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Finding a Therapist Who is Right for You
Especially if you’re thinking about entering therapy for the first time, it can be confusing and difficult to figure out how to find the right therapist for you. For the lay person, the field of psychotherapy can be difficult to navigate. Therapists arrive at their practices from a fairly diverse set of backgrounds, training, and orientations.
I’d like to provide an overview of the basics that may help you to effectively choose the best therapist for you with a minimum of confusion.
Especially if you’re thinking about entering therapy for the first time, it can be confusing and difficult to figure out how to find the right therapist for you. For the lay person, the field of psychotherapy can be difficult to navigate. Therapists arrive at their practices from a fairly diverse set of backgrounds, training, and orientations.
I’d like to provide an overview of the basics that may help you to effectively choose the best therapist for you with a minimum of confusion.
Selection considerations include the therapist’s:
• Gender
• Theoretical orientation
• Education
• Style
And, there are:
• Practical considerations
• The “fit”
• Shopping around
The Therapist
• Male vs. Female
If you have a distinctly easier time relating to a man or a woman, you may want to select accordingly. That will help you to feel more at ease from the first session. Effective psychotherapy requires openness on the part of the patient, and the easier this is to achieve, the better. However, finding a really good therapist is always more important than the therapist’s gender.
• Theoretical orientation
o Psychoanalytic
• Psychoanalysis is founded in Freud’s theories. Since Freud laid the groundwork, the field has been expanded by following theorists.
• In general, psychoanalysis is the most in-depth form of psychotherapy, with patients often in treatment 2, 3, or 4 times per week. However, psychoanalysis is also an orientation that can be practiced at lesser frequency, often once a week.
• Psychoanalysis treats the whole person, not just symptoms on the surface. It focuses on making unconscious issues and conflicts conscious.
o Cognitive/behavioral
• The underlying theory of cognitive therapies is that problems are caused by distorted thinking. Therapy focuses on changing the way the patient thinks. It is the most structured and instructional form of therapy.
• Most frequently used in treating phobias and obsessive behavior.
o Relational
• Interactions between persons are the basic medium in which the psychological work takes place for relational therapists (i.e., between the therapist and the patient).
• The mode of work is more level, less authoritative, than other forms of psychotherapy.
• Integration of the self is one of the goals of relational therapy.
o Self psychological
• A theory within psychoanalysis originated by Kohut.
• The use of empathy and mirroring are crucial therapeutic tools for a Self Psychologist.
• Most commonly associated with treating patients with narcissistic personality disorders.
o Object relations
• Form of psychoanalytic theory originated in Britain
• In this theory, an internal model of relationships is built up inside the self, which determines the way the person thinks and feels and perceives the world.
• The therapist works with the patient to change the inner constellation of parts of the self.
o Ego psychology
• A development within mainstream psychoanalysis
• Emphasizes the development of the ego (from Freud’s id, ego, and superego)
• Approach focuses on conflicts, the demonstration of resistances, and a strengthening of the ego for optimal ego functioning
o Eclectic
• Education
o MSW (Master of Social Work)
• This is 2-year graduate program focusing on psychotherapy and social services.
o Psychoanalyst (Certified)
• Training completed at a psychoanalytic institute, usually a minimum of 5 years. Training includes years of supervised practice seeing patients. This is the only degree that requires students to complete their own psychoanalysis as patients as part of their training.
o Psychologist (Masters)
• A 2-year masters degree with a variety of different focuses within the field of psychology. May or may not include education in psychotherapy.
o PhD
• Doctorate level training in the field of psychology. Usually takes a minimum of 5 years to complete.
o PsyD
• Almost as much training as a PhD, but with less emphasis on the scientific aspects of the field (research, etc.). Usually includes clinical training.
o Psychiatrist
• This is a medical degree. A psychiatrist has graduated from medical school (MD), and has gone on to complete a psychiatric residency program. A psychiatrist may or may not have any training in psychotherapy. This is the only degree that allows one to prescribe medication. Many other types of psychotherapists have working alliances with a psychiatrist in the event that a patient needs medication.
• Practical Considerations
o Fee structure
o Location
o Desired frequency
o Medication
o Flexibility of scheduling
• The “fit”
o The fit between a psychotherapist and a patient is not quantifiable or overt. Different factors contribute to a good fit, such as the therapist’s style of working, personality, and manner. As a patient, you will know if there is a good fit with a therapist if you feel at ease speaking openly with the therapist.
• Shopping around
o It’s ok to meet with several therapists before you decide on one who’s best for you. You may want to meet different types of therapists to determine which theoretical approach is most comfortable. It can also help to get referrals from people you know who are, or have been, in therapy themselves. Once you find a therapist you want to work with, it’s not necessary to keep shopping just for the sake of it. You might as well get started.