Picking a therapist, Where to Start.
Choosing a therapist to work with can be very overwhelming. Who do I choose you? Where do I look for a therapist? What kind of questions do I ask a therapist when I call them? The choice can seem overwhelming considering the many therapists that are available to choose from.
Here are some things to consider to help you in your search.
Managed Care Therapist or Fee for Service Therapist (Out of Pocket):
When choosing a therapist one of the first questions I would ask myself is - Do I want to go with a therapist that is offered by my HMO/health care insurance? Some of you may not have health care insurance therefore this may not even be a question, but for those of you who do have managed care health care you may want to consider the pros and cons of starting therapy with someone through your HMO/health care insurance. Some of the reasons I personally and professionally encourage clients to seek therapists that are fee for service therapists are outlined on the page titled Fees. Some of the other reasons to consider stepping outside of your HMO are because some HMOs limit the amount of times you can receive services, your plan may state that you are eligible for example, 20 sessions but you must meet the criteria for medical necessity, meaning you have to have a DSM IV diagnosis and be determined impaired in your functioning in some manner to qualify you for medical necessity. Therefore just because your plan states you are eligible for a certain amount of sessions does not mean you can get approved to use those sessions. Furthermore if the sessions are approved some managed care systems are so overrun by client need that you are often not seen on a regular basis, at most you are seen once a month which does not provide the consistency needed for progress in the therapeutic process.
Choosing a fee for service therapist, that is a therapist you pay out of pocket provides you with the ability and flexibility to see your therapist when you want rather than when your managed care provider had an opening. Some may say that your health care provider allows you to see a private practitioner however the private practitioners that are covered by your health care provider may not specialize in the areas you are seeking therapy for, considering looking outside of your health care coverage opens you up to the possibility of seeing the therapist that is best suited for you.
Finding a Specialist, Not Just a Therapist:
Once you have made a decision about seeing a therapist through your health care provider or fee for service therapist you may ask yourself how do I find a therapist. I always suggest asking people you know if you feel comfortable if they have a recommendation, you may be surprised to learn how many people see a therapist for support. You can also go online, now with the popularity of online profiles therapists can also be found through the same means you might find another service. Some trusted sites are PsychologyToday.com or NetworkTherapy.Com
This is still very broad, so I suggest to think about the issues you want to work on. Narrow your potential therapist list by the therapists that specifically specialize in that area(s) you want to work on. A lot of therapists claim to be a jack of all trades and while many of us got our start in community clinics or agencies in which we were trained in a range of issues we all have our strong points and areas of more knowledge. I strongly encourage clients to seek a therapist that is a specialist in the area(s) they are working on - I compare it to living with a physical illness, if I were for instance suffering from chronic migraines I would want to be treated by a neurologist not just a general practitioner, with a neurologist I would get more specialized care and better treatment.
You want to verify that the therapist has the experience they are claiming they have, unfortunately many therapists will tack on "specialties" they find interesting but have never had any experience in treating. If a therapist's only experience has been working with adolescents in a group home and they claim to be a couples and martial expert you might consider asking how he or she acquired such experience. It is okay to ask a therapist about their work experience, you are after all entrusting your therapist with yourself and you should feel comfortable that you are working with someone who is actually trained to help you in the area(s) that you need.
What does that therapist offer me?
After you have narrowed your search down to specialists, you may want to ask some questions to the therapists on your list, some may have websites or profiles on professional websites that offer the information to your questions. What kind of therapy modalities do they practice? Do they have experience working with your particular cultural identity if it is important to you, for example if you are LGBTQIA, does the therapist have experience working with the LGBTQIA community?
I always suggest calling at least 2 or 3 therapists and meeting with each of them in person so you can get a feel for them. Do you feel comfortable with them? Did they answer your questions? Feel free to ask if they offer a free in person consultation most do and if they don't they might consider it. In the end it is all about who you feel comfortable with and that is KEY to having a good working relationship. You may also consider your needs? Are you wanting therapy more than once a week? Is this therapist able to provide such services?
I encourage clients to verify a therapist's license, like with any other professional service you want to make sure the person you are hiring is licensed and that their license is active. You can verify a therapist's license by visiting the BBS, Board of Behavioral Sciences. You'll find a therapist's license number on their website or business card.
What's with the alphabet soup? LCSW, ACSW, LMFT, MFTI, Pys.d, Ph.D?
Something you may want to consider in your choosing a therapist is what discipline they are. You may have wondered what all those letters mean, well they all do mean we are psychotherapists but from different backgrounds.
LCSW = Licensed Clinical Social Work (Degree obtained is MSW, Masters in Social Work)
ASCW= Associate Clinical Social Work (Degree obtained is MSW, Masters in Social Work, will be working under a licensed psychotherapist if in private practice or if in a clinic/agency will be supervised by a licensed psychotherapist).
LMFT = Licensed Marriage and Family Therapy (Particular to California, the degree obtained is usually a MA, Masters in Counseling. Although the licensed title is "marriage and family" it is important to note that not all LMFTS have practiced with couples or families, so like mentioned above it is important to verify a therapist's experience).
MFTI = Marriage and Family Interns (Degree obtained is usually a MA, Masters in Counseling, will be working under a licensed psychotherapist if in private practice or if in a clinic/agency will be supervised by a licensed psychotherapist).
Psy.D/Ph.D = Doctorates in Psychology, Ph.Ds usually are more focused on research and academia.
A few words about ACSW/LCSWs:
I can not speak for every discipline however I can speak for my own. I obtained my degree, a Masters in Social Work at Smith College School for Social Work which focused on clinical social work. My degree prepared me to work with clients in the mental health field by helping me see clients holistically. How has society influenced you? What are some of the psychological problems you have encountered? Are there identity conflicts you face? Have there been spiritual conflicts in your life? What has been your social environment? For me, being an LCSW has prepared me to work with clients in a manner that is empowering and based on understanding the whole of where you come from. Most LCSWs are trained in sociology, growth and development, mental health theory and practice, human behavior, social environment, psychology, research methods and societal oppressions.