“Shopping” for a psychotherapist can be a tricky endeavor. It’s one of those things for which there is no guidebook or clear-cut path. And it sounds funny to use the word “shopping,” but that’s basically what this selection process is. Wouldn’t it be nice if a therapist could tell potential clients how to go about looking and what to look for? I’ll give it a try…
Sometimes it’s kind of striking how many people are in therapy, but refrain from telling others that they are in therapy, because they assume they are alone or because they harbor some kind of embarrassment or shame for it. But if you happen to be lucky enough to have friends that openly share this information, you can take advantage by asking them for their therapist’s information. Be sure though, to make sure that they are comfortable with the idea of you seeing the same therapist. Any ethical therapist will maintain good boundaries between their work with clients, and they will refer out if a conflict of interest can be anticipated.
Word of mouth can be one way to learn about potential therapists. In this day and age, the internet can be a great way to shop, too. We therapists are not yet on Amazon, but many of us do have websites and/or utilize online directories. You may be able to find descriptions online, which can give you an initial feel, but this is no substitute for an actual conversation on the phone, or even in person. Many therapists will offer you a chance to briefly meet and ask questions, before committing to working together. Feel is important; research has indicated that between 30% to 70% of what facilitates change in therapy, is the therapy relationship itself.
This same research has also indicated that the therapy technique accounts for only 15% of what allows change to happen. So feel may be the most important factor for you to attend to, but different therapists do operate differently, and so you may want to ask about the therapist’s “theoretical orientation.” There are many therapy models out there, but two of the most common are “Cognitive-Behavioral Therapy (CBT)” and “Psychodynamic Therapy.” There are several different variations of each.
In general, CBT tends to focus on concrete links between thoughts, emotions, physiology, and behaviors. It is problem focused and tends to also emphasize the development of skills. Psychodynamic therapy tends to focus on the influence of one’s family of origin on one’s unconscious. This therapy helps to bring the unconscious into consciousness. Some therapists strictly adhere to one modality or another, but many of us are “integrative.” The word “integrative” implies a more systematic integration of psychological theory, whereas “eclectic” is sometimes considered a more haphazard utilization of theory, but I think this distinction may be a bit of a fallacy. Integrative and eclectic therapists both do what they think will help.You may also consider pragmatic variables. For instance, would you be more comfortable with a male or female therapist? What age? Though, if you instantly think you’d be more comfortable with a given demographic, you may want to explore that with any therapist (perhaps the person you think you’d be less comfortable with). This kind of preference can be great “grist for the mill” in therapy. Other practical considerations may also be important to you. A therapist’s location can make a difference as you squeeze therapy into your day, and you might think about niceties such as being able to grab lunch nearby. If you want to utilize your health insurance, you may want to first determine the specifics of your plan, and learn who the local in-network providers are, and whether or not they will submit directly to your insurance company for you. But finding a good fit may be more important to you than finding the most financially feasible or convenient option. Your emotional well-being is worth the investment.
If you have reservations but manage to take the leap and “try” therapy, mull over the idea of trying at least 4 sessions before deciding it is too uncomfortable or not a good fit. I learned this from one of my clients…
Several years ago, I worked at a university where upon her last session, my client said that she would tell all her friends that she was initially the biggest skeptic of therapy, but that after 4 sessions, she knew it was going to be an impactful process. She had decided that anybody could benefit from therapy if they hung in there long enough. I’m glad she hung in there with me. Being bold enough to discuss reservations with your therapist, as they occur, can facilitate the process of therapy, helping to move beyond surface level conversation.