12 Steps To Finding The Right Counselor For You (Plus 12 Tips To Help You Do It)
Making the decision to start counseling or psychotherapy does not come lightly. It takes courage. To reach the point where we know that our life needs a change, new growth or direction toward healing requires a boldness many don’t fully appreciate. Yet the idea of being emotionally vulnerable and baring our deepest thoughts to another is often enough to scare many “brave” people away. So before we start, let me tell you; YOU are brave. It takes real courage to seek out and welcome change, especially when you do not even know what it may look like once you get there. Being willing to “let go and grow” is something far too many adults overtly avoid throughout their lives. If you are looking towards self-change and growth – feel good about that. But how do you set about finding the right counselor?
There are many incredibly gifted, experienced and ethical professionals working in emotional health. There are also far too many that are undertrained, have little or no experience to speak of, are practicing outside of their training scope or have put commerce so far above their clients that they hurt the reputation of the entire industry. Finding the right counselor in the vast seas of professionals out there can feel a little overwhelming. Hopefully, this article can help a bit. (I am fully aware that some other professionals in my field may take issue with what I am going to point out below – and frankly, if they do – they just further prove some of the points you will read below.)
My hope in writing this is to provide anyone looking to find a counselor or psychotherapist with some insights to help you make an informed choice and more importantly, find the one that is right for you.
So, as we say in Texas, “let’s thin the herd!”
License VS Certification
Although a license doesn’t guarantee ethical or professional care – it does at least mark a minimum level of competence required to practice. Additionally, it is flat out illegal to practice psychotherapy without a license. Even then, all licenses are not equal. Some licenses cover a specific area. For example, in Texas we have a specialist license called an LCDC; Licensed Chemical Dependency Counselor. This license holds professional competence in addiction and dependency. But it would be completely inappropriate and outside the scope of their training for an LCDC to provide marriage counseling. Some licenses hold a service level as well – as in the interpretation of psychiatric tests requires a licensed psychologist; an LP. (more on this in section 3)
Stick with me. The important part is that license assures you of a base level of competence. Certifications on the other hand can be very misleading. Some certifications, like the ones issued by the National Board of Certified Counselors (NBCC) also have a measure of competence and require a minimum of a masters degree to even test for it and just like a license – they require continuing education training throughout your practice life. Others, like the CSAT (specific to sexual addiction treatment) require an extensive period of applied practice before you can earn the credential. These types of certifications – above and beyond graduate training and a license – may add to the potential abilities of a prospective counselor.
But be warned there are many other certifications out there that are mediocre at best, if not entirely worthless. Some can be earned with a multiple choice online questionnaire and $40 fee. Some at a one day seminar. The quick check I often suggest is this; if you can get the certification without a graduate degree in a related field – then don’t put too much confidence in the certification. (*you can spend 5 minutes online and check the value of any certification pretty quickly.)
Tip 1: Be sure they have a license and what it is. Search any certification they have online.
Generalist VS Specialist
I can’t tell you how many times at a conference or symposium I hear a psychotherapist or psychologist tell someone they work “with all ages and all issues”. (OMG, people!) I tell every client I speak to that if they ever hear someone say they work with everyone and everything – just run. Unless that counselor is a generalist ( which means generic – not a specialist in anything), it simply is not possible in a human lifetime. Period. No exceptions. If you want to learn basic stress management or how to work through mild seasonal ‘blues’ then a generalist is probably okay, I guess. But then I could say, go to a yoga class or talk to respected clergy or a mentor – you’ll probably get the same help.
A true specialization, in my book, is not something you can earn with one or two training classes. When I refer to someone as a specialist in this field it means that (a) they have formal training in that area (internships in graduate school do not count towards this). (b) they take continuing education classes every year in that area to ensure they stay up to date in that arena and (c) they have worked with that specialty subgroup for a minimum of 25% of their practice load for no less than the last 5 years, preferably 10 years.
So, do the math. They cannot be a specialist in 20 different areas. And if they got their license (their fully independent license – not the supervised/intern level) within the past 5 years, they are surely not a specialist in anything. Training and education are wonderful and hold great value. But actual time spent in the field, applying that knowledge in real life situations with real people is where professional practice wisdom comes from. There is no fast track for that. “I’m glad your doctor was the top of his class in medical school – and you say he’s doing his first organ transplant surgery ever, on you?”
Tip 2: Don’t tell them what you are looking for until after they tell you what areas they specialize in.
Degree is Academic, License is Professional
This is bound to ruffle feathers with a few out there, but again, if your ego cannot handle the facts – you probably shouldn’t be practicing in this profession. This comes up again and again. It’s been an issue in managed care for decades. It crops it’s head up in litigation over and over. The title afforded a person by their educational degree is an academic title. This statement is not at all meant to minimize the respectability of the accomplishment. Whether the doctoral degree was in political science, anthropology, english, accounting or international business – the title of “doctor” is deserved. But it is still an academic title only.
In psychology this gets confusing to those not working in the field. There are many psychologists out there and most of them hold a license, but a great deal of them are not Licensed Psychologists. The reason is that “Licensed Psychologist” (LP) is an actual credential. You have to earn your doctorate and then pursue this licensure for several years afterwards. Many psychologists opt instead to get a license that is also available to masters level psychotherapists (In Texas these are LPC, LCSW or LMFT). These professionals are psychologists by academic title, but they are not Licensed Psychologists. Academically they have more education and a higher degree that a masters, but from a professionally licensed standpoint, they are essentially the same.
Tip 3: don’t let the title “doctor” sway your decision one way or another.
None of this is a measure of how good they are or if they are the best fit for you. There are fabulous masters level counselors out there and there are fabulous psychologists out there too. But don’t be too impressed by the “doctor” title unless you really understand what it means. And regardless of license and title – remember the specialist section above. That will speak more to what you may need than the degree the hold or license type.
The Folly of Youth
This is somewhat of a similar track to something mentioned earlier. So, I will be brief. There are a lot of young, recently trained and licensed clinicians hitting the arena – especially in bigger cities. Some of these folks are fantastic – high energy, teeming with optimistic drive and freshly trained. You can discover a great resource here. What you cannot discover is someone recently out of school or newly licensed who is seasoned and experienced in what happens when you apply what you learned in school or practicum and it doesn’t work. There simply has not been very much time working within the field to have gained the finesse and wisdom that comes with time and practice. You can’t short cut experience.
I’ll give you an example. I attended a conference a few months ago where one trainings being billed was an advanced training on mindfulness in clinical practice. I have blended Eastern and Western approaches for over two decades and studied Eastern philosophy in college – continuing to study in that area since. So, this interested me. The “advanced trainer” for the class was 23 years old and working under a temporary license. Her Power Point was full of bright images but the text content had been cut and pasted from various websites as images and stuck into the slides (she just copied things off various websites and stuck them in her presentation). She offered a lot of content and definition but floundered when audience members asked her to give applicable examples and to relay how she employed it in her own life. One attendee asked her to whether she was more influenced by Taoist or Buddhist philosophy – she said she didn’t really know anything about philosophy and it went downhill fast from there. (yikes!)
It has also become popular and profitable for a doctor or seasoned counselor to staff several inexperienced interns or new counselors below them and drive business to them from a brand or image based on their senior image/experience. Don’t be fooled – see only the counselor you screened and agreed to see. (The Katy/West Houston area has seen a lot of these take off)
Tip 4: Ask what year they graduated from graduate school in.
The Illusion of Age
Not to make you think I am being too hard on the newest and brightest stars to the field, we also have a frequent misconception that perceived age somehow means wisdom or assures us of a measure of quality. There are a lot of clinicians in the field who came into this area as a second career. I know of several locally who have come from backgrounds such as food industry, education, finance and hospitality. This is not to say that they may not be very accomplished in their counseling profession – but herein age gives the perception that they have been in practice a long time while in actuality some of the younger folks we noted above have actually been in practice longer. Can wisdom from a previous career add to this one? Sure, in some circumstances it can be an extension of knowledge (as in an MBA who now does professional coaching) – but it does not replace or equal actual time in this field. Chronological age is not career maturity.
Tip 5: Ask what year the therapist was fully and independently licensed in.
Internet Is A Tool, Not A Truth
This is probably more common sense to the younger “digital natives” who are reading this but for those of you are not as tech savvy this will be an important reminder. Internet searches, websites, reviews, etc are all marketing tools. They are built, sought, maintained and paid for with one primary purpose: to generate business. Yes, you can find great information out there, but please – just because someone says they are a specialist on their website or has 13 great reviews online – don’t let that alone be your deciding factor. Websites are only as good as the service who built them, wrote the content, do the SEO, etc. Reviews can be purchased. Bad reviews can be hidden with services paid to clean up your online image. A lot of search tools; like Psychology Today and Good Therapy are paid for and the specialties are self selected by the professionals listing themselves. It may be accurate – but who knows? – it is not a measure that anyone continues to validate with any high level of scrutiny. Consider it a shopping mall. Everybody puts their best smile on and knows that their product is the best deal for you. Shop smart.
Tip 6: You wouldn’t choose your babysitter from an online posting – you’d do your own due diligence in finding out who they really are. Do no less with your future counselor.
They Were On My Insurance Plan
Being In-Network with your insurance company means one thing – they will accept a very discounted rate, hopefully for the same level of service to you, in order to get a higher volume of patients. This doesn’t in any way speak to their abilities, ethics or professionalism. The base requirements to get on most major insurance panels are incredibly low. Many allow providers with only 3 years of experience to get on the panel. Some get on with less if they are in an office with a physician that the insurance company wants to keep on their insurance panel. What’s more is that most of the specialties are ones that the counselor can just self report and be listed with. Remember what we talked about with specialties earlier. Your insurance company very likely has a lot of “specialists” on their site that you would never go to if you could see how little time or experience in those areas they actually have.
Yes, insurance is necessary, and legally required, for most of us. And you the “you get what you pay for” doesn’t always work out as there are fleets of over-priced mediocrity out there. What’s important is that you understand that insurance is not about professional skill, ethics or actual care. Insurance is about payment.
Tip 7: Find the specialist that is the best for you. If they don’t take insurance and you really can’t afford it – then arrange to see them every other week or every third week, even. Don’t settle for less. Get the person who is best for you.
Who Recommends Them?
This is sadly funny. I have met a lot of practitioners who actually have their clinician friends listed as all of their references. Sometimes all of their references are even in their same office or group. I think that these clinicians may have missed the intention of a professional reference.
This is not a reference for a job application. This is reference from other practicing professionals (even in complimentary positions or fields of practice) that refer to them because of what they do and with no other relationships connecting them. Ideally they should be (a) someone they do not work with, (b) someone they do not work for and (c) someone they have never worked with or for. Bear with me.
You are trying to get a sense of who uses them because of their caliber of work. Previous work mates and employers have a bias. I know we can’t screen all this out, all the time. So, at least look for higher credentials and possible one-off sources: like a child therapist who has several pediatricians from other businesses who would attest to him/her.
Tip 8: Ask for the names of 3 medical doctors in the community (outside their office) that would recommend them. Then call those doctors and ask the office manager or charge nurse if they know anything about “Therapist Jones”. If they’ve never heard of them – not very many referrals are coming out of that office to that therapist. If they have heard of them, ask them what they’ve heard.
How Long Have They Been a Preferred Referral Source?
This one is easy. It adds on to the section just above. When you find a doctor’s office that does say they know a therapist and do refer to them – ask them how long they have been sending patients to the therapist? If they don’t know, they probably don’t send that many.
Tip 9: Your time frame a doctor’s office tells you should easily fit within the period since licensure that the therapist reports. Sounds pretty easy right? But, you’d be surprised how often an office will say a longer time than the counselor has even been licensed. (whoops. Not buying that line.)
This is an obvious one and easy to maneuver. When you call to talk with a counselor and do your own pre-screening of them (how very wise of you) ask them several questions before you talk about yourself and your specific needs. You can make inquiries about several of the issues noted above. If the counselor or psychologist gets flustered or irritated and upset about answering a small handful of questions – hang up.
They do not need to know the details of your specific case before telling you the age groups they work with, the specialties they do not work with, when they were licensed and three doctors who recommend them, etc. How they respond to being asked questions will tell you a lot about their ego strength and what they are really invested in.
Tip 10: Ask them to tell you 3 areas that they do not specialize in and that are outside their scope of practice. This is a fair question and a grounded, competent and ethical clinician will have no problem answering it. A scoundrel will waver and try to avoid answering directly.
You Are Responsible
Always, always always read the entire Services Agreement (services contract) before you go to your first appointment. And keep a copy. In this day and age there is absolutely no excuse for this not being available to you on their website. It’s professional and sets an open disclosure standard so that you are aware of expectations, what the services entail, your rights and responsibilities and so on. You don’t buy a car without reading the contract and yet you won’t have that car nearly as long as you will have you. Read it and ask whatever questions you have before you begin sessions. Finding the right counselor takes a little effort, but it’s not hard and really is time well spent.
Tip 11: You always have the right to say when you are uncomfortable, are not happy with the direction treatment is going and to even stop sessions – always. They are the professional and they also can stop sessions at any time, with cause. So, please, read the Services Agreement so you know the expectations on both sides.
Beware The “Been There’s”
Okay, this is a pet peeve of mine. Yes, there can be some value in working with a clinical professional who has experienced a similar challenge and that can be especially enticing to some folks. (I’ve been through a long, debilitating illness that culminated in surgery – sometimes this experience brings me together with my medical patient clients). But, there are some pretty bold problems here too.
First, this can all too often be a banner for some by which they seek to establish a level of credibility: “I’ve been divorced myself, so I can help you better than most through your divorce.” While this might ring with a few bits of truth in some situations, it is not a measure of clinical caliber or experience as a professional. I don’t care if my heart surgeon had heart surgery too – I want to know that he’s the best available at performing my heart surgery! Using the “been there” too heavily can create a false impression of ability. Be clear about it. Been there doesn’t mean good at helping you through it.
Secondly, “been there’s” (especially the heavy duty ones) often times have lost all professional objectivity and instead of treating you as your own person; as an individual, they end up treating you as an extension or repeat of themselves. In the chemical dependency arena we often refer to them as “one-shot-wonders”; clinicians who ride the laurels of their own personal experience and have only one route for guiding clients – the same route they took. It’s not to say that it can’t be helpful to some, but a true professional meets each client where they are and facilitates their progress by the path most likely to be successful for the individual client. The “one shoe fits all” is a surefire marker of clinical mediocrity.
Tip 12: “Been There’s” are not necessarily a problem, but they are definitely not a measure of quality. Everyone has a personal story, even your counselor. But if the counselor is routinely using their own story to guide their client, or marketing their story as proof of their professional ability – you are probably better off with a self-help book or some retail therapy.
Yes, it sounds a bit like a tirade and I am sure I have outed a few colleagues who are even now taking me off the holiday party lists or making wax dolls of me to stick with pins. But, finding the right counselor isn’t easy and there is so much the everyday client doesn’t see that can make such a real difference in their experience and ultimately to find the best fit for them. I came into this field as a passion and a commitment – I want my clients to be healthier, be happier and to succeed in the lives they pursue. I hope this at least helps get more people off to a good start. You don’t need to know all of the above – but at least use the tips to guide your questions and do read the Service Agreement carefully. A little knowledge and a little effort can go a really long way.
Oh, and one more thing – here’s the “Benji Bonus” ; the research shows that how much you connect with and feel you can trust your counselor has much more to do with the outcomes than whether they have a masters or a doctorate degree, are male or female, younger or older or trained in one approach or another. So ask your questions, do your research and when you have the information you need – consider it and go with your gut. Your ability to feel safe with and bond with your counselor has more to do with long term positive results than anything else.
Within the first session or two ask yourself if you feel you could probably trust this person with your deepest secrets and if you could trust what they said after you did. If you don’t think so, look for someone else. But if YOU think it’s a good match – the odds are in your favor that it probably is.
I respect your courage and wish the very best in your pursuits.
Thanks for reading!
Live Better Live Now / Finding The Right Counselor For You / Houston, Texas