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Sunday, March 26, 2023

4 Steps To Getting Great Therapy

How To Find a Great Counselor

It’s such a common feeling these days; we’re struggling, we know we need help, and we suspect therapy would work wonders, but we have no idea how to proceed. And once we do find a therapist, usually by word of mouth, or by endlessly scrolling through mental health care registries that leave us feeling more confused than hopeful, we often don’t have the wherewithal to to maximize our therapeutic hours.

These two issues; finding a great therapist, and helping ourselves get great therapy deserve some serious attention. Following are four steps that will help anyone do both.

  1. Finding the best clinician for you: licensing, modalities and gut.

Not all therapists are created equal. Not only do they differ in specialties, licensing, and preferred modalities (are they more classically trained? Do they focus on behaviors first? Do they conceptualize cases more individually or systemically? And on and on…,) they differ in personality. The perfect therapist for my best friend might be the worst therapist for me. 

So how do we sort it all out?

Beyond using a mental health professional matching service like Psyche Finder (which I created specifically to address the very difficulties I am writing about) there are some common sense strategies. 

First, either by word of mouth, a service like Psyche Finder, or a mental health registry like Psychology Today, try to pin down three options that are near you and take your insurance. If you don’t have insurance, look for clinicians who offer sliding scales or pro bono treatment. Then, do a little research (unless you’ve chosen to use Psyche Finder who does this part for you.)

What is the therapists actual license and what does it mean? 

There are seemingly endless different types of licenses from social work, to psychologist, health coach, clinical counselor etc. Look up the licensing definitions of whomever you have chosen, and make sure what they do falls in line with what you need. (Just search the letters after their name, and you’ll instantly find great information.) You might be surprised, many job descriptions like social worker have changed in focus over the last ten years, and often overlap with more traditional types of counseling.

Next you need to look at your potential clinician’s speciality and preferred modality. Again, unless you’re using Psyche Finder which will do this piece for you, it might be hard to determine what a therapists real specialty or modality is. Whether you’ve gotten them by word of mouth, in which case the person giving you the referral likely won’t know, or from a registry, in which case clinicians often check off long lists of specialities or modalities in order the cast as wide a net as possible, this is a question you’ll probably only answer by speaking to someone in person. 

Request a 10-15 minute phone call with any clinician before you make an actual appointment to explore these ideas. 

Someone who works exclusively with Cognitive Behavioral Therapy versus someone who has a background in Psychodynamics will offer dramatically different approaches to treatment. Often, (but not always) a good choice is a therapist who seems to be an integrationist, and willing to tailor treatment specifically to you. By speaking on the phone with a potential therapist in advance you save everyone time and energy.

The last, and really most important task for you in finding your ideal therapist is to listen to your gut. At least 90% smarter than your brain, your gut and what it whispers to you should transcend all of this other information. If someone looks great on paper but feels bad in person, say thanks but no thanks and be on your way. If someone looks meh on paper but feels “right” to your gut, roll with it. 

Also, many people stay with therapists because they are loathe to start over with someone new. Who can blame them? Starting treatment is a difficult, sometimes boring, sometimes painful process. Starting it again can be even worse. But staying with a bad-for-you clinician will not only get you sub standard results, it could take twice as much time to get half (or less) of the work done. 

You should get a sense of whether someone feels right within the first few sessions, but if at any time during treatment it suddenly dawns on you— this is just not the person for me— heed your inner wisdom and move on. (And don’t worry about hurting a clinician’s feelings. They might get hurt, but we are trained to manage those emotions and if we can’t, well, maybe we need to be in treatment ourselves!)

2) Be honest in session.

Okay, so you’ve done the hard work (or Psyche Finder has done it for you) of finding a great therapist. It should be smooth sailing from here on out, right? Well, not necessarily. There is one thing that tons of clients do which compromises their treatment. 

In a word, they lie. 

Whether it’s a lie of omission, an outright lie to save face, or a lie they are actually telling themselves because they are not ready to face the truth, lies can be the biggest stumbling blocks on the road to healing. 

While we may not have the ability to correct unconscious lies, or lies we tell ourselves just yet, we do have the ability to be open and vulnerable with our therapist once trust is established— which will take a different amount of time for everyone depending on what issues are bringing them into treatment in the first place. 

Remember, you’re not in therapy because everything is going so well in your world, and your therapist doesn’t expect (or need) you to have your shit together. Use the time with her to really let your hair down and say and feel whatever you want or need. Making that one choice will dramatically change the course of your treatment, and possibly, your life. 

3) Consider inviting other people into treatment.

Without a doubt, one of the best ways I have found to get to know and understand clients better is to interact with some of the important people in their lives. 

This is not appropriate across the board. If a client has an abusive spouse, for example, bringing them into session could be totally counterproductive or even dangerous. But, if a client feels reasonably safe with a spouse of family member with whom they may be struggling, or who may play a role in a key issue, having them come into even one session yields a wealth of information about interpersonal dynamics, how the client operates outside the therapy room, how their energy is impacted by the person or people in question, and lots of other useful stuff. 

Discussing with the therapist beforehand what the goal of the session is, and how the client can be made to feel supported throughout it is essential, but with those things in place, it’s generally a fruitful endeavor. I will often see a completely different side to a client with someone else in the room and call pull from that in myriad ways to enrich treatment. 

4) Consider going twice a week (or more.)

Obviously we know the whole psychotherapy genre was founded by Sigmund Freud, and to this day, those who subscribe to his analytic theory, Psychoanalysis, will commonly have three to five sessions with clients weekly.  While that might not seem optimal for those us of who, I don’t know, have a job or a family, in essence I believe it is an outstanding idea. A lot of life happens in a single week, and one hour does not seem sufficient to process all of that, as well as all that came before it, and all that we wish will come afterwards. 

Upping the frequency of your treatment to twice, or even three times a week, does several things. First, it connects you more deeply to your therapist, building a sense of trust and familiarity that is the back bone of great outcomes. Second, it gives you the opportunity to keep your treatment front and center in your life, and really integrate it with your emotions and experiences as they happen. Third, it tends to cement the things we learn about ourselves more strongly. 

It makes sense. If you do anything more frequently— like two hours versus one hour of learning a language weekly— you are bound to be “better” and it, and thus more satisfied with the result. I’m sure bona fide psychoanalysts would have plenty to add to this list, but for me, these are reasons enough. 

Finding the very best therapist to fill our particular needs at a particular juncture of our lives can feel daunting, and rightly so. The world of mental health treatment has become increasingly complex, and though stigmas have diminished and mental health care is more accepted and widely available, it’s also more confusing. And once we do find the right clinician, it can be hard to know how to enhance our therapeutic experience. By doing the research, trusting our gut, being as honest we are able, possibly allowing other people to take part in our treatment, and considering going more than once a week, we will find that true healing is available to us. And that is something everyone in the world needs and deserves. 

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