How do you pick a good shrink?

I suppose this is sort of a GQ, but I thought there might be opinions, so I put it here. Feel free to move it.

So, let’s say I’m looking into seeing somebody again. In grad school it was free at their counseling center, but now I’m a big grownup. There’s a list of providers my insurance will cover (90%, and there’s a deductable I’d have to meet, and a huge copay, but all in all not bad if I understand it correctly.) I’m not sure if I would have to get a referral from my PCP but I don’t think so. (I mean, I went out and got my own OB-GYN with no referral…? My insurance is very confusing to me.) Anyway, I’m sure I can figure all that out.

My question is, so I have this list of names, how do I find a good one? I don’t know anybody who sees a therapist that I know of, and it would be weird to ask them anyway. Do you just call people on the list? What kind of doctor does one generally go to? (I don’t want drugs.) I’m not even sure what to plug into the benefits - psychiatry? Psychoanalysis? Give me a hand here, guys!

If it’s talk therapy you are after, you probably want a psychologist. Some will talk to you over the phone so you can get an idea of what he or she is like.

One thing: if it’s not working out for you, you can go to a different psychologist. Not every client-psychologist relationship works out, no shame or fault on either side. I learned all this from my sister, the psychologist. :slight_smile:

Well, I’ll tell you what I don’t want - looking around online I find one local lady who’s written the book “BirthQuake: A Journey to Wholeness”. That’s basically the most succinct way I can imagine to explain what I’m not looking for in a therapist.

According to a psychiatrist I know, there’s no reason to see a psychiatrist for talk-therapy alone, you could just as well see a psychologist or a social worker (MSW) who does counseling. For those who are taking mediation, its very common to see a psychiatrist to monitor the meds and go somewhere else for counseling.

What’s the degree for a psychologist?

And are they under “doctors” when I look up my preferred providers?

It’s like buying shoes. You need to try on a few before you find one that fits.

I think they’re usually listed under Mental Health or Psychologist.

PsyD or PhD. I just check my insurance website for me they’re all under “Behavioral Health”

Ah, for me at least on the website I have to say whether I want a doctor or something else before I can pick an area. Choices include Doctors, Other Health Professionals, Counselors, Dentists, Hospitals, Pharmacy, Labs, Routine Mammography Services, and Other.

Prolly counselor for talk therapy; other health professional for prescribing shrink. I think.

Okay, extensive head scratching and experimenting suggests, if anybody else has this problem with their insurance information, that psychiatrists are “doctors”, while psychologists are “other health professionals”. Counselors covers other counselors, but I can’t tell from looking at it what degree they have.

Okay, so I want a psychologist, I guess. How do I find one to try? It’s a very long list.

You can google their names and see if they are linked to a website/directory. Those sites will often tell you what they specialize in, if they have a secular of spiritual approach, if they are skilled with gay,lesbian, etc issues.
You can also call their office and ask if he/she will speak to you over the phone so you can ask directly what their approach is. If it sounds good, make an appointment. Any of the counselors/psychologists I’ve been to make it clear from the beginning that if you feel they’re approach isn’t working or you don’t feel you’re compatible to let them know. They don’t take it personally.

Googling names turned up one with two good reviews. Would my regular doctor be a good person to ask? I mean, she’s a good doctor, but I see her all of once a year. Of course, I may need a referral to have insurance cover this - I e-mailed customer support at BCBS to find out.

I don’t know if your regular doctor would recommend a psychologist, but it doesn’t hurt to ask.
Here is the [url=]Blue Cross Blue Shield web site, I don’t know if they can tell you if you need a referral or not.
There may be an 800 number on your BCBS card that you can call for information, or can you ask your Human Resources Dept. at work where you can get information about referrals and coverage.
Like everyone else was saying, you may not find someone who’s easy to talk to at first; if you feel you’re not making any progress then look for another one. One psychologist who works out for one person could be bad for someone else, you have to try them out.
Good luck.

I really and truly used this method, and it worked out well for me:

A friend of a friend had always impressed me as someone who really had his shit together. He had a good circle of friends, he was working hard at a career he loved, and he was always a pleasure to be around. I took him aside one day and bluntly asked if he’d ever been in therapy. He said, loudly and smiling, that of course he had. So I asked for his shrink’s name and started seeing her. She was great – kind of a elderly, white Whoopi Goldberg and she really didn’t put up with my shit (I had a tendency to take conversations off on irrelevant philosophical tangents when I didn’t want to talk about something else, and she called me on it). Unfortunately, after about two years, she retired, but not before referring me to another therapist who was almost as good as she was. Unfortunately, when you go this route, you’re not working from within your health care provider, and neither of them were on preferred providers lists.

I’ll second that. Sometimes it takes a couple tries to find the right person - someone you can relate with and open up to. If you can’t open up to the person, therapy is worthless.
And as The Chao Goes Mu said, it’s good to find out if they deal with specific issues (marital problems, eating disorders, etc), and especially if they’re religious and you’re not, vice versa.

Great, a subject I know something about, and all the good answers have been taken. :slight_smile:

I just wanted to add to the excellent advice above that if the psychologist you see thinks meds would be a good idea for you, s/he can help you get evaluated for them, either by consulting with your primary physician or referring you to a psychiatrist. Most of the psychiatric meds in this country are prescribed by primary physicians and gynecologists. Most are comfortable prescribing anti-depressants, especially if they know you are in therapy and have talked to your psychologist.

Thanks, groo, but I don’t know anybody who has their shit together. :slight_smile:

It seems that I do have to get a thumbs up from my PCP, so I faxed her office six freaking pages of preferred providers. The nurse said she might have to see me to do it, which is really, really irritating, can I say?

You can usually call your nearest college/university counseling center. Let them know you’re not a student but you’re looking for some community referrals. Describe briefly why you’re looking for a therapist (e.g., anxiety; life event; relationship issues; etc.), what general counseling process you’d like (e.g., psychodynamic, cognitive-behavioral, feminist, etc.), any therapist factors (e.g., female, older than you, expertise in a particular issue or technique), and what insurance you have. Sometimes your state psychological association has a referral line, too. You probably have to with your insurance, but choosing a licensed professional means you’re getting someone who’d agreed to follow the law, passed licensing standards, and is getting a number of hours of continuing education every year.

This may help: From your state psychological association: Referral Service.

Echoing everyone else here, do everything you can in your power to find a person who you feel you can open the most intimate details of yourself to. In contrast, though it’s sure nice to have a friendly GP, even if you have a rude one, he/she still can get the job done as long as they are good doctors. It ain’t so with therapy. The work is all about communication and anything that hinders this communication will undermine all of your efforts.

I volunteer on a crisis line in my not-so-abundant spare time and have spoken with hundreds of people in various stages of therapy over the years, and one common denominator that seems to always be important is the quality of the patient-therapist relationship.

I have spoken with folks who tell me their problems and when I ask if they have told their therapist, they say that don’t feel comfortable doing so. The problems they share are obviously a heavy burden on them and are probably the dominant factor in their life at the time, but the therapist wouldn’t know that and ends up trying to address everything but the right issue.

The other side is true as well: I have spoken with folks who are so frustrated with their counselor because he/she never listens to them.

Something I have noticed about psychiatrists in particular: many people find themselves in a situation where they actually only speak with their psychiatrist for two minutes each month, with the doctor simply prescribing refills on their meds. Whether or not that’s proper surely depends on each situation, but it bothers me. (More troubling still, IMHO, is when folks go to their GP and get serious antidepressants prescribed without ever having a proper psychiatrist involved in the process.)

Another angle on the relationship is outside interference: some people are not free to go to therapy without another person being around. Imagine a woman who’s controlling husband insists on being present, or a teenage girl who’s mother insists on being in the room when she is in therapy. Though a minor likely doesn’t have the same rights as an adult in this situation, I can’t imagine that either can speak freely enough to gain benefits from the therapy.

I hope things go smoothly for you.