Searching for a therapist? You’re not alone. Millions of people
see one every year, experts say, and countless studies show that therapy –
which teaches patients strategies and
tools to manage and resolve unhealthy behaviors and thoughts – is effective for
treating depression, anxiety and other psychological issues.
Therapy can be administered by a range of mental
health professionals: psychologists, who are specially trained in the study of
mind and human behaviors; counselors, who provide talk therapy but don’t
diagnose conditions or provide medication; and psychiatrists, who are
physicians that prescribe medication like antidepressants but are also be
qualified to give counsel. However, finding the right therapist is difficult –
and perhaps an even bigger challenge is trying to decide which type of therapy
you should receive. There are countless therapists, not to mention myriad schools of thought in psychology. All too often, it’s easy to get overwhelmed
by the options.
Here are a few tips on how to find a therapist, along with an overview
of common types of therapy offered by mental health professionals.
Finding a Therapist
Before deciding which type of therapy you want or which therapist
you want to see, it’s important to know why you want to go to one in the
first place, says Faith
Tanney, a District of Columbia-based therapist. “What do you want to have changed, or what do you want to come
to accept about your life?” she says.
Once you’ve identified the underlying reason you’re seeking treatment, it’s time to get
specific about which type of therapy will work best for you, says Jennice Vilhauer, an assistant professor of psychiatry and behavioral sciences at Emory University
School of Medicine.
For instance, she says, many treatments are based on
diagnostic disorders. Do you have an already-diagnosed psychiatric disorder
like obsessive-compulsive disorder or anxiety? Are you depressed? Then you
might want to find a therapist who’s been trained in certain types of therapy
that clinical studies have indicated are effective for those types of problems.
Or are you more interested in an exploratory kind of therapy that will allow
you to examine your past and present thoughts and feelings in greater depth? If that’s the case, you might be interested in
finding someone who specializes in that area.
Once you’ve pinpointed
your motivations and needs, it’s time to start searching for a therapist. Jeffrey Binder, a professor of psychology at the
Georgia School of Professional Psychology at Argosy University in Atlanta, recommends simplifying what can be a daunting
process by relying on word of mouth: asking friends, family or a trusted
internist or family practitioner if they know of a therapist they’d recommend.
He also suggests contacting local universities with clinical psychology or psychiatry departments, or visiting an online therapist rating system like the
one offered by Psychology Today. Binder adds that if someone has looked into the particular types of therapies practiced by a
professional he or she is interested in seeing, that person might want to see if
there’s been any outcome-based research published in a peer-reviewed journal
that shows the therapy’s benefits. That could help him or her decide whether or not
they want a therapist who specializes in a certain kind of therapeutic
After you’ve narrowed your choices to a handful of mental health professionals – Tanney recommends scoping out at least three before making a final decision – she says you should feel them out via phone or an initial consultation to see
whether their personality and skills mesh with your needs. It’s also
important to ensure that the therapist is licensed to practice in your state, receives regular professional training and has malpractice insurance. Age, gender and
availability might also be factors, as well as special sensitivity toward issues such as sexuality and lifestyle orientation. Bottom line? If the professional isn’t quite the right fit for you, don’t settle.
Above all, Vilhauer stresses, it’s important to
ask your potential therapist lots of questions about his or her approach. “What type
of therapy do they practice? How will this particular therapy help you with
your specific problems? What will the treatment model be like, and how long has
your therapist been practicing this model? How many people have been treated
successfully using this type of model?” she says. “These are things people
sometimes don’t ask that they probably should.”
Choosing a Therapy Type
decide not only which therapist they want to see, but also which kind of
therapy they wish to receive. Many patients, however, often have no idea what
to expect from their first therapy session. People tend to think of Sigmund
Freud, a leather couch and a long session of psychoanalysis when they first
conjure up images of therapy. But modern therapy, experts say, doesn’t
necessarily resemble its early roots.
“The field of psychotherapy
has evolved a lot over the last few decades,” Vilhauer says. “It’s no longer
what we’d call a one-size-fits-all model.”
Multiple types of therapies exist, experts say, and they fall into
various “schools” of thought, each with their own theories and techniques Just as there are “different types of medication, or classes of medications, for various
kinds of depression,” Vilhauer says, “there are a lot of different types of
psychotherapies that people will use to treat a problem.”
Still, there are two primary philosophical models of psychotherapy: psychodynamic and cognitive/behavioral. Psychodynamic therapies focus on a patient’s unconscious process by having that person talk freely about his or her thoughts or feelings, and it aims to delve into past memories that might
yield understanding of present problems. Subtypes of dynamic therapy include psychoanalysis – a long-term therapy that
patients can engage in multiple times a week – to short-term
psychodynamic therapy, which has a 20-session protocol.
Cognitive/behavioral therapies, on the other hand, are based on
understanding one’s thought process or behaviors in the present and identifying
how dysfunctional patterns in these areas may contribute to a larger life
problem. By gaining awareness of these thought patterns, patients can work with
therapists to change them. Cognitive/behavioral therapies are more structured
than psychodynamic therapies and tend to be shorter in duration, depending on
the person’s needs.
A common form of treatment in this category is
cognitive behavioral therapy, which blends cognitive and behavioral components. The cognitive side centers on how a person’s thoughts influence
mood or actions, while the behavioral part focuses on his or her actions and learning strategies to modify problematic behaviors.
“One of the working assumptions in cognitive
behavioral therapy is that faulty cognitions and [irrational] ways of thinking
lead to negative feelings and maladaptive behavior,” Binder says. If you modify the content and
illogical irregularities of the flawed thought patterns, and teach people
to think about the events of their life in a more rational way, negative feelings such as depression and anxiety will decrease. Meanwhile, changing
one’s behavior and adapting positive coping mechanisms can decrease destructive
habits and lead to an improvement in overall well-being.
Experts say cognitive behavioral therapy is the most widely
researched psychotherapy, and it’s effective for people with anxiety, depression,
eating disorders, mood disorders, bipolar disorder, phobias and insomnia. Sessions
are highly structured; patient and therapist work together as a team to
identify and change faulty thoughts and actions, and patients are expected to
complete “homework” assignments when they’re not in session – say,
keeping a “thought record” of negative thoughts, their context and what triggered
Another type of cognitive/behavioral treatment is
dialectical behavioral therapy, says Shireen Rizvi, an associate professor of clinical psychology at Rutgers
University and director of the school’s Dialectical Behavior Therapy Clinic.
According to Rizvi, dialectical behavioral therapy was originally used to treat severely suicidal
individuals, or those with borderline personality disorder – a serious psychological illness characterized by unstable
moods, behavior and relationships.
behavioral therapy emphasizes self-acceptance and validation, and teaches patients
coping skills that help them control
their emotions and tolerate stressful situations. It also places an emphasis on
mindfulness, or focusing on the present moment. Dialectical behavioral therapy
is now used to treat a range of disorders characterized by emotional dysregulation, including eating disorders, substance abuse and some types of depression. Treatment
typically includes weekly therapy sessions and once-a-week skill-based
group therapy sessions, and lasts from six months to a year.
Finally, interpersonal therapy is used to treat major or
low-grade depression, but doesn’t necessarily fall into any particular category. Instead, Binder says, it focuses on a patient’s relationships and looks
for patterns across different interactions to identify maladaptive behaviors. “The idea is not that you’re focusing on what’s going on inside
your head – although that’s implicit – but really what’s going on between you
and other people that is causing problems,” he says. By improving the way you
relate to others, you’ll help treat your depression. Dialectical
behavioral therapy and cognitive behavioral therapy also incorporate
interpersonal skills training.
Therapy sessions can be delivered in more than one way, Tanney
says. While therapy is often one-on-one, therapists can meet with
couples, groups and families. Group therapy, for instance, makes sense if you want
to be surrounded by like-minded, empathetic individuals experiencing similar
struggles. It can also help patients understand how others view their actions
or behaviors. “It’s great for character issues – things we do that are maybe
offensive to others, and we don’t even know it,” she says. And couples and
family therapy can help facilitate communication between family systems that
are dealing with disruptive problems, relationship issues or emotional
barriers. Treatment can last for six months to a year, or longer.
Additionally, some psychologists practice in an “eclectic way,” Binder says. This refers to therapists who apply a combination
of therapeutic approaches with the recognition that a patient might need a more
individualized, tailored type of treatment.
However, Binder says, you should choose a therapist based first
and foremost on how good he or she is – no matter which types of therapy they’re
trained in. “Therapy is
essentially a particular kind of relationship between two people,” he says.
“One of them has certain knowledge and skills, but it boils down to how well
the two people click and how good the therapist is in applying whatever techniques
he or she has.”