Choose a Counselor With Care

A few years ago, a movie, “The Doctor,” slipped in and out of theaters without much fanfare.  The thrust of the film was that even doctors become patients at some time in their lives.  For one who works in the health care industry, this movie spoke volumes to me.  It served to remind me of the anxieties patients (clients) often experience when they face the prospect of confiding their innermost thoughts and insecurities in therapy.

One of the more memorable themes running through the movie involves the patient (who is the doctor) becoming obsessed with the arrangements and procedures associated with his upcoming operation.  The process is both humorous and yet pointed in showing how much different the operation is approached – from scheduling of the operation to following through with the postoperative visits – when it’s the doctor’s own body on the operating table.

The cautious approach of this doctor-turned-patient is something with which we can all relate.  Whether it’s our car or our teeth in need of fixing, finding someone who is both competent and trustworthy is among our greatest concerns.  The endeavor becomes even more critical when the thing in need of fixing involves matters of the heart.

Psychotherapy can be an intimidating undertaking for many people.  There are those – mostly men, in my experience – who simply refuse to entertain the thought of counseling, no matter how bad the marriage gets (for instance). Such individuals may have had a bad experience in therapy in the past, may reject the idea out of pride, or may feel threatened by the prospect of self-disclosure.  Even those who are more open to therapy typically approach counseling with some apprehension.  It is natural to feel anxious the first time you open up to a stranger and such mixed feelings of wanting help and yet resisting it often persist throughout the treatment process.

While choosing a therapist can be a challenging task, there are several things that can help.  For instance, a recommendation by a trusted source (e.g., friend, family member, doctor) is a good starting point.  Few factors weigh as heavily as knowing that a professional has a good track record with someone you know and trust.

Another way of finding a therapist is through a brief ‘interview.’  Any therapist interested in your business should first be interested in you.  (S)he should be willing to spend 10-15 minutes with you – free of charge – to give you a chance to ask questions (e.g., concerning training, experience, expertise, availability, cost of services, therapeutic approach, etc.) and so you can get a feel for his/her personality.

Undoubtedly, there are professionals who disagree with me on this free consultation (either because they’re already too busy or because ‘there’s no such thing as a free lunch’) but I think it’s a service all professionals – from mechanics to lawyers to general contractors to doctors – should be willing to provide.  In investing your time, money, and trust in another, you deserve to have a good idea of what to expect.  Think of the therapist as a prospective employee – interview several of them, then hire one.

Among the things to look for in a therapist, none is more important than feeling comfortable in his/her presence.  At the core of all healthy relationships, trust has a direct bearing on the quality of rapport that will develop.  In no profession is ‘bedside manner’ more important than in that of psychotherapy.

Other factors which may influence your decision include the age, gender, race, ethnicity, religious orientation, availability, and therapeutic approach of the therapist.  Training, experience, and areas of expertise will be critical.  Fees, too, are an issue.  The health care industry’s movement towards managed care and provider networks now often dictates whom you can see, as well as what your cost will be.

Once you have chosen a therapist, use him/her as you would a tool.  Be explicit in how (s)he can most effectively operate in your behalf (e.g., tell him/her that, “I find it most helpful when you confront my inconsistent statements” or “It bothers me when you talk so much”).  Having your welfare at heart, your therapist should invite you to share all of your problems freely (including any you may have with him/her). Furthermore, with rare exception, (s)he shouldn’t ever divulge confidential information to anyone without your permission.

Research shows that no one psychotherapy profession has the corner on the market in terms of its effectiveness.  Personal skills, along with training and experience, are factors that prove most critical.  As in all professions, here you will find good and bad social workers…psychiatrist…psychologist…marriage and family therapists…and so on.  And sometimes it’s not even a matter of good and bad, but rather one of with whom you are and aren’t comfortable.  It’s worthwhile to find someone who ‘fits’ with your personality, value system, and way of thinking.