How to Choose a Psychotherapist
At some time in our lives, each of us may feel overwhelmed and may need help
dealing with our problems. According to the national Institute of Mental Health,
more than 30 million Americans need help dealing with feelings and problems that
seem beyond their control—problems with a marriage or relationship, a family
situation, or dealing with losing a job, the death of a loved one, depression,
stress, burnout, or substance abuse. Those losses and stresses of daily living
can at times be significantly debilitating. Sometimes we need outside help from
a trained, licensed professional in order to work through these problems.
Through therapy, psychologists help millions of Americans of all ages live
healthier, more productive lives.
Consider Therapy If...
You feel an overwhelming and prolonged sense of helplessness and sadness, and
your problems do not seem to get better despite your efforts and help from
family and friends.
You are finding it difficult to carry out everyday activities. For
example, you are unable to concentrate on assignments at work, and your job
performance is suffering as a result.
You worry excessively, expect the worst, or are constantly on edge.
Your actions are harmful to yourself or to others. For instance, you are
drinking too much alcohol, abusing drugs, or becoming overly argumentative and
What Is a Psychologist and What Is Psychotherapy?
Psychologists who specialize in psychotherapy and other forms of
psychological treatment are highly trained professionals with expertise in the
areas of human behavior, mental health assessment, diagnosis and treatment, and
Psychotherapists work with patients to change their feelings and attitudes and
help them develop healthier, more effective patterns of behavior.
Psychotherapists apply scientifically validated procedures to help people change
their thoughts, emotions, and behaviors. Psychotherapy is a collaborative effort
between an individual and a psychotherapist. It provides a supportive
environment to talk openly and confidentially about concerns and feelings.
Psychotherapists consider maintaining your confidentiality extremely important
and will answer your questions regarding those rare circumstances when
confidential information must he share
How Do I Find a Psychologist?
To find a psychologist, ask your physician or another health professional.
Call your local or state psychological association. Consult a local university
or college department of psychology. Ask family and friends. Contact your area
community mental health center.
Inquire at your church or synagogue.
What To Consider When Making the Choice...
Psychologists and clients work together. The right match is important. Most
psychologists agree that an important factor in determining whether or not to
work with a particular psychotherapist, once that psychotherapist's credentials
and competence are established, is your level of personal comfort with that
psychotherapist. A good rapport with your psychotherapist is critical. Choose a
psychotherapist with whom you feel comfortable and at ease.
Questions to Ask...
Are you a licensed psychologist? How many years have you been practicing
I have been feeling (anxious, tense, depressed, etc.), and I'm having
problems (with my job, my marriage, eating, sleeping, etc.). What experience
do you have helping people with these types of problems?
What are your areas of expertise—for example, working with children and
What kinds of treatments do you use, and have they been proven effective
for dealing with my kind of problem or issue?
What are your fees? (Fees are usually based on a 45-minute to 50-minute
session.) Do you have a sliding-scale fee policy? How much therapy would you
What types of insurance do you accept? Will you accept direct billing
to/payment from my insurance company? Are you affiliated with any managed care
organizations? Do you accept Medicare/Medicaid insurance?
Many insurance companies provide coverage for mental health services. If you
have private health insurance coverage (typically through an employer), check
with your insurance company to see if mental health services are covered and, if
so, how you may obtain these benefits. This also applies to persons enrolled in
HMOs and other types of managed care plans. Find out how much the insurance
company will reimburse for mental health services and what limitations on the
use of benefits may apply
If you are not covered by a private health insurance plan or employee assistance
program, you may decide to pay for psychological services out-of-pocket. Some
psychologists operate on a sliding-scale fee policy, where the amount you pay
depends on your income.
Another potential source of mental health services involves government-sponsored
health care programs—including Medicare for individuals age 65 or older, as well
as health insurance plans for government employees, military personnel, and
Community mental health centers throughout the country are another possible
alternative for receiving mental health services. And, some state Medicaid
programs for economically disadvantaged individuals provide for limited mental
health services from psychologists
Credentials To Look For...
After graduation from college, psychologists spend an average of seven years
in graduate education training and research before receiving a doctoral degree.
As part of their professional training, they must complete a supervised clinical
internship in a hospital or (organized health setting and at least one year of
post-doctoral supervised experience before they can practice independently in
any health care arena.
It's this combination of doctoral-level training and a clinical internship that
distinguishes psychologists from many other mental health care providers.
Psychologists must be licensed by the state or jurisdiction in which they
practice. Licensure laws are intended to protect the public by limiting
licensure to those persons qualified to practice psychology as defined by state
In most states, renewal of this license depends upon the demonstration of
continued competence and requires continuing education. In addition, members of
the American Psychological Association (APA) adhere to a strict code of
Will Psychotherapy Help Me?
According to a research summary from the Stanford University School of
Medicine, some forms of psychotherapy can effectively decrease patients'
depression, anxiety, and related symptoms—such as pain, fatigue, and nausea.
Research increasingly supports the idea that emotional and physical health are
closely linked and that psychotherapy can improve a person's overall health.
There is convincing evidence that most people who have at least several sessions
of psychotherapy are far better off than individuals with emotional difficulties
who are untreated. One major study showed that 50 percent of patients noticeably
improved after eight sessions, while 75 percent of individuals in therapy
improved by the end of six months.
How Will I Know If the Therapy Is Working?
As you begin therapy, you should establish clear goals with your
psychologist. You might be trying to overcome feelings of hopelessness
associated with depression or control a fear that is disrupting your daily life.
Remember, certain goals require more time to reach than others. You and your
psychotherapist should decide at what point you may expect to begin to see
It is a good sign if you begin to feel a sense of relief, and a sense of hope.
People often feel a wide variety of emotions during psychotherapy. Some qualms
about therapy that people may have result from their having difficulty
discussing painful and troubling experiences. When you begin to feel relief or
hope, it can be a positive sign indicating that you are starting to explore your
thoughts and behavior.
Examples of the types of problems which bring people to seek help from
A man in his late 20s has just been put on probation at work because of
inappropriate behavior towards his staff and other employees. He has been
drinking heavily and is getting into more arguments with his wife.
Once the contributing factors that may have led to the man's increase in stress
have been examined, the psychologist and the man will design a treatment that
addresses the identified problems and issues. The psychologist will help the
client evaluate how he coped with, and what he learned from, any earlier
experiences he had with a similar problem that might be useful for dealing with
the current situation.
Functioning as a trained, experienced, and impartial third party, the
psychologist will help this client take advantage of available resources (his
own as well as other resources) to deal with the problem. The psychotherapist
also will assist this client with developing new skills and problem-solving
strategies for confronting the problem he faces
Crying spells, insomnia, lack of appetite, and feelings of hopelessness are some
of the symptoms a woman in her early 40s is experiencing. She has stopped going
to her weekly social activities and has a hard time getting up to go to work She
feels like she lives in a black cloud and can't see an end to the way she feels.
The symptoms of depression are extremely difficult to deal with, and the causes
may not be immediately apparent. Significant life changes—such as the death of a
loved one, the loss of a job, or a child's leaving home for college—may
contribute to depression.
Psychologists have a proven track record in helping people deal with and
overcome depressive disorders.
A psychologist will approach the problems this woman presents by addressing why
she is reacting the way she is reacting now. Does she have a history or pattern
of such feelings, and, if so, under what circumstances? What was helpful to her
before when she dealt with similar feelings, and what is she doing now to cope
with her feelings?
The psychologist will work to help the client see a more positive future and
reduce the negative thinking that tends to accompany depression. The
psychologist also will assist the client in problem-solving around any major
life changes that have occurred.
And, the psychologist may help facilitate the process of grieving if her
depression resulted from a loss. Medical problems may contribute to the symptoms
the woman is experiencing. In such cases, medical and psychological
interventions are called for to help individuals overcome their depression.
William, a successful businessman, has been laid off from work. Instead of
looking for a job, he has gone on endless shopping sprees. He has gotten himself
into thousands of dollars of debt, but he keeps spending money.
What can be more perplexing than someone who does the opposite of what appears
to be reasonable? William's friends and family members will likely be confused
by his behavior.
Yet, such behavior is not unfamiliar to psychologists who understand bipolar
disorders. Of course, any psychologist would have to do a thorough evaluation to
be able to understand the apparently contradictory behavior William exhibits.
Following an evaluation, the psychotherapist might conclude that the behavior
actually is a symptom of a depressive or some other form of mood disorder.
Typically, the best results for such a condition have come from treatment that
combines medication and psychotherapy. Although psychologists do not provide
medication, they maintain relationships with physicians who are able to assess a
patient's need for appropriate medication. The psychologist offers understanding
of human behavior and psychotherapeutic techniques that can be effective in
helping William deal with his disorder.
Scott, a teenager, has just moved across town with his family and has been
forced to transfer to a new high school. Once an excellent student, he is now
skipping classes and getting very poor grades. He has had trouble making friends
at this new school
For most teenagers, "fitting in" is a critical part of adolescence. Scott is
attempting to make a major life transition under difficult circumstances. He has
been separated from the network of friends which made up his social structure
and allowed him to feel "part of the group."
Young people often respond to troubling circumstances with marked changes in
Thus, an excellent student's starting to get poor grades, a social youngster's
becoming a loner, or a leader in school affairs losing interest in those
activities would not be unusual.
A psychologist, knowing that adolescents tend to "test" first and trust second,
will likely initially spend time focusing on developing a relationship with
Scott. Next, the psychologist will work with Scott to find better ways to help
him adjust to his new environment.
American Psychological Association 1995
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