8 ms·

Finding a Therapist

114 points by danarch 8y ago

mhkool 8y ago
Ask yourself what TYPE of therapist you want: - the type that give you a prescription drug to suppress the symptoms that you complain about, or - the type that knows how to search for the root cause of the health issues and informs you how to get rid of them. My advice is to go to http://www.brokenbrain.com http://www.brokenbrain.com before you make a decision.
- danarch 8y ago
  That's a good point. If you are only looking for drugs, you're probably doing it wrong.
  - paulie_a 8y ago
    While I want to actually visit the doctor, I've found it incredibly difficult to find one, apparently all calls get routed to the billing department
    - danarch 8y ago
      Fair point - it can be really hard to get in with a psych. I'd talk to your PCP and see if they can get you a referral at least.
      - paulie_a 8y ago
        She actually made a referral, then I found out that department wasn't accepting new patients... It's been a frustrating process.
- rhcom2 8y ago
  A psychiatrist prescribes and should usually be used in concert with a therapist. That link sounds a lot like alternative medicine too.
- ksenzee 8y ago
  In the US, "therapist" generally means a licensed counselor (master's level education), marriage and family therapist (also master's level), or psychologist (doctorate). None of those practitioners has the authority to prescribe in most US states. (A few states allow psychologists limited prescribing rights.) There is no type of therapist that will give you a prescription drug to suppress symptoms, especially without also providing talk therapy, which is the job they trained to do.
  - notananthem 8y ago
    THIIIIIS.
    - sctb 8y ago
      Please stop. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html
faitswulff 8y ago
That is a significant amount of work to engage in for someone who is already in a compromised mental state :'(
- danarch 8y ago
  That's very true. Sometimes the work only comes once you start to get better (and then don't think you need the help). This advice could work if someone has noticed a loved one needs help and has to seek out help on another's behalf. It took me years to finally reach the step of starting the search which was super hard. I'm getting good results though.
- vinbreau 8y ago
  My wife has called over 10 therapists in the last few months. All of them have had no openings for new patients unless you agree to see them off the insurance. The rejection from so many therapists is taking it's toll. It's even more depressing to get up the motivation to research a new batch of therapists, get up the nerve to call, only to be rejected again. The act of finding a therapist is more depressing than just having depression.
  - didgeoridoo 8y ago
    That is technically insurance fraud. As a provider, when you accept insurance from a specific company you sign a contract that says you are required to accept that insurance as payment if you see a client who is a customer of that insurance company. You cannot hold specific "insurance" and "cash pay" slots. A large practice in Boston is being investigated for this right now, and it might put them out of business.
    - uxp100 8y ago
      Is it fraud to have cash pay slots that require you not have insurance? From your description it sounds like it isn't. They might (They do, this has happened to me, and the end result was not getting care I needed, but anyway) suggest you not inform them of your insurance, then it's your fraud, not theirs.
rhcom2 8y ago
A couple of other suggestions from someone who has had a long journey on the SS Mental Health: - Gender. Consider what gender you might be more comfortable with. Many of my male friends prefered female therapists, I personally felt like I was talking to a maternal figure and found I was better off with a guy. No shame in either choice. - Trial period/multiple options. When I first moved to my current city I made appointments with multiple therapists, even seeing two simultaneously for a few weeks. You want to be comfortable with them and it can be very hard to tell from one session. This is obviously very insurance dependant though.
- holman 8y ago
  Agree with both of those. The gender thing in particular I went back and forth with a few times until I settled on what made the most sense for me. I think it's something most people will want to think about. The other thing I'd include is that it's helpful to realize you're not trying to find a best friend. You're looking for a therapist, and how they can help you is a lot different from other relationships you might have had with people in the past. Once I realized that, it made it easier for me to adjust and find someone that fit me best, rather than someone I had to like, or enjoy my time with, or other "normal" benchmarks you tend to look for otherwise.
intellectronica 8y ago
Another suggestion: age. It's usually wrong to discriminate on age but when it comes to therapy there's broad agreement that people with more life experience (and likely more time practicing) are often better placed to offer help. Let others be the guinea pigs of that young and promising therapist and choose for yourself someone with a few decades of experience.
- kevinoid 8y ago
  > there's broad agreement that people with more life experience are often better placed to offer help. Broad agreement among whom? As with MDs, I would expect several complex trade-offs. Particularly between the value of medical (and life) experience against the value of being trained with the current science and treatment methods. For therapists I would also expect more significant trade-offs due to the difficulty of building strong therapeutic relationships across large age differences for some patients. Are you aware of any studies on the issue?
- nickbarnwell 8y ago
  Can you link to published research indicating that there is any correlation between therapist age and patient outcomes? Many people come to the helping professions later in life, and time spent practicing is the just about the only factor that counts for behavioural therapies (with the caveat that therapy outcomes are a difficult thing to measure). [1][2]: 1: Estimating variability in outcomes attributable to therapists: A naturalistic study of outcomes in managed care - Wampold, Bruce E.,Brown, George S. (Jeb) Journal of Consulting and Clinical Psychology, Vol 73(5), Oct 2005, 914-923 2: Huppert, J. D., Bufka, L. F., Barlow, D. H., Gorman, J. M., Shear, M. K., & Woods, S. W. (2001). Therapists, therapist variables, and cognitive-behavioral therapy outcome in a multicenter trial for panic disorder. Journal of Consulting and Clinical Psychology, 69(5), 747-755.
  - diab0lic 8y ago
    > time spent practicing is the just about the only factor that counts for behavioural therapies When using age as the predictor I'd imagine time spent practicing is the latent metric actually being measured. You can't have 10 years of experience at age 25. That said it seems silly to use age when time spent practicing is a readily observable value.
darthlucio 8y ago
If you're in the NYC area, I know a bunch of folks who have had a really positive experience with http://www.kenwoodpsych.com/ http://www.kenwoodpsych.com/ - it's a practice that helps match you to a therapist that matches your needs, communication style, and financial/location constraints.
mhkool 8y ago
Go to http://www.brokenbrain.com http://www.brokenbrain.com to understand the root causes of mental diseases. On this website you can also find the solutions (relatively easy once you know the root cause). After visiting this site you most likely understand that you want a doctor that finds the root causes that hurt you. Note that a person that tries various drugs to see if they have some effect on you is not a person that finds root causes.
didgeoridoo 8y ago
Shameless plug: my wife runs a psychology practice in Boston and wrote a little free guide on this topic. PDF grabbable here: https://azimuthpsych.com/downloads/Azimuth_How_to_Find_a_Therapist_[ebook].pdf https://azimuthpsych.com/downloads/Azimuth_How_to_Find_a_The...
- rhencke 8y ago
  This is actually really good. I've seen more therapists in my lifetime than I care to admit. But something like this would have helped a lot when I was starting out. The casual approach does a really nice job at breaking things down and explaining parts of the process, without feeling like it's being dumbed down at all. It makes it feel very approachable, which is very welcome, given how daunting it felt (at least for me) starting out. I cracked up at "My therapist is dull and doesn’t laugh at my cat memes. Should I keep seeing them for therapy?".
  - gonnadoit05 8y ago
    I’ve been in and out too. The biggest problem is cost, because in-network doesn’t provide you with enough sessions (insurance limits the number of sessions), you’re stuck having to pay out of network costs if you want more than once a month or once a week. I was looking at an extra 4 times a week, but therapists were quoting me $250 per 50 min session. That’s $1000 per week, I cant afford that and I’m confident in my extreme thoughts getting worse and there’s nobody I can talk to about extreme vengeful hurtful thoughts and once a month or even once a week isn’t going to help when I’m genuinely asking for 4 sessions a week but insurance will never cover that so I’m stuck having to pay out of pocket and as I said this once a week is just not enough and so I’m stuck with my thoughts where only every now and then I can make a rational thought and the rest of the day is filled with unimaginable extreme pain and extreme thoughts. And worse, therapists won’t reduce their price from $250 per session hour for these extra 4 sessions per week that I’m requesting, because, obviously $1000 per week (for 4 sessions) is a lot of money for them. This industry turns into a sham when therapists can charge $1000 per week to the man scraping by (but looks healthy enough to give the impression he can afford that amount)
- 8y ago
lokufda222 8y ago
I wonder why nobody mentioned ratemds.com ? Is it not that well known or ? (Not related to them in any shape or form btw)
- notananthem 8y ago
  Doctor rating sites are crap because people are far more likely to emotionally sway hard positive/negative to doctor exp than something like restaurants. I find doctors by word of mouth and visit then once, and grade them HARD on my first experience, including their practice/admin/location etc. I think people trust their own experiences over others' in rating something as personal as a doctor (or therapist)
collyw 8y ago
I always find it strange that going to a therapist is something relatively normal in the US. I don't think I have known anyone who has openly talked about going to a therapist in this part of the world (UK / Spain). Does the US culture there produce more stress and broken people, or us Europeans just more ashamed of admitting to this sort of thing or is it something else?
- birdmanjeremy 8y ago
  I can't speak for Europeans, but in the US it greatly depends on the person. There are many who are open about seeking help, and many who would never go to a therapist. Talking about problems and issues with someone is important. If it's not friends, or a community leader (priest/rabbi, etc), a therapist is a great option. Do Europeans talk about their problems with their friends more openly? Perhaps this is the cause of the difference?
  - collyw 8y ago
    Girls will definitely talk about their problems more openly (than guys, no idea about how it compares to US women). Guys will probably tough it out to a degree. It really depends on the person and the more local culture (I found people in the South of England very polite, but uncommunicative compared to Scotland).
- chickenfries 8y ago
  Relatively normal where? It's a recent development, and is definitely not true of everyone. My father will probably never see a therapist, even though he most definitely could use one. You aren't "broken" because you go to a therapist.
  - collyw 8y ago
    Normal as in I see references to it in popular culture, US TV shows and films. A Hacker News article, which is international, but must have a heavy US bias. As I say it seems somewhat strange to me. (I hope this doesn't come across as offensive) but why would you go to a therapist of you aren't "broken" to some extent? (Maybe broken isn't the best choice of words, but I think you understand what I mean by it). It's not cheap to go to a therapist is it? It's not something we do over here. If it is more common than I realize then its not something we talk about.
viburnum 8y ago
Most therapists can't help you, but mean well and don't know it, so if you're not seeing dramatic improvement after 6-8 sessions, find a new therapist. If you find it hard to break up with your therapist, that means they're really doing a bad job, and you should definitely find a new therapist. Also, don't be impressed by credentials (PhD, MD, etc).
- notananthem 8y ago
  Hey incredibly rude, self-centered internet comment troll, if therapy doesn't work for you please don't try to spoil the experience for someone else. Evidence based research into efficacy of CBT (cognitive behavioral therapy) shows its response rate is higher than alternatives and especially beneficial for: anxiety disorders, somatoform disorders, bulimia, anger control problems, and general stress. AKA, all your bullshit! It is true that you need to click with your therapist- ask trusted friends who they see. Don't disclose to coworkers/bosses/work about seeing a therapist because its still stigmatized, case in point the idiot who posted the comment I'm replying to. Credentials are important as to how/where therapists received training- and the difference between PHD, MD and other titles are CRITICAL to differences in psychiatrist vs psychology, etc. Some prescribe medicine, some don't, some shouldn't, some are quacks. Find them based on reputation and perform your own checks to satisfy your concerns. Therapy is really healthy :)
  - Osmium 8y ago
    Your own comment would have been a lot better without its first sentence and that "idiot" clause :) I didn't find the parent's comment rude or trollish. It seems clear that therapy can help people. It also seems clear it is not a panacea, and that it can depend on both the person seeking therapy and the therapist, as well as the reason for therapy. It sounds like the parent was sharing their own experiences, which are just as valid as your own. If we elevate therapy and therapists to be beyond criticism, all we end up with is a cult. Take the parent's comment on credentials and licensing: I'm sure that we want our therapists to be licensed, using evidence-based techniques, but that doesn't mean all credentials are created equally, or that because someone has credentials automatically means that they can be helpful to you personally.
dawhizkid 8y ago
I'm wondering if a barrier to more people seeking help is the appointment vs walk-in option - how many more people, if they could see a therapist like they could go to a urgent care center, would do it?
- canes123456 8y ago
  People do try to use therapy as an urgent care center. People go to a therapy for help not committing suicide or harming someone else. It is a terrible idea. They can and should go to an actual emergency room.
  - saryant 8y ago
    San Antonio has found that emergency rooms are ill-equipped for this. Nurses and ER doctors are not generally mental health professionals. The city, county and various other authorities have built a sprawling system of mental health care facilities, partly designed to funnel people out of emergency rooms and into dedicated centers with staff trained in those situations. http://apps.bostonglobe.com/spotlight/the-desperate-and-the-dead/series/solutions/ http://apps.bostonglobe.com/spotlight/the-desperate-and-the-... > Take the Restoration Center, a big, boxy building on the edge of downtown. It’s a point of entry for people in psychiatric or substance abuse crises, mostly for those who lack health insurance. In the past, they went straight to emergency rooms or jail. Now many come through here — some 2,400 people a month. > Open 24 hours a day, seven days a week, the center has a locked psychiatric ward for short-term stays, detox units, a medical clinic, and other services. Some patients walk in on their own. Others are brought by police or referred by hospitals. Anyone reporting suicidal or homicidal thoughts is seen within 15 minutes, day or night. > In Massachusetts, there is no equivalent. Here, hospital emergency rooms function as crisis centers, and often ineffectively: Many people with severe mental illness end up being discharged without any promise of meaningful treatment.
JoblessWonder 8y ago
This article leaves out 2 important types of providers, especially for California. These vary by state so I'm not surprised she left them out since it might not apply to her: Licensed Marriage and Family Therapist (LMFT): In CA they have at least 3,000 hours of experience. Similar to LCSW except they have a Masters in Marriage and Family Therapy and not in Social Work. Licensed professional counselor (LPC): Same as above but in more states than CA. Also, Psychologists and Psychiatrists do not necessarily have more experience since they can practice the day they graduate. What is important is the amount of time they have been practicing.
aidenn0 8y ago
YMMV but I live in a high-cost-of-living area and here if the therapist will take insurance that's almost a guarantee that they are not going to be good; mainly because in order to make a living at the rates insurance pays they have to take far more clients than a good therapist would consider reasonable. This, combined with the fact that there is enough disposable income floating around to pay good therapists out-of-pocket means good therapists will just not take insurance (though you may have some success getting reimbursed). If you can't afford, many of those good therapists will find ways to help you pay, and perhaps even offer you a bit of a break in their rates[1] 1: One psychologist I know personally quit a non-profit to start a private practice after determining that they could do better work and make more money by charging a high rate, and doing pro-bono work for poor people who really needed help.
- cm2012 8y ago
  I've noticed this also. The best therapists avoid insurance plans
deleted 8y ago
[deleted]
abledon 8y ago
So if we are trusting therapists to manage our psyche, does that mean therapists have the most stable and well managed personal lives? Are they some sort of strange philosopher-king like super category of humans? I’d love to see a large statistical survey of all the psychologists/therapists in Europe or North America and how their personal lives are happening.
- leesalminen 8y ago
  Heh. I’ve thought that myself once or twice.

114 points by danarch 8y ago

Ask yourself what TYPE of therapist you want: - the type that give you a prescription drug to suppress the symptoms that you complain about, or - the type that knows how to search for the root cause of the health issues and informs you how to get rid of them. My advice is to go to http://www.brokenbrain.com http://www.brokenbrain.com before you make a decision.

danarch 8y ago
That's a good point. If you are only looking for drugs, you're probably doing it wrong.
- paulie_a 8y ago
  While I want to actually visit the doctor, I've found it incredibly difficult to find one, apparently all calls get routed to the billing department
  - danarch 8y ago
    Fair point - it can be really hard to get in with a psych. I'd talk to your PCP and see if they can get you a referral at least.
    - paulie_a 8y ago
      She actually made a referral, then I found out that department wasn't accepting new patients... It's been a frustrating process.
rhcom2 8y ago
A psychiatrist prescribes and should usually be used in concert with a therapist. That link sounds a lot like alternative medicine too.
ksenzee 8y ago
In the US, "therapist" generally means a licensed counselor (master's level education), marriage and family therapist (also master's level), or psychologist (doctorate). None of those practitioners has the authority to prescribe in most US states. (A few states allow psychologists limited prescribing rights.) There is no type of therapist that will give you a prescription drug to suppress symptoms, especially without also providing talk therapy, which is the job they trained to do.
- notananthem 8y ago
  THIIIIIS.
  - sctb 8y ago
    Please stop. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html

faitswulff 8y ago

That is a significant amount of work to engage in for someone who is already in a compromised mental state :'(

danarch 8y ago
That's very true. Sometimes the work only comes once you start to get better (and then don't think you need the help). This advice could work if someone has noticed a loved one needs help and has to seek out help on another's behalf. It took me years to finally reach the step of starting the search which was super hard. I'm getting good results though.
vinbreau 8y ago
My wife has called over 10 therapists in the last few months. All of them have had no openings for new patients unless you agree to see them off the insurance. The rejection from so many therapists is taking it's toll. It's even more depressing to get up the motivation to research a new batch of therapists, get up the nerve to call, only to be rejected again. The act of finding a therapist is more depressing than just having depression.
- didgeoridoo 8y ago
  That is technically insurance fraud. As a provider, when you accept insurance from a specific company you sign a contract that says you are required to accept that insurance as payment if you see a client who is a customer of that insurance company. You cannot hold specific "insurance" and "cash pay" slots. A large practice in Boston is being investigated for this right now, and it might put them out of business.
  - uxp100 8y ago
    Is it fraud to have cash pay slots that require you not have insurance? From your description it sounds like it isn't. They might (They do, this has happened to me, and the end result was not getting care I needed, but anyway) suggest you not inform them of your insurance, then it's your fraud, not theirs.

rhcom2 8y ago

A couple of other suggestions from someone who has had a long journey on the SS Mental Health: - Gender. Consider what gender you might be more comfortable with. Many of my male friends prefered female therapists, I personally felt like I was talking to a maternal figure and found I was better off with a guy. No shame in either choice. - Trial period/multiple options. When I first moved to my current city I made appointments with multiple therapists, even seeing two simultaneously for a few weeks. You want to be comfortable with them and it can be very hard to tell from one session. This is obviously very insurance dependant though.

holman 8y ago
Agree with both of those. The gender thing in particular I went back and forth with a few times until I settled on what made the most sense for me. I think it's something most people will want to think about. The other thing I'd include is that it's helpful to realize you're not trying to find a best friend. You're looking for a therapist, and how they can help you is a lot different from other relationships you might have had with people in the past. Once I realized that, it made it easier for me to adjust and find someone that fit me best, rather than someone I had to like, or enjoy my time with, or other "normal" benchmarks you tend to look for otherwise.

intellectronica 8y ago

Another suggestion: age. It's usually wrong to discriminate on age but when it comes to therapy there's broad agreement that people with more life experience (and likely more time practicing) are often better placed to offer help. Let others be the guinea pigs of that young and promising therapist and choose for yourself someone with a few decades of experience.

kevinoid 8y ago
> there's broad agreement that people with more life experience are often better placed to offer help. Broad agreement among whom? As with MDs, I would expect several complex trade-offs. Particularly between the value of medical (and life) experience against the value of being trained with the current science and treatment methods. For therapists I would also expect more significant trade-offs due to the difficulty of building strong therapeutic relationships across large age differences for some patients. Are you aware of any studies on the issue?
nickbarnwell 8y ago
Can you link to published research indicating that there is any correlation between therapist age and patient outcomes? Many people come to the helping professions later in life, and time spent practicing is the just about the only factor that counts for behavioural therapies (with the caveat that therapy outcomes are a difficult thing to measure). [1][2]: 1: Estimating variability in outcomes attributable to therapists: A naturalistic study of outcomes in managed care - Wampold, Bruce E.,Brown, George S. (Jeb) Journal of Consulting and Clinical Psychology, Vol 73(5), Oct 2005, 914-923 2: Huppert, J. D., Bufka, L. F., Barlow, D. H., Gorman, J. M., Shear, M. K., & Woods, S. W. (2001). Therapists, therapist variables, and cognitive-behavioral therapy outcome in a multicenter trial for panic disorder. Journal of Consulting and Clinical Psychology, 69(5), 747-755.
- diab0lic 8y ago
  > time spent practicing is the just about the only factor that counts for behavioural therapies When using age as the predictor I'd imagine time spent practicing is the latent metric actually being measured. You can't have 10 years of experience at age 25. That said it seems silly to use age when time spent practicing is a readily observable value.

darthlucio 8y ago

If you're in the NYC area, I know a bunch of folks who have had a really positive experience with http://www.kenwoodpsych.com/ http://www.kenwoodpsych.com/ - it's a practice that helps match you to a therapist that matches your needs, communication style, and financial/location constraints.

mhkool 8y ago

Go to http://www.brokenbrain.com http://www.brokenbrain.com to understand the root causes of mental diseases. On this website you can also find the solutions (relatively easy once you know the root cause). After visiting this site you most likely understand that you want a doctor that finds the root causes that hurt you. Note that a person that tries various drugs to see if they have some effect on you is not a person that finds root causes.

didgeoridoo 8y ago

Shameless plug: my wife runs a psychology practice in Boston and wrote a little free guide on this topic. PDF grabbable here: https://azimuthpsych.com/downloads/Azimuth_How_to_Find_a_Therapist_[ebook].pdf https://azimuthpsych.com/downloads/Azimuth_How_to_Find_a_The...

rhencke 8y ago
This is actually really good. I've seen more therapists in my lifetime than I care to admit. But something like this would have helped a lot when I was starting out. The casual approach does a really nice job at breaking things down and explaining parts of the process, without feeling like it's being dumbed down at all. It makes it feel very approachable, which is very welcome, given how daunting it felt (at least for me) starting out. I cracked up at "My therapist is dull and doesn’t laugh at my cat memes. Should I keep seeing them for therapy?".
- gonnadoit05 8y ago
  I’ve been in and out too. The biggest problem is cost, because in-network doesn’t provide you with enough sessions (insurance limits the number of sessions), you’re stuck having to pay out of network costs if you want more than once a month or once a week. I was looking at an extra 4 times a week, but therapists were quoting me $250 per 50 min session. That’s $1000 per week, I cant afford that and I’m confident in my extreme thoughts getting worse and there’s nobody I can talk to about extreme vengeful hurtful thoughts and once a month or even once a week isn’t going to help when I’m genuinely asking for 4 sessions a week but insurance will never cover that so I’m stuck having to pay out of pocket and as I said this once a week is just not enough and so I’m stuck with my thoughts where only every now and then I can make a rational thought and the rest of the day is filled with unimaginable extreme pain and extreme thoughts. And worse, therapists won’t reduce their price from $250 per session hour for these extra 4 sessions per week that I’m requesting, because, obviously $1000 per week (for 4 sessions) is a lot of money for them. This industry turns into a sham when therapists can charge $1000 per week to the man scraping by (but looks healthy enough to give the impression he can afford that amount)
8y ago

lokufda222 8y ago

I wonder why nobody mentioned ratemds.com ? Is it not that well known or ? (Not related to them in any shape or form btw)

notananthem 8y ago
Doctor rating sites are crap because people are far more likely to emotionally sway hard positive/negative to doctor exp than something like restaurants. I find doctors by word of mouth and visit then once, and grade them HARD on my first experience, including their practice/admin/location etc. I think people trust their own experiences over others' in rating something as personal as a doctor (or therapist)

collyw 8y ago

I always find it strange that going to a therapist is something relatively normal in the US. I don't think I have known anyone who has openly talked about going to a therapist in this part of the world (UK / Spain). Does the US culture there produce more stress and broken people, or us Europeans just more ashamed of admitting to this sort of thing or is it something else?

birdmanjeremy 8y ago
I can't speak for Europeans, but in the US it greatly depends on the person. There are many who are open about seeking help, and many who would never go to a therapist. Talking about problems and issues with someone is important. If it's not friends, or a community leader (priest/rabbi, etc), a therapist is a great option. Do Europeans talk about their problems with their friends more openly? Perhaps this is the cause of the difference?
- collyw 8y ago
  Girls will definitely talk about their problems more openly (than guys, no idea about how it compares to US women). Guys will probably tough it out to a degree. It really depends on the person and the more local culture (I found people in the South of England very polite, but uncommunicative compared to Scotland).
chickenfries 8y ago
Relatively normal where? It's a recent development, and is definitely not true of everyone. My father will probably never see a therapist, even though he most definitely could use one. You aren't "broken" because you go to a therapist.
- collyw 8y ago
  Normal as in I see references to it in popular culture, US TV shows and films. A Hacker News article, which is international, but must have a heavy US bias. As I say it seems somewhat strange to me. (I hope this doesn't come across as offensive) but why would you go to a therapist of you aren't "broken" to some extent? (Maybe broken isn't the best choice of words, but I think you understand what I mean by it). It's not cheap to go to a therapist is it? It's not something we do over here. If it is more common than I realize then its not something we talk about.

viburnum 8y ago

Most therapists can't help you, but mean well and don't know it, so if you're not seeing dramatic improvement after 6-8 sessions, find a new therapist. If you find it hard to break up with your therapist, that means they're really doing a bad job, and you should definitely find a new therapist. Also, don't be impressed by credentials (PhD, MD, etc).

notananthem 8y ago
Hey incredibly rude, self-centered internet comment troll, if therapy doesn't work for you please don't try to spoil the experience for someone else. Evidence based research into efficacy of CBT (cognitive behavioral therapy) shows its response rate is higher than alternatives and especially beneficial for: anxiety disorders, somatoform disorders, bulimia, anger control problems, and general stress. AKA, all your bullshit! It is true that you need to click with your therapist- ask trusted friends who they see. Don't disclose to coworkers/bosses/work about seeing a therapist because its still stigmatized, case in point the idiot who posted the comment I'm replying to. Credentials are important as to how/where therapists received training- and the difference between PHD, MD and other titles are CRITICAL to differences in psychiatrist vs psychology, etc. Some prescribe medicine, some don't, some shouldn't, some are quacks. Find them based on reputation and perform your own checks to satisfy your concerns. Therapy is really healthy :)
- Osmium 8y ago
  Your own comment would have been a lot better without its first sentence and that "idiot" clause :) I didn't find the parent's comment rude or trollish. It seems clear that therapy can help people. It also seems clear it is not a panacea, and that it can depend on both the person seeking therapy and the therapist, as well as the reason for therapy. It sounds like the parent was sharing their own experiences, which are just as valid as your own. If we elevate therapy and therapists to be beyond criticism, all we end up with is a cult. Take the parent's comment on credentials and licensing: I'm sure that we want our therapists to be licensed, using evidence-based techniques, but that doesn't mean all credentials are created equally, or that because someone has credentials automatically means that they can be helpful to you personally.

dawhizkid 8y ago

I'm wondering if a barrier to more people seeking help is the appointment vs walk-in option - how many more people, if they could see a therapist like they could go to a urgent care center, would do it?

canes123456 8y ago
People do try to use therapy as an urgent care center. People go to a therapy for help not committing suicide or harming someone else. It is a terrible idea. They can and should go to an actual emergency room.
- saryant 8y ago
  San Antonio has found that emergency rooms are ill-equipped for this. Nurses and ER doctors are not generally mental health professionals. The city, county and various other authorities have built a sprawling system of mental health care facilities, partly designed to funnel people out of emergency rooms and into dedicated centers with staff trained in those situations. http://apps.bostonglobe.com/spotlight/the-desperate-and-the-dead/series/solutions/ http://apps.bostonglobe.com/spotlight/the-desperate-and-the-... > Take the Restoration Center, a big, boxy building on the edge of downtown. It’s a point of entry for people in psychiatric or substance abuse crises, mostly for those who lack health insurance. In the past, they went straight to emergency rooms or jail. Now many come through here — some 2,400 people a month. > Open 24 hours a day, seven days a week, the center has a locked psychiatric ward for short-term stays, detox units, a medical clinic, and other services. Some patients walk in on their own. Others are brought by police or referred by hospitals. Anyone reporting suicidal or homicidal thoughts is seen within 15 minutes, day or night. > In Massachusetts, there is no equivalent. Here, hospital emergency rooms function as crisis centers, and often ineffectively: Many people with severe mental illness end up being discharged without any promise of meaningful treatment.

JoblessWonder 8y ago

This article leaves out 2 important types of providers, especially for California. These vary by state so I'm not surprised she left them out since it might not apply to her: Licensed Marriage and Family Therapist (LMFT): In CA they have at least 3,000 hours of experience. Similar to LCSW except they have a Masters in Marriage and Family Therapy and not in Social Work. Licensed professional counselor (LPC): Same as above but in more states than CA. Also, Psychologists and Psychiatrists do not necessarily have more experience since they can practice the day they graduate. What is important is the amount of time they have been practicing.

aidenn0 8y ago

YMMV but I live in a high-cost-of-living area and here if the therapist will take insurance that's almost a guarantee that they are not going to be good; mainly because in order to make a living at the rates insurance pays they have to take far more clients than a good therapist would consider reasonable. This, combined with the fact that there is enough disposable income floating around to pay good therapists out-of-pocket means good therapists will just not take insurance (though you may have some success getting reimbursed). If you can't afford, many of those good therapists will find ways to help you pay, and perhaps even offer you a bit of a break in their rates[1] 1: One psychologist I know personally quit a non-profit to start a private practice after determining that they could do better work and make more money by charging a high rate, and doing pro-bono work for poor people who really needed help.

cm2012 8y ago
I've noticed this also. The best therapists avoid insurance plans

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abledon 8y ago

So if we are trusting therapists to manage our psyche, does that mean therapists have the most stable and well managed personal lives? Are they some sort of strange philosopher-king like super category of humans? I’d love to see a large statistical survey of all the psychologists/therapists in Europe or North America and how their personal lives are happening.

leesalminen 8y ago
Heh. I’ve thought that myself once or twice.