Ask Beatty: Buyer Beware, Is Your Therapist Helpful or Harmful?

More and more people of all ages and stages in life and from every socioeconomic background are seeing therapists for a variety of reasons including: depression, anxiety, loneliness, bipolar disorder, substance abuse of various kinds, sexual abuse, family estrangement and relationship and sexual problems. Choosing the right therapist is literally one of the most important decisions anyone can make in their life.  The choice has the potential for far-reaching consequences – both positive and negative.

We’re continually bombarded by advertisers and “influencers” on television, radio, print and social media platforms, proclaiming that their products and services are the ‘best’.   Consumers are frequently making decisions- relying more and more on how many followers, ”likes” and “stars”  a product or service might have. This includes everything from lipsticks to physicians. I frankly was shocked to discover how many sites there are that tell you exactly where you can BUY instagram followers, “likes” and 5 star reviews.

In the current mental health and wellness space, we have never before seen as many love coaches, life coaches, wellness experts and therapists of various kinds- many with questionable credentials- if any.

So how does a consumer go about finding a bonafide psychotherapist with the necessary degrees and clinical experience who can take them on a safe, evidence-based clinical journey?

The following are some suggestions to help you find a therapist that is right for you:

Get a referral from someone you trust – your family doctor is a good person to begin your search. Don’t be taken in by splashy ads, television appearances or ‘likes’. And remember that your best friend’s therapist may not be the best therapist for you.

Make sure that the therapist you choose has considerable clinical experience and specializes in your particular problem(s).  It’s not possible to be an expert in everything.

Ask yourself whether you would prefer working with a woman or a man.

Check your potential therapist’s  license and make sure that there are no past or pending malpractice complaints filed against him/her.

Expect that your therapist will ask you a lot of tough questions about your family background, relationship history, sex life, possible sexual abuse, sexual assault, previous psychiatric issues, addictions, affairs, any hospitalizations, suicide attempts, thoughts or gestures (past and present) and medications that you take (prescription and over- the- counter), including psychedelics. Be honest. It’s also very important to make sure that your current symptoms are not related to aphysical problem or medication that you may be taking.  So don’t hesitate to have a complete physical.

Ask yourself after the first few sessions whether you’re comfortable with your therapist.  Don’t expect a strong level of comfort instantly. Like any relationship, it takes time for trust and comfort to develop. However, if you continue to feel uncomfortable after several sessions, remember that there are other therapists with whom you would be able to have a better connection. Exit respectfully and give yourself permission talk about your decision and reasons why you feel that it’s not a good fit.

Remember that there should never be any inappropriate advances – sexual, verbal or physical — at anytime- under any circumstances, during the course of therapy.

Sessions should last a minimum of 50 minutes — ideally 60 minutes. I find that longer sessions work even better, particularly in the beginning.  My own patients find that 2-hour or even longer sessions help to achieve faster results.

After a couple of sessions, your therapist should be able to tell you your diagnosis, including a detailed treatment plan. I believe that anything less than weekly sessions, (at least in the beginning), will not give you the best possible momentum to achieve success in your therapy.

If money is a problem, try and negotiate your fee with your therapist or even suggest a payment plan. Don’t be afraid to ask for what you want, based on what you can afford.

You should ask your therapist whether your spouse, parents, siblings or children will need to participate in your therapy. Clearly, if you are having relationship difficulties, it is essential (assuming that you feel safe), that your significant other and family members participate at some point.  Some therapists only deal with the individual patient and will refer you to a couple’s or family therapist if needed.

Ongoing evaluation is necessary in order to determine how well your therapy is going.  Expect that at times you will feel considerable pain, since effective therapy helps you take an honest, hard, long look at yourself and your life (past and present), including the kinds of choices you’ve made.  This process enables people to free themselves from their demons so that they can finally begin to live the life that they deserve — a life that is genuinely in their best interest.

The question of medication often comes up.  Although no one likes to take medicine, there are certain clinical situations that absolutely require a combination of psychotherapy and medication. Please don’t beat yourself up if you have found that exercise, massage, acupuncture, energy healing, yoga, meditation, vitamins, and healthy eating have not helped to alleviate your symptoms.  Brain chemistry is very  complex, so let the experts do their jobs.  And if you do need to go on mediation, find a skilled psychiatrist who specializes in psychopharmacology who will work with you to ensure that you are on the right medication and correct dose for the right period of time.

Successful therapy depends not only on your therapist’s expertise, but also on how much time, work and energy you are prepared to put into your therapy.

Finally, remember to spend at least as much time (ideally much more), researching your therapist as you would in deciding which car, computer or cellphone to buy.

Beatty Cohan, M.S.W., L.C.S.W., A.A.S.E.C.T. is a nationally recognized psychotherapist, sex therapist, author of For Better for Worse Forever:  Discover the Path to Lasting Love, columnist, national speaker, national radio and television expert guest and host of the weekly ASK BEATTY SHOW on the Progressive Radio Network.  She has a private practice in New York City and East Hampton.  Beatty would love to hear from you.  You can email your questions and comments to BeattyCohan.msw@gmail.com. For more information go to BeattyCohan.com.