Guidelines for Finding and Using Therapy Wisely
A. When to look for a therapist:
1. You have problems that you can’t solve by yourself or talking to friends and family.
2. You cannot control such behaviors as temper tantrums, alcohol or drug addiction, painful relationships, anxiety attacks, or depression
3. You have serious difficulties communicating in your relationships.
4. You have sexual problems or sexual dysfunction that does not go away by itself.
5. You have violent or abusive relationships.
6. You have a general, pervasive unhappiness with your life.
7. You and your partner have disagreements and struggles you can’t resolve yourselves.
B. Where to look for a therapist:
Finding a counselor is easy. Licensed counselors of every sort exist everywhere, and they can be found in the phone book or via an online search. Finding the right counselor is harder, but critically important to your success in counseling. Like lawyers, plumbers or doctors, the quality of counselors and therapists can vary. You need a referral or recommendation of an effective, suitable and experienced counselor in your area. There are several sources that are good, depending on what's available to you.
This is the least dependable source for the right counselor, because you usually can not tell from an ad whether the counselor has had the proper training for your issues, or whether you’ll feel good about him or her. If you don’t have a referral from someone you know, you can interview therapists by phone as the guidelines below show you, and choose the best one.
Even if you are not suicidal or a domestic violence or rape victim, you can call a local hotline and most of them will refer you to a counselor or clinic in your area. These hotlines often know the counselors personally you can ask how they screen their referrals. Hotline staff are well-trained, and know the resources in your area. Look in the front pages of your phone book for a list of hotlines.
If you have access to online searching, you can find a lot of therapists online. Look for online groups that specialize in your issues, such as depression, anxiety, addiction, or relationships.
Non-profit professional associations
Associations of counselors and therapists can refer you to therapist in your area that has met the organizations qualifications. This is especially important if you live in an area where counselors are not licensed. Try The Association for Humanistic Psychology (www.ahp.org,) The American Association for Marriage Family Therapists, (www.camft.org,) or The American Psychotherapy Association. Such non-profit organizations are also listed in the phone book and directory assistance, with branches in major cities.
Referrals from friends
The best source for a good counselor is probably referrals from friends who have seen a counselor and can tell you first hand that he or she is competent, friendly and effective. Any counselor who is recommended by someone you know will most likely be your best bet.
Find a counselor who is supportive and understanding and with whom you are comfortable. If you don't, you will be less open and forthcoming about your problems, and your counselor cannot be helpful. To see a counselor and withhold information is the equivalent of taking your car to a mechanic and giving him false information about what's wrong. The counselor, like the mechanic, is liable to focus on fixing the wrong thing.
A good, knowledgeable counselor will be informative and helpful when you call to ask for information, and will gladly explain the counseling process to you. He or she will also be willing to answer any questions you have about the counseling process at any time, and will lead you step-by-step through the procedure.
What to expect from a counseling session: Knowing how a session should go will help you maximize the benefits of counseling, and also to prevent potential problems.
So far, so good. You've decided to seek counseling, found a referral, and now you're facing the moment of truthcalling for an appointment. There is no need to be afraid of this. If this is a counselor who's been personally recommended, you have an excellent chance that you've found someone good. If you got the name from other sources, then it's up to you to check your chosen professional out. Here's how to go about it:
C. Interviewing a therapist
What you need to know
Normally, you will call the counselor first for an appointment. If know in advance what you'd like to find out about the counselor, you can take charge of the phone conversation, and make sure you find out as much about him or her as he or she does about you. There are several things you will want to know in advance:
• I must first do no harm.
Is the counselor licensed? What is his or her area of expertise? Does he or she work with depression, anxiety, recovery, or whatever issue you want to focus on?
How long is a session? What is her rate, is there a sliding scale?
Will he take a check, does he take your insurance, are there charges for filling out insurance papers, do you pay in advance and have insurance reimburse you, or does he get paid by them directly? Some counselors today even take credit cards.
Does she recommend how often you come in, or can you set the frequency of visits according to your needs, finances and work schedule? Does she see clients nights or weekends?
Does this counselor do long-term or short-term therapy? Not very long ago, most therapy was very intensive and took years to complete, but today’s therapy techniques can handle your immediate problems in just a few sessions, especially if you have done the exercises in this book, and already have an understanding of what you might need to work on.
If a receptionist or a secretary answers when you phone a therapist, ask to speak directly with the counselor. Most often, the therapist will be “in session”counseling someonewhen you call and will not be able to take your call immediately, but he can call you back if you leave a message that says specifically when you're available (“after 6:00 in the evening” or “Saturday all day”, for example) or you can find out when he is available to take calls and call back then. Some counselors will offer a free or low-cost initial interview in which you can ask questions and find out details for little or no charge. Keep calling and interviewing therapists until the above questions have been answered to your satisfaction, and then make an appointment.
The first session
When you go into the office, you will probably be given forms to fill out, as in a medical doctor's office. There are several reasons for this:
1) to get the necessary information for filling out insurance forms (name, address, social security number, date of birth, nature of problem, name and number of your medical doctor);
2) to learn some facts about you that will help in counseling (family history, marital history, any previous hospitalizations for mental illness, current medications, previous therapy)
3) to begin a file the therapist will keep on you and your progress.
Although it is rare, these records can be subpoenaed by a court, so don’t answer any questions you find uncomfortable. Give your answers verbally to the counselor instead, and explain that you don’t want them written down, because you want your privacy protected. Don’t be too worried about this, your counselor will not divulge information unless a court requires him to, but you have a right to know what is and is not protected information.
Once the forms are filled out, your counselor will see you in her office and the session will begin. The first session is called an intake session, which is an initial interview. If you have a clear idea of what the problem is before you go in, your counselor will be more effective. You will probably be asked what is wrong, what you have tried to do to fix it, and how you think it should be resolved. A good counselor will be neutral, helpful, and may offer suggestions, even give you “homework” (an exercise to do between sessions,) but should not impose his beliefs or ideas on you.
If you felt good about your counselor on the phone, this session should verify that you are in knowledgeable hands. If, in the first few sessions, you can see that the therapy will be helpful, and you're learning new things, you’re probably in the right place.
Therapist statement of ethics
This is the statement of ethics published by the American Psychotherapy Association, for their members to hand out to their clients. Other professional associations have similar codes. I reproduce it here to give you an idea of ethical counseling behavior.
As a psychotherapist:
• I will promote healing and well-being in my clients and place the clients and public’s interests above my own at all times.
• I will respect the dignity of the persons with whom I am working, and I will remain objective in my relationships with clients and will act with integrity in dealing with other professionals.
• I will provide only those services for which I have had the appropriate training and experience and will keep my technical competency at the highest level in order to uphold professional standards of practice.
• I will not violate the physical boundaries of the client and will always provide a safe and trusting haven for healing.
• I will defend the profession against unjust criticism and defend colleagues against unjust actions.
• I will seek to improve and expand my knowledge through continuing education and training.
• I will refrain from any conduct that would reflect adversely upon the best interest of the American Psychotherapy Association and its ethical standard of practice.
A counselor or therapist who adheres to this or a similar code will behave ethically and be an effective help in your search to demystify your past.
Whether you do your search to demystify your past by yourself, or use the help of a therapist, you’ll find that the information concealed in your own mind is fascinating and valuable.
© 2004 Tina B. Tessina (from It Ends With You: Grow Up and Out of Dysfunction)