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Finding the Right Therapist

At California State University, Northridge, we care about our employees and want to do everything we can to help, especially during difficult times.  For many of us, there comes a point in our lives when we could use help with sorting out and managing the challenges we face.  Seeing a therapist is one option for getting that help.

When it comes to successfully resolving a personal problem, finding and working with the right therapist can make all the difference in the world.  Therapy is a process of collaboration, exploration and resolution.  Finding the right match, someone with whom you feel comfortable and have a good rapport, is essential. 

It is our hope and intent that the following information helps guide you through the process of finding the right professional for your individual needs. Should you have additional questions or need assistance at any point in this process, please feel free to contact the EAP Coordinator at (818) 677-6566.  We are here for you. 

Therapists differ in a number of ways:

1. Licensure:
   1. Psychiatrists have an MD.  They are licensed to practice by the state Board of Medical Quality Assurance and, because they are also trained medical doctors, they are able to prescribe medication.  Generally, the role of a psychiatrist is to provide medication and hospitalization management, although many also provide therapy.
   2. Psychologists have either a Ph.D. or Psy.D.   They are licensed to practice by the state Board of Psychology. 
   3. Licensed Clinical Social Workers (LCSWs) and Marriage & Family Therapists (MFTs) have masters’ degrees.  They are licensed to practice by the state Board of Behavioral Science Examiners.
2. Style: (Therapists Differ…Continued)
   1. Some therapists are very directive, actively guiding you through the treatment, while others allow the treatment to be more client-driven.
   2. Some therapists speak a lot and ask many questions, while others remain fairly quiet, with fewer interjections.
   3. Some therapists provide homework, while others focus exclusively on work done in the therapy session.
   4. Some therapists provide structured treatment, while others are more existential.
3. Areas of Expertise:
   Standards of practice require that all licensed therapists practice within the scope of their training.  Unless the practitioner has received specialized training beyond what is required to qualify for their license, they are considered “generalists”.  Most practitioners fall into this category. The following is a brief listing of some of the more commonly encountered areas of expertise:
   1. Child Specialist (MD, Ph.D., Psy.D., LCSW, or MFT)
   2. Adolescent Specialist (MD, Ph.D., Psy.D., LCSW, or MFT)
   3. Family &/or  Couples (MD, Ph.D., Psy.D., LCSW, or MFT)
   4. Cognitive-Behaviorist (MD, Ph.D., Psy.D., LCSW, or MFT)
   5. Neuro-Psychologist (Ph.D. or Psy.D.)
   6. Neuro-Psych-Behavioral Testing Specialist (Ph.D. or Psy.D.)

Regardless of differences, ALL therapists/practitioners are:

4. Ethically bound to uphold Professional Standards of practice established by their respective licensing boards and, 
5. Legally bound to abide by State Laws relating to the provision of mental health care. 

Additional Factors to Consider

1. Before seeing a therapist for the first time, you should always visit your family physician to rule out possible medical causes of your problem.  Some medical conditions can appear as if they are strictly behavioral or emotional when in fact, they are not (such as thyroid or blood sugar disorders).
2. After you have determined that the problem is not caused by a medical condition, take a look at the mental health benefits covered by your insurance plan.
   • Pay particular attention to
   1. Number of visits allowed
   2. Types of treatment allowed
   3. Exclusions for mental health treatment
3. Contact your insurance plan’s Customer Service Department
   1. Ask how to access your mental health benefits, paying close attention to applicable requirements for Prior Authorization.
   2. Ask for at least 3 referral names from the plan’s provider list.
   3. *** To increase the likelihood of finding the right therapist, ask the Customer Service Representative to consider the following when selecting referrals for you:
      1. Practitioner’s availability for appointments.
      2. Location of practitioner’s office.
      3. Out-of-pocket expenses that apply.
      4. Preferences you have regarding the practitioner's:
         • Age
         • Gender
         • Race
         • Religious background
         • Licensure
4. Contact one of the practitioners on your referral list and schedule an appointment.
5. Confirm that the provider accepts your insurance.
6. During your first visit, talk about the events and/or feelings that led you to seek help.  It is also recommended you ask the therapist the following:
   • Area (s) of expertise, education and number of years in practice.
   • What kind of therapy/treatment they recommend.
   • Whether the recommended therapy is a proven method that has been shown to be effective in treating problems such as yours.
   • What are the benefits of this treatment and what are the possible risks.
   • How long do they anticipate your treatment will take. 
   • Will your insurance cover treatment for the amount of time or visits recommended by the therapist.
7. If you are not comfortable with the practitioner you just saw, consider contacting one of the others on your referral list.
8. You may also want to consider alternative treatment options and/or therapeutic resources outside your insurance benefit (see handout or click on link Finding Wellness and Wellbeing: Community Options and AlternativeResources: http://www-admn.csun.edu/ohrs/eap/eap_resources.doc
9. Whether you decide to use the mental health benefits provided through your insurance carrier, or seek treatment outside your plan, please keep in mind:
   • The goal of therapy is to improve how you feel about yourself and your life.
   • The process of therapy takes hard work and can sometimes be painful, but it can also be enormously rewarding and life-changing.
10. Your Rights and Responsibilities:
    • During the process of therapy, it is important to feel “heard” and know that your therapist understands why you are seeking help.
    • It is your responsibility to convey to the therapist what you are feeling or thinking; they are not mind readers.
    • It is your therapist’s responsibility to uphold professional standards at all times, maintaining focus on treatment, professional boundaries, and your wellbeing.
    • You have the right to refuse to do anything you do not feel is ethical, safe or beneficial with regard to therapeutic treatment and/or resolution of the problem that led you to seek help.
    • You have a right to privacy (confidentiality) regarding what is discussed during therapy sessions.
11. Exceptions to Confidentiality You Should Know About!

On occasion a therapist will have reason to breach the concept of strict confidentiality and disclose information that you have relayed during the course of therapy. This can only be done when you have given authorization or under legal compulsion.

• Consent
  If you have given informed consent for information to be released, the psychiatrist is permitted to reveal information learned in the course of therapy. It should be noted that to be informed the consent must be voluntary and intentional (20.2 April 1999; American Psychiatric Association).
• Overriding Interest of the Public
  Most courts have found that a therapist has a “duty to warn” if you pose a threat to a third party. In fact, the therapist can be held liable for any harm that occurs if a warning was not given to the intended victim(s) and law enforcement.
• In Your Best Interest
  Disclosures can sometimes be justified on the grounds that they are necessary in order to protect you from harming yourself. For instance, it would generally be acceptable for a therapist to enlist the support of your family if you were to become suicidal.
• Mandated Reporting Circumstances
  In California, therapists are required by law to report:
  1. Reasonable suspicion of child abuse and/or neglect
  2. Reasonable suspicion of elder abuse and/or neglect
  3. Injuries resulting from Domestic Violence

For additional information contact:

American Academy of Child and Adolescent Psychiatry
3615 Wisconsin Avenue, NW
Washington, DC 20016-3007
Telephone: 202-966-7300
Fax: 202-966-2891
http://www.aacap.org

American Association of Marriage and Family Therapy
112 S. Alfred Street
Alexandria, VA 22314-3061
Telephone: 703-838-9808
Fax: 703-838-9805
http://www.aamft.org

American Psychiatric Association
1000 Wilson Blvd., Suite 1825
Arlington, VA 22209-3901
Telephone: 703-907-7300
Toll Free: 888-357-6850
http://www.psych.org

American Psychological Association
750 First Street NE
Washington, DC 20002-4242
Telephone: 800-964-2000
http://www.helping.apa.org

National Association of Social Workers
750 First Street NE, Suite 700
Washington, DC 20002-4241
Telephone: 800-638-8799 or 202-408-8600
Fax: 202-336-8310
E-mail: info@naswdc.org
http://www.naswdc.org

Note: These are suggested resources adapted from SAMHSA on line. For additional information please go to http://mentalhealth.samhsa.gov/

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• Updated on 4/7/09