Counseling & Psychotherapy 101: How To Choose A Therapist by Elena Davis

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When struggling with overwhelming life challenges or emotional turmoil, the thought of trying to find a counselor can feel like blindly shooting darts at a moving target.
The field of counseling and mental health is laden with confusing acronyms and jargon, not to mention the infinite choice of hundreds of individual counselors (a.k.a. therapists) who practice in most urban and suburban cities.
Despite how cumbersome this process may feel, connecting oneself with a skilled counselor to help navigate through tough times can make a huge difference in one’s quality of life and emotional well-being.
The following tips are meant to help explain and demystify the process of finding a good therapist:
Types of Counselors
The counseling field includes: Psychologists (PhD or PsyD), Licensed  Clinical Social Workers (LCSW), Licensed Professional Counselors (LPC),  and Licensed Marriage and Family Therapists (LMFT), just to name a few.
In my experience, the specific degree does not matter as much as the  individual counselor’s life experience, intelligence, demeanor,  compassion and clinical knowledge. I have talked with colleagues from  all of these fields and have found in general that within each  discipline there are both “good fits” as well as “not-so-good fits”.
That said, don’t worry so much about the degree a potential therapist  holds but rather concentrate on the specific personality, style, traits  and expertise of that individual counselor. Lastly, if you are looking  for medication, you will need to also see a psychiatrist, psychiatric NP (nurse practioner), or a psychiatric PA-C (physician's assistant). Most therapists will be able to provide referrals to reputable colleauges  who can provide consultation and medication services.
Types of Counseling
Therapy can be short term (four to six sessions) or long-term (six months to many years), or anywhere in between.
Individual therapists have various theoretical orientations that guide their  practice. Examples include cognitive behavioral, solution-focused,  psychodynamic, narrative, spiritual-based, hypnotherapy, and life  coaching.
Interestingly enough, research shows that the specific type of counseling received is not the most important factor; rather, the most important predictor for whether or not counseling  will be successful is the quality of the  relationship between the therapist and client.
That said, focus on finding a counselor whose personal style and philosophy  you feel comfortable with rather than focusing on specific techniques or trainings achieved.
Cost Considerations
If you have health insurance, by all means call them and find out the  details of your benefits for “behavioral health” (a.k.a. mental health).
Be sure to find out if you have a deductible, how many sessions per  calendar year are covered, what your copay is, and which specific  providers the insurance company will cover.
Some therapist have resources to make this call for you, saving you time and simplifying the process.  Also, many employers offer Employee  Assistance Plans (EAPs), which typically provides three to six sessions  to employees and their families at no cost.
The average fee for a private practice therapist is $80-125 per session;  the specific fee varies widely depending on the individual therapists’  level of expertise and years of experience in the field.
Health Spending Accounts (HSAs) can often be utilized to pay fees  out-of-pocket. In addition, some therapists offer a sliding-scale fee or can help refer you to low-cost counseling services available in your  community.
Making the Initial Call
Be ready to briefly describe why you are seeking therapy (in as little or  as much detail as you are comfortable) and to ask specific questions to  learn more about the services offered.
Be sure to confirm office location and hours of availability to ensure  they will fit your needs. Be proud of yourself for taking the first  step, which often times proves to be the most difficult!
The First Session
Many first-timers worry that they will get into the therapy session and not  know what to say, that they will cry uncontrollably, or that they will  be judged, blamed, or otherwise misunderstood.
A skilled therapist knows how to guide the conversation, to explain that  tears are natural and often a common occurance, to help you feel  supported and understood, and to provide a physical space that feels  safe and comfortable to begin the counseling journey.
Good communication is essential for successful therapy to occur, and it can  speed therapy along if you take the lead on communicating what you would specifically like to get out of the subsequent sessions.
First sessions often include discussions of expected duration of therapy,  specific goals and areas of focus, and overall expectations. First  sessions feel scary to most people, so when you finally make an  appointment (and show up for it!), please remember to give yourself a  big pat on the back for taking the next step!
The “Rule of Three”
Three sessions is generally all it takes to assess the “goodness of fit” of a relationship with a specific therapist.
The first session will generally feel a bit awkward and uncomfortable;  sharing details of your life with a complete stranger can certainly be a bit awkward and uncomfortable.
The second session should feel a bit more comfortable, but there may still  be bumps in terms of the therapist not quite understanding you or you  not quite feeling totally understood – after all it’s only the second  session.
By the end of the third session, if there are still difficulties in  communication and/or any red flags, it might be time to move on to  another therapist.
A "Good Fit" is Essential
Research shows that the most progress in therapy is made in the first 12  sessions. A good therapist will discuss whether the relationship feels  like a “good fit” to you and will not take offense but rather be happy  to refer you on as needed.
Finding a good therapist “fit” can happen on the first try or it may take many  phone calls and initial sessions. Insurance limitations, financial  concerns, busy schedules, and fear all limit our willingness and  opportunity to seek out counseling support.
Regardless of whatever barriers you might encounter, it’s well worth the time and  effort to take the steps necessary to connect yourself with a good  therapist– one who can help support you through challenging times and  guide you in creating the life you want.
Remember: Your health, happiness and emotional well-being are worth it!
This article was written by  Elena Davis, LCSW and was published in Colorado Health online  magazine.  You may access the original article and more like it online  at:
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