Therapy Shopping

Are you in the market for a psychotherapist? Jimmy Owen encourages you to empower yourself by selecting someone who will be a good fit for you.

Imagine walking into an unfamiliar office and sitting in a strange room for the first time. As you look around, you notice a box of tissues, a license hanging on the wall, some innocuous art and a shelf of books. You are probably sitting in a comfortable chair or on a couch, and you might get a sense of being in a living room, but you know it’s an office.

This stranger introduces him/herself to you, and you begin talking—sharing the most intimate thoughts and feelings in your head. You talk in a way that feels out of the ordinary and awkward, yet comforting and safe. Then, when the time is over, you hand money to this person and schedule a time to do this all again. And hopefully, by talking to this stranger, you feel better than when you walked in the door.

This ritual happens every hour, every day, all over the world when a client comes to their first appointment with a psychotherapist. It is a process which demands blind trust, an implicit reliance that this stranger has your best interests at heart, along with the professional education and specialized training to help you begin your emotional healing.

Even after over 20 years of working as a private practice psychotherapist, I am still in awe when a new client walks into my office. I feel privileged and honored to be handed their trust, to watch their process unfold as they share joys, pains, secrets. Sometimes the process flows easily and a synchronicity exists; other times it starts slowly and moves into a beautiful alliance. And occasionally it just isn’t a good fit.

What can you do to maximize the selection process in this day and age, as you go about looking for a therapist? What measures might you take as you begin looking for a clinician? Where do you look? As an LGBT person, are there additional considerations to factor in? And how do insurance and managed care affect your selection process?

The most important thing to remember is you are a consumer and you are buying a service. You are in charge. Be proactive.

Don’t know where to look? Start with your friends and colleagues. Because therapy is such a personal event, if they’ve had a positive experience, they’ll probably be happy to give you a referral. They may also give you names to avoid. Remember that what works for one person may not work for another. Look in the local LGBT media; call local LGBT support services. Go online and look for professionals who utilize the web. This is probably the most efficient way of gaining valuable information about potential clinicians. Today, half of my referrals come from my website.

When making the initial call for an appointment, ask questions. Find out about the therapist’s experience and credentialing. Are they licensed? Do they have a governing board by which there is accountability for their service? What are their fees, their hours? Are they comfortable working with LGBT clients? What kind of practical experience do they have working with LGBT people? Do they have any personal value conflicts regarding LGBT issues that could keep you from receiving the best treatment possible? As a therapist, it is my ethical and legal obligation to refer clients whom I am not equipped to counsel or with whom I have a conflict of interest. By asking these questions upfront, you can weed out clinicians who are not appropriate.

If you want a self-identified LGBT practitioner, don’t be afraid to ask. The clinician may decline to give you an answer—and that is their right. It is also your right as a consumer to keep looking. There are many allied professionals who offer a very positive and beneficial therapeutic experience, but if you want to work with an LGBT therapist, you can make it happen.

During the initial phone conversation, notice how it feels to talk with your potential therapist. If someone else does their scheduling, ask to speak directly with the clinician. Can you sense a rapport? Is she/he taking the time to answer your questions? Do you feel comfortable talking to her/him? Does he/she seem to feel comfortable talking to you?

Regardless of style or therapeutic orientation, I believe a primary factor for a successful experience in therapy is safety. When you feel safe you dig deeper; you go further inside and will work more collaboratively with your clinician. Pay attention to this.

Continue to notice these things during your initial appointment. Ask yourself, does the environment feel comfortable? Is your confidentiality being respected? If you don’t want to immediately schedule another, that is OK. Remember, you are the consumer; you are buying a service. If you need to go home and contemplate, trust your gut and do so. You don’t have to purchase a car simply because you take it out for a test drive. It is also OK to test out a few therapists before moving forward.

If you are going through your insurance company, ask them the same questions. You may be given a list of providers who are covered by your insurance company. Ask your insuror if they have clinicians who self-identify as LGBT and if there are any who list working with LGBT people as an area of specialization. If you can’t find what you’re looking for within your insurance company, you may consider looking at your out-of-network coverage. Don’t be afraid to call a clinician who’s not covered by your insurance company—they may be able to provide some direction or help you in finding a provider within your insuror. You may also decide the value of the relationship is more important than the insurance savings. Some practitioners will charge a lower fee for clients paying out of pocket. Don’t be afraid to ask.

Finding the right therapist is a critical step to your emotional healing. Empower yourself by making a selection that reflects what you want and need. Do your homework; take your time. When you do find it, you will be able to experience the trust, truth, vulnerability and authenticity that happen between client and therapist.