So You Realize You Need Therapy; Now What?
Given the myriad therapies and disparate therapists there are to choose from, it can be daunting to decide which way to turn for psychological help. For simplicity's sake we can divide the vast sea of treatment types into five major divisions, namely: Psychoanalysis and Psychodynamic Psychotherapy, Behavior Therapy, Cognitive Therapy, Humanistic Therapy, and Integrative or Holistic Therapy. All these treatment modalities have helped some patients some of the time, and none have helped all patients all of the time.
As a consumer of psychotherapy there are two crucial questions to ask at this point. The first is how would you describe the nature of your difficulty? How you answer this question is telling, because it reveals your initial way of framing the problem and suggests certain treatment types over others. This is what psychotherapists call the presenting problem. Do you conceptualize your struggles as behavioral, emotional, existential, cognitive, psychoanalytic, sexual, spiritual, family-focused, couple-focused? How you answer this question will help you decide what type of treatment seems the best fit. For example, if you are focused on your symptoms, such as having trouble concentrating, often feeling scattered, and avoiding planning for things, some type of cognitive or behavioral treatment that teaches you how best to learn and employ executive functioning skills could be an appropriate choice. On the other hand, if you are curious about your psychology, often feel out of sorts, have difficulties maintaining romantic relationships and a family history of trauma, and want to explore how your early life experiences have impacted your current relational difficulties, then some form of psychoanalytic work would be a reasonable option.
Once you have decided on the type of therapy that you think is best for you, the next question is who do you want to work with? It is a good idea to interview several clinicians before you decide on one. Good clinicians are not robots, and just because they identify within the same theoretical school, i.e., psychoanalytic, cognitive, behavioral, etc., they are all individual people with their own styles, aesthetics, strengths, and weaknesses. Questions to consider include: How does it feel to be with this person? Is this person responsive to me? Does this person answer my questions in ways I can understand? What is the office like? Does it feel comfortable to be there?
A note about fees. Typically, the more senior the clinician, the less likely they will take insurance and the more expensive they will be. There are, however, exceptions. Chief among them are training institutes representing all the major schools, which can be found in all major cities, and which offer drastically reduced fees. It is usually the case that the candidates in these institutes are already seasoned clinicians who seek specialty training. So, if finances are a concern, that means once you decide on the type of psychotherapy you are interested in, you are likely to find an experienced and affordable therapist for yourself at one of these places.
You’ve gotten over the initial hurdle of acknowledging your need to talk to a professional. Now all you must do is to decide on the type of conversation you think will be most helpful and with whom you want to have it.
