Q: Iâ€™m trying to find a psychotherapist, but Iâ€™ve never been in therapy before, and Iâ€™m not sure how to go about it. How do I find the right one? Which kind of therapy has the highest success rate? Should I see a queer therapist, or does it matter?
A: Psychotherapy is a serious commitment, and itâ€™s important to be careful and deliberate in finding the right person to help you. Ideally, the best thing to do is to get several referrals from your doctor or insurance provider. If you can afford to do it, interview all the therapists on your list. before you make a decision After that, you might find it helpful to make a contract with the one you select to see that person for, say, a month, before you make a final decision.
Many people feel on the defensive, or even a little ashamed, in an initial meeting with a therapist, and sometimes donâ€™t ask important questions because theyâ€™re too focused on making a good impression on the therapist. This is understandable, but unfortunate. Itâ€™s important to remember that what youâ€™re doing is hiring a consultant to help you resolve important issues in your life, and that you have as much right to ask questions as the therapist does. You may want to know about his or her education, background and qualifications. You may want to know how much experience he or she has had in dealing the kinds of issues you want to discuss. You may also have some personal questions. Therapists differ in how much personal information theyâ€™re willing to share, and it will be important to get a good idea of the ground rules and boundaries of the relationship before you commit to it.
Honor your own biases and preferences in choosing the kind of therapist you want. If you want a gay therapist, then by all means find one. I know many straight therapists to whom I wouldnâ€™t hesitate to refer gay clients, but not all therapists who describe themselves as â€śgay sensitiveâ€ť or â€śgay positiveâ€ť are without ignorance or biases regarding our tribe. Feel free to question any potential therapist about the extent of their professional and personal experience with gay people. If they donâ€™t give satisfactory answers, or if they refuse to answer or are evasive, itâ€™s probably a good idea to move on.
Remember that therapy happens in a relationship. It may be a professional relationship, but itâ€™s still a dialogue between two human beings who are trying to reach an understanding about important issues in your life. The factors that make it work are about the same as those that make any intimate relationship workâ€“trust, mutual respect, a sense of safety, personal warmth, genuineness, and so on. One interesting study of the outcome of treatment found that the early reaction of a client to a therapist is highly predictive of the outcome. If you feel a â€śclickâ€ť and sense that youâ€™re talking to a person who respects you, and whom you can trust, than this person is probably right for you. If you have an early negative reaction, you may ultimately get past it and be able to work together, but this is less likely than if the initial take is warm and positive. As in any intimate relationship, trust your intuition.
What kind of therapy is most effective? There are so many different schools of thought about how therapy should be done that it would be a full-time job to sort them all out. Professionals naturally tend to become partisans of their own approach, but there isnâ€™t really very much evidence that decisively favors any one school over another. A Vanderbilt University study found that differences in theoretical orientations among therapists didnâ€™t make much difference in their success rate. The study did find that some therapists were more effective than others, however. The ones who were more effective were those who provided clients with information, encouragement and opinions, made special efforts to facilitate discussions of problems, focused more on the here-and-now than on early childhood experiences, and encouraged the client to seek new social activities. Active involvement rather than passive listening appears to be more effective, regardless of the school of therapy to which the therapist belongs.
There are some client factors involved in success in therapy, too. One of the most important of these is patience. Unless youâ€™re seeking therapy for a simple behavior change (like quitting smoking) therapy can be a time-consuming and, at times, frustrating process. Change is typically incremental rather than dramatic. The â€śAh-ha!â€ť experience that instantly transforms a patientâ€™s life is mostly a Hollywood fantasy. Clients who are impatient or intolerant of slow change seem to benefit less that those who can tolerate careful exploration and a series of small changes over a period of time.
Tom Moon is a psychotherapist in San Francisco.