Finding the right therapist for you...

People typically enter counseling when they're in a difficult situation or struggling with charged emotions. It can be hard enough just to complete your daily tasks when you add this into the mix. With the stress that comes along with the situation you're facing, it's not exactly the ideal moment to be worried about how to find someone with whom you feel safe. The truth is, we often settle for 'good enough' when it comes to the healthcare professionals in our lives. You may be able to deal with a general practitioner who's bed-side manner leaves something to be desired because you only have to see him once a year. However, when choosing a counselor, discrimination is critical. An engaging personality is no guarantee of an ethical therapist with a strong set of skills. And a therapist who is perfect for one person may not be a good fit for the next. The process of finding a therapist can be anxiety producing but it doesn't have to be.

Where to start

• Referrals from other professionals can be helpful. Doctors, lawyers, clergy, and teachers often hear about the work of therapists and can assist in your search.

• A professional who participates in his or her professional organization has made acommitment to uphold high standards of care. For example, marriage and family therapists in California are likely to be members of the California Association of Marriage and Family Therapists (CAMFT). CAMFT maintains a website (www.TherapistFinder.com) where you can search for a therapist by name, location, or by clinical issues. Professional publications such as Psychology Today also provide a similar service: visit www.psychologytoday.com for more information. www.psychologytoday.com

Questions to ask

A qualified, professional counselor will be happy to answer your questions (we see that as a sign that you’re invested in yourself and in the process of counseling!) so ask away! Even if you feel a little uncomfortable doing so, it’s better to ask than to be left to guess. During your phone consultation or initial session ask the following and any others you can think of:

1. Are you licensed by the State?

Licensure means that the therapist, psychologist, or psychiatrist has met the minimum requirements in education and experience set forth by the state. You can visit the website of the licensing organization to verify that the counselor’s license is current and inquire regarding their status (i.e. if any complaints or concerns have been reported against them). If the counselor reports that they are an intern, this isn’t necessarily a bad thing. An intern is someone who has met the minimum educational requirements for their field and is currently accruing work experience towards licensure. Choosing to see an intern can often be a viable alternative to counseling with a licensed therapist. Because they have yet to receive their license, their rates are often significantly lower and they must be supervised by a licensed professional. Translation? Two brains for the price of one!

2. What is your level of education?

Depending on the professional you’re working with, each has had to complete a minimum level of education. For example, a marriage and family therapist has earned a Master’s Degree while a psychiatrist is actually a medical doctor. If your therapist is licensed or a registered intern, then you can assume they’ve completed the minimum educational requirements. It’s okay to ask to see their degree or a copy of their license!

3. What are your areas of expertise?

You’ve seen once counselor you’ve seen them all, right? Not so! Most therapists are really good at a few things, but not everything. They may specialize in a certain age group, gender, or population. What success have they had in working with people in your specific situation?

4. What theory do you practice and why?

Again, it is important to remember that not all counselors are the same. A therapist that practices psychoanalysis works very differently from one who utilizes cognitive behavioral techniques and what works for one person may not work for another. The Psychology Today website (www.psychologytoday.com) provides a concise overview of various counseling techniques.

5. How long have you been in practice? Where else have you worked?

This can be a source of information regarding the therapist’s effectiveness. A therapist who is not effective will have a hard time maintaining an active referral base and staying in business. This will also provide you with useful information about their level of experience working with specific populations.

6. How much do you charge per session?

Costs among therapists can vary widely. In Orange County, you can expect charges ranging from $85-$250 per session (approximately) when seeing a counselor in private practice. Their fees are often related to their number of years in training as well as the type of tools or interventions they can offer. For example, a psychiatrist will be more expensive than a social worker or marriage and family therapist. Why? A psychiatrist utilizes more intense treatment modalities such as prescribing medications. This is often necessary when dealing with more severe symptoms or complex mental health history. It should be said that not all mental health issues require the intervention of a psychiatrist and many difficult issues can be addressed utilizing traditional “talk” therapy.

7. Do you accept insurance?

Psychotherapy can be expensive and having your treatment covered by insurance will greatly help defray costs. Some therapists will handle your medical billing for you. All you’ll need to do is provide them with a copy of your insurance card (and a couple of signatures permitting them to submit billing on your behalf). Others will require that you pay your fees up front (at the time of service) and they will provide you with a “superbill” that you then submit to your insurance company for direct reimbursement. Either way, it’s important for you to do a little homework first to find out if your plan covers the services:

• Call the customer service number for your plan administrator and request information regarding your benefits and eligibility for out-patient sessions with a marriage and family therapist (or psychologist, or psychiatrist—whichever the case may be);

• Ask if there’s a difference in your coverage for an ‘In-Network’ and an ‘Out-of-Network’ professional (sometimes the rate of reimbursement will be higher if they belong to your plan’s network);

• What is the maximum number of sessions available per calendar year?

• What are your maximum out-of-pocket costs? Don’t worry if you don’t understand all of the insurance lingo the customer service representative spits out…the therapist should be able to tell you exactly what it means.

8. What is your cancellation policy?

In the therapy world, time is a valuable commodity. When you schedule an appointment, the therapist is committing this time to you and you alone. Unlike a doctor’s office, a therapist cannot schedule several clients at once for the same time frame. Typically, you can expect to be charged for a missed appointment if you cancel less than 24 hours before your scheduled session. Why? Many counselors have other clients waiting to be seen and cancelling less than 24 hours in advance makes re-filling that timeframe rather difficult.

9. Are references available?

Due to strict confidentiality rules, you most likely will not be able to get the names and contact information to former or current clients. However, your therapist should be able to provide you with professional references.

10. Do you have a policy for emergency situations or contacting you outside of our session time?

Your therapist should have a specific manner in which to deal with emergencies. They should also provide you with a means to contact them outside of your appointed session time.

11. What is your policy on confidentiality?

All licensed and registered pre-licensed professionals are required to protect your confidentiality. Although there are specific incidences and situations where they are mandated to report private information to outside parties, this should be outlined for you very clearly. Ask as many questions as you can think of in order to ensure that you understand the limitations of confidentiality.

A Final Note...

Keep in mind, too, that while the therapist may be recognized as being very effective and you can be an ideal client, people are different and sometimes relationships don't work out. If that happens, don't be discouraged...we can't 'click' with everyone. The counselor should NOT take this personally (nor should you!) and they should be more than happy to provide you with the names of three or more therapists you can check out.