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Psychotherapy 101
Choosing a Therapist

By Nancy Schimelpfening, About.com

Updated June 11, 2009

About.com Health's Disease and Condition content is reviewed by the Medical Review Board

Psychotherapy can be a time-consuming, expensive process. You don't want to waste money and effort on a therapist who won't help you achieve results. The following tips will help you select a therapist who best meets your needs.

Find Someone You Are Comfortable With

Although the therapy relationship is not a friendship, you will still get the best results if you trust your therapist and feel comfortable with him or her. You should feel able to open up and be honest with your therapist. If you withhold information, you cheat yourself out of making real progress. Just like with any relationship, you and your therapist may not "click". If not, you owe it to yourself to seek another therapist.

Psychiatrist, Therapist, Counselor or Social Worker?

Three important factors that will influence your choice are:

  • Is your depression situational, a result of biochemical imbalance or a side-effect of another illness?

  • How severe is your depression?

  • How are your finances?

The interplay of these three factors makes it difficult to offer hard and fast rules for selecting a treatment provider, but you may use the following as a guideline:

  • Short-term counseling is generally cheaper and may be the best choice for situational depression. Counselors help you work to resolve the specific situation which is troubling you.

  • It is wise to see your family doctor for a medical checkup to rule out illnesses which may create the symptoms of depression as well as any medications you may be taking that have depression as a side-effect.

  • If your depression is severe, consider seeing a psychiatrist first for medication. You will make more progress with your therapy if your moods are stabilized. In addition, psychiatrists do possess the training to administer therapy. While many psychiatrists prefer to handle only medication matters and refer their patients to another professional for therapy, it is possible you can get one-stop-stopping. It's worth checking into.

  • A combination of psychotherapy and medication is generally the most effective treatment if you can afford it.

  • Choose professionals with the highest level of training that you can afford. Psychiatrists and psychologists being preferred. Clinical social workers would be your next best alternative, especially if they have several years experience.

  • Avoid obtaining treatment from your family doctor (other than the initial physical) unless there is no other alternative available. They cannot offer you therapy nor do they have adequate knowledge about how to prescribe and fine-tune psychiatric medications. You may get lucky and do well on the first medication they prescribe, but you may also waste valuable time if you do not respond.

  • Take whatever help you can afford. Although it may not be the best fit, some help is better than none at all.

What Are the Minimum Qualifications to Look For?

Look for at least a Masters degree. A therapist should be licensed in the state in which he or she practices. Avoid counselors who have little or no formal training. If in doubt, ask about the therapist's credentials. An ethical therapist should have no problem providing you with the requested information.

Where Can I Find a Recommendation for a Therapist?

The best sources for recommendations are trusted friends. Alternatively, ask your family doctor or psychiatrist--if you have one--for recommendations of colleagues. There are also several databases on the Internet, such as About.com's UCompareHealthCare, which provide listings. Many patients have reported good success by simply choosing a name from the phone directory. Be aware that your insurance provider may limit who you may see.

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