How To Find a Therapist

Getting helpin a timely manner is essential: how to find a therapist.

By Hara Estroff Marano, published on February 01, 2002 - last reviewed on August 30, 2004

Few questions are asked as often: How do I find a therapist? And few questions are more crucial. Getting help in a timely manner is absolutely essential not just to relieve a current episode of depression but to prevent what otherwise likely becomes a recurring disorder.

Still, inside that initial question lurks another, more urgent one. People are not asking strictly about the mechanics of finding a therapist, although many do want to know that too. What they really seek to know is, how do they find someone who can actually exert some traction to help pull them out of the pit of depression.

The question is on target, for not just any warm body will do. First, depression is a complex disorder and certain kinds of treatment have proven more effective than others; one must ascertain beforehand that a mental health professional employs methods known to work.

Second, depression imposes some limitations on those actively in its grip; it is the nature of the beast to impair cognitive functioning and to induce passivity. Consequently, the depressed need search strategies that overcome their own debility.

* The fastest and most reliable way to find a good therapist is to ask a friend or someone you respect who has been helped by therapy. People you trust with helping you make other decisions can help with this one too, observes psychologist Bernardo Carducci, Ph.D., of Indiana University Southeast. Asking a friend relieves the burden on your judgment, while your friend's success provides a clear indicator that what the therapist does actually works against depression.

"One needs a therapist with a track record of helping people who have the kind of problem you do," contends Lori Gordon, Ph.D. "They have to be known for their effectiveness in helping with the kind of problem you have and achieving the kind of goal you are seeking."

A second-best referral source is your family doctor. Whichever route you take, ask prospective therapists whether they've treated depressed people before, and how often they have done so.

* Professional credentials are necessary. Call (or check online) the state licensing board of whichever professional you select to make sure that the therapist is licensed. Also check to make sure there's no history of legal or ethical complaints lodged against the therapist.

* But credentials alone are an insufficient index of qualifications. A therapist's knowledge of depression, personal values, state of mind, and cumulative wisdom all count because they are your springboards to recovery.

Although conventional wisdom holds that psychotherapy is a value-free enterprise, that is a myth, insist eight of the 10 seasoned experts consulted for this article. As Frank S. Pittman III, M.D., a psychiatrist in private practice in Atlanta, puts it: "Most psychotherapy is really about values. It's about the value dilemmas of ordinary people trying to lead a life amidst great personal, familial, and cultural confusion."

The best way to discover the values of a therapist is to ask people who have been to the therapist. "Ask your friend, 'when you tell your therapist what you just told me, that you're leaving your job, what is your therapist's response?'"

After checking credentials, says Ellen McGrath, Ph.D., gauge the life experience of the therapist. Ask yourself whether he or she has lived enough according to values you respect to know about life and love independent of their theoretical orientation.

"Most patients can judge the therapist firsthand," offers psychiatrist Peter D. Kramer, M.D. "Their social judgment is not impaired; they know who's sitting across from them even when depressed. A therapist should show wisdom, courtesy, insight, perhaps a touch of brilliance, and a good measure of patience and equanimity."

* Seek a therapist who is open to deploying all the tools proven to work against depression. Ask a prospective therapist what kinds of treatment he or she employs.

"Studies show that a combination of medication and psychotherapy is the best treatment for depression," observes Rick Strassman, M.D., a psychiatrist in private practice in Taos, New Mexico. "The results are better, quicker, and longer-lasting." Unfortunately, he notes, while psychiatrists are the only mental health professionals who can prescribe drugs, they are often no longer trained to do psychotherapy.

After getting medication under control, he reports, "most patients are interested in doing psychotherapeutic work. I'm doing more psychotherapy than I thought I'd be doing."

* Perhaps the best question you can ask a prospective therapist is, why am I depressed? The answer will tell you as much about the therapist as about you.

What should you look for in an answer? Comprehensive understanding and wisdom. "Depression is a chemical state, and you can get into it by a physical route or a psychological route or by the circumstances of your life," says Atlanta's Dr. Pittman.

"Running around angry all the time will depress you. Drinking alcohol daily and not getting any exercise will depress you. Doing things that make you feel guilty will depress you. A therapist who can explain that simply and honestly is likely to have the resources to help you through what you are going through."