Looking for a Therapist- making the most of your appointments

Therapy is a collaborative process, so finding the right match-someone with whom you have a sense of rapport-is critical. After you find someone, keep in mind that therapy is work and sometimes can be painful. However, it also can be rewarding and life changing.

Two kinds of therapists warrant special note: psychiatrists and clinical social workers. Psychiatrists are medical doctors and can prescribe medication. Clinical social workers are trained in client-centered advocacy and can assist you with information, referral, and direct help in dealing with local, State, or Federal government agencies. As a result, they often serve as case managers to help people "navigate the system." Clinical social workers and many other mental health professionals cannot write prescriptions. However, nurse practitioners that specialize in psychiatry and mental health can prescribe medication in most states. And, under a new law, psychologists in New Mexico can prescribe medications after receiving training (New Mexico State Legislature, 2002).

Before going to a therapist

Arriving prepared for your first therapy session is helpful. Spend some time thinking about your situation and expectations. Here are some tips to think about before seeing a new therapist. I suggest spending some time alone to think and write about the questions below. Though not a necessity, your therapist should help you explore the questions.

Write about the problem in detail. How does this problem affect you?
What is your goal with therapy?
What will you not tolerate in a therapist? Are there things a therapist might do that would prevent you from working constructively with them?
What qualities would you like to see in your therapist? Are there qualities that would help you during therapy?
Are there any unacceptable forms of treatment? If yes, what are they?
Are there any treatment forms you strongly believe in? If yes, what are they?
While it is unethical for a therapist to promote his or her own religious beliefs during therapy, there are some therapists who use a Christian, Spiritual or other religiously based approach. If the therapist is ethical he or she will be open about such religious affiliation. I would suggest discussing your own preferences with religiously based approaches up front with your new therapist, and to reach an agreement on the place of such approaches in your therapy.
Do you have any special concerns when looking for a therapist? If yes, what are they?
Have you had any previous bad experiences from mental health professionals? If yes, what are they? How did they affect you? What lessons did you learn from those experiences?
Have you had any good experiences with mental health professionals? If yes, what are they? How have they affected you? What lessons did you learn from those experiences?
Write down specific questions before meeting your new therapist. Meeting a therapist for the first time can be a difficult experience and most people find it helpful to have their questions written down.
Therapists have different certifications and educations. Therapists at least have a MA or MS in Psychology, along with a certification for certified social work, or marriage, family, child counseling (MFCC) which is legal in your state. Many therapists have PhDs or plan on getting them. Often, therapists with a full PhD are much more expensive than those with a MA or MS. PhD's also have an area of specialization and more supervised hours. However, the certifications towards a licensed social worker, or a MFCC, are demanding and rigorous. I believe having a good feeling about your therapist is more important than whether or not they have a PhD. Psychiatrists, MD's who specialize in brain functions, also sometimes provide therapy. Knowing your therapist's background and education is important.
There are several therapists who have not gone through licensure. They sometimes present their therapy under a religious or spiritual umbrella. Most of these therapies, such as rebirthing, integrated breathwork, and certain meditation practices, are very controversial. For some, even hypnosis can be controversial. Other forms of therapy still being tested by the psychology community have not been accepted as mainstream. It is important to carefully consider your needs before accepting such a therapy, and realize that there are no safeguards, should something go wrong. Unlicensed therapists are not necessarily trained in ethics. Nor do you have any legal recourse if the treatment goes wrong, or makes you feel worse than when you started therapy. If you choose a controversial therapy, thoroughly research its pros and cons. Listening to the therapy's detractors is often as illuminating as listening to the supporters. If you choose an unlicensed therapist, take extra care in finding one. During the therapy, continue to check that you are reaching your original goals.

Visiting your therapist the first time.

Remember, you hire your therapist. You can fire your therapist if you feel you cannot work with this person for any reason. Your first meeting should be partially viewed as the therapist's job interview.

Here are some suggested questions to ask a potential therapist when meeting them for the first time. Please add or subtract any questions as they fit your comfort level.

What are his or her credentials? Where did they get their education? Where have they worked before? What is their job related experience?
Does this person have any experience working with people with your specific issues?
What treatment methods does this person use?
How do you arrange payment with this person?
When and how often do you meet?
In case of emergencies, how can you reach your therapist? What do emergency calls cost? What are this therapist's rules and boundaries in emergency situations?
If you have any specific treatment forms which you especially like or dislike, ask how the therapist uses these forms.
If you are seeking help for anything controversial within psychology, such as DID, False Memories, ADHD, or other mental health issues of controversy, ask your prospective therapist where they stand on those issues.
Any other questions you feel would be important to ask your therapist to help you feel comfortable seeing him or her.

Examples of questions the therapist might ask you during the first meeting.

Why are you seeking therapy?
How can I best help you?
Do you have any specific concerns or fears about going to therapy.

Points to ponder for yourself after the first meeting.

Is this a person you can come to trust given the time and opportunity?
Did the therapist put you at ease?
Did you feel this person genuinely cares about you?

Again, remember, you hire a therapist, and you can fire a therapist. This is about working through your difficulties, and it is important you feel comfortable.

Steps for choosing a therapist - Finding the right therapist