My Two Cents On Therapy

(I just wrote this as a follow-up to a comment on the LJ advice community. It seemed worth reposting here.)

There are a lot of therapists out there who aren't really competent. There are also some very helpful ones. An incompetent therapist can waste years of your life and thousands of dollars. A good one can play a huge positive role.

The problem is to find a good therapist.

One way is to use word of mouth. If you have a friend or family member you trust who has been in therapy, see if they would recommend their therapist. Or if you trust your primary care doctor, ask them for a referral.

If you can't get a recommendation, you can still improve your chances of getting a good therapist by picking one from the wealthiest town within reach. Sad to say, the poorer a town or city is, the more likely they are to have therapists who aren't particularly good at what they do. There are exceptions to that rule, but in my experience wealthy towns attract people who are better at their professions.

Another point: choose a psychiatrist if you have an issue that might require medication. Choose a psychiatrist or psychologist if you need "talk" therapy. Avoid behavioral social workers; some may be good, but the majority of them seem to fall into the "rent-a-friend" category. That's probably because they get the least training out of the three categories.

Generally speaking, therapy should not be a sob session - you're not there just for sympathy. And it shouldn't be totally comfortable. The role of the therapist is to help you face and think about issues that you've been avoiding, or to look at your thoughts in new ways. If you don't feel that you're breaking new ground during most of your sessions, it might be a good idea to consider looking for a new therapist - with the caveat that it's not wise to be constantly changing therapists. That's a common way to avoid really dealing with your problems.

Assuming that you have health insurance, be aware that your insurer will generally want to steer you towards the cheapest possible care. That's often "treat & street" care, which usually consists of an antidepressant, a ten- to fifteen-minute med-check with a psychiatrist once a month, and weekly sob sessions with a social worker. Do not let yourself be pushed into that course of treatment - it often does more harm than good.

When you begin therapy a psychological/neuropsychological evaluation should probably be performed (usually by a psychologist or psychiatrist). In some cases a full neurological evaluation may also be recommended.

Speaking of health insurance companies, many will limit the number of therapy sessions you may have in one year - 26 is a common number. Just something to be aware of.

Having said all that, I should make it clear that I am NOT a behavioral specialist of any sort - just a well-informed layman!

My Two Cents On Therapy

(I just wrote this as a follow-up to a comment on the LJ advice community. It seemed worth reposting here.)

There are a lot of therapists out there who aren't really competent. There are also some very helpful ones. An incompetent therapist can waste years of your life and thousands of dollars. A good one can play a huge positive role.

The problem is to find a good therapist.

One way is to use word of mouth. If you have a friend or family member you trust who has been in therapy, see if they would recommend their therapist. Or if you trust your primary care doctor, ask them for a referral.

If you can't get a recommendation, you can still improve your chances of getting a good therapist by picking one from the wealthiest town within reach. Sad to say, the poorer a town or city is, the more likely they are to have therapists who aren't particularly good at what they do. There are exceptions to that rule, but in my experience wealthy towns attract people who are better at their professions.

Another point: choose a psychiatrist if you have an issue that might require medication. Choose a psychiatrist or psychologist if you need "talk" therapy. Avoid behavioral social workers; some may be good, but the majority of them seem to fall into the "rent-a-friend" category. That's probably because they get the least training out of the three categories.

Generally speaking, therapy should not be a sob session - you're not there just for sympathy. And it shouldn't be totally comfortable. The role of the therapist is to help you face and think about issues that you've been avoiding, or to look at your thoughts in new ways. If you don't feel that you're breaking new ground during most of your sessions, it might be a good idea to consider looking for a new therapist - with the caveat that it's not wise to be constantly changing therapists. That's a common way to avoid really dealing with your problems.

Assuming that you have health insurance, be aware that your insurer will generally want to steer you towards the cheapest possible care. That's often "treat & street" care, which usually consists of an antidepressant, a ten- to fifteen-minute med-check with a psychiatrist once a month, and weekly sob sessions with a social worker. Do not let yourself be pushed into that course of treatment - it often does more harm than good.

When you begin therapy a psychological/neuropsychological evaluation should probably be performed (usually by a psychologist or psychiatrist). In some cases a full neurological evaluation may also be recommended.

Speaking of health insurance companies, many will limit the number of therapy sessions you may have in one year - 26 is a common number. Just something to be aware of.

Having said all that, I should make it clear that I am NOT a behavioral specialist of any sort - just a well-informed layman!