How do I find a GOOD therapist??

Is there some way to find 'ratings' or something on therapists?

How do I find the GOOD ones, with LOTS of experience, and who actually WANT to treat what I have??

How can I prevent getting another jerk like the one I met last week?

I have been thru so many bad and incompetent therapists I am just ready to SCREAM...or worse...just give up.

I'm even willing to travel or do online therapy if I can just find someone who knows what the hell they are doing and who will actually CARE about whether I get better or not and will treat me with respect.

I may have Borderline Personality Disorder. I know for sure I've had some form of Depression since childhood. Some docs have suggested Bipolar but I'm not sure I fit that.

I'm a 6 hour drive from San Francisco...and honestly considering trying to find someone there. How sad is that...

PC, in conjunction with Psychology Today, has a "find a therapist" option, here. My caveat is that it works best for those in decent-sized cities. I live in a town of 13,500 and all it gives me is a couple of T's in MN -- which is no more than a half-hour drive from this part of Wisconsin, but still frustrating.

Other than that, I too would love to hear tips for finding a good T, as I have completely struck out here! One thing I have learned (and relearned, 'cause I'm dense ) is that picking one at random out of the phone book or your insurance provider's directory is a BAD. IDEA. It can be hard to get recommendations if you don't want to blab your mental health issues to people, but sometimes that's still the best way.

Good luck!

Candy

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candybear said:
PC, in conjunction with Psychology Today, has a "find a therapist" option,

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Yeah, tried that, closest is over 70 miles away. They don't list ANY of the ones in my town, on this website.

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One thing I have learned (and relearned, 'cause I'm dense ) is that picking one at random out of the phone book or your insurance provider's directory is a BAD. IDEA. It can be hard to get recommendations if you don't want to blab your mental health issues to people, but sometimes that's still the best way.

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Okay...been there done that. So how DO I find one without just looking at the insurance list and taking whoever actually returns my phone calls???

I don't know anyone - period - to ask for a referral from. I just wish I could find out a therapists's strengths and stuff somehow.

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How do I find the GOOD ones, with LOTS of experience, and who actually WANT to treat what I have??

</div></font></blockquote><font class="post">Ask your healthcare providers for referrals. Do you have a family doctor? That is an excellent place to start. After you get the referrals, make the calls, and specifically say, "I've been feeling depressed (or whatever your issue is) and I am looking for a therapist who can help." If they don't treat depression, they will tell you, and you can also ask them if they can recommend colleagues who do treat your problem. If I were you, I wouldn't mention too many specific diagnoses. Focus on symptoms. "I am feeling depressed and would like to work with a therapist." Rather than, "I have X, Y, and Z" and list off personality disorders, etc. They will probably want to make their own diagnosis based on your symptoms.

Other places to look for referrals: other professionals such as dentists, physical therapists, lawyers, ministers, rabbis can be good too. But I think the family doctor or other medical doctor is a first place to ask.

I think asking friends for referrals isn't always a good thing. Would you want to go to a friend's therapist? But friends may have heard of good therapists who are not necessarily their own therapists.

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I just wish I could find out a therapists's strengths and stuff somehow.

</div></font></blockquote><font class="post">You can use the first session to gather this information. Don't start doing actual therapy with the therapist until you have asked the questions you need to ask, such as "what are your strengths?", "how long have you been practicing?", "what is your approach to treating depression?" or whatever else you need to know.

Here is one link that might be of help. You still have to check them out individually:

http://www.sidran.org/sub.cfm?sectionID=5

Basically, I do not know how one goes about finding a skilled therapist if you need one badly. That is because, I think, one badly affected has a very hard time judging people.

See if there's good info here: http://www.oregoncounseling.org/

I don't think there's an easy way to find a GOOD therapist - what is good for one may be awful for another. I think going in and meeting them face-to-face with a list of questions to find your best match is your only option. It gives you a control in who you want by having a set amount of objectives you want your therapist to be able to complete with you.

I think finding a good therapist is in part at least knowing what you want out of therapy & what role you want your therapist to play. Your first session should be at least half about interviewing them, asking about their approach, their training, their experience with working with problems such as yours, and how many sessions they think you'll require. Some T's prefer short term focussed therapy on specific issues whereas others do long term psychotherapy and deal with your whole life. A big part of it's simply personality fit and style to. I really like my T and my pdoc becasue they both actively ask questions and respond to what I am saying. I'm less thrilled with my addictions Dr. because she keeps a perfectly straight face and barely talks at all. She can however be very direct and a little scary at times, if she feels you need to do something and aren't doing it.

I was lucky I found my current T from a friend's referral.

--splitimage

Hi there,

Here's a place to start.

http://www.div39outreach.org/search%...nstitutes.html

I contacted the psychoanalytic isntitute in the largest city close to me, asked if they had a candidate (student who is hightly qualifiied and screened, is currently a therapist, etc) who was in my area. I found my T that way because I wanted psychodynamic/psychoanalytic psychotherapy. I wanted depth therapy and not CBT-type therapy.

I am BPD and she is wonderful. This won't be short term and I am happy about that. She isn't covered by my insurance but I actually like that.. no one to 'report' to about treatment.

The San Francisco area seems to have an abundance of therapists and analysts. I can see why you would be thinking about that. Try the institutes and see if you can find someone closer.

> How can I prevent getting another jerk like the one I met last week?

So that is the verdict then? Did you hear back from the APA already? Give him a chance to explain what he was thinking?

Remember that when people have been victimized they tend to read revictimization into present circumstances...

I was shocked when I found out what was considered appropriate in a diagnostic interview according to Kaplan and Saddock's standard textbook for psychiatry. It said that very detailed questions were in fact appropriate.

When I was involved in a lesbian relationship you wouldn't believe how many p-docs would ask me what we did together sexually. I looked at them like they were little bugs and ignored the question - I thought they were being inappropriate... But perhaps... They weren't.

The thing is that you won't really know until you give him the chance to explain. To write him off so swiftly... When there isn't an abundance of therapists in your area... Junerin started a post on your behalf on general about internet therapy. If you haven't seen it already.

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Alex said:
When I was involved in a lesbian relationship you wouldn't believe how many p-docs would ask me what we did together sexually. I looked at them like they were little bugs and ignored the question - I thought they were being inappropriate... But perhaps... They weren't.

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Why is this necessary?What does describing specific acts do for you as the patient? You know what you did, why do you have to share every little detail about it? Why the heck would a T need/want to listen to this.

I'd like to understand why I am such a freak about my personal space before I discontinue therapy. But I do not want to go step-by-step through each relationship and what I did when.

mckell, you are not a freak. I don't think therapists need to know about our sexual lives unless it is directly relevant. My T has asked me just a few questions about sex, and they were always directly related to what we were discussing and he had specific reasons for needing to know. And he let me know what those reasons were. At the very least, if a T is going to ask detailed sexual questions, he should tell the client why he needs to know, so he can put to rest any fears he is getting off on the content. I think if a T doesn't have a good reason for needing to know, that is a big red flag. And something lame like "bonding with the client" wouldn't be reason enough for me.

I think if a T is asking questions that make a person uncomfortable, the client's first question should be, "why do you need to know?"

I don't think you are being a freak about your personal space. Everyone who has responded to you here has said that they would similarly feel uncomfortable about being asked such specific and detailed questions and the majority of people here (myself included) did indeed wonder about the ethics of that.

Part of it was that you told him that impulsive sexual behavior was one of the things that you wanted to work on. So I'd imagine that he was conducting an assessment of the problem.

If you told him that traumatic memories of sexual abuse was one of the things that you wanted to work on I'd imagine that an assessment of the problem would involve asking about when you had those memories (how frequent, how debilitating) and perhaps a little about the content, yeah.

Makes some difference to treatment whether you are allowing guys to sleep with you if they want to and taking a passive role kind of lying back and thinking of England... Compared to whether you are actively seducing guys and taking a very active role in the behaviors you are engaged in. Makes some difference to treatment if there are S and M themes and which of those themes tends to predominate for you. Makes a great deal of difference for treatment whether you enjoy the sexual act or whether you experience it more as a kind of compulsion that you can't resist. Makes a great deal of difference whether you are fixated on oral acts (for example) or %#@&#! themes or whatever...

Now of course I wasn't there. All I'm meaning to say is that one can't know whether he is an unprofessional crank or not on the basis of one initial meeting like that.

From Kaplan and Saddock:

SEXUAL HISTORY: ... The psychiatrist should ask how the patient learned about sex and what he or she felt were the parents' attitudes about sexual development. Also inquire whether the patient was sexually abused in childhood... The onset of puberty and the patients feelings about this milestone are important. Adolescent masturbatory history, including the nature of the patient's fantasies and feelings about them, is of significance. Attitudes towards sex should be described in detail. Is the patient shy, timid, agressive? Does the patient need to impress others and boast of sexual conquests? Did the patient experience anxiety in the sexual setting? Was there promiscuity? What is the patient's sexual orientation?

The sexual history shuold include any sexual symptoms, such as anorgasmia, vaginismus, erectile disorder, premature or retarded ejaculation, lack of sexual desire, and paraphilias (e.g., sexual sadism, fetishism, voyeurism). Attitudes towards fellatio, cunnilingus, and coital techniques may be discussed. The topic of sexual adjustment should include a description of how sexual activity is usually initiated, the frequency of sexual relations, and sexual preferences, variations, and techniques...

And that is in the context of a general history and not within the context of assessing symptoms of a sexual disorder well enough to treat it...

Alexandra_k ...Woooh, I guess Kaplan & Saddock get a bit personal. :-)

In your last statement are you suggesting that Kaplan & Saddock included these questions as part of taking a [i[general history[/i], not as part of an expanded history when a sexual disorder is suspected? If so, what the heck is left to ask after all this?

Some of the questions sounds appropriate; but much of it sounds like something a sex therapist or a T with some other specialty certification or training would delve into.

Yeppers. It is in chapter 6: Psychiatric History and Mental Status Examination.

In particular you might get a kick out of this:

'Be non-judgmental. Asking *when* masturbation began is a better approach than asking *do you* or *did you ever* masturbate'.

Lol.

I'm not sure how often psychiatrists conduct a FULL assessment of all the factors that Kaplan and Saddock run thought. But it seems that, according to Kaplan and Saddock it could indeed be appropriate to ask about attitudes towards spitting vs swallowing (for example) in a psychiatric assessment, yeah. But that being said... Whether someone is a crank or not takes time to assess... If I went to see a doc about a fear of spiders and he asked whether I spat or swallowed I'd probably walk out, yeah.

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But it seems that, according to Kaplan and Saddock it could indeed be appropriate to ask about attitudes towards spitting vs swallowing (for example) in a psychiatric assessment, yeah.

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Alex, that is absolutely fascinating. Do you know what they were looking for in asking that? I have very strong feelings on the topic, and would be interesting in knowing what those strong feelings meant in a psychological sense.

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alexandra_k said:
So that is the verdict then? Did you hear back from the APA already? Give him a chance to explain what he was thinking?

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I have not heard back yet - at least not on my specifics. They did give me the reports that said his license is valid and he has never been disciplined by the state board. I sent an email on Friday with more details and I haven't heard back yet.

I had an appointment with him tonight, 5:30. I cancelled - my husband is working tonight and I need to pick up our daughter from daycare (really). I did also send a short email to that therapist on Friday basically asking why he had to get so detailed so early.

Let me remind you...it was only my 2nd visit with this therapist. He doesn't know my entire history yet. Yes, we were discussing some impulsive behavior but I really think he went too far. I don't know.

Either way...I just don't feel comfortable going back there. My appointments are after-hours because of my work schedule, and that building gets empty by 5:01. I know it's slightly irrational but I'm scared he could do something since no one would be around. It's an independent office...not even a receptionist.

Anyway...enough of that. I just need to forget about it and move on.

I do have an appointment Tuesday on my lunch break with a different therapist. I already feel better about this one in one sense - he's married, and works with his wife in a shared office - she's a doctor / pain specialist. And they have a receptionist. So...I'd just feel a little safer if you kwim. Wish me luck....

One problem is I can't just ask on the phone if they've dealt with Borderline patients, because I've never officially been diagnosed, and it's bad to self-diagnose before you get in there. I'm just crossing my fingers hoping this guy will at least try and help.

nah, i don't know. though i'd be interested to know because i have strong feelings about that too...

maybe different theoretical orientations give you different stories? dunno...