Hands down the question I’m asked most frequently, in person and online, is about how to find a therapist. I understand why. I’ve been a mental health patient myself for 20 years and know that locating a therapist can be a daunting task. It is a highly personal relationship which requires trust and understanding in order for the therapy to be successful. Finding someone with whom you can have a successful therapeutic relationship requires a lot of investigating and researching.
I always advise people to conduct a brief, initial interview with their short list of potential therapists. You are interviewing the clinician for a job as your therapist. Before you are required to pay for their services it’s important that you know they would be a good candidate for the job.
I firmly believe that you should be allowed a short period of time, without cost, to talk to a potential therapist on the phone before you book an appointment. This is, in my experience, a practice which benefits the therapist just as much as it does the potential client. I need a few moments to see what kind of help the individual is seeking and they need a few moments to find out more about me. If I’m not a good fit for them I certainly don’t want to schedule an appointment and thereby delay their reaching the therapist who can truly help them.
Some therapists won’t allow this type of phone interview. That always raises a red flag for me. We aren’t talking about more than five to ten minutes, so time isn’t an excuse. Why would they want to see me before they even know if they can help me?
Of course, there are always exceptions. Some therapists are popular experts in their field who get way too many calls for appointments every day to accommodate a brief phone interview with each one. Ultimately, you have to decide whether you want to schedule an appointment when you aren’t allowed to speak with the therapist beforehand.
When you have that initial interview these are the top five questions you should ask and the things to look for in the therapist’s reply:
How long have you been practicing?
Being a high quality clinician requires a combination of both training and experience. For this reason, you will typically want a clinician that has had several years of clinical practice. There are always exceptions. But typically I advise people to look for someone who has at least five years of experience.
What are your specialties and how did you become specialized in these areas?
It is a rare therapist who has worked with every kind of issue to the point that they are an expert in all psychological problems under the sun. Most therapists have developed several specialties. You want to know if your issue fits into their realm of expertise.
You also want to know what they did to reach the point of being an expert. Did they take extra coursework in the subject? Did they acquire additional practical hours under supervision? If they’ve declared themselves a specialist they should be able to explain how they reached that status.
What is your theoretical basis for therapy?
This is the place where a therapist should be able to describe what drives their theoretical method. Do they rely on Cognitive-Behavioral theories? Do they believe in Humanistic theories? Maybe they’re a Dialectical Behaviorist. Every therapist should have a theoretical basis for how they both identify and treat their client’s issues.
If they can’t tell you what their theoretical basis is that is a big red flag. It’s also a red flag if they tell you their approach is eclectic—which basically means they pick and choose from different theories according to what suits their and the client’s needs.
You need to know if the way they interpret the psychological world meshes with your beliefs. You also need to understand what kind of treatment they will provide, which is something their theoretical framework will dictate. For example, I once tried to work with a therapist who was a Jungian. We didn’t mesh because Carl Jung’s theories don’t mesh with my personal ideals. In a future post I’ll explain all of the major theoretical frameworks and their treatment methodologies. Until then Google might be your best friend.
How often do you typically see your clients? For what length of time do you typically see your clients? (not session time, but time in terms of sessions per week and length in months or years)
Both of these things are important. You need to know if a therapist generally sees their clients twice a week or twice a month. Either frequency might not be a good fit for you. You also want to know if they are a five sessions and you’re done kind of therapist. Some therapists are. Others tend to see clients for years. Again, this is a question of fit. There are always exceptions but these are the kinds of generalities you need to know when making your decision on who would be the best therapist for you.
What is your fee schedule?
You need to know what a therapist charges so you know whether they are affordable. You might have already seen their fee schedule on their website or from another source. In that case, make sure to confirm it so you won’t be surprised with changes when you show up for an appointment.
It’s important to note that you not only need to listen to what the therapist says, but how they say it. Are they open, friendly, and professional? Watch for condescension, defensiveness, and vagueness. How they speak to you on the phone is likely to be how they will speak to you in person. If you aren’t comfortable speaking with them now because of their word choice, tone or inferences then you aren’t going to be comfortable with them in person. Even if they say all the right words cross them off the list if they say them in a way that makes you feel less than a valued human being.
Take notes as you speak to the therapist. Use them later to compare all of your potential therapists. Chances are high that you will have both an intuitive and logical choice that rises to the forefront. In a future post I’ll list what to look for in an initial appointment to evaluate whether you’ve made the right choice or should move along to another candidate.