Choosing a Psychotherapist

You will probably want to read the pages on types of psychotherapy before reading this section.

If so many therapists have essentially the same goal and even employ similar approaches to practice despite their seemingly divergent theoretical orientations, how do you pick one? Actually, I already stated the most important answer to this question: You pick a therapist who says things that click for you. But that’s not quite fair to the poor therapist who’s meeting you for the first time. So when should things be clicking? And how do you find one who’s likely to get around to saying things that click sooner rather than later or never?

Psychotherapists have no 1-800-4SHRINK number, thank goodness, and I don’t think such a thing would help you anyway. There are two main reasons for this. As we discussed in "Why go" parts 1 and 2, people enter treatment because they have become lost or stuck, because there are motivations and determinants of their feelings and behavior that are out of awareness and out of control. In short, people usually don’t know what’s wrong with them. How, then, can they know what treatment they need? 

Second, in psychotherapy one must be wary of specialists. For one thing, what does it mean to be a specialist in some disorder? It may mean the therapist took extra courses or conducted research. But such pursuits, especially research, often contribute little or nothing to one’s skills as a therapist. They may help, but if the therapist is not good at doing psychotherapy then no amount of course work or research or scholarly publication will change that. What makes a good therapist most of all is experience and excellent supervision. (It’s kind of like hoping that reading books about singing will make you a good singer; books help, but mainly you have to actually sing and have a teacher listening when you do.)  

Furthermore, what does it really mean to be an expert in some disorder? Does that mean you are not an expert in other kinds of behavior? How can you be an expert in bullies and not be able to help the flinchers? They suffer from the same core issues, as we saw in the sections on personality and symptoms. And once therapy is truly under way, the details of the acting out -- the symptoms -- usually fade in importance next to the issues and feelings that those symptoms are covering [Ed, Ed - II, Bully, Ron, Jim]. And even though symptom relief is the goal, we often achieve it without even talking symptoms.[Mike, John].

So how do you choose? Start with credentials. For some reason people don’t like to think about this in relation to a therapist. I would encourage you to conquer this resistance, despite the discomfort it may cause, and ask.

Credentials - Types of Psychotherapists