choosing a new therapist

Choosing a therapist is an important thing. And there are a few things that can help you in your decision-making process.

First, let me just say, Sarah, that I'm always looking for interesting things to write about. I have (as you all must know by now!) lots of stuff that goes on in my head and lots of things I like to talk to you guys about. But what interests me most to write about is whatever interests you guys most. I'm happiest when I get to write about things you guys ask about. 

So... on to choosing a therapist. There are both subjective and objective factors you'll want to consider. From an objective viewpoint, you'll want to find out what kind of experience the person has, and how long he/she has been practicing. 

For instance, how much experience does the clinician have working with people who suffer from eating disorders? What kind of training did he/she get in this specialty? What specific education did he/she have in the causes and treatment of these illnesses? What percentage of his/her practice is specializing in working with people who have EDs?

In addition to training/experience, I think it's helpful to know a bit about how they view eating disorders, how they conceptualize treatment and recovery. For example, some people see EDs as addictions, others as at least somewhat genetically based, others as societally or personality based or a combination... You want to work with someone whose philosophy about these disorders makes sense to you.

You might also want to ask if they work collaboratively- do they have a dietitian, medical doctor, psychiatrist, etc, with whom they regularly work? 

And then, there are the subjective factors: how does it feel to sit in the room with this clinician? Do you feel comfortable? (you don't have to LOVE the person that first meeting, but you sure shouldn't feel afraid, intimidated, patronized, criticized.... anything creepy)? Do you feel listened to? Do you feel the clinician is hearing you and understanding what you're saying? What does your intuition say about the meeting? What does your "gut" tell you? 

When someone new comes to meet with me I encourage him/her to ask any/all questions she can think of. I also encourage people to meet with as many clinicians as they want to, and to meet with each of them several times before they make a final decision, if that's helpful for them.

Someone told me something today that is relevant here (and most other places in life!): life is written in pencil, not in pen. You can always try out a therapist for awhile, see how it goes. It will become very clear to you if it's a good match. If it is, great. If not, continue looking for someone with whom you do have a good connection. Therapy is too important not to get to have a clinician who is a really good fit. So, don't sell yourself short- keep looking until you find who you want to work with. And trust yourself in this process.

Sarah, you've been in therapy, you know things that work and maybe even things that don't. So, trust that about yourself. And don't be afraid to talk to any prospective new therapists about your experience in therapy- what you like, what you didn't, how you work... any of that's fine and good to talk about. It's also totally fine to talk about your previous therapist- sometimes people worry about doing that, but I assure you, it's a good idea- and any competent therapist will encourage you to do so, as much as it is helpful for you. Good luck with the transition! There are a lot of really good therapist out there, lots of people who really want to help.

Comments

[PTC]

My T went on maternity leave and the woman she sent me to see while she was away was just awful. I guess she's more into psychoanalysis, which I did NOT enjoy at all. I couldn't stand her and thought she was "an idiot," to be perfectly honest. She asked me some of the dumbest questions ever, and I just became frustrated. I only saw her five times, but I got to the point where it was just humorous to go see her because I couldn't wait to see what kind of stupid thing she was going to say to me.

I love my T. Right now I'm also working with another T in training because I'm doing a body image study (ugh, that's a whole other story). I love the girl I am working with too and know she is going to be an awesome pyschologist. I wish I could continue to see her and my T, but that's not possible. First of all, she is still in school, but even if I could see her, I couldn't because my insurance wouldn't cover two people. It's going to be really hard when I have to say goodbye to her in two weeks. I wish we had met under other circumstances because I think we'd get along in the real world really well. I don't like that I won't be able to ever see her or talk to her again. It sucks and I think it's stupid.

[Sarah]

Thanks for all of the suggestions! I met with three therapists, and have decided to 'try out' the one that I felt most comfortable with. I am looking forward to seeing her again, so I figure that is a good sign!

There are a couple of things that worry me a little about this therapist, like she is not generally supportive of psych meds for non-psychotic illnesses, and I'm pretty sure I'll be on meds for the rest of my life. I did talk to her about that concern on our initial meeting and she seemed pretty reasonable about it. In any case, I really like what you said about choosing a therapist not necessarily being a permanent decision, that helps me be less afraid of making a big mistake!

Issues around food and eating aren't my main reason for therapy, I am more focused on managing anxiety and depression. (I have found that as I have gotten better control over these, I binge a lot less, even when I haven't worked on that explicitly.) So that wasn't originally one of my major criteria for choosing a therapist.

I ended up looking for a therapist with an ED background, but more because I worry about being judged for my size than because I want to see someone with expertise in these issues. (There is an awful essay by Irvin Yalom where he writes about a fat psychotherapy patient he saw and how disgusted he was by her body, after reading that I worried a lot more about how therapists would see me!!)

Except, I find that the things you write about (and the comments from other readers) resonate with me more than any of the anxiety/depression stuff I read. And my current therapist says that I minimize the eating issues. So reading and thinking about your posts reminds me to be scrupulously honest with myself about the role these things play in my life and the work I still need to do around them. It also reminds me that it's probably a good thing at this point in my therapy to be seeing someone who is knowledgeable about EDs.

Not sure if that all makes any sense, I just want to say that I appreciate your blog and the time you take to write to all of us, and that it makes a difference for me!!