Finding a Good Therapist

So your character is looking for a therapist. What should she look for? How will she find a good one? (Or, conversely, if you want to find a rotten therapist for your character, have her ignore all of what follows!)

1. Have your character get a referral from someone she trusts. For example, she can ask local friends or doctors she already sees and trusts.

Why: We tend to like people with personalities like ours, so someone who your character already connects well with will often recommend someone else who will connect well with her. There's also nothing wrong with someone politely asking why the recommending person thinks the therapist he's endorsing is good.

2. Have your character look for a licensed therapist—at the master's level, look for a title like "licensed professional counselor" (Different states use different wording and different acronyms, but in the state where I live, this includes LPC [licensed professional counselor], LPCC [licensed professional clinical counselor], and LISW [licensed social worker]). At the doctoral level, this is a psychologist (psychologists do therapy but usually can't prescribe medications) or a psychiatrist (who can prescribe medication and may or may not do therapy)

Why: Most people don't realize that anyone can hang their shingle out and call themselves a "psychotherapist," a "counselor," or a "therapist" — and I do mean anyone. Finding someone who's licensed helps to protect your character from quacks. Use Psychology Today to find a therapist.

3. Your character should love the therapist he decides to see regularly. I don't mean he thinks "they're okay"—I mean he should respect them and think they're fantastic. When someone gets referrals from friends (as mentioned above), always have your character make sure the recommending person loves the therapist they're recommending.

Why: Over and over again, research has shown that the key component that leads to healing is the relationship between counselor and counselee. If your character doesn't think her therapist is fantastic, she's not going to feel like they "get" her, nor will she respect their interventions, which will leave her spinning your wheels and wasting her money.

4. Your character shouldn't be afraid to shop around for a good therapist if he doesn't love the first one he tries (or the second, or the third). We aren't afraid to shop around for handymen or landscape services or dishwashers, but for some reason people don't realize that they may have to shop around for a therapist. In fact, most people give up on therapy if the first therapist doesn't work out, not realizing that a different person can make all the difference.

Why: Again, a great relationship with the therapist is crucial to getting what one needs out of therapy. Your character shouldn't be afraid to leave a therapist who isn't helping him (or helping him enough)!

5. Counselor theoretical orientation is less important than relationship. Theoretical orientation is the approach a therapist takes to treatment. For example, cognitive therapists target irrational and dysfunctional thought processes and usually require practical homework, whereas psychodynamic therapists focus more on relationships and unconscious influences from the past. Most modern therapists are "integrative" or "eclectic," which means they use whichever theoretical approach seems to fit the client's problem best.

At the same time, most therapists have certain problems they like to work with in particular, and seeing a therapist who treats problems like your character's all the time may mean that that therapist is well-versed in what works.

Why: A therapist can use all the "proven" methods for a particular problem, but if your character thinks that therapist is an idiot, she's not going to get much out of his therapy.

6. A therapist with a doctorate may NOT be better than a therapist with a master's degree.

When I was doing therapy regularly, I would occasionally hear of would-be clients demanding to see a doctoral-level therapist rather than a master's-level one. (This—along with demanding a particular theoretical orientation—was particularly prevalent when I worked in college counseling centers. I think some students take a bunch of psych classes and then assume they're an expert on who they should see, completely ignorant about the importance of relationship.)

Psychopharmacology Essential Reads

Long-Term Use of Benzodiazepines and Dementia Risk

Does Antipsychotic Medication Work?

Why: The reality is that things like years of experience in the field, expertise with particular problems, and—you know the drill by now—relationship with the client make a bigger difference than whether someone is master's-level or doctoral-level.

To summarize, Duncan (2005) says your character should find a different therapist if she:

• Doesn't like him.
• Thinks he doesn't like her, or believes he thinks she's hopeless or her problem is impossible to solve
• Regularly disagrees with his goals, ideas, or suggestions
• Finds that her feedback doesn't make any difference in his approach
• Doesn't notice any positive change within 3 to 6 sessions
• Finds him pushing medication when she hasn't asked for it or doesn't feel it's necessary. (Note: Sometimes therapists will recommend medication, but they should have a rationale they're willing to explain, and they should appreciate that it's ultimately the client's choice whether to take medication.)

Use Psychology Today to find a therapist

References:

Duncan, B.L. (2005) What's right with you: Debunking dysfunction and changing your life. Deerfield Beach, FL: Health Communications.

© 2012 Carolyn Kaufman, PsyD ♦ Psychology for Writers on Psychology Today

Carolyn Kaufman, PsyD is the author of The Writer's Guide to Psychology: How to Write Accurately About Psychological Disorders, Clinical Treatment and Human Behavior. More information is available on the book's website.

You may also enjoy The Badass Character in Therapy and Should Your Character Really Get a Diagnosis?