How are you? I finished S-town. Incredible. I love brilliant people like John B., and I get now why you are disappointed in him. He was a racist. It makes me a little sad that he would not like people like us. Although he didn’t just hate black people, he hated everyone. Even himself. I think that’s what’s sad about the story. You can’t hate others without hating yourself, and in the end that hate killed him.
Anyway, yes, so therapy. You want to see someone or are you asking for a friend? Either way, here is my advice.
First, you should like and respect your therapist. Everything else I’m going to tell you should be filtered through this lens. If you break one of my recommendations but you like and respect your therapist good for you! If it ain’t broke don’t fix it! The single biggest predictor of success in therapy is the therapist-client relationship.
Next, you want to look for a fully licensed Marriage and Family therapist (LMFT), Professional Counselor (LPC) or Social worker (LCSW). Do not under any circumstances go to anyone who isn’t fully licensed. See what happens is after we therapist graduate from therapy school we have a degree, but we have no idea what we’re doing. Licensure boards know this and make us gain experience for 2-4 years in order to become “fully licensed.” In the mean time, the agencies that new therapist work at offer counseling with them at low cost. One clinic I worked at charged $10 and another one $25. This is really cheap especially since most fully licensed therapist charge anywhere from $100-$150. Trouble is going to a new therapist verses a fully licensed professional is like going to see a Nurses Aid instead of the Physician.
Also, I’d stay away from someone licensed as a drug or alcohol counselor. Most addiction counselors just try to convince and shame you into not using drugs. But one of the things we know is that addiction is a way to self medicate past wounds. So if the best way you can deal with your pain is by using drugs, I assume your pain must be pretty bad and I’d rather not take away your most effective strategy for dealing with that kind of pain.
So what should you look for?
It might help if I break down the different degrees
- Psychiatrist- these are MDs trained in medication. Most are not trained in counseling. Truth is medication doesn’t have a great track record for much besides stabilization. Most medication takes about a month to get working, so you shouldn’t be changing very often. Also, any decent psychiatrist will give you a referral to a counselor. So if they change your meds regularly and don’t recommend counseling you need to switch to a different doctor.
- Psychologist- these used to be the most highly trained therapist. Now they mostly focus on testing. Testing is helpful if you think you have autism, a learning disability, or some sort of delay. But we’re not looking for those things. We’re looking for clinical skill.
- Social workers- they are trained mostly in case management. They are great at making sure you are connected to local resources like food banks, getting medicaid, or enrolling in other assistance programs. Some of them do work clinically. You’ll want to look for a LCSW- Licensed Clinical Social Worker.
- Professional Counselor- They are trained in counseling from a individual standpoint. Typically they are licensed as an LPC- Licensed Professional Counselor.
- Marriage and Family Therapist- These are NOT marriage therapist. They actually are just as bad at marital counseling (the hardest form of counseling) as anyone else. They are trained to look at how your problem makes sense in the context of your relationships. You want an LMFT- Licensed Marriage and Family Therapist.
So, on top of being fully licensed you want to find someone who has a certification. Most clinical training for therapist is abysmal. If your therapist has a certification that often times means they’ve had a master therapist give them moment by moment feedback on how to work with an issue. This is what we want. Also, if someone has a Ph.D ignore it. I went into a Ph.D program to become a better clinician and …well…eh… it didn’t help me become a better clinician. All a Ph.D means is you’ve read more books and written more papers. If someone has a Ph.D ignore it. I means nothing about clinical skill. If I could do it over again I’d have just found things I wanted to get certified in. We are looking for clinical skill.
Here’s a short list of some of the top certifications in the field
- EMDR- top trauma certification.
- EFT- the top marriage certification. DON’T GO TO ANYONE ELSE FOR MARRIAGE ISSUES.
- MBST-general anxiety, bipolar, depression stuff.
- DBT -general anxiety, bipolar, depression stuff.
There are a few other ones, but as long as your going to a fully licensed therapist with a certification they you are MILES ahead of the game. It will cost you, but every dollar will be worth it. If you need help paying let me know. I’ll talk to Laura and try and help you out.
The final thing is that you should like and respect your therapist. Yes, I’ll say it again. The single biggest predictor of success in therapy is the therapist-client relationship. A good therapist should be trained in helping you feel comfortable- which means you should like them. So if your gut is telling you it’s not a good fit, then bounce. Just please, keep looking until you find a good one.
Anyway, that’s my advice. Let me know how it goes. Oh, and sorry I didn’t call you on Monday. I got busy writing for my blog and then it was 11 o’clock … so yeah. I’ll try and call you later this week okay?
Ps. What’s our next podcast going to be? I’m thinking Revisionist History, Making Oprah, or LaVar Burton Reads? Whatcha think?