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Mental Health — Choosing a Therapist

Introduction

Choosing a mental health therapist who is right for you is an important first step in getting counseling. In order to do this, you need some basic information on mental health services, and ways of choosing a good therapist for you.

Note: This topic was prepared to help you find reliable health resources on the web. This site is not responsible for the information on other sites. The information here — and on all websites — is not meant to take the place of care by a health professional.

Getting Started

Most people pick a counselor the same way they would choose a lottery ticket — they put their money down and hope for a good one. But getting counseling is both a big financial commitment and an important step toward a better future. So don't leave it to luck — shop around for a counselor as if you were buying a car.

Sports Car or Sport Utility?

Just as you might spend a lot of time choosing between a sport utility vehicle and a flashy red sports car, you should also carefully think about which kind of mental health provider best fits your needs. In general, your options include professional counselors, clinical social workers, marriage and family therapists, psychologists and psychiatrists. Clinical social workers and marriage and family therapists do counseling, and marriage and family therapists specialize in working with couples and families. They also work with individuals. Psychologists can often do psychological testing as well as counseling. Psychiatrists are medical doctors and are the only mental health providers able to write prescriptions for medicines like antidepressants. Very few psychiatrists do counseling, so it is good to work with both a counselor and a psychiatrist if you choose to try medications. Most counselors are trained to work with a wide range of issues, but you may want to find a counselor who has special interest and experience working with your issue. For example, if you think you may be having panic attacks, it would be best to find a therapist who has a lot of experience working with panic attacks.

Quality and Performance

How do you keep from getting a "lemon" when buying a car? You learn as much about the vehicle as you can. The same goes when choosing a counselor. There are many things to look for to find a good counselor. Even though counselors in Colorado do not need to be licensed, having a license does show that the counselor has passed a test of clinical knowledge and has been counseling for at least a year. Counselors without a license should meet regularly with a licensed counselor for supervision and guidance. The number of years that a therapist has been counseling can be one measure of skill. However, there may be benefits to choosing a newer counselor or even a supervised intern who is up to date on new techniques and who may offer a large degree of enthusiasm at a smaller price.

Financing

While counseling doesn't cost as much as that shiny new car, cost is still important when deciding whether to get counseling. If you have health insurance, review your plan to find out:

  • Which mental health services will they pay for? (For example, some plans may pay for individual counseling but not for couples counseling.)
  • How many sessions will they pay for in a year?
  • How much will you have to pay up front before your insurance will begin to pay (deductible)?
  • How much do you have to pay each session (co-pay)?
  • Are you limited to a certain list of providers, or can you see anyone?

If you don't have health insurance, there are still ways for you to afford counseling. Many counselors offer lower fees based on income. Therapy groups are often less expensive than individual counseling. If you have Medicaid, you can go to Touchstone Health Partners, 525 W. Oak St., for counseling. Touchstone can also serve others with severe, long-term mental illness. If you have a very low income, the Pro Bono Mental Health program — available through Mental Health Connections, (970) 221-5551 — offers relief. Pro bono therapists and psychiatrists offer fees as low as $8 per session. Connections can also help you find therapists who take your insurance, or who can reduce their fees.

The Test Drive

Once you've narrowed it down to two or three counselors, it's time to take them for a "test drive." As strange as it sounds, this can be the most important step to make sure there is a good match between you and your counselor. One way to do this is to call two or three counselors to ask questions about their experience and how they might work with you. Some counselors even offer free or low-cost first sessions. Some ideas for questions to ask are given below.

Questions to Ask a Counselor

Here are some questions that may be useful to ask when choosing a therapist:

  • What can I expect from you, and what do you expect from me, in counseling?
  • What are your qualifications? Include these questions: How long have you practiced counseling? What is your degree in? Are you licensed in your field? Do you receive regular supervision, or do you have other therapists who you can go to for ideas?
  • How will you work with my specific problems/issues? Are these approaches known to work with my issue(s)?
  • How long is your average client with similar issues to mine in therapy? How long will it take me to feel better or notice things getting better? What will I notice to tell me that I am getting better? Are there any risks to me during therapy?
  • Are there other types of treatments for my problem? What are the benefits, risks and differences between these treatments?
  • Who decides when therapy is done? What is that decision based on?
  • Are you more "goal-oriented," or do you tend to leave therapy "open-ended?"
  • Do you tend to take charge of the counseling session, or do you prefer to let the client take the lead more?
  • Do you tend to focus on what is happening in the present or on what has happened in the past?
  • What should I do if I am not feeling that therapy is helping me?
  • Can you tell me about how you will keep my information private?
  • Can you tell me about your fees and payment expectations?

Keeping Your Hands on the Wheel

Once you've "driven out of the lot" with your new counselor, it is important to keep your hands on the wheel — your counseling is for you, and you should be a part of choosing what direction you are going in. Make sure that your counselor involves you in choosing your counseling goals and the length of counseling. If at any time you do not feel there is a good match between you and your counselor, or that counseling isn't helping you, talk to your counselor about your concerns. Tell him or her what you want, or what you don't want. Always remember that you have the right to shop around, ask questions, be part of all decisions, and even end your counseling at any time if it doesn't meet your needs.

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