How to Find a Therapist

            People sometimes feel “stuck” enough in their lives that they consider trying psychotherapy as a help with their frustration and pain.  If that sounds like you right now, how should you best choose a therapist?

            Psychotherapy involves talking and becoming engaged in a helpful relationship, so it is essential to find someone with whom you can talk comfortably and with a feeling of safety.

            Several avenues of training can equip one to be a therapist, and there are many psychiatrists, social workers, psychologists, pastoral counselors and psychiatric nurses who are fine therapists; so the discipline to which the therapist belongs does not provide much guidance.

            Each discipline does have its higher levels of certification, which show that the therapist has passed tests designed to demonstrate high levels of competence.  But even these things only tell you that a therapist is generally competent, not necessarily optimal for you.

            It’s best to shop.  The Triangle is one of those places that psychotherapists like to live, so there are lots of them and it is a buyer’s market.

            For those who live in rural areas far from centers of education and culture, therapy is often defined for you as whatever the single psychiatrist or psychologist in town wants to do with you.  But here one has a lot of choice, and it should be exercised.

            (There is an important exception to this that has been growing lately, and that is insurance plans involving managed care.  If you belong to one of these, and you cannot afford to seek help outside of it, then you will likely have to see whomever you are told to see, and your “treatment” may be limited to psychiatric mediation, or a few sessions teaching adjustment tricks that are as generic and superficial as the articles of psychological advice in popular magazines: but these are issues for other columns.)

            If you do have choice, begin with people you have reason to consider competent, and with recommendations from others whose judgment and experience you respect.  Then try at least a couple of different therapists for a few sessions each.

            Focus on how it feels to relate to the person.  Do you feel understood?  Do you feel safe?  Do you have a sense that the therapist can “speak your language” enough to really understand you and help better understand yourself?

            You should feel at least a little better after even a single session.  If you do not – if instead you feel even more confused, or more demoralized, or more defective – then consider the possibility that it is not you who are lacking, but rather that this particular therapist is not right for you.

            Research shows that people get more out of therapy when they experience their therapist as being genuinely understanding and personally caring, and when they seem to be a real and decent person, rather than someone just trying to enact some professional role.  This is not to imply that good therapy is not painful.  A given session may be extremely painful, but the pain should feel meaningful and carry with it a sense of deepened self-understanding that is satisfying and makes the pain feel worth bearing.

            People who have no experience with psychotherapy tend to think of it in terms of other familiar roles, such as that of physicians, or minister, or teacher.  The good therapist, however, is really different from each of these.

            She or he will not emphasize a diagnosis of illness and give a treatment that is to be passively taken, nor will the major emphasis be on teaching you how to think and behave differently.  Directions from some authority cannot really help us solve life’s problems more  effectively.

            Each of us has within us the means to do that successfully if we can listen to our own feelings and inner judgment in the right way, and the best therapist is that person whom we experience as being helpful as we try to do that.

Jim Carpenter, PhD