Monday, October 13, 2014

Choosing a Therapist and Making Therapy Effective

In a recent issue of the Wall Street Journal (9/25/14), they ran a helpful article by reporter Elizabeth Bernstein in the Health and Wellness section about how to choose the right therapist. It got me thinking about how important it is for patients to be active in the process of choosing a therapist, and then to actively participate in therapy in order to get the highest benefit from it.

Choosing a therapist is a very personal choice. You need to select someone who you can feel comfortable with, and open up with. You may not know where to start the search. Here are some things to consider:

1. No therapist is an expert at everything. Most therapists have a scope of practice. Ask potential therapists about their areas of practice. Do they see adults? Teens? Children? Couples? Families? In general, MFT's (marriage and family therapists) have special emphasis in helping with relationships. Psychologists do testing as well as individual counseling. Psychiatrists assess for medication. Social workers have special training with linking to community resources, and LCSW's have experience doing counseling as well. Find out how many years they have been in practice. Make sure they hold a state license in their field.

2.Ask people you trust for referrals. You can get names from friends, family members, co-workers, your child's school counselor, your family physician, the pediatrician, your Ob/Gyn. Think about whether your preferences (gender, age, language). Even if you are bi-lingual, most people feel more comfortable speaking about feelings in their first language.

3. Check the therapist's website. It should give you some ideas about their background, experience, training, specialties and office location.

4. Call several therapists. Start by screening them by phone. You should get a call the same day you call if it's a weekday, unless their message says they are out of the office. Responsiveness is important. Ask about their office location, availability, how far out you have to book an appointment, how long their appointments last (this can range from 45-60 minutes). Ask about hourly fees. Find out if you can pay by cash, check, debit, or credit card. Ask if they can bill insurance or provide receipts so you can submit them to insurance for reimbursement. You may want to ask if they are in full-time private practice, or part-time. Ask if they offer a brief complimentary meeting, so that you can meet with  a couple therapists in person, and determine the best fit. The therapist should ask you some questions too, to determine that it's an appropriate fit.

5. Meet in person. They should be on time, and have an office that makes you feel at ease. The office setting should be private and quiet.

6. Good therapists are good listeners. Make sure you feel comfortable with their style. Do you feel like this individual would be someone you could let in more deeply over time?

7. The best therapists are curious about you. They don't box you in or act like they know it all. They want to understand you in all your complexity. They don't jump to conclusions.

Once you select a therapist and begin treatment, stay involved. You will maximize the effectiveness of therapy if you:

1. Ask questions. Ask them to clarify if you're not following them.

2. If you have had previous therapy, the clinician should ask (or you can volunteer) what has been helpful and not helpful in the past. In the first few sessions, the counselor should take a thorough history.

3. Together with the therapist, define what you want to accomplish. Set goals. Within a few meetings, the therapist should be able to give you the diagnosis they have made, and what the treatment plan is. They need to explain how they can help.

4. Don't edit yourself in therapy. You need to be able to talk freely about anything that's on your mind. You need to speak up in counseling, because your therapist can't do therapy without your involvement. Anything is okay to talk about in therapy. There are no limits.

5. Good therapy is collaborative. It's a journey to understand yourself and to grow emotionally, and you and your therapist are on it together.

6. Try to do some of the constructive action your therapist asks you to. They should have your best interest at heart, but if you don't incorporate some of their suggestions you may be missing some of your potential growth.

7. Therapists need feedback. I try to always encourage my patients to give me some. Share positive and negative reactions. It may be critical for moving your therapy forward, as the therapeutic relationship between therapist and patient needs to be a safe place to learn about yourself in relationships, and how to express yourself and develop your voice. Therapist make interpretations, and we can be wrong. It's okay to feel angry with your therapist. Let them know and work it through.

8. Discuss with your therapist if you want to change the frequency of sessions, or need a change. Sometimes you can only do part of your journey with one therapist, and your therapist should be open to helping you work through making a change if you need it. They shouldn't be defensive. Therapy doesn't go on forever, so it's important to talk about when therapy will end, and how you can continue to grow after it terminates. It is a great joy for me when my patients complete therapy and then call later in their lives to come in and check-in and perhaps work on a different life stage.

9. A good therapist should challenge you to grow. They should care about you, but they aren't your friend. You should be continuing to learn new things about yourself. They shouldn't JUST be listening, you also want feedback.

10. No therapist is an island. They should be networked with other helping professionals, so that they can make referrals for you as needed, for educational testing, career testing, medication evaluation, dieticians, support groups, parenting classes, divorce recovery programs and more.

Choosing the right therapist and actively collaborating with the therapist you choose can be the beginning of greater self-understanding, insight, healing and  healthier relationships. It might be one of your most important decisions.

No comments:

Post a Comment