Monday, November 7, 2016

How To Pick A Therapist

People frequently message me to ask for recommendations for counselors in STL, or to ask me how to find a therapist in general. I don't mind this at all, but I often don't have anyone to refer to since I don't do a lot of networking in this area. I just kind of do my own thing, and most of my clients are either word of mouth referrals or they pick me from an internet search. I frequently refer to my friend Ryan Thomas Neace's practice, because I genuinely think he's good and hires good people. 
But I'm going to just tell all of you at the same time, being perfectly honest: it's hard to find a good therapist who's the right fit for you. You have to be prepared to shop around, and to move on from a therapist who isn't a good fit, without getting discouraged. I myself have tried five different ones in the past five years, and none of them were a good fit for me (which could be more about me than them, I'll admit) BUT more importantly, I really didn't think any of them were particularly good insofar as none of them really challenged me or gave me *new* stuff to think about. 
That said, I can give you some tips that might help you find a counselor that is a good fit for you. 
First things first, DO NOT JUST PICK SOMEONE WHO TAKES YOUR INSURANCE. I understand the desire to use medical insurance, and even the need for it. I'm not saying don't use your insurance! I'm just saying don't make this THE deciding factor. Here are a few things to consider:
a) when you use your insurance, you have to get a medically reimbursable diagnosis. So if you don't have some significant MH issue, you'll at the very least get a diagnosis of an adjustment disorder, which your insurance may or may not pay for. Having a diagnosis on your health records isn't as big of a deal in the age of the ACA since you can't be denied coverage due to preexisting conditions, but you'll probably still want to be aware that you're getting a diagnosis, and some therapists may not explicitly state this.
b) If you have a deductible to meet, you'll be paying the same amount out of pocket that you'd pay either way, until you meet your deductible. So if you're not going to meet it, it makes no difference whether your therapist bills your insurance or you pay them directly and bypass insurance.
c) Lots of really, really good therapists don't take insurance, (myself included), for these and many other reasons, so you are seriously limiting your options by only looking at therapists who do. Just saying. I get it if you actually can't afford therapy without your insurance, but don't ASSUME you can't. At least check to see if a therapist you like who doesn't take insurance may have a sliding fee scale, for example. Many of us do! Some therapists offer out-of-network reimbursement, too, so you may be able to recoup part of your fees. 
Next, in terms of how to pick a counselor, the easiest thing to do is to use the Psychology Today search engine (or just google it, or use some other search engine) and look at A LOT of profiles. You can sort by all kinds of criteria. Save the ones you want to come back to in an ongoing list. Look at all of their websites in depth. If they have blogs, read them. Try to get to know them that way and to get a sense of what their style is. 
Along those lines: trust your intuition. If someone's page "feels" good to you, or you think they look nice or kind or something nebulous like that, trust that. I get that you may be afraid you're deciding something *so important* based on something that's intangible and irrational, but honestly you have to like the way your therapist's face looks. They have to feel good to you. I know this sounds shallow, but I don't mean they have to be attractive, I just mean you have to find their face pleasant to look at. You have to like their vibe. You have to LIKE THEM. You're going to be telling this person all of your innermost thoughts & feelings, so feeling safe and comfortable and "liking" them is crucial. 
This is actually really important because the therapeutic relationship is the most important factor in healing. What this means is that the connection between you and your therapist is a HUGELY significant part of ***what makes you get better***. A counselor can have all the technical skills and education in the world, but if they don't deeply connect as a human being with their clients, all of that education is basically useless. (Side note: this is why I share more with my clients than most therapists would approve of, and why they "know" me in a way that isn't consistent with "traditional" therapy models. I think it's important for my clients to feel connected with me, and I have to basically fall in love with them in oder to be able to work well with them. It's that human connection that makes it work.) 
So all that said, I'm still happy to field your questions about who you should go to. But I'll often refer you to these suggestions as a place to start. Feel free to share this post with friends who may be looking for a provider. 
TL;DR: Do research. Trust your gut.

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