In my experience, you definitely have to shop. You have to find someone who is a fit for you personally. Don't settle until you find someone who truly helps you; someone you anticipate seeing each week. It takes time and is an investment in yourself. Have patience and expect to spend a lot.
A therapist will never say to you, "You know what? I don't think we're a good fit" or "I don't think I can help you as effectively as someone else." It's up to you to figure that out, unfortunately. Personally, I have found that the more decades a therapist has in the field, the more helpful they are to me.
A lot of the best therapists do not take insurance and are not part of a group practice. Why? Because they do not want the enormous paperwork hassle. And if they are good, they get enough referrals to fill their schedule with people who can afford to pay out of pocket.
Also: this is one of those fields where credentials aren't as important as raw experience. Masters-level social workers can sometimes be more helpful than PhD- or PsyD-level clinicians.
Thanks. I could benefit from therapy to address trauma I experienced with a previous (awful) therapist. And I get a sinking feeling considering the shopping I would need to do.
> A therapist will never say to you, "You know what? I don't think we're a good fit" or "I don't think I can help you as effectively as someone else."
Would you say more about this? If I were a self-respecting therapist and I read this I would feel defensive on behalf of my field. The therapist is the professional in this situation- it’s obvious they have an ethical responsibility to catch bad therapist/client fits. I honestly have so many questions here!
- Why should we not expect the therapist to catch scenarios of bad fit?
- Do therapist professional associations make any attempt to set an expectation in this regard?
- Tactically, could therapists be required to set an auto survey to go out, say every three months asking “Is our work helpful?”, to make it easy for the patient to speak up, and once the patient has spoken up, the therapist has some limited timeframe to remediate the relationship or it’s terminated by default?
- Is the reason that I perceive a market for lemons simply that therapists’ profit motive is a moral hazard? IE the worse the therapist, the less likely they will catch (admit to?) a bad fit, so due to probability, over time, we patients will converge on the bad therapists? How could we systematically mitigate this “externality”?
- If therapists could collectively improve the therapist shopping experience, could they grow the market for therapy? IE how many people like me are out there, that need therapy but don't seek it, because of distrust for the the industry. Is anybody working on this?
> Would you say more about this? If I were a self-respecting therapist and I read this I would feel defensive
My background: for 8 years, I was married to a doctoral-level clinical psychologist with an active practice. I learned a lot about the industry from her. I've also seen many different therapists over my lifetime. Finally, I've the great fortune to have discovered a wonderful therapist almost a year ago. This was not my first wonderful therapist. But I've also had a number of poor matches over the years.
> it’s obvious they have an ethical responsibility to catch bad therapist/client fits
I can't really answer why they never come out and say, "I don't think I can help you as effectively as someone else." I don't really know. They just don't. I'm sure if you ask enough therapists, you'll get the odd exception here and there, like a therapist not comfortable with a client's erotic transference who then lets the client go. I don't know.
> Why should we not expect the therapist to catch scenarios of bad fit?
Perhaps they don't have the perspective. Perhaps they are trained to think they can help everyone, to some degree or another, and perhaps that's generally true. I don't know. But like finding a teacher who resonates with you, you won't learn the material as well or progress as fast unless the two of your resonate.
> Is the reason that I perceive a market for lemons simply that therapists’ profit motive is a moral hazard?
I don't think the majority of therapists go into their field for the money. I think there are lemons because of lack of experience and the highly-personalized experience; one person's lemon is another person's diamond.
I can't answer your other questions. I just want to emphasize that you need to advocate for yourself. If you don't feel like the therapist is helping you after 3 sessions, move on. Yes, you should have some progress after 3 sessions in my opinion. Doesn't have to be earth-shattering but should be something.
Re-read my above comment because I edited it several times after your post, adding more info (e.g. info about insurance)
A therapist will never say to you, "You know what? I don't think we're a good fit" or "I don't think I can help you as effectively as someone else." It's up to you to figure that out, unfortunately. Personally, I have found that the more decades a therapist has in the field, the more helpful they are to me.
A lot of the best therapists do not take insurance and are not part of a group practice. Why? Because they do not want the enormous paperwork hassle. And if they are good, they get enough referrals to fill their schedule with people who can afford to pay out of pocket.
Also: this is one of those fields where credentials aren't as important as raw experience. Masters-level social workers can sometimes be more helpful than PhD- or PsyD-level clinicians.