How To Choose A Psychotherapist

How To Choose a Psychotherapist

 

By Jerry Gelbart, M.D., F.A.P.A.

Psychiatrist

 

Most people I talk to have no idea where to start looking when they want a good therapist. Many therapists can be amiable, supportive, encouraging, but in 2013 we need to expect more than that. We now have therapies such as Dialectical Behavioral Therapy (DBT), Cognitive Behavioral Therapy, (CBT), Acceptance and Commitment Therapy (ACT), and others that have been shown to be effective in scientific studies, and many therapists are not up to date with these. For example, many therapists still use older models such as Jungian, Analysis, or Supportive therapies that have not proven to be cost-effective in getting the job done.

 

Here are 7 things to look for if you’re choosing a therapist:

 

1. Therapist sets tangible goals with you. Goal setting:

 

a. Gets you, therapist, and other members of treatment team (i.e. Psychiatrist, Primary Care MD) all focused in same direction

 

b. Helps you see if you’re making progress.

 

c. Goals help you move forward instead of looking back.

 

2. Therapist is open minded to various treatments, including nutritional, medications, Eastern approaches, group therapy, hospital outpatient or inpatient. “Whatever works.”

 

Not defensive, willing to consult with others or send you to someone else if not a good match.

 

3. Therapist is engaged and engaging, versus passive, remote, disinterested.

 

4. Therapist is not just supportive, listening, reflecting (I call this HHT, “Hand Holding Therapy”).

 

5. Therapist can say what kind of therapy they are doing.

 

The models mentioned above are not the only effective therapies, but are a few examples based on learning new skills, and changing behaviors and thinking. They mostly stay out of the past and intellectualizing about “why” you are the way you are. Instead they are focused on being in the present, getting rid of judgments and taking more control over your life.

 

6. Therapist gives homework. Homework:

 

a. Keeps you thinking and working between sessions.

b. Helps with continuity.

c. Consider therapist sessions as mostly teaching while the lab/application is in the real world between sessions.

 

7. Therapist is willing to confront you with things you may not want to hear in ways you can hear it.

 

Plusses:

1. Coping skills training.

     Especially teaching Emotion Regulation Skills (managing anxiety, anger, rejection, shame and guilt).

2. Mindfulness-based.

     Mindfulness teaches you how to be in the present and disengage from judgments.

3. Biological, Psychological, Social, and Spiritual perspective.

     Focuses on body, mind, relationships, and existential issues. 

 

Remember that no one thing makes us healthy and well. Health and Wellness require a multi-pronged approach involving self-examination, reprioritizing values, and behavior change.

 

Jerry H. Gelbart, M.D.

 

Synergies in Treatment

A series of articles written by Dr. Gelbart for the Northern California Psychiatric Society Newsletter. These articles are a bit more “technical” than others on this blog, but they can help anyone interested in how mindfulness, positive psychology, Wellness approach, and skills training can help with self-esteem, anxiety, depression, motivation, and other difficulties. It may help you in choosing a therapist, and/or bring up questions for discussion with your therapist or friends.

  1. Introduction
  2. Judgmental Thinking
  3. Mindfulness and Psychiatric Treatment
  4. Teaching The Patient To Swim
  5. Focusting On The Positive
  6. Changing The Shoulds To Wants
  7. Mindfulness Psychotherapy And The Brain
  8. Which Tool When

Synergies #2: Judgmental Thinking

Is ‘Judgmentalness’ A Symptom?

A reality of our society is that most people don’t “complete” psychodynamic psychotherapy to resolutions of their childhood conflicts. Most often this is for cost reasons, and/or as people feel better they often fade from the psychological treatment, too often falling back on longer-term medications or relapses when perhaps psychological resolution would have been realistic.

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Synergies In Treatment: For Psychiatrists, Therapists, and Everyone

SYNERGIES IN TREATMENT #1

What is Emotional Wellness? Just as the concept of physical wellness doesn’t necessarily mean that exercising and healthy nutrition will get rid of your diabetes or hypertension (although it sometimes will) an emotional wellness program won’t necessarily cure someone’s mood disorder.  Such a program might however help prevent someone from getting depressed in the first place, or keep them from relapsing once their episode is treated.

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