On Choosing a Therapist

Some of the most confusing parts of choosing a therapist is decoding the jumble of letters after their name and assessing the significance of their chosen approaches. How do you know if you need an LMHC, Psy D, LCSW or an LPC? And whether it matters if they’re CDAC, SA or EMDR certified? Or whether their treatment approach is ACT, EFT, CBT or psychodynamic? Deciding to find help is a big enough hurdle to surmount; trying to decide which one of these anonymous faces with their alphabet soup qualifications might be best able to help you can be too much.

So let’s start with the most important part of selecting a therapist – once you’ve decided that their fees or insurance plans have ruled them into the running (I’ll post a glossary of credentials and certifications later this week). Here’s the good news: you don’t have to know very much about treatment approaches, certifications or even specialties. If they’re licensed – and your therapist should be licensed – it doesn’t much matter whether they’re a doctor of clinical psychology (Psy D) or a licensed clinical social worker (LCSW) or a licensed professional counselor (LPC). All of them receive basically the same training in practicing psychotherapy. There’s no Jedi level secrets being held from one that are disclosed to another. While there are some credentials that may be more relevant to you (MFT’s specialize in marriage and family counseling, some specialize in pastoral counseling, etc), all of them are trained to offer a basic level of mental health care to diverse populations. So don’t worry too much about which credentials your therapist carries.

What about certifications? Depending on why you’re going to see a therapist it may be helpful to know whether they have received training in a particular area – such as certified drug and addiction counselors (CDAC), specialists in sex addiction (SA) or those trained to offer eye movement desensitization and reprocessing (a technique used to relieve emotional distress) – but even in these areas, a massive degree of help is available even in counselors who don’t have specialized certifications. The reason for that is that the training required for practicing psychotherapy covers fundamental aspects of relieving mental distress, establishing goals and changing behavior. So while it’s helpful to have specialization, the basic training all therapists have means it’s nowhere near required in order to be genuinely helpful.

Well, then – what about theoretical approach? Interestingly, whether they are committed to psychodynamics (about bringing unconscious thoughts into awareness to avoid re-enacting a past wounding), Cognitive Behavioral Theory (focusing on how unproductive thinking leads to overwhelming feelings and stuck patterns of behaving) or Acceptance and Commitment Theory (emotional regulation through learning mindful release from mental struggles) or any other approach – all of these have been empirically proven to be equally effective in dealing with most mental health issues. Therapists select theories largely based on what works for them, not for any purely objective reason. What matters more than whether YOU know which approach they’re using is that THEY believe in it. So you’re in no danger of selecting the wrong theory for your issues.

With all that in mind, how do you choose a therapist? By choosing one. I am aware that the answer is irritating. But by far the most important factor in whether they will be helpful to you is relational fit – and you can’t determine that until you book an appointment with one. Personal recommendations from people you trust generally are a much better guide than randomly spinning the wheel online. I know it’s daunting. But the benefits of therapy are just big enough to make it worth the ordeal.

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