How do I find a therapist?

I have a little problem I'd like to discuss, but don't know how to get started.

Published May 12, 2005 7:43PM (EDT)

Dear Cary,

How does one find a therapist? For the first time in my life I feel that I simply need to talk to someone regarding a matter of the heart winning over the head. I don't have a general physician and none of my close friends can offer referrals. How do I do this?

Simply in Need

Dear Simply in Need,

Before you make an appointment with a therapist, make an appointment with yourself. Write it in your appointment book. Set aside two hours. Get yourself a phone book, a pad of paper and a pen or pencil. Sit down where you can concentrate and won't be disturbed. Look in the phone book under counseling services, psychologists, psychotherapy, psychiatry, however your phone book lists it. Make a list of several therapists and their phone numbers.

At this point you can choose in any way you like. The point is to get the list made. If you prefer women or men, if certain names appeal to you, if any brief descriptions of their approach sound good to you: Use any intuitive reactions you have in order to make your initial choices. Just make a list. And then call them up. Probably you will just be leaving messages, but therapists are usually good about returning phone calls. When you get a chance to talk live, just tell them what you told me and have a conversation.

In your initial conversation, you should check to make sure the therapist is licensed by the state, and find out just what academic and professional preparation the therapist has. Some have masters degrees in social work or counseling, some have Ph.D.s in psychology and some are medical doctors. Try to suss out what kind of help you'll need. Do you need someone who specializes in marriage or family counseling? Do you think you'll need medication?

Since you say you don't have a primary physician, I'm guessing you also don't have health insurance. So price will also be a concern for you. Explain that you don't have health insurance, and ask if the therapist offers a sliding-scale fee for people without insurance. There are also issues of availability -- can they fit you in their schedule and vice versa? I would not rule out the right therapist on price or scheduling difficulties alone unless such obstacles prove insurmountable: The right therapist will be worth the money and the effort.

It's possible to get a preliminary feel for a therapist over the phone, but you can't really know how you're going to click with someone until you meet them in person. So if the conversation goes smoothly, make an appointment. When you get to their office you'll have to size them up, quickly, the way you would a new acquaintance or colleague. Do they seem interested in what you have to say? Do they ask good questions? Do they seem smart? Are they distracted, or focused on you and your issues?

Besides getting to know them, at your first visit you might want to ask them about their experience -- how long have they been in practice, what kind of training do they have, do they have a specialty, are they affiliated with an academic institution, etc. It's your right to ask questions too. Be a smart consumer.

Like anyone you meet for the first time, you will likely have a gut reaction: You either like them or you don't. Go with that. If you're not sure this is someone you can work with, don't waste time trying to figure it out. Move on to someone else on your list. Sometimes you have to shop a little before you find the right person.

One more thing: I make this sound simple, but simple does not always mean easy. One of the main impediments to finding a therapist, strangely enough, can be just having the nerve and the perseverance to call them up and make appointments. You may find yourself putting this off. If so, I suggest you ask someone to come over and you can do the task together.

Good luck. The right therapist can make a big difference.

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