Navigating healthcare

By Diane L. Marolla, LICSW

What should I look for in a therapist?

“Discovering the truth about ourselves is a lifetime’s work, but it’s worth the effort.” – Fred Rogers

Because I am a licensed mental health clinician, I am often asked by others in need of a therapist either for themselves or a family member for referrals. Before I make the referral, I always ask questions as to what the situation is so I can get a sense of what type of therapist is needed. For example, I would ask if the therapy is needed for a child, teenager or adult. I also ask what is going on with the individual. Are they depressed? Are they anxious? Did they suffer a loss of some kind? Does the person have a problem with drugs or alcohol? Once I have a sense of what type of counseling is needed, I will give names of practices and/or individual counselors who I think would be able to provide the services that are needed.

In addition to being asked for referrals, I am also asked what someone should look for in a therapist. Here are my go to tips and suggestions for individuals who are looking for a therapist for either themselves or a loved one.

Ensure that the individual has the proper licensure to provide services. In Rhode Island, this is either a Psychiatrist, a Psychologist, a Nurse Practitioner, or a licensed master’s level clinician (LICSW, LMFT, LMHC). Depending on the licensure, a chemical dependency professional may not need an advanced degree to hold that licensure and be able to practice in Rhode Island. Chemical dependency professionals specialize in treating substance abuse.
Most professionals have a website that give an overview of the practice, what services they provide, and biographies on each health professional at the practice. Review the credentials of the individual. Where did they go to school? What do they specialize in?
It is reasonable to call an office and ask to speak with the therapist first before scheduling the actual appointment. Most therapists are happy to speak with someone with questions they may have before they are ready to book and appointment. (Please keep in mind, that the therapist does not know you, therefore, they can answer general questions, and cannot provide a long, detailed discussion with you on the phone.)
Once you have scheduled an appointment, the office may ask you to fill out forms prior to coming to the office. It is important to fill out the forms ahead of time, otherwise, you spend your appointment time filling out forms. Be honest with the answers you give on all the questions asked on the forms.
Before you schedule an appointment, always ensure that the therapist takes your insurance. Also, be sure you understand what your co-pay will be for each visit.
When you arrive for your appointment, what is the environment of the office? Is it professional?
On your first visit with a counselor, they will be spending an hour with you. During that hour, the counselor is completing an assessment with you, therefore, they will be asking you lots of questions. Be honest in answering all the questions. Follow up sessions typically are 45 minutes.
On your first visit, you should be getting a sense of the therapist. Do you feel comfortable talking with them? Are they giving you their undivided attention?
During your first session, I feel it is important for the therapist to take time an explain their approach to treatment so that the individual knows what to expect. When I sit with a client for the first time, I always tell them who I am, what my approach is, what my personality is like, and what to expect in the therapy process.
Remember that a therapist is a tool for you. In order for counseling to work you have to be engaged in the treatment process, show up for appointments on time, and do the work that is necessary to help bring change. For example, if you are seeing a therapist for anger management issues, your therapist will work with you in using interventions that will assist you in controlling your anger. If you don’t put into practice any of the techniques discussed with you during therapy, your anger issues will continue to be a problem for you.
Your counselor is not your friend. Your counselor is a professional who is trained to provide services to their clients to empower and support them to improve their overall health and wellbeing. Licensed counselors also have a Code of Ethics which prohibit dual relationships ( A dual relationship is having any type of relationship with the client beyond a professional, therapeutic relationship. An example of this might be, you are an Accountant, and you see a therapist for counseling, and then the counselor starts using you to do their taxes.)
Whereas on line reviews can be helpful, I would caution against using them a source of truth regarding a therapist.
Review the RI Department of Health’s website and see if any complaints have been filed against the therapist you are seeing.