Evaluating Help When You Decide it’s Time to Get Serious

For many of us, the time rolls around when we decide it’s time to enlist some help in changing a habit, a situation, a career, a marriage, or some other significant part of our life. Then comes the search for who.

One might think it would be straightforward: 1) go to Google; 2) enter psychologist, or counselor, or whatever description you have decided on; 3) read the locations, reviews; 4) call and see who’s taking new clients; 5) make an initial appointment; 6) address the problem.

If only it was that easy.

Complications?

  • How is this going to be paid for? Using insurance means sacrificing confidentiality;
  • Is the therapist a “match” and how many session will it take to decide?
  • How much time do you want/need to invest vs how much time the therapist wants to sell you (it’s usually easier to get a client to continue than to find a new one);
  • Are you and the provider equally interested in actually addressing the problem (that’s not a “given,” many clients are invested to appearing to be doing something about a problem and they team up with a therapist who’s looking for long term clients afraid of realchange);

Some rules to make the process a bit easier:

  • Interview the potential providers (initially try to see three);
  • Inquire as to specialties, experience, training, etc.
  • Ask for an estimated course of treatment (most issues can be addressed with an assessment and twelve weeks of sessions).

Inform yourself and have relevant questions such as what combination of approaches does the counselor use? Those who push AA or “residential rehab” for alcohol use obviously are neither concerned with efficacy nor confidentiality. Read relevant books ahead of time and you won’t have much trouble sorting out competence. A good selection for your shelf could include:

  • The Sober Truth by Dodes;
  • The Codependency Conspiracy by Katy and Lu;
  • House of Cards by Dawes;
  • AA: Who it Helps, Who it Harm, Who it Kills and Why by Wilson;
  • Three Minute Therapy by Edelstein;
  • The Assertiveness Guide for Women (equally good for men, passivity not being a gender specific problem) by Hanks.
  • Her Best Kept Secret by Glaser
  • And recommendation from your potential provider.

The readings are important – they are a cheap intro and education and any provider recommendation will tell you a lot about their orientation. Some books would be giant red flags: The Big Book of AA; Codependent No More by Beatty; and so on.

Hiring a therapist is like hiring a doctor – most of us slip into a subordinate position just when we need to be assertive. Remember, you’re paying, they work for you, you are ultimately responsible for the outcome, you have the ultimate authority to decide what’s worth doing or
continuing.

Good therapists welcome proactive clients just as good physicians do. Indeed, being proactive is the easiest way to sort out the competent from the posers, and the latter are by far the most common (see House of Cards, listed above).

You can change but real, lasting change is dependent on you investing in yourself: time, money, effort. I sometimes think of the sign an elderly mechanic had posted in his shop when I was a kid:

“GOOD, FAST, CHEAP. PICK TWO!”

Or as I commonly tell potential clients: I can’t do it to you or for you but I will do it with you.

I started providing services nearly 40 years ago because I didn’t think people should have to spend years finding their way out of whatever mess had snared them when, with a little help, they could escape in weeks with less damage, greater confidence, and a well-earned pride in the accomplishment. Nothing in the intervening decades has changed my mind about that.