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How to choose a therapist? Part 1

Once you have decided on the kind (or kinds) of therapist that could be right for you, the next step is to pick the person that suits you best.

Which person should you choose?

There are four things that you should consider when selecting a therapist from a mental health profession: 1. Credentials, 2. Experience, 3. The relationship, 4. Orientation.    Credentials aren't everything, but they are important. They let you know that the psychotherapist you are working with has at least met certain minimum standards. However, proper credentials don't automatically mean that someone is a great therapist, and even the best paperwork doesn't make up for experience, personality or talent. Experience makes a tremendous difference, particularly in areas like OCD, addiction, eating disorders, schizophrenia, postnatal depression, sexual abuse and post-traumatic stress disorder. Therapists experienced with your difficulties have seen people facing these struggles many times. They have a clear sense of what to expect, when to worry (or not), what works and what to avoid, and they aren't likely to get caught up in the next treatment fad. This is priceless. Newer therapists do however bring energy and enthusiasm that goes a long way. They tend to be more hopeful and work harder to please. There is no need to avoid these therapists provided they regularly consult with more experienced colleagues. You are meeting with a trained professional (rather than a good friend) because of your interest in making use of their expertise. It's okay to ask them questions about their background and interest in the areas that bring you.  With credentials and experience being equal, the next factor to consider is the relationship. Research confirms that the largest predictor of a positive outcome in psychotherapy is the quality of the relationship between the therapist and patient.  A therapist should feel like a potential partner on your journey towards growth; someone that you can connect with. This is vital: how often do you take the things that someone says seriously when you don't value your relationship with that person? Also, how likely are you to show your most authentic and vulnerable self to someone you don't particularly like or trust? They should also impart confidence that you are safe with them, that your experience, feelings, and actions can be understood and accepted, and that the sessions won't be about the therapist. No one can predict how you will respond to the work, but they should impart some sense of hope, even if it's just the hope that things will become clearer in time. You certainly should not walk away feeling looked down on, told off, judged, mocked or criticized. Well, not unless this is how you always feel, in which case you should leave with some sense that even these are feelings that can be discussed together, accepted and worked with.  The last area you may want to consider is the therapist's theoretical orientation. This refers to the school of thinking that informs how they make sense of the matters you bring, how they approach these, what to aim for and, as a consequence, the duration of the therapy. For example, someone working from a biomedical orientation (medical doctor) is more likely to prescribe medication, while a psychoanalyst might encourage in-depth analysis, and a CBT therapist would target specific symptoms. This is over-simplified, but the principle is sound.  Although some schools market themselves more effectively than others, there is no scientific consensus that one is unequivocally better than the rest. They do have different focuses and aims, and some are more appropriate in certain contexts. In an ideal world, you would be assessed by an experienced professional who is well-versed in a range of approaches and has access to psychotherapists from each orientation to refer you to. In practice, there are few psychotherapists who are able to assess other orientations without bias.   Orientations aren't easily summarized in a manner that does them justice, and you certainly don't need to know about your therapist's orientation to enjoy its benefits. They are raised as a factor because some people do resonate more with one approach than another.

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