitting face-to-face with your therapist having a genuine conversation with an independent expert who is trained to help you.