The Tricky Task of Finding a Therapist

Finding a therapist is not always easy.  There are so many choices and it can be confusing.  I wrote this column for Snap Milton (www.snapmilton.com), to try to address some of the issues and give clear information.  Enjoy.

Dear Susan,

I’ve been thinking about going to counselling for a long time and I started to do some research.  I’m feeling very confused and overwhelmed with the amount of information I’m getting.  There are so many different names for things and types of therapists.  Some people are covered by insurance and some are not.  Where do I start?

B.C.

Dear B.C.

Starting is definitely one of the hardest parts.  First, I’ll address your question about who does it and coverage:

People Who Practice Therapy

  • Psychiatrists- M.D. Specialists (OHIP Covered)
  • Family Practitioners-M.D. with an interest in counselling (OHIP Covered)
  • Psychologists-Ph.D. in Psychology and Registered with the College of Psychologists (Benefits at work)
  • Social Workers-M.S.W. and Registered with the College of Social Workers (Some work benefit plans)
  • Masters in Counselling-M.A., M.Ed. (Work benefit plans if supervised by a Registered Psychologist)
  • Masters in Divinity-M.Div. (Work benefit plan if supervised by a Registered Psychologist)
  • Occupational Therapists (Work benefit plane if supervised by a Registered Psychologist)
  • Lay People with private training (Covered in rare circumstances if there is a general paramedical fund with no registration requirement)

Regulation of all people who practice psychotherapy (who are not otherwise regulated by a college) is coming soon.  Ask your therapist if he or she will be joining the College of Psychotherapists and Mental Health Counsellors.

By far the majority of service provided in the community is done by Master’s level (M.A., M.Ed., M.S.W.) therapists.

Your question about approach is a harder one to answer.   You must first understand if you want help with a very discreet and narrow issue or a broader and more long standing problem.  In general, the more specific you are about what you want to do, the shorter and more focussed therapy can be.  However, chronic depression, long-standing self-esteem issues and childhood trauma are not usually amenable to short term approaches.

Some generally accepted short term approaches are:

  • Cognitive Behavioural Therapy (CBT)-this one is very popular with the medical community and the insurance industry
  • Solution Focussed Brief Therapy-usually a three session focus
  • Interpersonal Therapy (IPT)-looks at the impact of immediate significant relationships
  • Psychoeducational approach-where a therapist will educate the client on a condition or behaviour

Some popular long term approaches are:

  • Psychodynamic psychotherapy-considers the unconscious as a driving force for present day behaviour and experience
  • Relational psychotherapy-focuses on the matrix of relationships and how they form the sense of self, often has a psychodynamic component (unlike IPT above)
  • Humanist-Existential psychotherapy-considers and explores the potential of the client to make meaning in life within the given talents and restrictions of each individual
  • Transpersonal therapy-considers the place and role of the client within their lives and also the broader universe, incorporates lots of metaphor and spirituality
  • By no means is this list comprehensive. 

The single most important thing you can look for when assessing a potential therapist is whether or not you feel you can grow a sense of trust and confidence with that person.  Without that, no amount of technique will save the relationship or the effectiveness of the process.   It’s important for a therapist to share or at least really understand your value system.  Ask the hard questions right up front.  You can ask for a ½ hour interview free of charge.  A therapist who refuses to have an initial interview without payment is not ethical.  It may be in person or over the phone.  Go with your gut and make the decision that feels right for you.

Good luck on the healing journey.

Susan