How to Find the Right Counselor
Points to Consider When Choosing
Many people will have occasion to need the advice and direction of a clinical counselor (mental health or relationship health) at some point in their life. Having some guidelines on how to choose a counselor can be helpful at the onset so that your search can go quickly and smoothly, and may enable you to avoid choosing the wrong kind of counselor or one that you are not compatible with. In addition, when you enter into counseling, you are purchasing a product, and even if the insurance company is footing the bill, you want to get your money's worth.
Decide what it is that you need: do your issues arise to clinical levels?
Most people do not fully appreciate the different levels of mental health and relationship health professional helpers. The word 'counselor' is a generic term that can mean anything from a camp counselor with a high school diploma through pastoral support with a member of the clergy to a Ph.d in psychology.
Determining if you need a counselor at a professional level is not always easy to do. If you have sought out support from family, friends, and even a member of the clergy, and your issue is still predominating your life, then it is likely that a professional counselor is in order. In most cases, mild difficulties such as sadness, grief, or relationship conflicts can be resolved with the supports mentioned in fairly short order. But if your issue seems to be getting worse or at least not resolved over the course of about a month, this is another marker for the need for professional help.
It is important to note that any issues that include thoughts or feelings of wanting to harm yourself or others, or experiencing consistent strange thoughts or experiencing hallucinations are problems that there is no question of needing professional help for. If you or someone you know is experiencing any of these, immediate treatment is needed!
Professional level mental health and relationship health providers may include Licensed Professional Counselors, Licensed Social Workers, Clinical Psychologists or even psychiatrists, who hold a medical degree. Each of these may provide a different kind of focus and basic outlook on the nature and treatment of your problem. In addition, some of the professionals above my be practicing as generalists, meaning that they treat a variety of issues with a variety of therapy approaches, or they may be specialists in one particular area (like couple's counseling) and may use a specific therapeutic approach (like Cognitive Behavioral Therapy) to help people.
Do you need a specialist or will a generalist do?
Most people are limited by their choice of counselors by either location and availability of professional counselors, or limited by insurance plans that will pay only for certain kinds of counselors or particular counselors in a regional area. When faced with a wider choice, it is often desirable to seek out a counselor who specializes in the issues that you have. Having said this, if your choice is narrow, any quality generalist should be able to help you to make progress on your issues.
It is also important to note that those professionals with non-specific titles, like a Licensed Professional Counselor as opposed to a Certified Play Therapist, may be just as good or even better than the professional with the more specific specialty title. This is because there is more to counseling that the title or specialty. Just like any profession, experience and skill can go way farther than letters behind a name.
Ask around for names of good counselors.
A great number of my referrals come from satisfied people who made progress with my help. In most cases, people you know have a good bit in common with you, and so if they were helped by a particular counselor, there is a good chance you will be helped as well. If you keep hearing the same name over and over again (in a positive way!) it is a good bet that that counselor is pretty good. Some geographic locations may have rating or feedback sites (like Angieslist.com) that can also be helpful in making your choice.
Check to see if your insurance covers this particular counselor and what the co-pay is.
With the dawn of managed care and a tough economy, not all insurance companies work with all counselors. Just like doctors and dentists, some insurance companies have lists of which professionals that they will pay for. While you can pay a counselor out of pocket if you choose, with a single session ranging up to a hundred dollars or more, a series of sessions can get quite expensive. If you are insured and your company will pay for your chosen counselor, there is quite often a co-pay as well as a limited number of sessions that the insurance company is willing to pay for. Finding this information out before your first session is not only practical, but will help you focus on why you are really at the counselor's office in the first place.
Check out the counselor first on line, then in person.
Many counselors these days have either personal professional websites or group websites for a practice. Take the time to look through the counselor's web site and visit all the pages. Check out their listed credentials and then do research on what those credentials mean (the sheer volume of degrees and certifications can be mind boggling). If there is some free reading material on the site, read it. If there is a page of endorsements, look at it. You can often get a sense of what the counselor is like and what their professional focus and approach is by carefully examining their website. The site and site materials should be inviting, pleasant, and look professional.
Ask the clinician about their credentials and experience.
Some clinicians offer an initial, brief, no cost phone consult just to get acquainted and to answer questions of credentials, experience, focus and approach. Indeed, any counselor should be agreeable to doing this, even if they do not advertise it. If the counselor seems to be insulted or impatient with such questions, they may not be your best choice of someone to help you with your issues. One important question I tell folks to ask their prospective counselor is: 'Have you ever been in counseling yourself?' If the answer is 'no', then go elsewhere. Any clinician worth their salt needs to have been on the counselee side of the counseling chair.
Ask the clinician about their counseling approaches to your issues.
A trained and experienced counselor should be able to clearly tell you, in layman's terms, what kind of approaches or types of therapies that they use on a regular basis. While most counselors approach their work form a particular perspective, or have a favorite kind of therapy that they find effective, if the counselor states that they use only one approach, and cannot articulate alternatives that they can use to help you, then you may want to continue your search for a counselor. This is because seasoned and effective counselors know that there is more than one way to help people, and different people and situations often call for different approaches and therapy types. If they only have one tool in their toolbox and it is a hammer, everything begins to look like a nail.
Ask what the counselor feels the course of treatment will be (length and plan)
recommended session schedule.
This is a fair and reasonable question. If the counselor balks at answering it, or gives you a vague response, this is not a good sign. While the counselor cannot give you down-to-the-exact- number of sessions you will need (after all, a good bit of how fast things go rely on your willingness to work), they should be able to give you a round about number of sessions, weeks, or months. Most insurance companies these days favor clinicians who can help people in a matter of weeks or months, not years.
While different kinds of therapies may take less or more time, depending on which kind of therapy is indicated, a good counselor should be able to tell you the approximate length of time needed, and what the 'course of treatment' will be. 'Course of treatment' means not just how long it will take, but what specific approach will be used and things to expect along the way (stuck points as well as signs of progress). Asking for a written treatment plan is a good idea, and one that a competent counselor can produce by your next session. Don't forget to ask questions about the kind of therapy approach, how does it work, and why does it work? Write down the name of the approach and then do some research on an unbiased website that talks about both the benefits and criticisms of the approach.
Ask the counselor what you can do between sessions to continue to work on your issues.
Even though they like to keep their seats full, a good counselor wants you to get better as fast as you can reasonably do so. It should be their reputation at doing this that keeps their seats full, not drawing out therapy for years. If the counselor does not offer things to do between sessions (sometimes called 'homework') then ask for it. Homework does not mean paper and pencil work, although it can be that. Many clinicians will give you an assignment to pay attention to something that you are doing, or ask you to spend time thinking about a particular issue or practice thinking or behaving in a particular way. Other clinicians may recommend some articles to read or even a book that will be helpful.
Pay attention to the way that the counselor pays attention to you.
I can't tell you how many clients I have had that told me horrendous tales of their previous counselors. Everything from the counselor that was cold and impersonal to the counselor that treated them like a naughty child to even the one that did other tasks or went to sleep during their session! On the other hand, if you begin to feel uncomfortable with the kind of intimacy you are feeling directed at you, like the counselor becoming too personal too fast, they begin to touch you (other than a handshake), begin to treat you like a friend, or suggests to see you outside of the counseling office, don't just run in the other direction, report the clinician for an ethics violation!
In a session, the legitimate, quality clinician's focus should be on you, and there should be no interruptions from the outside. You should feel like in the moment, you are the most important person in the room, and that the counselor is genuinely caring about you and your issues, while maintaining boundaries that leave you feeling secure and comfortable. Finally, use your own emotions to tell you if the counselor is right for you.