The Challenge of Choosing your Therapist Wisely

The Challenge of Choosing your Therapist Wisely

This is not an easy topic to write about - for a couple of reasons. First off, we are searching for someone who presence, skills, life experience and personality are going to make a big difference in our lives. Yet in today's health and mental health environment, we never know what changes are going to have a huge effect on what we can afford to pay for good (if any!) psychotherapeutic treatment. And then there are many types of psychotherapists and many levels of training that permit people to call themselves psychotherapists.

Psychotherapy is an art as well as a science. It takes years for someone to become a well-rounded psychotherapist who offers their help in a friendly thoughtful appropriate manner. There are people who have minimal training who can technically call themselves psychotherapists, as well as others with lots of training who lack the basic relationship skills to help people who are lonely, angry, confused, misunderstood, depressed, anxious (the list goes on) to feel understood and able to make their lives less painful, more interesting and satisfying. So training is no guarantee either.

Having said all this, I want to share advice from my mother who was a special kind of cook. She said "always look for the best tomato; not the largest, or smallest, but the one right in the middle, with the best color, skin, that comes from the garden with the best soil and sun".

The better therapists usually have Doctoral degrees (Ph.Dd, Psy.D) or Master's Degree in Social Work combined with private certified Institute training. These therapists have most often made a lifetime commitment to learning their art and craft. They have chosen to pay for private supervision, and have developed a community of colleagues who they meet with regularly to discuss (confidentially of course) any issues with the patient/clients. Psychologists with PsyDs/PhdDs have over five years of postgraduate specialized training and clinical internships to round out their knowledge base. Social Workers who choose advanced Institute training have two years of academic education and clinical experiences plus many years of supervision beyond the L.S.W. Supervision is an essential part of training. In many ways, it is an intimate honest exploration of how a therapist views a patient, their issues, strengths and moment by moment behavior in sessions. Supervision should be a safe place for a therapist to work out stuck places in the treatment.

Psychiatrists have training in psychopharmacology and psychotherapy, yet the balance for most psychiatrists these days is still in psychopharmacology. If you think you might need medication, your Psychologist or advanced Social Worker should be prepared with names of Psychiatrists for you. If you are very wealthy you might choose a psychiatrist to see regularly for medications and psychotherapy, but this is the most costly route. If you are low on finances, there are lowcost clinics that offer therapists in training. That way you can get good help, although those therapists often move on after they graduate. If you and your therapist are a good match, you might consider going with them!

Less than well-rounded psychotherapists are those who have learned a technique or two and try to fit the patient/client into the technique. In my years as a professional, I have sadly met quite a few folks who are inspired by what has helped them, but often lack the general experience to help a wide range of people. If they are starting out, and are serious, they will eventually find the funding to get themselves more education and training. If not, they can be of little value or even (unfortunately) harmful.

Serious psychotherapy training always requires or strongly recommends that each therapist have a considerable amount of consistent psychotherapy of their own. This is essential. Nowadays, it is universally known that the therapist's own personality, life history and symptoms all go into the making of a good psychotherapist who can look humbly at their own behavior, thoughts, feelings and attitudes toward each client/patient. As therapy deepens, this increases in importance.

All therapists make errors; those new to the profession make certain kinds of errors, and those with much experience make different kinds of errors. This is well-documented and must be true in all professions. Therapists must/should be open to your objections about any/all things, including the way they behave toward you! This is such a crucial part of any good psychotherapy experience. I encourage you to speak up as soon as you need to.

A thoughtful, empathic, creative, approachable psychotherapist is out there for you. She/he may cost a bit more than you hoped, but it will be worth your while. Personally I love a bargain, but this is not the arena where a bargain is worth the risk!

I hope this information is useful to you. If not, I am, as always, open to hearing about it.

Best,
Joan Lavender Psy.D.
212-866-0461

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