5 Rules for picking the right therapist


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By David Joel Miller.

5 Rules for picking the right therapist.

How do you choose a counselor?

What are the key things you should look for when choosing a therapist? How do you know if this person could help you? Let’s look at some suggestions for having a good experience in therapy.

Do you relate well?

The number one predictor of a therapist’s ability to be of help to you is – If you think they can help you they can. And conversely, if you get the feeling that this person will not be able to help you, then they probably will not be able to be helpful.

Whenever you enter a helping relationship look first and foremost for a person that you get a good feeling about. In the first session, you should be interviewing the counselor as much as they are interviewing you. See if this person “gets you” and if you feel comfortable disclosing things to them. If you feel the need to hold back and not tell them something you are off to a bad start. I see two extremes to this finding a fit problem the client who works for years with the same therapist and gets no better and the client who bounces from provider to provider and never stays in a relationship long enough to get any work done. You need to give the process time, but not forever.

Do you need a specialist? Does their training or specialty matter?

Some therapist list very specific areas of experience. Truth be told all counselors see people with the same sort of problems, mostly anger, depression, and anxiety. Couples who want a better marriage and schizophrenics who have few friends both need help with relationships. But there are some issues that call for a more specialized approach. Eating disorders, sexual issues, and developmental problems need special expertise. So does substance abuse in my opinion. If several therapists tell you they don’t see that type of client and give you referrals to call, pay special attention, they are telling you that your sort of problem does not call for a mental health general practitioner. If you are referred to the same name two or three times seriously consider this person.

How long do you want counseling to take?

Some schools of therapy believe in the long slow approach, working on basic childhood and personality issues.  They take a lot of time and can be expensive but can help you change the way you relate to the world. Some clients feel they need to see a therapist on a regular basis to continue to function well. Without their weekly visit to the therapist, these people may fall apart and end up unable to hold a job or end up back in the hospital again.

Other therapies believe in brief problem-solving approaches. Cognitive and behavioral approaches generally expect you to do work on yourself between sessions. They assign homework. Do you want to do your work in session or are you expecting a crash program that includes homework?

What is your reason for wanting therapy?

Are you facing a choice – should you get a divorce or stay together or which job should you take? Do you need the counselor to provide information or just listen? A good counselor will NOT tell you what to do. That makes you dependent on them for your life decisions. They should help you grow so you can make your own informed decisions.

Do you want to change something?  Give up drugs; learn to have a better relationship with your kid? Change requires a process if it is to be successful and if the change is to be maintained. A word of caution, be sure who you want to change. The therapist can’t change a person who is not in the room and who does not want to change. They can teach you new ways of relating to that person and if you change the way you act they may change also.

Are you confused and need some help in sorting it all out? Confusion issues may take a lot longer to work through. Are you prepared to spend that much time? There may be an underlying life issue, are you willing to take a look at that even if it involves pain or talking about something you want to forget?

Are you coming to counseling for you or for someone else?

If you are coming because your partner wants you to or because of a court order you need to be clear that you are doing this for someone else. Discuss how many sessions exactly the counselor will want you to come to before they will sign that court letter. Even if you are court or spouse ordered are you willing and open to change? If you do have to do this counseling for someone else I urge you to approach it as a chance to learn some new things and to grow and develop. If you only go to shut up the judge you are likely to make yourself miserable during the process if you are not willing to really do the process

Finances – the cost of therapy.

I have put this last for a good reason. People often say they can’t afford therapy. They complain about their pain and their life situation but they are not sure that it is worth spending money to have happiness. You should give this a lot of thought. If you spend a lot each week on entertainment, video games or eating out but find you are still unhappy, would you spend as much to see a counselor as you spend on a beauty treatment or drugs and alcohol? How much might help getting your child to behave better be worth to you?

If you have insurance talk to your provider, what is covered, what requires out-of-pocket payment? Some companies require you to see a contracted provider from a list they provide and you probably will have a co-pay. They should give you several names to choose from. Sometimes insurance companies will let you pick a counselor, pay that counselor and then submit the receipt for reimbursement. This may cost you a little more but it gives you lots more choices.  Some people chose to pay themselves because it puts them more in control of the process.

If you don’t have insurance carefully think about how much you might be able to pay and then look around to see what is available. There are low-cost clinics and providers who do sliding scale. I wrote in a previous post about other ways to get low-cost help when you really can’t afford to pay the fee.

Hope that you find this helpful. Best wishes on your journey to a happy life. David Miller. LMFT, LPCC.

For more on this subject see:

What to do if Therapy is not helping

How to Spot a Bad Therapist

Reasons Counselors and Therapists lose licenses 

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog, there is also a Facebook authors page, in its infancy, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. Thanks to all who read this blog.

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4 thoughts on “5 Rules for picking the right therapist

  1. Pingback: Reasons Counselors and Therapists Lose Licenses | counselorssoapbox

  2. Pingback: What do you do if therapy is not helping? | counselorssoapbox

  3. Pingback: How to spot a bad therapist | counselorssoapbox

  4. Pingback: Will marriage counseling help? | counselorssoapbox

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