Maybe you have never been in therapy. Perhaps you have been in therapy, and it hasn’t gotten you the results you’d hoped. This time, you want to try something a little bit different. You may even have a particular goal(s) and know what it is that you want to change. Now come the questions, “How do I get the results I want?” and, “Who is the best person to help me?” Despite the consumer-savvy world we live in, there is little information on how to find a therapist, let alone how to find a therapist who will truly help you achieve real results and change your life in the way that you want.
Here, you will find a five-step process to help you find a therapist who will help you achieve the goals you want to reach. Stop wasting time, money and effort with treatment that doesn’t work. Set yourself on the path to success today!
- Get COMFORTABLE. – Going to therapy can be a hard process, requiring courage to step outside of your comfort zone and ask for help. At times, therapy asks you to be quite vulnerable, talking with another person about your deepest, most private experiences. Treatment often requires you to be super uncomfortable, and even want to temporarily squirm out of your skin or run for the door. After all, you are in therapy to get help with areas that are likely challenging and possibly, quite painful. To venture to feel this awkward and uneasy, you must first be comfortable! It is so important that you are at ease in the presence of your new therapist and feel understood and not at all judged. In other words, think about whether this is a person to whom you would want to open up.
- Ask for a PHONE CONSULTATION to get a feel for the therapist. Most therapists will agree to talk to you for a free, 10-15 minute phone consultation. During this meeting, you can give the therapist an idea of what you want help with and hear his or her response. It is important to ask questions and leave time for the therapist to talk so that you can start to assess your feel for this clinician’s competency and ability to help you. Trust your instincts. The therapist should give you a choice (or you can ask) whether you want to schedule an in-person appointment right then and there, want time to think about it, or do not believe that this therapist is a good fit for you.
- MEET IN PERSON with the idea that you are still evaluating whether this professional is a good fit for your needs. During the first session, the therapist will likely ask you questions about why you are seeking therapy and many other detailed questions about yourself and your treatment goals. The more open you are will help you to experience how the clinician responds to you and gives you the opportunity to evaluate your comfort level with this person. Their response will provide valuable information about whether you would like to proceed or seek another’s help instead.
- Ask for a CASE FORMULATION. – A results-oriented therapist will be able to discuss their conceptualization of your problem(s) and what is currently missing for you to reach your goals. Likely, this won’t be obvious information that you already know. Rather, it should add more information to your understanding of your stuck point(s) and show you that this person has the education and experience to understand your particular problem area(s) expertly. Think of the analogy of visiting a medical doctor (M.D.). You may report your symptoms (e.g., poor digestion, feeling light-headed) and the doctor will not simply repeat your symptoms back to you: “You have poor digestion and feel light headed. That must be hard.” They will tell you, based on their evaluation (e.g., examining your vitals, blood tests), what is wrong (e.g., “You have high blood sugar.” “Your thyroid is malfunctioning.”). You can expect this same kind of expert information regarding your psychological and emotional health as well. A results-oriented mental health professional will not only repeat your complaints back to you; they will add information to fully conceptualize what is contributing to the problem and why you need help in solving it. For example, you may report repeated over-eating and sudden emotional outbursts. The results-oriented clinician may suggest after their assessment (e.g., conversation with you, standardized questionnaires), they believe these problems come from deficits in understanding how to change behaviors and regulate emotions successfully.1 The results-oriented therapist will explain this to you in detail and discuss precisely how this affects you. This explanation will be in language you understand, and the conceptualization should make sense to you. If you think the therapist is off-base, does not accurately comprehend your problem, or cannot communicate in a way that you understand and agree with, openly discuss this with him or her. If you still cannot come to an agreement, it may be time to interview another therapist for your treatment needs.
- Ask for a TREATMENT PLAN, including TREATMENT GOALS, prognosis, and length of therapy. – Just as your general medical practitioner will give you an idea of your treatment options, likely results, rate of recovery, and time needed to achieve these results, you can also expect this from a results-oriented therapist. For example, a clinician may tell you that in the first three sessions2, the two of you will collaborate to reach a case formulation. At that point (by the third session) the therapist will make a treatment recommendation. They will talk with you in detail about how the treatment he/she is recommending addresses your particular problem(s), will help you reach your goals, and the time you should expect to devote to attain this outcome, including frequency and length of sessions, and expected length of time in therapy. Alternatively, at the third session, the therapist may refer you to another professional with the expertise to help you meet your goals if you and the clinician have determined that is what is needed. Again, think of the M.D. If blood tests reveal you have a thyroid problem that is relatively simple and straightforward, the doctor may express this to you and lay out a treatment plan. If, however, the problem seems more complicated, the M.D. may then refer you to an endocrinologist or another specialist to help you achieve your health goals. Defining treatment goals in therapy is important because these goals will help you know if you are making progress and whether the therapy is working.
- Understand how you and your therapist will MONITOR TREATMENT PROGRESS and ask for HOMEWORK. – How will you know whether you are moving toward your treatment goals and making progress? This is a question a results-oriented therapist will be able to answer with clarity.
- Together, you and your therapist may choose to use standardized measures of symptoms or progress and chart them on a graph, making sure your symptoms are decreasing, and skills needed are increasing. You may also choose to track behavioral markers, such as how often per week you are engaging in a particular behavior or have the urge to do so. Successful treatment would show a decrease in those behaviors (and possibly urges) the therapist has agreed to help you decrease (e.g., over-eating). You will also see an increase in the behaviors moving you toward your treatment goals (e.g., taking three breaths before a meal, stopping eating your meal when you experience a feeling of satiation regardless of the quantity of food left). Your therapist may ask you to chart each time you have the urge to or actually engage in these behaviors in between sessions to track your progress.
- PRACTICE, PRACTICE, PRACTICE, and then, you guessed it, more PRACTICE is needed to make changes and reach your goals. Homework will always be present in results-oriented therapy. Homework doesn’t mean that you will be sent off to write a 5-page paper about what you learned. Rather, therapy homework is a way for you to put into practice what you are learning in therapy. Typically, therapy sessions last about 50 minutes once per week. What about the other six days of the week and 24 hours each day? 50 minutes is not going to change your life in the way that you want. A results oriented therapist will send you home with something to practice (e.g., filling out a worksheet about a skill you learned at your session, practice saying “no” and noticing in detail the thoughts that come into your head or sensations in your body). If you want results, you must practice. Change does not happen in our thinking. Change happens when we do things differently over and over and over again. If you want results, ask for homework!
- CONTINUE TO EVALUATE, on an on-going basis, whether your treatment is helping you move toward your goals and achieve the results you want. A results-oriented therapist will regularly review treatment progress with you using the techniques described in Step 4. Therapy is not meant to be life-long. Remember, you are hiring a professional to help you reach specifically-defined treatment goals. At some point, if therapy is working (as you are carefully monitoring), you will have achieved those goals and will either want to develop new treatment goals or decrease the frequency of your contact with this clinician or terminate your treatment.
Therapy can be an enriching, life-changing experience if you choose an effective treatment. Use the five steps above to help you get the help you need and deserve, and start shifting from surviving to thriving today!
- This is provided as an example only and does not imply that all causes of over-eating or emotional lability come from the same source. These statements are meant to clarify the topics addressed in this article, not to assess or diagnose.
- Not all clinicians assess within one to three sessions. This is meant as an example only. Please check with the therapist you plan to see about their individual policy and of course, ensure that it makes sense and is reasonable to you.
Frequently Asked Questions:
- What is the difference between a Ph.D., Psy.D., LMFT, LCSW, MFTi, etc., and will it affect the quality of my treatment?
A Ph.D. and Psy.D. both have doctorate degrees in psychology. LMFTs and LCSWs have a master’s degree. A Psychological Assistant (someone with a doctorate who is not yet licensed) and MFTi (Marriage and Family Therapist intern) indicate this person is still in training and under supervision before they can become licensed. While the degree itself may show different types of training and specialties, what is usually more informative is how the therapist works with their clients. I have results-oriented colleagues with LMFT and LCSW licenses who work similarly to myself and other contemporaries who have doctorate-level training. I also have met professionals with doctorates who are not results-oriented and do more of a supportive-type therapy. In my opinion, if you follow the five steps laid out in this article, you will significantly increase the likelihood that you will work with a therapist who will help get the results you want, regardless of their type of license. Trainees can also be good options. I personally would choose to work with a Psychological Assistant or MFTi if they met all of my requirements in the 5-steps to finding a results-oriented therapist. The quality of work a therapist demonstrates to me is more important than where they are in their education and whether they have a master’s or doctorate degree. One caveat: if your problem is quite complicated and you have been to several clinicians before who haven’t helped, you may need a skilled and seasoned eye and choose a therapist who has some years of experience under his/her belt.
- Should I look for a therapist with a particular theoretical orientation?
Some of my results-oriented colleagues may argue that it is imperative to receive treatment from someone doing “evidence-based therapy,” such as cognitive-behavior therapy (CBT). I like to be careful about making this generalization. There are certainly CBT practitioners who are results-oriented, and there are those who are not. Because someone professes to work under a particular modality is not an assurance that they do. More relevant is whether the therapist helps you develop treatment goals, assigns homework, monitors your progress, etc. I am less inclined to be concerned about the modality and more interested that the therapist can give you evidence that their treatment recommendation(s) works (has been researched to be effective) and the way the therapist is applying the treatment to your problem makes logical sense to you.
- What if my therapist tells me that being uncomfortable with him/her or wanting to leave therapy is as a result of my problem(s) and I should not act on this?
This answer is not a straightforward “stay” or “leave.” Rather, it is a more nuanced answer: Use your WISDOM. On the one hand, if this is a new therapist, it is important to be comfortable and feel at ease in his or her presence right away. (See Step 1.) You will already be challenging yourself to grow in various ways throughout your treatment; no need to do this with the relationship with your therapist. I have talked to countless people who have stayed with a therapist they didn’t like or felt uneasy around because they assumed they (the client) were at fault and there was something wrong with them that they felt this way. I previously had a personal experience visiting a therapist with whom I was uncomfortable. I told her so, and she stated that she thought this meant I had significant problems with intimacy and needed to sit physically closer to her than I was comfortable with and work through the problems in my relationship with her. At that moment, I felt ashamed and unsure of myself. After leaving the session, and discussing it with a loved one, I determined that the only relationship in my life that I was having a significant problem with and wanted to get out of was the one with my therapist. I left, found a new therapist who I was immediately comfortable with, and therapy was successful. I have heard some version of this story from many clients about their past therapy, and often, once they remove themselves from that clinician, they find much success moving toward their goals with much more ease. On the other hand, it could be useful to ask yourself if your therapist has a point. Does this reaction toward your therapist happen in many other relationships? After visiting a few therapists, do you feel this same way about each of them? If so, you may want to consider whether this is something you want to target (work on) in therapy and may decide to stick with this therapist. You may want to consult with a trusted loved one and get some help tuning into your WISDOM to make this decision. Also, remember Step 5 and to continuously evaluate whether this treatment is helping you.