How to choose a "shrink"?

This is somewhat of an embarrassment for me but I thought I would ask the wise masses at the Dope here for help. I feel that I need to see a psych. for treatment of depression as well as other things.
Here is the deal. My insurance has an ‘employee assisstance program’ where you can see a doctor for 4 times at no cost, then after that it goes through the insurance for coverage. I called the only place listed for my insurance- It is a referral center for doctors. They asked me if I would feel more comfortable with a female or male doctor- I said female since some of my problems might not be understood by a man. They gave me the names of three doctors close to my home.
Now my problem: How do I choose which one to go to? When I call, what specific questions should I ask? Is there other things that I should know or be wary of? I realize the first step to getting help is admitting you need it. I have done that, now I need help getting to the second part- picking a doctor. Suggestions from the Doper masses??

Pick the one with the best magazine subscriptions for the waiting room! :smiley:

Seriously, see if they have a “initial consultation” or something like that where you can meet them all and see who you feel most comfortabe with. Of course, if you moved up north, you might not be so depressed. :wink:

Good luck!

I second scheduling an initial consultation. I would suggest going to all three. Let them know that’s all you want to do at this first meeting, and you’d like to hold it to a half an hour (they may not charge you for this).

For me, having worked with several therapists, the most important factor is your level of comfort with them. Do you feel that they have your best interest in mind? Do you feel acknowledged and validated? Does their strategy/technique mesh with you? If you feel it initially, but then don’t after awhile, raise it to your therapist and see if you can work it out. If not, find another therapist. There are many, and they vary in skill/training/experience, etc.

Even if one of the three is a male, I would still make a consultation appointment. You never know…

In your consultation, I would ask what their professional strategy is toward depression. How long have they dealt with patients with depression? Do they consider dealing with depression to be a strong suit or a focus of their practice? If not, who would they recommend? There are many issues that therapists deal with, and IMO you want to find someone who’s good at dealing with depression.

Ask them how they might structure your treatment, and what their goals might be for you. You may want to ask about their training and certification.

That’s my opinion. Good luck. And don’t forget to give yourself a high-five for valuing yourself enough to seek help. Once you find a therapist you like, keep going. I swear it will feel crappy at first, but it will help you!

Thanks niblet for the good questions to ask… some I would not have thought of, nor asking for an initial consult (poss. for free)

if it makes me fell less crappy than I do most of the time then it will be worth it :smiley:

gato, thanks for your humor- it is always appreciated :slight_smile:

I’ve always followed the axiom of choosing doctors that were board certified. That means they have additional training usually, and are more highly qualified.

I don’t have any concrete advice other than to say that if it doesn’t click right off the bat with the pshrink, then say ‘see ya’, and don’t look back.

I was saddled with a marriage counselor I didn’t like, but my wife loved. He could not relate to my image of guyness, and danced around her problems. A complete WOFTAM.

This is an excellent site on the subject:

It has a chapter called: “Finding a Psychotherapist”.

Well, all of the numbers given to me by my insurance are just therapists, not doctors, so I guess there is probably no board certfication. Anywho, I made an appointment with one of them- mainly because she could see the the soonest- 2 weeks. The other 2 were over a month wait :eek:. For the therapist I made the appointment with, I had them put me on a call list in case they could fit me in at an earlier date. I guess I will see how that goes, but what I don’t know is, are therapists/psycologists really capable of treating moderate to severe clinical depression? I would prefer to get better without meds, which I am afraid if I see a psychiatrist they will just stick me on meds.

Sorry you’re feeling like shit.

a) Decide beforehand, after serious contemplation, whether or not you feel like subjecting yourself to forced treatment.

b) Read up on what various psychiatric drugs and electroshock therapy can do to you. (It includes lots of not-good things, including really nasty permanent not-good things, but don’t take my word for it, Google it.

c) After b, repeat a. Now take a deep breath and gear yourself up to interview your potential shrinks. You need to ask them about forced treatment. You’re a depressive, it’s self-damage — suicide in particular — that they’re going to be hair-trigger about with regards to whistling for the proverbial men in the white coats. My entirely serious advice: promise your doc that you’ll use an agreed-upon safe word if you’re sufficiently worried that you’re going to hurt yourself that you want to be incarcerated for your own good; and promise your doc that you’ll use a different agreed-upon safe word or safe phrase that will enable you to talk about feelings you may have like wanting to be a dead person so that the pain will go away, etc., when you want the shrink to know and acknowledge that you are not planning on acting on those feelings. Tell the shrink you can’t do therapy if you have to worry that any time you are honest about those kinds of feelings you run the risk of being subjected to involuntary incarceration and/or involuntary treatment.

d) If the shrink doesn’t go for it, seek out a different shrink.

e) Fill out a Health Care Proxy, if your state has officially acknowledged them. If not, fill out a springing Power of Attorney. Whichever one you use, pick a person you really really trust and instruct them as to what kinds of psych treatments you’d want them to consent to on your behalf if you’re found to be lacking in capacity as a consenquence of mental illness, and keep a couple of xeroxed copies with you. This is just in case.

f) Call your insurance company. Find out in advance if they will pay for treatment to which you do not consent, and whether or not the Health Care Proxy or Power of Attorney will, if it comes into play, cause them to refuse payment for procedures that your designated trusted person does not consent to.

g) Consider seeking out other depressives and other mental patients in your area who are doing user-run self-help. We often have a better idea of what it’s like than the professionals do, and believe it or not it can be a genuine mood-boost to discover that you, too, can help other depressed and/or otherwise troubled people trying to cope with stuff. (“Hi, I’m AHunter3 and my official designation is paranoid schizophrenic, how’re ya doin’?”)

h) Your brain’s biochemistry can get into a rut (you’re depressed, so you do less and care less so you’re more isolated and numb which is depressing, vicious cycle) and psych drugs can help some individuals get out of the loop and over the hump; and other forms of therapy can help you gain perspective or break self-defeating patterns. BUT repeat after me: emotions are not a disease. Not even when they are horribly unpleasant. It is not pathologically wrong or sick to feel awfully bad, and sometimes it’s more honest and more genuinely you than to not feel those things, if the situation you’re in authentically calls for those feelings.

I also suggest an initial consultation with all of the doctors. Keep in mind that not all of them specialize in your particular problem, and may try to get you to conform to their field, where they’re most comfortable. After all, when you’re a hammer, everything looks like a nail.

That said, it’s also important to feel comfortable with your therapist in all respects. At your initial consultation, bring up and discuss medication. If s/he insists on medication, and that’s not what you want, find a different therapist. Likewise, if you think you’re a candidate for meds, and the therapist tries their best to talk you out of it, consider a different therapist. Insist that any medical interventions be discussed at length with you, the therapist, and the prescribing physician (assuming it’s a different person from the therapist). If the prescribing physician is your own family doctor, make sure there is regular communication between him and the therapist.

Above all, don’t be afraid to ask questions about your counseling. You’re the patient, and you have the right to this information. Don’t assume that the shrink knows best.


Well, I am going to oe of the therapists on the list on the 21st. I will have a list of questions and concerns. If I don’t like her or feel like she is not going to be able to help me, I will go elsewhere. I know (or at least I am pretty sure) I have depression, but no one need worry- I am not suicidal in anyway, never have been- ever. As far as having a trusted person, my husband would be the one one making decions If I was unable to. After knowing him for seven years, we have been together for six years, I trust him with my life, and he knows what I would or woudln’t want for treatment.
I am seeking treatment because I feel like crap 99% (and don’t really know why) of the time and I don’t think those people around me should suffer because I feel like crap. I just really want to feel like myself again, and I have put this off for way too long.
Thanks again for all the things to think about (questions to ask, things to watch out for etc…)

I’ve read many times, and believe for myself, that a combination of meds and talk therapy works best for depression. A psychologist cannot prescribe meds, but should be able to refer you to a psychiatrist who can. Finding a good psychiatrist is the same as finding a good psychologist. (Someone you feel comfortable with, who’s strategies make sense to you and is willing to work with you.)

In my experience, it’s harder to find a competent psychiatrist you like working with. However, your GP can also prescribe anti-depressants for you. Make sure if this is what your treatment plan calls for that your GP is knowledgeable about anti-depressants and is comfortable prescribing them and following up with you. If he/she isn’t, ask they refer you to another doc or a psychiatrist.

Remember, you may not need to take meds - if they are prescribed for you - for ever and ever. In my mind, dealing with depression can be like having to climb a very steep hill with a backpack full of heavy rocks. The meds just take the backpack off your shoulders so that you can climb that hill easier.

I also recommend you have a complete physical to rule out other causes of your malaise. You could be hypothyroid, for example.

In any case, there isn’t any reason for you to feel bad. There are solutions out there that will work for you. Keep us posted!

You can also ask your own regular doctor if he/she knows any of the names or has any opinions about them.

You need to give yourself a pat on the back for seeking out help.

For every one person that finally does admit that they need help or something isn’t right or something is no longer tolerable or they want to break the cycle of negativitiy in their lives, there are 1000 people out there that do nothing and have the doormat mentality of " it will never get better, what is the point…poor me…boo hoo."

Or they are afraid to go to a doctor because they will be labeled as such as depression or whatever it is that they probably are but won’t face up to because of the stygma of such an awful word, which is what they are but to afraid or are not ready to deal with the truth.

So, they don’t do anything and stay unlabeled, the situation does not get better, it probably gets worse or stays on an even keel of BLAH.

It is truly a vicious cycle, as AHunter so well put.

The first step is the hardest.
This advice is given by someone who has never seen a shrink except on a Sitcom. It may not totally be valid or comprehensible. Taxes and Title are extra.

I went to the appointment on the 21st as scheduled. She diagnosed me as suffering from major depression (not a suprise to me). We talked about my concerns regarding therapy and medication etc. I think she will be a “good fit” as a therapist. So I decided to give it a try and made two more appointments. I have my second appointment tomorrow (Tues) evening. So hopefully I will be on the road to recovery soon.

They asked me if I would feel more comfortable with a female or male doctor- I said female since some of my problems might not be understood by a man.


I take this to mean you’re female? If not, and you’re male, what issues would not have been understood by a male therapist? Just wondering.

Yes, I am female. For example, an issue (one of many) that might not be understood by a man is my desire not to have kids and the overwhelming pressure and constant nagging* my husband and I are getting from family to breed. Some men , not all, might not understand this. It is not that I have anything against male therapists in general.

*One example of this is his mother is already buying baby stuff and going on and on about having grandkids. We say we don’t plan on having kids. We get the ‘Oh you’ll change your mind’ line. Uh, no I won’t I am already almost 30 and have never once had a maternal urge in my life. I never even played with babydolls as a little girl. I try to defend my position nicely but I just come off sounding like a nasty, defensive bitch.

Just because you aren’t suicidal doesn’t mean that you won’t be treated as if you were.

I know AHunter sounds paranoid (in the colloquial sense) when he talks about the possibility of forced psychiatric treatment, but he’s quite correct. They can commit you if they think you’re gonna off yourself, and unfortunately, they are sometimes more interested in covering their own asses than in ensuring that you are getting appropriate care. I made the mistake of admitting to my ex-shrink that I had a “stop the world I wanna get off” feeling. I wasn’t the slightest bit suicidal–it was more of a feeling that I wanted to run off to Tahiti or something. But as soon as she thought there was even the slightest suicidal feeling, she tried to have me committed. And told me that she was doing it to protect herself! Thank Og the sensible intake folks at the hospital refused to admit me. (Yes, it’s true. I’m a loony-bin reject.) They examined me, determined that I wasn’t at all suicidal or destructive, told me that inpatient care was entirely inappropriate for my rather ordinary case of depression, and sent me home. So, I was lucky. But DAYUM! What a scary experience!

Now, my ex-shrink’s action was grossly atypical, and I don’t expect that kind of thing to happen again, but I’m certainly more cautious these days. One precaution I’ve taken is discussing this issue with shrinks directly and openly. For someone who’s been under psychiatric care before, this discussion will flow naturally from a new shrink’s questions about why you left past shrinks. It might be a little harder for someone like the OP, because she’ll have to bring it up out of the blue. I might suggest an approach like “Hey, I’ve heard these horror stories, blah blah blah, how would you handle this?” If you don’t like the answer, or if you feel too uncomfortable to even ask, that’s a big red flag right there.


What happened between you and your shrink after that?

Has she explained to you why she did this? Yes, to protect herself. From what? Lawsuits? Had she had a dozen or so oridinarily depressed patients commit suicide under her hands that very same week? Was she from a certain “school” (I can’t hedge that in enough) of psychology? Did she operate under some idiot managers rules?

Has she even offered you an apology?

Man, this makes us psychologists all look bad (I’ve got a Masters in Psychology, but never worked as one). Where is that sorry headshaking smiley when you need it?

Many shrinks feel that if you overtly describe wanting to kill yourself, that constitutes a suicide threat and that official inflexible iron-bound “ethics of the profession” require them to toss you into a loony bin at that point to keep you alive.

I do have some friends who see psychiatrists on a voluntary & recurring basis. One of them has explicitly worked out an understanding with her shrink: she needs to be able to talk about suicidal feelings she doesn’t anticipate acting on without the shrink feeling obligated to make the 911 phone call. They have a code word she uses rather than any of the hot-button phrases like “kill myself” or “wish I were dead” or “end it all”, etc., and after explaining to the shrink that if the repercussion is going to be involuntary psychiatric incarceration she’ll just never talk about these feelings, in which case she has far less use for a shrink, so the psychiatrist acknowledged that there just might be a reason why someone would want to talk about suicidal feelings without that constituting a suicide threat. It seems that this is not an easy concept for many psychiatrists to grasp.

I’ve met her shrink. I think she really and genuinely cares about my friend’s welfare and best interests, personally not just professionally, and I trust her intentions if not necessarily her judgment (she’s arrogant and oblivious in many ways) and this arrangement works for them.

But you have to window-shop psychiatrists thoroughly and carefully. No matter what you do you’re always, always going to be the lamb going into the lion’s den. Know your shrink well, know your shrink’s attitude towards forced treatment well, definitely do talk about it and get lines drawn that specify under what circumstances it would be imposed upon you, and if they’re fuzzy lines or you don’t feel you can trust the psychiatrist to abide by them, go elsewhere. But always remember that if the psychiatrist feels that it would be better for you for you to be committed for your own good, unless keeping the word that they gave – to a person they now think is not OK in the head, btw – outweighs their professional sense that you need to be on a locked ward for your own good, you’ve got damn few protections.