- Why people seek therapy
- Where therapists work
- How to get referred to a therapist
- How to pick a therapist
- The difference between a therapist and a psychiatrist
Divorce, along with the death of a spouse, can represent one of the most emotionally and psychologically challenging events in one’s life. Like the death of a spouse, divorce usually affects numerous aspects of life simultaneously, including finances, parenting, social life, career, where one lives, and more. While enduring the stress associated with such changes, divorcing individuals must also cope with the emotional pain associated with the loss of a spouse and any lingering feelings about an unsuccessful marriage.
However, many recently divorced people do not receive the same level of sympathy and support as widows or widowers, who may be perceived as victims in need of help (Jacobson, 1983). Even if a recently divorced person feels supported by friends and family, he or she may still find that a degree of emotional and psychological help is desired beyond that which friends or family members can provide. This may be especially true during the first two years after a divorce, which are usually the most difficult. (Hetherington, 2001). When this is the case a capable therapist can help facilitate the healing process and personal change.
It is natural when starting therapy, especially for the first time, to experience some uncomfortable feelings. There are a lot of unknowns about the person who is about to be brought in to your personal world. Feeling some ambivalence is to be expected. Given that, how does one find and pick a qualified mental health professional?
First, it’s important to decide where to seek help. Therapists work in a variety of settings that can accommodate a range of financial situations. They primarily include:
– Community-based mental health clinics. Many cities and counties run mental health clinics available only to residents. Such clinics typically offer low-fee therapy and counseling services to un-insured residents or those experiencing financial limitations. These clinics may employ students in graduate school programs in order to keep fees lower. These clinics can be found by contacting your city or county department of public health.
– Health Maintenance Organizations. Many HMOs have therapists on staff and available to members. Services are typically short-term and limited in scope. HMOs will not usually provide coverage for therapy services outside of their network.
– Private (or group) practices. Many therapists maintain a private practice or work as part of a larger private group practice and are not affiliated with a hospital or HMO. Hourly fees are usually higher with private practitioners, but most do offer a sliding scale to address individuals’ unique financial situations. Some private practitioners will accept or bill insurance plans while others require that individuals pay for services.
The process of being referred to a therapist varies depending on where services are rendered.
– Community-based mental health clinics. People typically call the clinic and tell them that they are seeking psychotherapy. Clinics usually schedule an intake interview that may be conducted on the phone or, more frequently, in person. During this interview general questions will be asked about why the person is seeking services and fees (if applicable) may be discussed. After the initial interview the person is usually assigned to a therapist who then contacts them to begin services.
– Health Maintenance Organizations. Follow the same procedure your HMO requires for seeking services from a specialist. Contacting one’s primary care physician and requesting a referral for mental health services (of “behavioral health services”) is usually an effective way to proceed with a HMO. Your HMO’s website may offer additional information on seeking psychotherapy.
– Private (group) practice. Perhaps the best way to get referred to an effective private practitioner is to ask friends or relatives for a recommendation. If a more anonymous route is preferred, national professional associations can usually refer individuals to qualified therapists in a particular geographic area. Some large metropolitan areas will have local professional associations capable of making referrals, as well. Health insurance companies that cover mental health services will also have a list of approved mental health providers in a given geographic area. To ensure there are no surprises down the road, it is always a good idea to ask an insurance company how many sessions they will cover and up to what dollar amount. Searching on the Internet is also becoming an increasingly efficient way to find a therapist.
Whatever setting a therapist is seen in, there are certain questions that can be helpful to keep in mind when choosing a therapist.
- Ask if they are licensed. States only grant licenses to clinicians who meet certain educational and training standards, along with passing a set of rigorous examinations. Make sure your therapist is licensed, or working under the formal supervision of a licensed clinician if he or she is an intern or resident.
- Ask about their related training and experience. Therapists have different areas of expertise and levels of training. Make sure you are working with a therapist who is comfortable helping with a life transition like divorce. If the clinician is newer to the field you may want to ask if they receive supervision from a more seasoned clinician.
- Ask the therapist about his or her theoretical orientation and how they work with clients. Clinicians will vary in theoretical orientation, or what they believe is usually the source of an individual’s problems. For example, some therapists might believe that problems in the present usually stem from events in individuals’ past, while others might believe that problems arise from unhealthy patterns of behavior or thinking. What a therapist believes will have a strong impact on the goals of the therapy and how directive the therapist will be during the sessions.
- Ask if the clinician has ever had a disciplinary action taken against him or her. Just as you would want to know if a surgeon that was treating you has been successfully sued for malpractice, you should check to see if a therapist has had any legal or ethics rulings against him or her for negligent or harmful treatment.
- Ask if they belong to a professional association. While not an infallible way of assessing one’s skill as a therapist, most good therapists will be members of local or national professional associations.
It might also be helpful to keep the following guidelines in mind when selecting a therapist.
- Make sure you like, and feel you can trust, the clinician. If you do not like the clinician, or feel you can not trust him or her, see a different therapist. Therapy is intended to be a meaningful and personal endeavor that requires a strong sense of trust and safety between client and therapist.
- Get a second opinion. A therapist should provide you with an initial clinical impression, state whether or not he or she feels that they can help you, and how they plan to treat you. If you don’t like something you are hearing or do not feel comfortable with the therapist, see another therapist, just as you would with any other type of health care provider.
- Be clear about fees. Make sure you understand the clinician’s fees, how they accept payment, whether or not they have a sliding scale based on financial resources if needed, and their policy for missed appointments. Clarify any psychotherapy benefits with your health insurance company prior to starting therapy if you plan on seeking coverage. It is also a good idea to clarify if the therapist will bill insurance directly or if you will need to pay up-front and seek reimbursement from the insurance company. Be wary of poorly defined fee policies.
Therapists, including psychologists, MFTs, MFCCs, and clinical social workers, are trained to provide psychotherapy, though each field provides different amounts and types of training. They do not have medical degrees or prescribe medication. In contrast, psychiatrists have medical degrees and are primarily trained to prescribe medication and usually are not trained to provide psychotherapy. The two professions complement each other and a good therapist should be able to help you determine if consulting with a psychiatrist may be beneficial.