Wednesday, March 27, 2013

Meeting Your Match: Finding the Right Therapist

I recently had a potential client come in to a session to "interview" me for the job of his therapist. This wasn't the first time I've been vetted for that position, but the occurence is realtively rare, as colleagues I questioned confirmed. It lead me to questioning "Why don't more people interview potential counselors before signing on as a client?" Certainly, most providers in the field would welcome these encounters--as helping professionals, our priority is the client's optimum care. If that care can be better provided by another counselor, we are happy to facilitate that connection. After all, it's all about what the client needs. And, like any relationship, the therapist/client connection works best when there is an atmosphere of comfort, the ability to build trust, and a shared vision of what the client is looking for. If you are considering pursuing counseling (or even changing therapists) here are some things to consider:

1. Insurance limitations. The recommendation you got from your neighbor or the suggestion from your doctor may end up being the perfect fit, save one tiny detail: the counselor doesn't accept your insurance. If using your insurance benefits is important to you (as it is to most folks!) check out your insurance company's website to see if the counselor is listed as an approved provider. Or better yet, as those websites are notoriously inaccurate and out-of-date, call the counselor and ask him yourself. We understand potential clients' desire to utilize their insurance benefits. We will let you know if we take your insurance so you can either set up an interview appointment or move on to the next name on your list.

2. Compatability. Consider what you are looking for in a therapist. Do you need someone who will be direct and blunt, who will push you to make needed changes in your life? Or are you looking for a supportive presence, someone who will provide reassurance, a safe sounding board, and nurturing to help you decide what life path is best for you? Maybe you have no idea what would work best for you. In that case, think about other professionals you've worked with, whether they be your physician, your dentist, even your accountant. Some people benfitted from their mechanic taking the time to walk them through the car repairs, even providing diagrams of the problem and solution. Perhaps they would prefer a counselor who is willing to explain theories, map out treatment goals and benchmarks for meeting them, and suggest books or videos that could be helpful to the treatment process. Perhaps you've enjoyed your phsyician's willingness to take extra time during vists, when needed, and listened thoughtfully and empathically to your physical complaints before partnering with you to create a solution. You might match best with a clinician who is nurturing, supportive and willing to build a long-term relationship with clients, versus having a short-term, behavioral approach to dealing with life issues. Whatever your preference, you are most likely to get your therapy needs met from someone who makes you feel comfortable and understood.

3. Constraints. Find out the therapist's hours, availability by phone or during a crisis, accessibility of her office, and modes for paying fees. While your cousin may rave about her counselor, if the worker's office hours are only during the evening, and you work at those times; or if you know you may need support by phone between visits, and the counselor has rules against regular phone contact, the fit won't work for your needs. Similarly, make sure the counselor works in modalities that you require: some therapists provide individual, couples and family therapy, while others specialize in only one type of treatment. Some therapists take credit cards for payment, others only checks or cash. Find out if the therapist bills the insurance directly, or if it will be up to you to get reimbursed by your insurer.

4. Licensure and experience. Counselors are used to being asked about their credentials, since our licensure often determines our eligibility for insurance reimbursement. Be sure that the counselor's license is accepted by your insurance carrier before you get started. Similarly, ask the therapist directly about her experience and comfort with working with people with your presenting concerns. Our goal is for you to get your needs met--if we aren't experienced with the issues you're confronting, we usually know someone who is.

5. Approach to collaboration. Will the counselor work together with your primary care physician or psychiatrist to ensure a holistic approach to your wellness goals? You may wish for your therapist to have contact with your family members; be sure that approach fits with the counselor's orientation. And ask about their relationships with other professionals in the field. It's helpful if your counselor has a network of trusted referrals if you need an evaluation for medication or are looking for a group therapy experience to augment your work with your counselor.

6. Trust your gut. While it's admirable that some clients are willing to give the therapy relationship a few sessions to determine if they feel comfortable with the counselor, it's my personal bias thar most clients know by the end of the first session if the fit will be productive. Your time is valuable; if you question whether the counselor can truly understand your issues or empathize with your feelings, feel confident in choosing to move on to the next referral on your list. You deserve the best care, and counselor's are committed to helping you get it, whether that's in our offices or the collague's down the hall.

Tuesday, March 5, 2013

The Learning Curve

Physical challenges can lead to psychological discomfort and stress, and we can all benefit from learning new ways to cope with these stressors and improve our self-care. I've recently been learning these universal lessons myself. After struggling with symptoms that were vague and inconsistent for the last 6 months, I finally motivated myself to get some answers from my doctor. My doctor's response was "It could be lots of things", and thus my journey to multiple specialists and a myriad of tests began. The process of obtaining a diagnosis can be as taxing as physical symptoms themselves. With every inconclusive result and every head-scratching response from a doctor, my frustration grew. As did my self-doubt. "Are these symptoms (fatigue, lightheadedness, numbness in my hands and feet, lack of coordination) rally that serious? Could they be in my mind, or a side effect from medication, or even anxiety? Is finding an answer really worth taking all this time off work, managing this growing medical debt?" As a therapist, I'm forever touting the importance of self-care to my clients, and here I was, feeling unsure and undecided about the steps I was taking in my own life. I'm aware that pain, illness and disease can cost us just as dearly in the realm of our mental health. Stress, fear and anxiety about the future and our abilities, depression due to loss of functioning--all these realities must now be dealt with alongside the physical ailments. No wonder we sometimes (or for many people, USUALLY) disregard our physical pain and suffering: it's just too overwhelming to deal with. But I'm a big believer in lessons from the universe, and I think our physical selves are a ripe classroom for those teachings. Besides re-learning the importance of self-care, my recent forays into the world of MRIs, EKGs, EMGs and Holter monitors has humbled me to an even more basic issue: remembering my own value. Having the tools to adequately care for ourselves, and knowing which to use when, can only work if we first VALUE what our Selves are experiencing and feeling. It's so easy for me to push aside my physical discomfort, the twinges and aches, because I've bought into our culture's unspoken mandate to put others first, to "stop your bellyaching" and get done what needs to be done. Valuing myself was easiest, I found, when evereything else--and everyone else-- was taken care of. But when my self-care began to come at the cost of my responsibilities and the needs of people around me, I was sorely tested. But that, in my philosophy, is exactly how the Universe lays out it's challenges. We don't learn by pulling back to burrow in the comfort of what we know; we learn by stretching to embrace a reality that is just slightly beyond our comfort zone currently. I've felt, at times, selfish, histrionic and even attention-seeking as I've slogged through appointments and procedures and needle jabs. But the discomfort of these experiences has been part of my learning landscape. I can't just take care of myself, VALUE myself, when it's convenient for my job, my family, my dog. True self-care means valuing my Self when it's most difficult, when I think others will roll their eyes or dismiss my symptoms as simply the downhill roll of aging. And regardless of the diagnosis (or lack thereof) or the treatment plan signed off on by my team of doctors, the most useful "pill" I can take right now is to keep my Self and my needs at the center of my perspective. Because I believe if I don't, the Universe will provide yet another variation of this challenge. And dammit, the dog needs to be walked, and the kitchen needs to be cleaned, and my billing needs to get mailed...alas, it appears I am still on the learning curve.