Cross-Cultural House

Choosing a Psychotherapist

Naomi Himmelfarb,
PhD, Veterans Administration West Los Angeles Health Care Center

All of us experience painful feelings at one time or another. Sadness, hopelessness, anxiety, and distress are examples of natural feelings that arise in the course of living. It is normal, for instance, to feel grief when a parent dies. Most students feel anxious before taking exams. In some cases, however, these feelings can begin to overwhelm you, making it hard for you to function normally on a day-to-day basis. If you are crying more than usual, having trouble sleeping or eating, if you are drinking or using drugs excessively, fighting a lot with your spouse or children, having trouble controlling your temper or getting along with other people, then you should seriously consider seeing a therapist.

It can be valuable to see a therapist if you are having more chronic problems too. While most people experience intense emotional reactions during times of particular stress, others find that they have ongoing problems adjusting to life, even when they are not in periods of extreme tension. They may have patterns of bad relationships, trouble holding onto jobs, and habitual difficulty getting along with others. Psychotherapy can be helpful for people with problems like these.

There are also specific warning signs that should alert you to the need for professional attention. If you are hearing disturbing voices of people who aren't present, seeing things that aren't there, feeling terrorized because you believe people are plotting against you, having periods of extreme highs and lows, then evaluation and intervention by a mental health professional would be helpful. In these cases, medication is likely to be an important part of the treatment in addition to psychotherapy.

What is psychotherapy?
The most common type, individual psychotherapy, consists of a single client meeting with a single therapist. Couples, family, and group therapies are also practiced. The term psychotherapist can refer to professionals from several different disciplines: psychiatrists, psychologists, or social workers. They all have training that allows them to help people work on and resolve emotional problems, primarily through talking about them.

What qualities should I look for in a psychotherapist?
Once you have decided that you would like to begin psychotherapy, you should consult with a few different therapists before selecting one. You will find that therapists vary a great deal in their approaches to problems and in their personal styles.

Good chemistry
Good chemistry between patients and their therapists is extremely important. Feeling comfortable talking to your therapist is necessary because to get help, you must share private thoughts and feelings. Therefore, you should look for a therapist who listens closely to what you tell him or her and who responds openly and non-defensively. It is part of a therapist's job to evaluate how well the therapy is working for you, so any concerns or questions you have about how your therapy is progressing should be open for discussion. If you feel that your therapist is not being responsive, point that out. One sign of a good therapeutic relationship is evidence that a therapist is able to adapt to the unique concerns of different patients. If the therapist cannot do this, you may want to consider whether he or she is the right one for you.

An explanation of the process When choosing a therapist, look for someone who has the ability to articulate how he or she approaches the therapy process. This would include an explanation of how change occurs and how the two of you will work together to bring change about. If you don't understand the process by which your therapist works, it will be more difficult for you to use the therapy effectively.

Ethical standards
Another important characteristic to look for in a therapist is high standards for ethical and professional behavior. Generally speaking, psychotherapists who behave professionally keep their personal issues and problems out of the therapy. They avoid dual relationships with their patients, which means that they have only one kind of relationship with the patient--the therapeutic one. They do not have patients who are also students, employees, or personal friends, because having other kinds of relationships with patients interferes with the therapist's ability to remain objective.

Ethical therapists start and end sessions on time and scrupulously maintain confidentiality. They give patients clear information about office policies, fees, and what they can expect from therapy. They are up-front and above-board about their rationale and motivations and respond openly to any concerns their patients have. This kind of behavior is essential to having trusting relationships with patients. Without it, psychotherapy cannot be successful.

Conclusion
Psychotherapists can help clients deal with stressful changes in their lives. They also treat more long-term, chronic difficulties of adjustment to life. A good match between you and a psychotherapist is important. Consult with several therapists before selecting one, and choose one with whom you feel comfortable. Look for a psychotherapist who has high ethical standards, who is open, and who is able to express in an understandable way how he or she approaches the therapeutic process. Investing time in finding a therapist you're comfortable with is likely to pay off for you by yielding the best possible results.