Elusis (![[info]](http://p-stat.livejournal.com/img/userinfo.gif){kind=small} elusis) wrote,@ 2008-05-13 17:37:00 |
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"How do I find a therapist?"
I have answered this question a number of times in various places, and decided to make it a public post that people can save to memories and I can refer back to as needed.
The following is my opinion, and is meant to be taken as such. For those who might get linked to this who don't know me, I have an MA and PhD in Marriage and Family Therapy, am a Licensed Marriage and Family Therapist in Colorado and am working on getting California to license me as well, and teach graduate students in an MA Counseling Psychology program that leads to licensure. I have been doing clinical work for nearly 11 years at the time of this post, and have been a client in therapy multiple times as a child and adult. I've participated in accreditation of graduate programs, and have published book chapters and articles in peer-reviewed journals.
So the best way to find a therapist is to talk to someone who has a therapist they like, who works with concerns similar to yours. Word-of-mouth is far better than starting with a directory. But that's not always possible.
In the absence of ideas from others in the area, I suggest you have a look in your zip code at http://www.therapistlocator.net - it's the website for Clinical Members of my professional association. Many therapists have "expanded listings" available there which can give you some ideas about their practice. Yes, I am biased toward Licensed Marriage and Family Therapists. It's the only profession whose clinical training I know enough about to be moderately comfortable recommending in a general way, and yet there are plenty of mediocre people in my field just like there are in the others (Licensed Clinical Social Worker, Licensed Professional Counselor, Licensed Psychologist, etc.)
There are hundreds of online resources for finding therapists; however you should realize that most of them are "pay for play," or fee-based directories. Therapists are required to abide by the laws regarding advertising set by their state, which may determine whether they need a license to practice, and what titles they can use for themselves, but these laws vary widely. National groups in addition to AAMFT (my national) that I know to be reputable include the American Psychological Association, the American Counseling Association, and the National Association of Social Workers. If they have directories, I'd tend to trust them.
I strongly encourage you to ask as many questions as you need over the phone, in order to get a feel for their personality. I personally didn't offer a "free consultation" because I found that people tended to no-show for them at a high enough rate that it wasn't worth the time I was taking out of my schedule. I had one or two potential clients taka a lot of exception to that, and I've seen people talk as though it's somehow shady for a therapist to not offer it. Obviously my opinion differs. My way of allowing people to check me out was to take time with them on the phone.
If you are someone who wants to research your therapist before meeting with them, as well as get a feel for them personally, I generally suggest asking things like:
- how long they've been in the field
- what their degree is, and what it's in (good: MA or PhD or PsyD in something like counseling psychology, counseling social work, marriage and family therapy, psychology, etc. Bad: bachelor's degree or some pseudo-degree with its own acronym, fields that sound dubious or woo-woo. "Sexology" is one of my personal buzzwords.)
- what their license is (good: LMFT, LPC, LCSW, licensed psychologist. Also fine: "I'm being supervised toward licensure as _____." Bad: not licensed, not working toward licensure. Some states allow this, but it is the category of practitioners most likely to have a grievance filed against them. Do with that info what you will.)
- tell them a bit about your situation. See what kind of questions they ask - do they seem able to summarize your concerns in a way you agree with? Do they seem to get intrusive or try to treat you over the phone? How do you feel when you're telling them your reasons for wanting therapy? Do you like them? Do they annoy you?
- ask them if they frequently see clients with similar concerns.
- ask them if they have a specific theory or methodology they use, and if it's not familiar to you, ask if they can briefly tell you about it in a way a layperson can understand. I call Quackwatch on some of the currently trendy pseudo-therapies like Neuro-Linguistic Programming, Thought Field Therapy, Emotional Freedom Technique (not to be conused with Emotionally Focused Therapy which is VERY well researched and a great approach), and (my opinion) EMDR. I am generally willing to try to answer questions about therapeutic approaches to the best of my ability, though as an MFT, my speciality is in family systems therapies, not in individual/psychodynamic therapies. Wikipedia pretty much sucks in this regard - most of the theories with good-sized entries have been written by promoters of said theories, and tend to be the new shiny quacky ones.
- you should ask about anything that would be a special concern for you. Do you want a therapist who is a feminist, or who understands social justice? Do you need access accomodation due to a disability? Do you want someone who understands queer people in general, or specifically transmen? Do you want a queer person or a person of color as your therapist, or would it be OK to see a straight or white person who has experienced working with marginalized people? Do you want someone who understands and supports Health At Every Size? Do you want someone of the same religion as you, or no religion at all?
- ask them how therapy with them typically looks. Do they normally see clients every week, every other week, or let the clients set the pace? Do they meet for 45 minutes, 50 minutes, 60 minutes, 90 minutes? What's the typical length of treatment for someone with your concerns? (my personal preference is to run screaming from anyone who says they do Brief/Brief Solution-Focused therapy or says they can treat people in fewer than 12-16 sessions, but that's me. My personal experience is that my clients typically came weekly for 3-4 months if they were very distressed to start, then bi-weekly for another 3-5 months, but it varied a lot.) What's their cancellation policy, and is it one that will work for your life? Do you need someone who's on your insurance? Someone who can see you in the evenings or on weekends?
- are they experienced with working with couples and/or families? I'm biased as an MFT myself, but I often found couple work to be helpful in treating many of the "individual" problems people called about, and the efficacy research supports use of couple/family therapy for many problems. You may not care about this point, but I'm including it because I wish more people would ask it!
And then you get to go with your gut. :)
Remember, you're the consumer here - it's your money and time you're investing. You have the right to ask for your questions to get answered or to move on.
I have rejected potential therapists for a variety of reasons. I excluded one therapist from consideration when I was shopping around because she acted really frustrated when I said I wanted every-other-week sessions - she really only met with people weekly. I ruled out another guy who had an MA in MFT but a PhD in neuropsychology, because he had no coherent answer when I asked him how his PhD work (in a very hard science field) impacted his understanding of his MA work (in a very systemic field that was born out of rejecting the medical model.) I ruled out a woman who said she was straight but "really liked working with gays and lesbians" because something about her answer made me feel like a science project (and besides, I had just said to her that I identify as bisexual.) I ruled out a guy who asked me a million questions when I called about services, then tried to schedule an appointment without giving me a chance to ask him any (I'm the customer here, bub.)
You're the customer. You have the right to find a therapist you can work with.
Yes, you can link to this. No, you don't need to ask me.
Also: this post is not intended as a stimulus for people to tell me about why I'm wrong about (insert field or approach here). You're welcome to have a different opinion than me. I've based my opinions on a lot of research and experience in the field, and I keep up on new developments pretty well. If you want to defend a particular therapy, please post about it in your own journal.
I have answered this question a number of times in various places, and decided to make it a public post that people can save to memories and I can refer back to as needed.
The following is my opinion, and is meant to be taken as such. For those who might get linked to this who don't know me, I have an MA and PhD in Marriage and Family Therapy, am a Licensed Marriage and Family Therapist in Colorado and am working on getting California to license me as well, and teach graduate students in an MA Counseling Psychology program that leads to licensure. I have been doing clinical work for nearly 11 years at the time of this post, and have been a client in therapy multiple times as a child and adult. I've participated in accreditation of graduate programs, and have published book chapters and articles in peer-reviewed journals.
So the best way to find a therapist is to talk to someone who has a therapist they like, who works with concerns similar to yours. Word-of-mouth is far better than starting with a directory. But that's not always possible.
In the absence of ideas from others in the area, I suggest you have a look in your zip code at http://www.therapistlocator.net - it's the website for Clinical Members of my professional association. Many therapists have "expanded listings" available there which can give you some ideas about their practice. Yes, I am biased toward Licensed Marriage and Family Therapists. It's the only profession whose clinical training I know enough about to be moderately comfortable recommending in a general way, and yet there are plenty of mediocre people in my field just like there are in the others (Licensed Clinical Social Worker, Licensed Professional Counselor, Licensed Psychologist, etc.)
There are hundreds of online resources for finding therapists; however you should realize that most of them are "pay for play," or fee-based directories. Therapists are required to abide by the laws regarding advertising set by their state, which may determine whether they need a license to practice, and what titles they can use for themselves, but these laws vary widely. National groups in addition to AAMFT (my national) that I know to be reputable include the American Psychological Association, the American Counseling Association, and the National Association of Social Workers. If they have directories, I'd tend to trust them.
I strongly encourage you to ask as many questions as you need over the phone, in order to get a feel for their personality. I personally didn't offer a "free consultation" because I found that people tended to no-show for them at a high enough rate that it wasn't worth the time I was taking out of my schedule. I had one or two potential clients taka a lot of exception to that, and I've seen people talk as though it's somehow shady for a therapist to not offer it. Obviously my opinion differs. My way of allowing people to check me out was to take time with them on the phone.
If you are someone who wants to research your therapist before meeting with them, as well as get a feel for them personally, I generally suggest asking things like:
- how long they've been in the field
- what their degree is, and what it's in (good: MA or PhD or PsyD in something like counseling psychology, counseling social work, marriage and family therapy, psychology, etc. Bad: bachelor's degree or some pseudo-degree with its own acronym, fields that sound dubious or woo-woo. "Sexology" is one of my personal buzzwords.)
- what their license is (good: LMFT, LPC, LCSW, licensed psychologist. Also fine: "I'm being supervised toward licensure as _____." Bad: not licensed, not working toward licensure. Some states allow this, but it is the category of practitioners most likely to have a grievance filed against them. Do with that info what you will.)
- tell them a bit about your situation. See what kind of questions they ask - do they seem able to summarize your concerns in a way you agree with? Do they seem to get intrusive or try to treat you over the phone? How do you feel when you're telling them your reasons for wanting therapy? Do you like them? Do they annoy you?
- ask them if they frequently see clients with similar concerns.
- ask them if they have a specific theory or methodology they use, and if it's not familiar to you, ask if they can briefly tell you about it in a way a layperson can understand. I call Quackwatch on some of the currently trendy pseudo-therapies like Neuro-Linguistic Programming, Thought Field Therapy, Emotional Freedom Technique (not to be conused with Emotionally Focused Therapy which is VERY well researched and a great approach), and (my opinion) EMDR. I am generally willing to try to answer questions about therapeutic approaches to the best of my ability, though as an MFT, my speciality is in family systems therapies, not in individual/psychodynamic therapies. Wikipedia pretty much sucks in this regard - most of the theories with good-sized entries have been written by promoters of said theories, and tend to be the new shiny quacky ones.
- you should ask about anything that would be a special concern for you. Do you want a therapist who is a feminist, or who understands social justice? Do you need access accomodation due to a disability? Do you want someone who understands queer people in general, or specifically transmen? Do you want a queer person or a person of color as your therapist, or would it be OK to see a straight or white person who has experienced working with marginalized people? Do you want someone who understands and supports Health At Every Size? Do you want someone of the same religion as you, or no religion at all?
- ask them how therapy with them typically looks. Do they normally see clients every week, every other week, or let the clients set the pace? Do they meet for 45 minutes, 50 minutes, 60 minutes, 90 minutes? What's the typical length of treatment for someone with your concerns? (my personal preference is to run screaming from anyone who says they do Brief/Brief Solution-Focused therapy or says they can treat people in fewer than 12-16 sessions, but that's me. My personal experience is that my clients typically came weekly for 3-4 months if they were very distressed to start, then bi-weekly for another 3-5 months, but it varied a lot.) What's their cancellation policy, and is it one that will work for your life? Do you need someone who's on your insurance? Someone who can see you in the evenings or on weekends?
- are they experienced with working with couples and/or families? I'm biased as an MFT myself, but I often found couple work to be helpful in treating many of the "individual" problems people called about, and the efficacy research supports use of couple/family therapy for many problems. You may not care about this point, but I'm including it because I wish more people would ask it!
And then you get to go with your gut. :)
Remember, you're the consumer here - it's your money and time you're investing. You have the right to ask for your questions to get answered or to move on.
I have rejected potential therapists for a variety of reasons. I excluded one therapist from consideration when I was shopping around because she acted really frustrated when I said I wanted every-other-week sessions - she really only met with people weekly. I ruled out another guy who had an MA in MFT but a PhD in neuropsychology, because he had no coherent answer when I asked him how his PhD work (in a very hard science field) impacted his understanding of his MA work (in a very systemic field that was born out of rejecting the medical model.) I ruled out a woman who said she was straight but "really liked working with gays and lesbians" because something about her answer made me feel like a science project (and besides, I had just said to her that I identify as bisexual.) I ruled out a guy who asked me a million questions when I called about services, then tried to schedule an appointment without giving me a chance to ask him any (I'm the customer here, bub.)
You're the customer. You have the right to find a therapist you can work with.
Yes, you can link to this. No, you don't need to ask me.
Also: this post is not intended as a stimulus for people to tell me about why I'm wrong about (insert field or approach here). You're welcome to have a different opinion than me. I've based my opinions on a lot of research and experience in the field, and I keep up on new developments pretty well. If you want to defend a particular therapy, please post about it in your own journal.
