ABCs of Mental Health Care

Seeking Help

print Interviewing a Therapist

Choosing the right therapist is important and often difficult to do simply by looking at ads in the Yellow Pages. Credentials can be important, but are not the whole story. Word of mouth is the best advertisement for the quality of a therapist.

While people are still reticent about talking about mental health, experiences of friends or relatives can be valuable. You can also seek information from your primary physician.

Finally, you can consult referral hotlines of professional organizations, including your state or local medical society, association or other professional group. They often list members who specialize in situations similar to yours.

Questions to ask when choosing a psychiatrist or therapist:

Are you licensed by the state?

Licensure is important because it means that the provider has passed minimum competency standards for training and expertise.

What level of education do you have?

Psychotherapy is available from a number of different providers. Psychiatrists are medical doctors who have completed special training in psychiatry. They can prescribe medication in addition to providing psychotherapy.

Psychologists usually have a doctoral degree in psychology. They can conduct psychological testing that might aid in the diagnosis of your conditions. Most other therapists have master's degrees in a related discipline, including licensed clinical social workers (LCSW), advanced registered nurse practitioners (ARNP) and licensed mental health counselors.

What are your areas of expertise?

Most therapists are really good at a few things, not everything. What success in treating people have they had?

How long have you been in practice?

This is a source of information regarding the therapist's experience, and might indicate something about the therapist's effectiveness. A therapist who is not effective will have a hard time maintaining an active referral base and staying in business.

How much do you charge per session?

Costs among therapists can vary widely and are often related to their number of years in training. A psychiatrist or psychologist will probably be more expensive than a social worker or mental health counselor.

While this is clearly not a situation of "you get what you pay for," you should be aware that training differences among these professionals can have an impact on your treatment. Usually, more severe symptoms or complex history and medication regimen, will require a psychiatrist, especially if this person will be primarily responsible for your care.

What insurance plans do you take?

Psychotherapy can be expensive and having your treatment covered by insurance will greatly help defray costs. Check that the person you are seeing is able to handle third-party billing (insurance) and that treatment is covered by your insurance plan. You can obtain this information from your benefits person or the therapist.

If you are not a medical doctor, do you work with a psychiatrist or other physician who manages the medication?

A "yes" answer improves the chances that your care will be coordinated if medication is prescribed.

Do you have a cancellation policy?

Some therapists charge for missed appointments or cancellations within a certain period of time. If you have inconsistent transportation or other issues that might affect your ability to keep appointments, this will be important information.

In cases of emergency, do you have an "on-call" system?

Hopefully, the answer is "yes." It is important to know that in times of crisis, you will be able to reach your therapist or someone who is on call for him.

The best method of choosing a therapist might be to gauge your reaction to her. Research on the effectiveness of psychotherapy has consistently shown that the personal qualities of therapists and how they "fit" with the patient are at least as important as the type of therapy used to produce a positive outcome. If you feel uncomfortable with a therapist after several sessions, make sure you discuss this. If an issue cannot be resolved to your satisfaction, seek another therapist. If the problem is with you, you will discover it soon enough.

Keep in mind, too, that while the therapist might be recognized as being very effective and you can be an ideal patient, you just might not be able to work together. People are different and sometimes relationships do not work out. If that happens, find another therapist.

Michael Herkov, PhD
© 2000 by University of Florida Brain Institute


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