I'd like to start seeing a therapist. How do I go about choosing someone? I'm a little nervous to tell all my secrets to a stranger.
Finding the right therapist is a bit like dating — with a few exceptions, as you can imagine.
I'm not recommending skipping from therapy couch to couch until you find the perfect match. But unless the professional sitting before you gives you the willies, I would suggest giving him or her at least three visits to see if your comfort level increases. But even comfort can be a tricky thing; if your new therapist reminds you of the mother you hate, it could be a good match -- she might help you access and work through the thoughts and feelings about your mother that always trip you up in relationships.
What happens in the room between client and therapist is often a reflection of what happens outside the room between clients and their significant relationships. Consequently, a good healing relationship with a therapist can be a powerful thing. But I'm getting ahead of myself.
Here are some basic considerations:
1. Make sure the therapist has the appropriate mental health license, which varies from state to state. This includes Licensed Clinical Social Worker (LICSW in Massachusetts), Licensed Marriage and Family Therapist (LMFT) or Licensed Professional Counselor (LPC). He or she might have a Ph.D. or PsyD in Psychology.
2. While it's generally not a good idea to see the same therapist as a relative (unless it's a family therapist), it helps to get referrals from trustworthy sources such as friends, colleagues or organizations that train therapists. If you want to use your insurance, there are also several online sites (e.g. Psychology Today) that match you with therapists who take your insurance.
3. Inquire about treatment approaches and specializations. Most therapists can treat depression, anxiety, self-esteem or relationship issues. But if you need help with a cocaine addiction, go to a treatment center or find someone who is a credentialed alcoholism and substance abuse counselor. If you have obsessive-compulsive disorder, make sure your therapist has experience treating OCD. A little research can go a long way.
Your secret’s safe
Now, about your other concern: Telling your secrets to a stranger can be quite liberating, especially when that stranger is a trained professional who is legally obligated to keep them. Seasoned therapists are rarely flustered by what they hear. Often privy to both the darkest and brightest corners of the human heart, we recognize that people are dynamic, multi-faceted creatures who wear many masks. We take confidentiality very seriously, but there are a few exceptions:
With written consent, we can share specific information with medical professionals, insurance companies and anyone else you designate.
We are legally required to report suspected cases of child physical and sexual abuse, past and present (the past is required in case the abuser still has access to children).
We are legally required to report serious potential threats to harming yourself or another person, especially if you have a plan and/or a weapon.
We can seek consultation from other mental health professionals, who are also legally obligated to keep this info confidential. In such cases, the therapist will keep your identity anonymous.
And here’s a secret about therapists: We have problems too. If anything, being aware of our humanity makes us all the more compassionate.