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How to Find a Good Therapist

How to Find a Good Therapist
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By Steve Nubie

Finding the right specialist for some of the psychological challenges we face is very different than finding a specialist for a specific, physical condition

When we have a heart problem we know that a cardiologist is a logical next step.  The same is true for oncologists and cancer, nephrologists and kidney conditions and down the list of medical afflictions.  Unfortunately, it’s often difficult to know what kind of specialist can help us with varied and complex psychological conditions.  To complicate matters further, many psychological afflictions and some forms of mental illness present a variety of symptoms across a range of conditions.  At times, a psychological condition can also lead to a physical illness; affect hormones and blood chemistry, and compound psychological conditions.

Perhaps the greatest challenge for anyone suffering from a psychological condition is understanding the nature of the affliction.  Physical conditions often present localized pain and patterns of symptoms that many individuals, and most doctors can easily recognize.  A person suffering from a severe mental illness like bi-polar disorder may not be aware of the severity of their condition nor it’s nature.  As well, many people confronted with a psychological condition are in denial or simply assume it will somehow get better, go away, or is just the way they are.

As a result, the first step towards finding treatment is coming to terms with the fact that something is wrong, or at least could be better.  For many people their family doctor is a good place to start if there are any concerns about mood, feelings, or ideas that seem troubling or unusual.  General practitioners are trained to assess the potential for a psychological condition and can often make a referral to a mental health professional who can begin the process of diagnosis, a recommendation for a psychological specialist, or possible treatment.

Unfortunately, many people fear the stigma of mental illness.  They’ll proudly talk about their by-pass surgery, how they beat cancer or share a concern with their doctor about dizziness or pain in some part of their body -but say little if anything about their sadness, anger, fears or suspected addiction to a substance.  This will often lead to an aggravation of the condition that has the potential to grow worse over time.

The first step to diagnosis and treatment is to acknowledge and accept that something is wrong or at least could be better.  This could lead a person to at least suspect or generally determine what their affliction might be so they can begin the conversation with a psychological health-care professional.  But where to start and who are these people?  Here’s a brief review.

Psychiatrist

A psychiatrist is an M.D. who follows his/her traditional medical training with intensive psychological training, education and internship.  They treat both the mind and body and in addition to counseling and therapy are licensed to prescribe medications for the treatment of various mental illnesses.  Psychiatrists typically focus on individuals with severe mental illnesses like schizophrenia, bi-polar disorder, suicidal behaviors or other conditions that require careful monitoring and pharmaceuticals to manage behaviors.

Psychologist

A psychologist should have a PhD. in psychology and is usually required to have extensive training as an intern.  They cannot prescribe prescriptions although some pursue additional training to become licensed in pharmacology so they can also prescribe medicines.  Typically a psychologist will work with your family doctor who is also licensed to prescribe pharmaceuticals based on the recommendations of the psychologist.  In fact, family practitioners and internists prescribe most of the psychiatric pharmaceuticals in the U.S.

If they deem it necessary, they will sometimes refer a person to a psychiatrist if they feel the condition is severe.  They are often consulted for post-traumatic-stress-syndrome (PTSD), depression, mood disorders, and other conditions that can be treated by a change to a person’s feelings and attitudes to help them develop healthier patterns of behavior.  They are also trained in counseling, psychotherapy, and psychological testing.

Licensed Professional Counselors

Counselors have degrees ranging from PhD. to Masters degrees and often have to serve an internship.  Licensed Professional Counselors are required by state licensure laws to have at least a master’s degree in counseling and 3,000 hours of post-master’s experience. They are either licensed or certified to independently diagnose and treat mental and emotional disorders. They typically offer counseling on a one-to-one basis or as facilitators of group-therapy sessions.  Marriage and family counselors have a masters’ degree in marriage, family and child counseling, but less academic training in psychology although equal training in terms of clinical practice, and most have the MFT (Licensed marriage, family and child counselor) license.

Social workers

Most social workers have a Masters degree in sociology and/or psychology   and receive a LCSW license (Licensed clinical social worker).  Training for a social worker may include more emphasis on community-based issues, and federal, state, and local agency related topics.  But again, their training as clinicians is usually the same as the Licensed Psychologists, and MFT’s.  They will sometimes do an assessment of a person’s condition and recommend an appropriate specialist, or engage the person in counseling or group therapy to improve their condition.

While it may seem that a psychological professional with advanced degrees and experience can diagnose and manage a variety of conditions, it important to inquire about specific expertise.  Adults and children with ADHD are a good example.  If this is a condition you want to manage make sure the professional you are considering has proven expertise in that area.  In fact, your first conversation should be about goals and inquiries with regards to their expertise.  In the same way that you wouldn’t consult a dermatologist for a heart condition, you want to make sure that your psychological professional is a specialist in the condition you want treated regardless of their degrees or years of experience.

This is especially true with children.  A specialist in geriatrics would be a poor choice for the treatment of a pediatric physical condition.  If you are seeking counseling or treatment for a child, make sure you are working with a specialist in child psychology.  One size does not fit all.

To find a psychologist it’s best to ask your physician or another health professional. You could also contact your local or state psychological association.  It’s possible to ask family and friends for a recommendation but some people are uncomfortable with this conversation.  There are also confidentiality issues with family and friends worth considering.  It’s a bit more secure if you contact your area community mental health center and you could always inquire at your church or synagogue.  Another resource is the APA’s (American Psychological Association) Psychologist Locator service.

Another way to find the right professional is to simply ask the people you trust.  Do you know or trust someone who’s a nurse or doctor?  Does a friend had a family member who was treated for a similar condition have any advice?  If you’re going through this for the first time it helps to have some sensitive advice from someone who’s been there and knows the process.

You should also think about using the Internet to check on counselors or psychologists you are considering.  What degrees and licenses do they hold?  What are their specialties?  How long have they been practicing?  Are there any reviews or comments about them?  This can give you reasonable reassurance before you meet with them for the first time.

Ultimately, the most important consideration is your confidence and comfort with any psychological professional once you, or a family member, have begun treatment.   Success is often defined by the quality of the relationship and the sense of partnership developed between the patient and the professional.  It’s that level of trust that will often affect a path to improvement, and a cure that you can live with.

 

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