Choosing the right therapist can be a daunting task. The title of therapist comprises licensed clinical social workers (LCSW), marriage and family therapists (MFT), licensed professional counselors (LPC) and psychologists (Ph.D.). Psychiatrists, who hold a medical degree in addition to specialized psychiatric training, are not generally referred to as therapists. However, therapists from any of the disciplines may have earned a Ph.D. and hold the title of doctor.
Here are some important questions to ask a prospective therapist. Therapists are usually required by law to offer you a printed document that lists the answers to these questions and more:
1. Are You Licensed or Otherwise Credentialed?
In the U.S., all states have their own licensing requirements for mental health practitioners, so ask your therapist what license he or she holds. Substance abuse counselors often have additional state credentials to verify their qualifications to work with alcohol and drug abuse.
You may find individuals providing psycho-therapeutic services without a state license, such as hypnotherapists. In that case, inquire about the person’s professional credentials. In general, most medical insurance plans will not cover non-licensed practitioners.
2. What Are Your Areas of Practice?
Mental health professionals focus their practice on areas where they are trained with appropriate education and experience. For example, because anorexia can be a life-threatening condition, practitioners in that field must possess specialized knowledge of eating disorders. A therapist without that specialized knowledge will refer you to someone with the appropriate training. Working with families, couples, children and trans-gender individuals also requires specialized expertise.
3. What Are Your Fees and How Do You Handle Insurance?
Many therapists operate on a fee sliding scale, but some do not. If the therapist accepts your health insurance, the insurance company will dictate the number of sessions and your copay for each session. If you chose to self pay without going through your insurance company, you may be able to negotiate a discounted fee. It’s important for consumers to know that when seeking reimbursement from medical insurance, therapists are required to make a diagnosis of the client’s mental health condition. That diagnosis then determines the number of sessions the insurance company will reimburse.
4. What Is Your Theoretical Orientation?
This question requires therapists to explain their views on the best methods for therapy. For example, a therapist may say that she uses cognitive-behavioral therapy, which seeks to uncover and challenge your thoughts. A psychodynamic therapist will look to your past experience. Reality therapists focus on what you are doing here and now to alleviate or complicate your situation. It is the therapist’s responsibility to clearly define his or her working frame of reference, and if you don’t understand the answer, ask again. Many therapists operate from a combination of theoretical orientations, and some will change their focus depending on the client or the client population.
5. How Do You Structure Therapy and How Do You Think You Can Help?
Notice that you’re not asking if your therapist can help, you’re asking how. The answer should give a detailed explanation of how often you will meet, either individually, in a group setting or both. The therapist may wish to see you alone or with family members. You may get homework assignments which you are expected to complete between sessions. You may be videotaped having an argument with your spouse. Perhaps you will have two long sessions to start, involving extensive information gathering, then move to the standard 50-minute therapy sessions. Therapists may structure their work differently, but as health care professionals, they are dedicated to helping patients achieve defined goals.