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How To Choose A Therapist

Whether you’ve been in psychotherapy or are giving it a try for the first time, finding a therapist is an important decision. Opening up to a stranger about your most personal issues makes most people feel vulnerable. And if you’re not feeling your emotional best or have problems you’re hoping to get help with, it’s important to find someone with whom you feel comfortable and confident as soon as possible. Below are some things to consider when looking for a therapist.

To Go With Insurance or Not?

It is important to look at your insurance benefits to see whether they cover psychotherapy, at all. Many companies offer in-house, short-term counseling through their Employee Assistance Programs (EAPs). This can provide some emotional support during a crisis. However, this is different from coverage your insurance plan might provide for therapy you seek outside your place of employment. Look carefully at your benefits description to see whether your plan covers mental health services.If you’re lucky enough to have coverage, there are still some important things to know and consider.

First, If you need to get “pre-authorized,” ask about how to do this. It may require a referral from your primary care physician.

Second, find out if there is a limit to how many visits you are allowed annually. These can quickly be exhausted if you are in weekly psychotherapy. If you run out of visits but want to continue therapy, can you get more? Some companies require that your psychotherapist send information about your condition and treatment in order to pre-authorize or allow extra sessions. This may not matter to you. Others want a greater degree of confidentiality.

Third, saving money is the most typical reason for using insurance to see a psychotherapist. Find out how much your copay will be. Most therapists will want to see you weekly, so even with insurance, your treatment is an investment.

However, say you find a fantastic psychotherapist who does not accept your insurance. Some insurance plans will reimburse out-of-network, typically some percentage (up to a capped amount) of a therapist’s rate. You pay up front, and most psychotherapists will provide you with the information (something called a “superbill”) for you to get partially reimbursed by your insurance company.

Finally, for a variety of reasons, some choose not to involve their insurance companies at all. Some people want to keep their mental health treatment separate from their medical record. Others don’t want to be limited to the therapists who take their insurance or find, when they call, that these practices are already full.

MFT, LPC, LCSW, Psychologist, Psychiatrist…Aren’t They All Therapists?

Do an internet search to find a psychotherapist and you will stumble over an array of lettered degrees after people’s names. In general, there are five groups of professionals trained to provide mental health services. (I am not including here “coaching” or “life coach” professionals. So far, this is a fairly unregulated profession and even “certified” coaches may have vastly different levels of training and expertise.)

LCSWs (Licensed Clinical Social Workers) have at least a Master’s degree. They are a subset of the social work profession that is trained to work with mental health issues.

LPCs (Licensed Professional Counselors) have at least a Master’s degree and work with people either as mental health generalists or have trained in a niche specialty.

MFTs (Marriage and Family Therapists) have at least a Master’s degree. Their emphasis is most commonly on couples and family systems, but many also work with individuals.

Psychiatrists are Medical Doctors (M.D.s) with a specialization in mental health. While some psychiatrists can and do provide psychotherapy, the majority focus on diagnosis and treatment of mental health issues with psychiatric medications.

Psychologists are doctoral-level professionals with a variety of specialties. In searching for a psychotherapist, you will want to look for a Psy.D. degree (someone whose focus in school was clinical, i.e., extensive training in direct work with people) or Ph.D. (someone whose focus in school was on research, but who will also have the necessary clinical experience to get licensed).

Students and Interns in psychology and counseling programs often work in community agencies under the supervision of a licensed professional to gain experience. This can be a great option if finances are an issue. Check local universities and colleges to see if they have Master’s or

Doctoral degrees in psychology or counseling and if they partner with any local community clinics.

The kind of professional you choose depends on you and your needs. There are well-trained, helpful people in all of these professions. It never hurts to speak with psychotherapists with different degrees to get a sense of who might best help.

Interview – or at Least Call – Several

It rarely dawns on most people to interview a doctor. However, speaking with a few psychotherapists can give you a lot of information about whether they might be a good fit for you.

First, try calling and give a brief overview of your situation and needs. Does the person on the other end of the line respond in a way that makes you feel understood? You can ask about anything that seems important for you to make a decision. Maybe education-level or number of years in practice is important to you. Or perhaps you want to know about the psychotherapist’s treatment philosophy. While a psychotherapist cannot provide treatment or give advice by phone, she/he should be willing to take 5-10 minutes to respond to your most important questions.

Second, if the phone conversation feels comfortable enough, see if the psychotherapist would be willing to meet with you to see if it’s a good mutual fit. This can take up to a few sessions to establish. If you experience some early benefit, go ahead and give the relationship a shot.

Remember, therapy is a process and most treatments require more than a few sessions. If, on the other hand, you’re still unsure about your psychotherapist after a few sessions, it’s all right to move on. In fact, continuing your search for a better match makes sense before you invest any more time and money into the process.

Ultimately, studies show that the effect of helpful psychotherapy is about 30% due to a positive relationship with the psychotherapist. So, keep looking until you find the right one.

Some Resources to Help In Your Search for a Therapist

Your state associations for counselors, social workers, psychologists and psychiatrists will likely have professional directories.

Word of mouth is a great way to find out about psychotherapists with good reputations.

Call your insurance company for a list of therapists on their panel.

Psychology Today: This site is one of the first and best known resources for finding therapists in your area. It allows you to set filters for many variables, including insurance.

Good Therapy is another well-established therapist clearinghouse site that lists different kinds of professionals.

Therapy Den is a therapist clearinghouse created in 2017 that includes therapists with a variety of backgrounds.

Psychologist Locator is the listing of therapists for the American Psychological Association.

The National Register for Health Psychologists has a clearinghouse of psychologist members.

Mental Health Match was established in 2019 and includes therapist listings of all types.

© Amra Stafford, PsyD

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