According to a 2007 survey reported in the American Journal of Psychiatry, approximately 3% of Americans said they had at least one psychotherapy session in the past year. That number remained steady between 1998 and 2007 according to the same survey.
At last count (July 2010), our country had roughly 310,300,000 inhabitants, give or take a few thousand or so. That translates to approximately 21,721,000 Americans who sought out therapy in 2007. For the remaining 288,579,000 of you who might be interested in how to go about finding a therapist who is a good fit for you, I can offer my observations--from both the therapist's chair, and the couch.
My first therapy session--ever--was as a client. It was over 20 years ago, prior to becoming trained as a therapist. I knew little about how therapy worked, but I had just experienced a difficult break-up and decided it might be good to "talk to someone about it." As I recall, I arrived on time, and entered a nicely appointed office. My therapist had come highly recommended. I thought He must be good, right? so I didn't really ask him anything prior to arriving for my first session. After a few introductory remarks, he smiled, nodded knowingly and said, "How can I help you?"
Over the course of the next 12 weeks I talked. And talked. And talked some more. My therapist, by contrast, never said a word. Aside from his cordial one-word "Hello," at the top of our hour, he settled back in his chair, looked and me and smiled, which was my cue to begin. Occasionally, he looked up from his note pad (he took extensive notes) and peered over his half-rimmed glasses with the slightest hint of interest--I thought: He's gonna say something now. He's ready to tell me what's wrong with me. He'll tell me what he wants to know. He'll help me fix this.
But he never did. Not once. By the end of 12 weeks I was impatient. No, I was more than that--I was angry. This wasn't what I thought therapy would be like. In my naivete, I had expected this warm and consoling conversation with a sage and experienced pro who would make me feel a whole lot better. Instead, I got a mute Yoda-like creature who offered no wise words, no quick fixes. Instead of feeling better, I felt worse--and angry on top of it all.
So, in session number 13, I shared my frustrations with him about the therapy, his silence--everything. He simply nodded and smiled. And then he said, "I was waiting for you to tell me this. I was waiting for you to talk yourself out." Dumbfounded, I think I muttered something like, "Oh," and left, deciding that there must be another way to do this that worked better for me. I never went back.
Years later, I found myself in therapy once again, after my father had died. I needed help with the grieving process. This time, I found a therapist who was a wonderful fit. He listened, and then gave feedback. He told me about the grieving process and how it worked. I didn't feel like my situation was so unusual any more. I didn't feel as alone. I wanted feedback and ideas that would help. He gave me this and more. Over the course of our work together, I felt better. I was able to process my grief and handle it as it washed over me from time to time. I will always be grateful for his wisdom and help.
I mentioned in my last post about how clients who actively shop for and participate in their therapy tend to have better outcomes. To that end, before you decide on a therapist, I encourage you to get an idea of the type of therapist and the kind of experience that will work best for you. A few tips:
1. Talk to some friends who are in therapy. Ask what they like about their therapists. If your friends aren't in therapy, then ask prospective therapists if they have any clients with whom you can talk. Ask for references.
2. Think about how you'd like the sessions to go. Are you someone who would appreciate little interruption from your therapist, with only an occasional summary or interjection? Or do you want alot of feedback, with interpretations, psycho-educational information about your diagnosis, as well as homework exercises designed to help you move through your distress? Or would you prefer something in between?
3. Ask prospective therapists how they work. Does their way of working sound like it would be a good fit for you? If they use words or terms that are unfamiliar to you, ask for clarification. Notice how they answer: Are they warm and reassuring? Or reluctant, finding your questions tedious? Chances are, their demeanor in your sessions is likely to be similar to your phone experience.
4. If you don't know, ask. How long are sessions? How long is treatment likely to go? How much does each session cost? Does your therapist accept insurance? How is insurance submitted? Is there convenient parking nearby? Is the office close to public transportation?
5. Try out your therapist. Just because you choose a therapist doesn't mean you're wed forever. However, in fairness, give your therapist and the process a chance. If, after three or four sessions, you have misgivings, have a candid talk with your therapist and see if you can work out your differences. If you feel like you can't, ask if he or she can recommend another therapist (based on your feedback). A good therapist won't take any of this too personally, and should be able to recommend a colleague to help you.
Additionally, there are any number of online sites and therapist directories that can help you find a qualified therapist in your area. Many of my colleagues and I are listed on www.PsychologyToday.com Click on "Find A Therapist" in the tool bar.
Ideally, you'll find a therapist who is a good fit. After all, according the the U.S. Bureau of Labor Statistics, there were 1,138,000 therapists in the U.S. in 2008--and growing. One of them is bound to be just right for you.
Thanks for listening.
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