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Choosing the Right Therapist

At some point in our lives, we all run into problems that seem too big or too persistent to handle alone. Yet our pride and fears can get in the way of asking for help. Making the decision to find help is a sign of strength and courage. And help is available. In fact, it can make the difference between feeling that things are spinning out of control and gaining new tools to turn life around in positive ways.

Having taken that crucial first step to seek help, you may have some questions about therapy. You may wonder, for example, about sharing information that is very private - will it be kept confidential? What is the best way to go about finding the right therapist?

You can rest assured that all mental health professionals are ethically bound to keep what you say during therapy confidential. However, therapists also are bound by law to report information such as threats to blow up a building or to harm another person, for example.

Therapy is a collaborative process, so finding the right match - someone with whom you have a sense of rapport - is critical. You may have to shop around before you find someone you are comfortable with. After you find someone, keep in mind that therapy is work and sometimes can be painful. But it also can be rewarding and life changing.

Whether you seek help from a marriage and family therapist, a social worker, a psychologist, a psychiatric nurse, or a psychiatrist, the steps to choosing the right mental health practitioner for you will basically be the same.

  1. See your primary care physician to rule out a medical cause of your problems. If your thyroid is "sluggish," for example, your symptoms - such as loss of appetite and fatigue - could be mistaken for depression.

  2. After you know your problems are not caused by a medical condition, find out what the mental health coverage is under your insurance policy or through Medicaid/Medicare. Many employer-sponsored insurance policies have limits on mental health services and may cover only 50 percent of the costs of a fixed number of visits per year.

  3. Get two or three referrals before making an appointment. Specify age, sex, race, or religious background if those characteristics are important to you. Your primary care physician and/or your faith leader probably know mental health care workers in your area. Also, ask friends, colleagues, neighbors, and family members for referrals. Chances are you will find that several people in your circle of acquaintances have been, or are, in therapy and can refer you to a competent therapist. You may also review the therapists listed in our Provider Directory, which may serve as an excellent resource in building your referral list.

  4. Call to find out about appointment availability, location, and fees. Many mental health professionals schedule evening appointments so you do not have to miss work. Selecting a therapist whose office is easy to get to - either from work or home - also can make a difference in your progress toward improved mental health. Ask the receptionist:

    • Does the mental health professional offer a sliding-scale fee based on income?

    • Does he or she accept your health insurance or Medicaid/Medicare?


  1. Make sure the therapist has experience helping people whose problems are similar to yours. You may want to ask the receptionist about the therapist's expertise, education, and number of years in practice.

  2. If you are satisfied with the answers, make an appointment.

  3. During your first visit, describe those feelings and problems that led you to seek help. Find out:

    • What kind of therapy/treatment program he or she recommends;

    • If it has proven effective for dealing with problems such as yours;

    • What the benefits and side effects are;

    • How much therapy the mental health professional recommends; and

    • If he or she is willing to coordinate your care with another practitioner if you are personally interested in exploring credible alternative therapies, such as acupuncture.


  1. Different psychotherapies and medications are tailored to meet specific needs. Be sure the psychotherapist does not take a "cookie cutter" approach to your treatment - what works for one person with major depression does not necessarily work for another. The best therapists will work with you to create a treatment program - perhaps using a single approach, perhaps incorporating several different ones - that works for you.

  2. Although the role of a therapist is not to be a friend, rapport is a critical element of successful therapy. After your initial visit, take some time to explore how you felt about the therapist. For example:

    • Was he or she someone with whom you felt comfortable?

    • Did he or she listen?

    • Did he or she seem to understand your concerns and address them?

    • Is this a person you feel you can trust?

    • Did he or she seem knowledgeable about your problem and suggest a therapy/treatment program that suits you?

    • Was the "chemistry" right?


  1. If the answers to these questions and others you may come up with are "yes," schedule another appointment to begin the process of working together to understand and overcome your problems. If the answers are "no," call another mental health professional from your referral list and schedule another appointment.
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