It can be difficult to decide if and when psychotherapy would be helpful. A general guideline that we recommend is called the “interference rule.” That is, if a problem is significantly interfering in your ability to live your life in the way you’d like, then psychotherapy may be helpful.
Deciding to seek help is a big first step. From there, it’s important to find the right therapist because you’re more likely to find success in therapy if you and your therapist are well matched. The best therapist for you is the one who has the appropriate training and expertise to treat the issues you want to work on.
Considering the Therapist’s Expertise
Below are common reasons why people seek therapy and some things to consider while deciding if a specific therapist might be a good fit for your needs.
Issues in a Romantic Relationship
If you’re struggling with a romantic relationship, it’s helpful to see a therapist who is qualified to offer couples therapy. Even if you’re not initially interested in couples therapy, it may be useful to have this option available down the road. Therapists with this type of expertise are comfortable helping their clients navigate difficult relationships, resolve conflict, and improve couples’ communication. This expertise helps them work effectively with people in relationships, not just couples.
Issues Related to Trauma or PTSD
For issues stemming from very difficult or even life-threatening experiences—like a car accident, an assault/rape, or a terrorist attack—you may want to find a therapist who is qualified to use cognitive behavioral therapy (CBT). In clinical research trials, CBT that includes “prolonged exposure” has been shown to be effective in overcoming these types of difficulties.
Issues Related to Depression
There are several types of psychotherapy that can be helpful in treating depression. Three of the most effective approaches are interpersonal therapy (IPT), cognitive behavioral therapy (CBT), and behavioral activation (BA). This nationwide listing is a fantastic resource that offers information about qualified therapists who are competent in one of these areas.
Issues Related to Anxiety, Panic Attacks, or Phobias
Cognitive behavioral therapists are the best equipped to treat clients struggling with anxiety, panic attacks, or phobias. The Association for Cognitive and Behavioral Therapies makes finding a professional near you very simple through its “Find a CBT Therapist” directory.
Issues Related to Perfectionism, Obsessions, Compulsions, Germaphobia, etc.
For difficulties with perfectionism, obsessions, compulsively-repeated behaviors, “germophobia” or contamination fears, it is important to seek out a therapist with training in exposure and response prevention, which is a type of cognitive behavioral therapy. The International OCD Foundation is a good resource for this and offers a nationwide therapist directory.
Issues Related to Overuse of Alcohol or Drugs
If you’re struggling with possible addiction issues, it’s not necessary to find a therapist with a personal history of addiction, although some people find this helpful. Depending on the nature of the difficulty, one of the following types of therapy might be useful: motivational interviewing, behavior therapy, or dialectical behavior therapy. If your difficulties are more severe it is wise to seek out a therapist with significant experience helping those struggling with substance use.
Issues Related to Disordered Eating
For people who have concerns about their eating habits—including anorexia, bulimia, binge eating, and an unhealthy preoccupation with “healthful” eating (known as “orthorexia”)—contacting an eating disorder treatment center can be a great place to start your search for a therapist. Even if it’s not near your geographical location, places like the Renfrew Center can refer you to a local provider with the relevant expertise you’re seeking.
Considering the Therapist’s Training
There are many types of therapists and the numerous letters after their names can be confusing. The type of training that the therapist receives influences how they approach therapy. It’s also important to be aware that some types of therapists receive significantly more training in therapy than others, which may also be important to consider.
There are no hard and fast rules regarding which degree creates the most effective therapists. (Learn more here.) Picking the therapist with the right training for you is the most important piece of this puzzle.
Below are some things to consider when making this decision.
Licensed Mental Health Counselors (LMHCs), Licensed Creative Art Therapists (LCATs), and Marriage and Family Therapists (MFTs) have typically received a master’s degree in counseling, which usually takes about two years to complete.
Social workers have completed about two years of graduate training to attain their degrees. Licensed Clinical Social Workers (LCSWs) have also completed at least three years of clinical training after getting their Master’s in Social Work (MSW), but this is not a requirement for Licensed Master Social Workers (LMSWs).
Psychiatrists are medical doctors (MDs). They are the only group of mental health professionals who are permitted to prescribe medication, which may or may not be necessary for you. Usually, psychiatrists have completed four years of medical school and a 3-4 year residency in psychiatry. Some psychiatrists only provide medication management with periodic meetings that can vary in frequency. Other psychiatrists also provide weekly therapy (although this is less common).
Nurse practitioners (NPs) and advance practice nurse practitioners (APRNs) also prescribe medications, and psychiatric nurse practitioners are specifically trained to prescribe mental health medications. They sometimes offer psychotherapy as well. Nurse practitioners go through a rigorous training program that typically includes a masters degree and one to two years of training beyond being a registered nurse (RN). They sometimes, but not always, will hold a Ph.D. or DNP (doctor of nurse practice) degree.
Psychologists (PsyDs and PhDs) typically complete a doctoral training of 5-7 years. In the state of New York, psychologists must also complete one additional year of training before becoming licensed. In my opinion, of the various mental health professionals described here, psychologists are the most likely to have extensive training in a specialized therapy for a specific problem or disorder.
When picking a therapist, it’s critical to be sure that you and the therapist are well matched.
Research on psychotherapy has consistently shown that the better your relationship is with your therapist, and the more you feel that you two are on the same page, the more effective the therapy will be. It is important that your therapist understands what you want to get from therapy, and that the two of you agree on how to accomplish those goals.
If you leave your first therapy session with serious concerns about your compatibility, consider trying out another therapist. Despite the additional time and money that will be involved, finding the right therapist for you will be well worth your while.