"Being
in therapy is great," comedian Caroline Rhea once joked.
"I spend an hour just talking about myself. It’s kinda
like being the guy on a date."
It’s
not a bad analogy — the dating one — when you’re setting
out to find a therapist. You want someone with whom you can
spend an hour week after week; someone with whom you can be
vulnerable; someone you trust and respect.
But a
therapist plays a unique role in your life — helping you
identify and tackle points of distress in a way that family
and friends and partners are unable to do. Sometimes at upward
of $150 an hour.
So the
search is sticky. And it’s usually embarked upon during an
already stressful time.
"It’s
a very vulnerable thing to be in therapy," says Lynn
Bufka, head of the department of practice, research and policy
at the American Psychological Association. "As with any
health care provider — whether it’s a physician or nurse
or therapist — you’re interested in finding someone who’s
competent. But the question of fit becomes even more critical
with a therapist, because you’re going to see that person
quite regularly and you want to have a comfortable
relationship."
Start
the search. "Asking a friend is a reasonable place to
start," says Bufka. "Many people find success with
that. You can also ask your health care provider."
An
Internet search for umbrella organizations can also lead the
way: The American Psychiatric Association, the American
Psychological Association, the National Association of Social
Workers, for example.
"We
all have national professional associations, and they all have
state chapters," says Mark Hamilton, executive director
of the American Mental Health Counselors Association.
"With electronic directories, you can often call up a
picture of the person and see their credentials and see what
area they specialize in."
Check
credentials. "Ensure the person is licensed within
psychology, which implies they’ve met at least the minimum
education and experience standards to practice within the
profession," says Bufka. "It also gives the patient
some protection, because the duty of a licensing board is to
protect the public."
It’s
also fine, Bufka says, to ask for a bit of background. Where
did you go to school? When did you get your degree? How long
have you been practicing? Do you have an area or areas of
specialization? Do you work with clients in similar
circumstances to mine?
Do some
self-reflection: Ask yourself where the root of your stress
appears to lie: Within yourself? Your child? Your spouse? Are
you struggling with an addiction? Are you entertaining harmful
thoughts?
And don’t
worry if you can’t pinpoint an exact starting point for your
feelings of malaise. A good therapist will help get you there.
"The
goals of therapy will be determined mutually between the
therapist and patient," says Bufka. "Therapy can
help you make significant changes in areas of your life that
might be contributing to your distress. It can help you see
how all the pieces fit together and when one problem developed
in relation to another."
Schedule
an initial meeting: Plan to spend a chunk of time on the phone
or in the office with a handful of therapist candidates before
committing to one person. Find out how each handles payment,
whether and what kind of insurance is accepted and how much
experience they have with your particular stressors.
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"You
could say, ‘I think I have OCD. Have you treated this kind
of problem?’" Bufka says. "They might say they
really want to do a good evaluation to make sure that’s
truly your situation. But they also might say they have a lot
of experience treating anxiety and OCD is a kind of anxiety
and here are some ideas how we would proceed.’"
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Some
people want to know how long it will take to start seeing
changes, says Bufka.
"That’s
a reasonable question," she says. "Your problems are
unlikely to change overnight, but change can be a variety of
things: symptom reduction, improvement in mood, improvement in
function, better ability to get to work, improved
relationships. Therapy outcomes can also mean an increased
self-understanding and not repeating prior patterns."
Trust
your gut: "It’s very important to keep in mind you are
the person seeking the service and you’re in charge of
deciding whether it’s the right fit or not," says Bufka.
"You’re not going to go to someone you don’t think is
going to help you."
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That
said, remember that you’re not looking for a pal — or a
date.
"You
don’t have to necessarily like the therapist," Bufka
says. "It’s important to feel the therapist respects
you and understands you and has the expertise to help you with
what you’re seeking help for.
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"Sometimes
a therapist is going to challenge you and push you, and it’s
not going to feel warm and fuzzy," she continues.
"They should push you in a way that feels respectful and
at a pace you’re comfortable with, but that doesn’t mean
therapy will be without difficulty."
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———
WHAT THE
TERMS MEAN
"The
term ‘therapist’ is a very general term that can be
applied to a variety of different professions serving a
variety of different needs," says Mark Hamilton,
executive director of the American Mental Health Counselors
Association. A primer on a few of the main types of mental
health professionals:
Psychiatrists:
Specialize in diagnosing and treating mental or psychiatric
illnesses and are licensed to prescribe medication.
Psychologists:
Hold doctoral degrees in psychology. Not licensed to prescribe
medication, but can refer patients to a psychiatrist.
Licensed
clinical social workers: Specialists who hold at least a
master’s degree in social work and have met state licensing
requirements for minimum working hours (likely 3,000). Often
help patients with psychological, social functioning and
relationship problems.
Licensed
mental health counselors: Required to hold at least a master’s
degree in counseling and 3,000 hours of experience. Able to
diagnose and treat mental and emotional disorders.