Mental Monday: When Talk Isn’t Cheap. A Guide To Finding A Good Therapist.


A different era of therapy that was simply...'Mad'

Finding a good therapist is very similar to dating. You’re not going to connect with everyone and, chances are, you might have to try out a few different types to find *The One.*

When you’re dating someone and you just don’t feel a connection, you probably won’t continue to see that person…right? Well, the same should go for a therapist. When you see a therapist, whether it’s for 10 weeks, 10 months, or for 10 years (you know, for the Woody Allen types), there needs to be a good connection, a good rapport, and a huge level of trust. Without those essential components, which we all know are necessary for any healthy relationship, it’s just not gonna work. Of course, trust and rapport don’t usually happen overnight. It will probably take a few sessions or more to figure out whether or not the therapist is a good fit or not.  It’s OK if the therapist is not the right for you. The best thing to do is tell them. Most therapists don’t take it personally and will even help refer you to someone else. Don’t you wish bad dates would do the same?

The Process of Therapy

There is something important to keep in mind: the therapist is not your friend.

Therapy is and should be hard work and a good therapist will challenge you. Often. Some clients take issue with the challenging stuff because it can be a painful process. The thing to remember is that a therapist is not out to hurt you but rather to help pave a way for you to get to a better place in your life. Good therapists are a support system. They not only help provide you with tools to help you but they also point out the your strengths, some of which may be buried beneath internal conflicts and everyday struggles. A therapist doesn’t give you advice about how to live your life. They won’t tell you that you should leave your spouse, quit your job, or give tough-love to an unruly teenager.  They don’t know the answers for you because they will never know you better than you know yourself. They don’t live with the consequences of your life choices. But what they can do is help shine a light on those internal resources and strengths within yourself to help get you to the place you want to be.

Different Labels – What the Degrees Mean

Therapists come with different labels:

  • Licensed Social Workers (MSW), Family Counselor, Professional Counselor (LPC), and Marriage and Family Therapists (MFT) have Masters Degrees (MS or MA). Many refer to themselves simply as psychotherapists, counselors, or therapists. They are primarily trained in diagnosing mental health problems and counseling.
  • Psychologists have a PhD or PsyD. They are licensed to conduct psychotherapy and use psychological testing to help diagnose mental health problems. They are not medical doctors and they are not licensed to prescribe medications.
  • Psychiatrists are medical doctors that diagnose and medically treat mental illness. Psychotherapists refer clients to psychiatrists when they need to be evaluated for medical treatment.

Therapists tend to work closely with other therapists and doctors. During the process of therapy, clients may be referred to a psychiatrist for an evaluation for medical treatment. In some cases, therapists may also refer clients to a General Practitioner (MD) for a medical evaluation. Some mental health issues are related to physical health problems: only a medical doctor can determine that link.

Types of Therapy

There are many different types of therapeutic styles and modalities. Most people are aware of the founder of talk therapy, Sigmund Freud, which is why so many people still assume that therapy is all about lying down on a couch discussing their fetal memories. Psychoanalysis or psychodynamic therapy is still prevalent, but it has been updated quite a bit since the days of Freud. This type of talk therapy usually requires many sessions and there is an emphasis on digging down into the past (but not THAT far back). In contrast, there is another widely used therapeutic modality called Cognitive Behavioral Therapy (CBT). CBT is more goal-oriented and focuses on the present and the future. CBT helps a client identify and change negative thought processes in a short amount of time. Although this type of therapy usually doesn’t require many sessions (no more than 10), CBT is also proven to be very effective for changing behavior.

Many therapists consider themselves to be “eclectic” therapists, which means they draw from a number of therapeutic modalities as they see fit. You probably won’t know what style your therapist is using unless you’re trained in psychotherapy…or you just simply ask. The most important thing is whether or not the therapy is working for you. Many people respond well to psychodynamic therapy, while others respond well to CBT. It doesn’t matter what works for you as long as there is progress. Just keep in mind that if you’re uncomfortable with the process, speak up and talk about it with the therapist. A good therapist will always discuss their course of treatment with you, if you ask. If they do not or will not disclose their treatment plan, I would suggest finding another therapist.

Another thing to consider is whether or not individual counseling is right for you. If you’re having problems in your marriage or relationship, it’s usually best to get counseling together. Not always though. If there is domestic violence or other volatile issues, joint counseling may not be a good idea.  If there are family issues involving children, the entire family might want to look into family therapy sessions.  For other issues, like bereavement or substance abuse and/or dependence problems, group therapy can also be a good idea. Sometimes people require a much larger support system and group therapy can be an ideal way to go.

Things to Ask Before You Start Talking

Referrals are usually a great resource when trying to find a therapist, but I also recommend calling around. When you speak to a therapist on the phone, ask them about their therapeutic style and if they have experience in the issues you are bringing into their office. Therapists usually know many other therapists and will refer you on if they know someone else who might be a good fit or are not taking any more clients.

Trust Yourself

Let me reiterate how important it is to have a good relationship with your therapist.  Trust your instincts and gut when it comes to your therapist. If there is no connection or if you feel there is something amiss, find another therapist.  I have personally spent many wasted hours and money with therapists that were not the right fit for me, simply because I didn’t trust my initial instincts. Don’t make the same mistake. If you dedicate the time and energy into finding the right type of therapist for you, the pay-off will be worth the effort.

One more thing. If your therapist ever asks you to go back into the womb…run.