Quick summary: To find a therapist listen to your gut… just like most things in life your intuition tends to be correct… if it feels like a therapist can be helpful to you… then they probably will be. The research has found that the therapeutic relationship is the most important component to successful therapeutic outcomes… in short, if you don’t like, trust, or feel empathized for by your therapist then the therapy is not likely to be effective. Also it is theoretical adaptability and not rigidity which has been correlated with successful therapists – this means that researchers such as Scott Miller (http://www.scottdmiller.com/) have found that successful therapists are those who adapt the therapy to the specific needs of the clients instead of doing things the same way for every client for their entire career (this is why experience doesn’t always effect outcome… many people in all fields do the same less effective thing for their whole career as they resist change or adaptation) .
We therapists can overwhelm people with information about our practices – our schooling, our theoretical orientation, our experience etc…
The truth is that we must do this market our businesses in the society that we live in… the larger truth is that none of that stuff really makes too much of a difference – basically all the main theories have been proven successful and time in the field and time in academia have not been shown to have a significant effect on outcome.
In my opinion a therapist is there too help you with your specific needs and to do so it is not necessary to sell you a theory… the right therapist for you will offer compassion and empathy while allowing their therapy to adapt to your specific needs.
It can be very difficult when you set out to find the right therapist… much of this difficulty comes from the fact that it was never really explained to the public what all the letters and the psycho- jargon means that fills up the descriptions of therapists.
- In my experience almost no one in the general public seems to know the difference between a social worker, a psychotherapist, a marriage and family therapist, a life coach, a psychologist and a psychiatrist.
- Even fewer people would be expected to know the difference between CBT, DBT, person centered, solution focused, strategic or structural therapy etc.
So how do you find a therapist without earning an advanced education in psycho-babble?
- Technique only accounts for around 8% of outcome (so all that CBT, DBT stuff really doesn’t matter too much… this is because mostly all techniques work if you have a positive therapeutic relationship with your therapist). This doesn’t mean that techniques don’t do anything… it means that most techniques are effective… different strokes for different folks.
- The credentials of a therapist only makes a difference in very specific instances – if you simply need support in overcoming a challenge… if you are looking for what could be called ‘typical’ therapy then anyone who offers psychotherapy can help you (so you do not have to worry about what the difference is between a PsyD, LPC, LSW, MA etc).
- The therapeutic relationship has been found to be the most important variable when researchers measure what impacts successful psychotherapeutic outcomes…
What about the Letters – MA, PHD, PsyD, MS, LCSW, etc… what do they mean? My next blog will cover the difference between all these credentials in more depth… in short…
- Psychiatrists can prescribe meds… they are the only medical doctors (they went to med school).
- Psychologists are licensed to conduct more assessments (like the Rorschach inkblot test). They typically have more education in research, college level teaching, and statistics.
- All Masters level therapist have an education in conducting psychotherapy (the only ones that all have this education)… but specialties are not always implied in their degrees (they could be a forensic therapist, a school counselor, a couples counselor etc).
- Most Social Workers have an education in conducting psychotherapy and social workers are generally very knowledgeable about community resources.
- A Marriage and Family therapist ideally has an advanced education in conducting therapy with more than one person in the room (this is a different skill set as you need to make all the clients feel safe, understood, and accommodated… this can require more structure to ensure clients don’t simply verbally attack each other). Unfortunately in certain states every therapist is labeled a marriage and family therapist despite their education.
- I wish I could make this easier for you, but the truth is that aside from what I wrote above, there is not a great way of figuring out exactly what a person’s credentials mean… A social worker could have ten years experience in a psychiatric hospital and therefore now more about diagnosable conditions than any one else… a psychiatrist could have attended every seminar about couples counseling for the last ten years… a psychologist could have studied meditation for twenty years etc… in short, the letters are unfortunately not that helpful.
What about specializations can I tell that from the letters? in short no.
- If you want to know about a therapist’s specialty call them up and ask… generally they will be happy to explain how they can help you or they will refer you to someone who would be a better fit.
If I get referred is it because of me? – No.
- It is a therapist’s responsibility to refer clients to the therapist that would be most helpful to the client.
- Examples: if a therapist is going through a divorce they will likely refer a new client with marriage issues to another therapist, if a therapist’s brother just died of cancer they would likely refer a client who is going through the same thing, certain conditions such as anorexia can require an advanced specialization – a degree alone is not always sufficient for all presenting concerns.
- If a therapist believes they lack specialization or if they worry that their own life issues might bias the therapy – they will refer.
- A therapist could also simply be full… some therapist like to maintain ratios in there practice (ex: 30% couples, 70% individuals)
To put it simply, for therapy to be helpful… it is most important that you:
- Trust your therapist
- Believe that your therapist sincerely wants to help
- Feel accepted by your therapist
- Feel compassion and empathy from your therapist
- Feel that your therapist puts your needs 1st while in session (and not their own needs such as a need to prove a theory or a need to be liked or any other need related to their own “stuff”)
- Feel that your therapist knows what she/ or he is doing
- Believe or have hope that your therapist can help you (sometimes hope takes a few sessions… part of the therapist’s job is to increase your hopefulness).
Though Research has shown that therapeutic relationships are the most important factor to successful therapeutic outcomes it can still be very difficult to buy the validity of such a statement.
Why? Why would empathy, trust and acceptance matter more than technique?
1.) You are not broken and you never were… within a supportive and nurturing environment everyone has the natural ability to reach his or her potential and to hold happiness.
2.) Humans are social animals (this has now been anthropologically, neurologically, and biologically substantiated) – We need supportive human relationships to be at our best… in today’s society we have neglected our relationships a bit… many psychological disturbances are the result of feeling detached from social support…
- Within a supportive context you can get your needs met and overcome the symptoms that arise from feeling that no one understands, empathizes, accepts, or holds compassion for you…. it is a biological necessity that we receive these things.