Shrink Shopping

“I need therapy.”

As a psychologist, I understand how hard those words are to say, whether you’re confiding in a friend or whispering to yourself in bed. When someone says them, they’ve realized that there’s a problem they can’t fix or face alone. It’s a moment of enlightenment, desperation or both. Deciding that you need therapy is difficult step, but the next one can be even harder: finding the right therapist.

The relationship between therapist and client is special and sacred. My clients tell me private, powerful things they share with few others. The right therapist will provide insight and guidance. The wrong therapist will waste your time at best and traumatize you at worst.

That’s why I think it’s important to do your homework and prepare to practice a little patience as you wade into the sea of mental health professionals. Let’s start with their training. Though there are dozens of professional monikers for shrinks, these are the big four: Marriage and Family Therapists (MFTs), Licensed Clinical Social Workers (LCSWs), Psychologists, and Psychiatrists. Most MFTs have a master’s degree focused on marriage and relationships. LCSWs will have a bachelor’s or a master’s, depending on the state you live in. Their training emphasizes broader social problems, such as hardships brought on by poverty, disability, and crime. Psychologists receive doctorates in a wide range of psychological issues with less emphasis on couples and families. Psychiatrists are medical doctors who prescribe psychotropic medication, such as antidepressants. A few psychiatrists also perform psychotherapy, but they’re a dying breed. All four categories above include therapists who are brilliant and therapists who couldn’t help you tie your shoes. Thus, you can’t pick a therapist just by looking at the letters behind his her or name.

Therapists also practice from a variety of theoretical models. They understand human behavior and address problems in different ways. Three schools currently dominate psychology:

1) Cognitive-behavioral. Let’s say you cannot keep a romantic relationship alive for more than six months. A cognitive behavioral therapist will help you figure out what’s wrong with your thinking, such having incorrect assumptions or irrational fears. Once these have been determined, your therapist will help you develop strategies for changing your thinking and behavior. You won’t be talking much about your mother.