The process of finding a therapist can be daunting. Whether you are considering therapy or you are merely curious to learn more about its nature, this post will discuss important factors to consider when searching for a therapist. There are hundreds of therapists out there, each specializing in a wide variety of different approaches.
Oftentimes, the reasons behind the desire to consult a therapist can already take up a considerable amount of a person’s mental and emotional resources; This makes navigating the internet, and scrolling through countless therapist profiles a challenging and sometimes confusing feat. The process may also be isolating, since sharing an interest to get therapy with others is still a source of embarrassment and anxiety to many people due to the intrinsic taboos and misconceptions surrounding mental health issues.
So, how does one decide which therapist to go to? What's the difference between the various approaches?
Almost obvious influential factors may include your insurance's coverage, the therapist's gender, their sexual orientation (many times not disclosed), cultural background, race, age, their location in relationship to you, and of course, whether or not they have an available time slot that matches with your schedule. There is something to be said about each of these important factors and how they can influence the nature of your relationship with your therapist. However, it is highly likely that honoring your preferences regarding these factors will increase the chances that your alliance with your therapist will be strong.
Aside from the economic and socio-cultural factors mentioned before, there is one crucial aspect that will significantly change the quality, quantity and the nature of your work in therapy: the therapist's theoretical approach.
As mentioned before, during your search for a therapist you will encounter many labels therapists use in their personal statements in an effort to communicate their approach to potential new clients. Among many others, keywords include Cognitive-Behavioral Therapy (CBT), Psychodynamic Therapy, Dialectic-Behavioral Therapy (DBT), Psychoanalysis, Person-Centered Therapy, Existential Therapy, Reality Therapy, Acceptance and Commitment Therapy (ACT), Gestalt Therapy, Creative Arts Therapy, Solution Focused Brief Therapy (SFBT), Rational Emotive Behavioral Therapy (REBT), Integrative Therapy, etc.
The approach a therapist uses is usually a result of their specific training, their experience, and the nature of the problem that brings the client in. The reason there is such a diverse plethora of approaches stems from the complex nature of the field of psychology and the juxtaposition of the different philosophical schools of thought that inform each theoretical approach. Unfortunately for most people, public knowledge regarding what distinguishes these approaches is limited and often shrouded in stereotypes and misinformation. Many approaches have been developed to help people with specific mental health issues and thus have a more narrow focus and application.
Let's review some of the most prevalent approaches. Be aware that the following explanations are merely overviews. Refer to original sources if you wish to learn more.
Cognitive-Behavioral Therapy: This type of therapy focuses on helping people change unhealthy thought processes that lead to maladaptive behaviors and emotions. The term is often used as an umbrella term to describe all the orientations that focus on the thought-behavior relationship. All CBT therapies postulate that our cognitions (the way we think impacts the way we behave and vice versa). REBT, ACT, MBCT and SFBT are all considered cognitive behavioral therapies.
Rational Emotive Behavioral Therapy: This approach focuses on helping people examine, evaluate and change dysfunctional beliefs/attitudes that lead to dysfunctional behaviors and emotions. This type of therapy is directive and didactic meaning that the therapist's goal is to teach you how to be your own therapist. It is short term and present focused. You will be assigned homework assignments in between sessions. The ultimate goal of this therapy is to help you achieve unconditional self-and-other acceptance.
Solution Focused Brief Therapy: Present and future oriented, the focus of this therapy is to help clients build solutions and help them reach their goals through the use strategies that use their current resources without spending too much time addressing their symptoms. You will spend less time talking about your feelings and more time talking about how you would like things to look in your life and what you can do to make it happen.
Acceptance Commitment Based Therapy: Rather than focusing on challenging and evaluating the nature or usefulness of thoughts, through incorporating mindfulness and other cognitive strategies, this type of therapy aims to help people accept and make space for the negative feelings they experience while encouraging value-congruent behaviors that lead to self preservation.
Dialectic Behavioral Therapy: this type of cognitive behavioral therapy focuses on teaching clients emotional regulation skills, impulse control and the incorporation of healthy coping skills to avoid undesired reactions.
Psychoanalysis: This term refers to the set of theories set by Freud and his successors which constitute the oldest form of talk therapy. The main goal of this approach is to increase the client's insight by bringing the unconscious thoughts and motivations into conscious awareness. This treatment tends to be long term and past oriented. It also places a strong emphasis on analyzing the therapist-client relationship.
Psychodynamic: this treatment approach is often understood as a less intense version of traditional Freudian psychoanalysis. It operates within the same theories and also focuses on uncovering unconscious material through similar techniques as psychoanalysis. It also tends to be more past oriented and long term.
Creative Arts Therapy: in this experiential type of therapy, Music, drama, dance and art (depending on your therapist specialty) become the medium by which the therapist will help you gain insight, process, share and experience your thoughts and emotions.
Gestalt Therapy: This experiential type of therapy usually involves role playing to help the client deal with and process unresolved emotional content of relationships. The focus is present oriented and meant to bring out intense emotional experiences in sessions.
Person-centered: The most essential aspect of this theory developed by Carl Rogers is the empathic attitudes and unconditionally supportive character the therapist assumes while working with the client. The therapist assumes a passive stance, offers no interpretations and does not provide feedback or advice, but facilitates the person’s self-discovery process.
Integrative: An integrative approach strives to use the most useful aspects of different orientations and combines them in a dynamic way to meet the individual case of each client.
Existential: Not specifically a treatment approach, but rather a philosophy within therapy, the term existential usually refers to the present oriented focus of the therapy process and the emphasis on helping the client’s search for meaning and the exploration of existential implications of death, isolation, meaninglessness and freedom.
A special mention for Evidence-Based Practice: any health related practice or practitioner that identifies as using evidence based practices is essentially letting you know that they use treatment orientations that have been shown to be effective through extensive research. It also means that they strive to keep up to date with new developments and insights from the field and have current knowledge of what interventions have the most effective results for a specific problem. This is relevant for you to know as a consumer since it means that practitioners who adhere to an evidence based practice will acknowledged the limitations of their approaches when treating certain conditions and will either implement a more effective approach, or will refer you to more appropriate clinically indicated services.
Your therapist's personality and its compatibility with yours will also play a big role in the development of a good alliance. This is important to think about, especially if you happened to have a bad experience with a therapist in the past. Many clients unfamiliar with the diversity of approaches within the field, fall into the trap of generalizing their experience with one therapist or with one approach, to all therapy.
The search for a therapist can therefore call for trial and error. Despite the challenges that go along with it, searching for a therapist marks the beginning of the process of change towards improvement. The self-preserving nature of acting on the desire to get help, is in itself the first step to break the chain of patterns you seek to improve. The second step is to make an appointment and show up. The third step will depend on how you work with your therapist. Good luck. Real change can happen!