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What To Consider When Trying To Find A Therapist

September 7, 2012
By Jim McElrath, LCSW-R - Director of Clinical Services, Family Service of the Chautauqua Region , The Post-Journal

There are many factors to consider when trying to decide the nearly always anxiety-provoking task of finding a therapist, especially for the first time. Word of mouth may be for better or worse; the most trusted source in particular if someone you trust has reported a good or bad experience with a particular therapist or agency. It is not as if most of us would want or be able to have to try out a number of therapists for telling our secrets and troubles; it's hard enough to tell one person, let alone a likely stranger.

Once you make the decision to try therapy, unfortunately insurance may determine your next step. If you have health insurance and it covers mental health a lot of preferred providers (which only means they have the credentials to be reimbursable) should be available in your area to choose from. You can call the particular agency or therapist and check for their specialties as well. There are often long waits for an initial appointment as due to the unfortunate state of mental-health counseling; full-time therapists may have between 60 and 120 clients who are active. You may want to ask how often you can be seen during the intake process. This is a ridiculously high number of people/families for anyone to manage properly, but this is the unfortunate reality of modern mental-health counseling.

At the intake or the initial session, a plan for counseling should be discussed. In particular you should ask about your therapist's expertise in your particular presenting problem area. Therapists are under pressure to use evidence-based therapy, which essentially is therapy that has proved mostly effective, most of the time (not all) for a particular problem such as depression and anxiety. Also insist upon your treatment being individualized to your needs. As far as the evidenced-based frenzy goes, I'll leave it to a smarter man than I -Albert Einstein - to comment: "Not everything that can be counted counts, and not everything that counts can be counted."

Regardless, you should be open and honest with your therapist, which requires rapport to build trust for therapy to be most effective. In terms of research, meaningful rapport (not just liking them - though that helps) leads to the best outcomes.

Admitting our flaws and roles in our problems is perhaps the most difficult thing to do in therapy, and perhaps in life. In good therapy your complete confidentiality is essential as is the expectation that your therapist will be non-judgmental no matter what you tell them.

In this writer's opinion, the job of the therapist is to help you figure out "what makes you tick" as Joseph Campbell once put it so simply, and then to accept, tolerate, and adjust to the unpleasant aspects of our lives. When this is accomplished, people get better. Obviously this is much easier written or said than done. Recognizing our flaws is also difficult for some. Sometimes it is important to involve family (whatever your definition) to help yourself and the therapist understand those issues more clearly. Therapy is not as helpful if we cannot say (for whatever reason) what we really mean or express how we really feel.

Therapy is not easy work. We all have different perspectives of what hard work means so this writer can only share his perspective on the field. The aforementioned high-case loads, relatively poor compensation and overzealous administrators who certainly do not seem to have your therapist's best interests in mind contribute to this already complicated undertaking.

Despite all this, once behind closed doors the process and outcome can be powerful. As has been said, the best things cannot be told, and the second best are misunderstood. There is a feeling you come to know and mostly trust as a therapist when something powerful has happened in your room. This is one of those things that can't always be counted or measured in terms of therapy. Making that first contact is often so difficult you want to feel welcomed by your therapist/agency of choice. You are the customer after all. What unfortunately most often occurs is that people do not show for their first appointment or come once, never to return.

Knowing this evidence should at least help therapists and agencies appreciate the importance of those initial contacts. This writer urges you to give therapy a chance even if you've had a bad experience. We all love our stories and telling our own. Though telling them is sometimes painful, doing so usually makes us feel better and more enlightened in the end.

If you feel I can be of further service in the area please contact me at Family Service of the Chautauqua Region. I can be reached at 488-1971 or by email at Jimm@familyservicecr.com.

 
 

 

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