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In the last discussion of our three-part series “Understanding Mental Health,” we pose the question of “Who” to see. With so many social workers, marriage & family therapists, psychologists and psychiatrists, how do you go about finding the right mental health practitioner for you?
This can be a daunting task because so much of it is about the relationship between client and clinician. The adage, “People don’t care how much you know until they know how much you care,” couldn’t possibly be truer than in the world of psychotherapy. It is key to find a professional with whom you resonate – one whom you can trust, confide in, believe in, and also challenge when you don’t agree. As much as I would lie to say that I connect with everyone and anyone who calls or enters my office, and that they connect with me, that isn’t always the case. Trust your instincts, notice if there is a natural report, and choose a therapist who specializes in the area you’re most concerned about. Therapy, like anything else, can be hazardous if you don’t use careful consideration!
It’s hard to know what to expect in that first session with a therapist. I’ve compiled a list of four critical factors that will most likely determine one’s experience. Notice that there are a combination of factors according to who the clinician is and who the client is:
Four Critical Factors in Psychotherapy
1) Theoretical Orientation
Theoretical orientation determines how a therapist will approach the issues or problems that you want to focus on. For instances, a cognitive therapist will look at your patterns of thinking; a psychodynamically oriented therapists will examine your past experiences, and a post modern psychotherapist will focus on societal influences, and so on. Many therapists use an eclectic approach, tailoring one’s unique circumstances, history, and personality. The client is primarily the one who sets the agenda and goals of their own therapy.
2) Personal Style A therapist’s personal style is somewhat determined by their theoretical orientation, for example, psychodynamic therapists encourage the client to do most of the talking with the therapist rarely commenting. On the other end of the scale are behavioral therapists who are more directive, giving clients’ specific direction as to how they should alter their faulty thinking patterns and overcome problems. However, all therapists should allow plenty of room for client feedback.
3) Client’s Attitude
This may indeed be the most influential aspect of therapy that most closely correlates to successful therapy. Clients who are committed to achieving results are far more likely to benefit from therapy than clients who take a “I dare ya to help me” stance. Reservations are understandable – talk them over with your therapist if these feelings arise.
4) Client’s Openness
I have such great respect for clients who are willing to share such personal information with their therapist. This is what therapy is for but it’s nor for the faint in heart – it’s hard work to be honest and open but this is the only way to reap the full benefits of objective perspective and professional expertise.Therapy really does provide a safe environment for as you, letting it all hang out without any repercussions like there would often be in interpersonal relationships with family or friends. In therapy, you won’t be judged for your thoughts, feelings, or actions no matter how embarrassed or ashamed you feel about them. There are also strict rules of confidentiality governing conversations between a clinician and client that are designed to allow one to feel as comfortable as possible in sharing the details of their situation. There are guidelines to confidentiality that should be outlined by your therapist upon your first meeting.
So how can one go about finding a good mental health practitioner? You can always start with your family physician or other health care professional. Call your state or local psychological, social work, or marriage and family therapy associations. Consult a local university or college department of social work or psychology. Inquire with your pastor, bishop, or rabbi. Check with your human resources department and insurance companies. Contact our local community mental health center. The yellow pages under the categories of “counselors” and “psychologists” are two key places, as well. And if you are open with your family and friends, you may consider asking them who they know in the mental health field, as well. You may not want to see the same professional another family member is seeingÃ¢â?¬Â¦as a matter of fact, I often won’t agree to see someone if there is a close relationship- because there is an ethical violation there and conflict of interest. However, that professional could be an excellent referral source.
Locator.apa.orgFrom my experience, there are five questions anyone should ask a therapist before making that first appointment. Start by asking to schedule a 10-15 minute phone interview with your counselor. If the professional isn’t willing to have an initial conversation with you over the phone, eliminate them from your consideration. NEXT!Five Questions to Ask1) “What are your credentials?”
Do you have a license to practice counseling? How many years of experience do you have? What do you do to stay current in your field? What professional organizations are you a member of? What is your approach in working with a client from another religion? My religion is Buddhist or LDS or CatholicÃ¢â?¬Â¦what are your attitudes about that? I don’t believe your therapist needs to be of your faith..but they absolutely must respect your faith and help you operate within the walls of your belief system.2) “What is your treatment style?”
Do you tend to be more directive and verbal with lots of feedback, or will you rarely comment and allow me to do most of the talking with only an occasional interjection from you. Will they examine childhood events, language patterns, negative thought patterns, or dreams? Ask if they will be willing to tailor the therapy to your particular circumstances, history, and personality.3) “What are your fees?”
How long is your session? Many more of us are doing longer therapy sessions these days and not the traditional 50-minutes. Do I pay at the time of service or will you bill me? Are you covered by insurance? What if I need to call you between appointments? Will there be a charge for that? May I e-mail or text you?4) “What is your success rate?”
Ask about your particular concern. For example, “Do you have experience helping couples recover from infidelity, If so, what is your success rate? What would be your goal for our marriage?” Now, well-trained marriage therapists will say something along the lines of “to help you both achieve marital fulfillment and save your marriage.” In other words, they are marriage therapists not divorce therapists but ultimately YOU decide the outcome of your marriage. At least know their theoretical background: are they pro-marriage, for instance?5) What are your attitudes about therapy?
Have you had your own therapy? Listen for the attitude. If the question is answered with great reverence for their own therapeutic process, excellent. If it’s met with defensiveness or an excuse that they had some therapy group experience once in college, that’s not enough. You want to work with a professional who has the insight to manage their own.
Keep in mind, there are various kinds of mental health professionals there are to choose from and consider, as well.
Types of Mental Health Providers
Psychiatrists: M.D. or O.D. – can prescribe meds and also offer psychotherapy.
Psychologists: Psy. D or Ph.D. Provide psychotherapy for a range of issues from marital problems to personality disorders.
Psychotherapists: General term for mental health provider. Can include marriage and family therapists, pastoral counselor, psychiatric nurse, social worker, etc.
Social Workers: Broad profession. Most have M.S.W. (masters of social work) but training and education vary widely. In general, social workers help overcome social and health problems.)
Psychiatric Nurses: Licensed registered nurses who have extra training in mental health. Under supervision of M.D., they offer mental health assessments, psychotherapy and medication management. A.P.R.N.’s can diagnose, treat, and prescribe meds in most states.
Mental Health Counselors: Broad term for person who provides counseling. May have a master’s or doctoral degree and specialize in a variety of areas, such as, career counseling, marriage issues or substance abuse.
Marriage & Family Therapists: Evaluate and treat disorders within the family context. They typically have master’s or doctorate degree.
Pastoral Counselors: Trained mental health professionals who have in-depth religious or theological training. Provide wide variety of services from mental illness to spiritual direction.
Psychoanalysts: Specific treatment that explores unconscious factors influencing relationships and behavior. Both training and treatment is intensive with several sessions a week for five to 10 years.
A common question asked is what is the difference between a psychologist and a psychiatrist? This really is the million dollar question! Psychiatrists are medical doctors (M.D.) or doctors of osteopathy (O.D.) who specialize in the diagnosis, treatment, and prevention of mental illness. After medical school, they complete at least four years of residency training. Because they are medical doctors, they can also prescribe medications, and they can also offer psychotherapy. They can assist one with everyday problems like stress or more complicated issues like schizophrenia.
Psychologists specialize in psychology – the science dealing with the mind, mental processing, and behaviors. The title”psychologist” is used for those who have a doctoral degree (Ph.D. or Psy.D.). They do not prescribe medications usually although there are a few with a most-doctorate master’s degree that can prescribe some select meds. Psychologists provide assistance with a variety of issues ranging from marriage problems to personality disorders.