What to look for in a family therapist?

My husband and I are interested in seeing a family therapist, but we’re not quite sure what to look for since neither of us have ever sought therapy in the past, family or individual. My son (6) seems to be having some anger issues cropping up lately, has had a bit of trouble in school (following instructions, listening, completing his work, etc.) and my husband and I just don’t feel equipped to handle it, my husband especially.

His typical response to the issues is to start yelling very loudly, to the the point where he scares our son or our son just checks out and stops listening. As a result, my son gets extremely clingy with me, probably too clingy, and it makes my husband feel alienated. We also have a daughter (2.5 years old) who doesn’t have any problems currently, but we’re concerned about how the whole dynamic around here could be affecting her or might affect her later.

So…with that out of the way, Dopers who looked for or worked with a family therapist, what qualities did you look for? If you’re working with a therapist now, what do you like about him/her? What would you avoid? And do you think it helps you?

I would look for a therapist who offers DBT counseling.

It really gives great training on how to handle explosive, negative behavior from a child, without escalating the situation, which it seems is happening with your husband.

Mrs. Spiff and I are in DBT now, along with our 14-year-old daughter, mainly to help us all deal with her extreme anger at the world, that seemingly exploded out of nowhere in January.

But in retrospect, we could see signs of this in her as early as elementary school, but we wrote it off as just being strong-willed.

So, my advice to you is to nip this in the bud with your 6-year-old.

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You should probably call your health insurance company and have them send you a list of approved providers before you start looking for doctors. This will likely narrow your search considerably, right off the bat.

Although it naturally depends on what carrier/plan you have, mental health coverage is probably more restrictive than medical coverage. With my insurance company, I have to adhere to their exact method for finding a provider. Any deviation from that method will result in a denial of coverage. It’s not worth the risk, therapy is expensive. And it’ll give you a list of dudes and dudettes to start from.

I saw a few therapists as a kid and I see one now. I had one I liked okay as a kid and I like the one I see now and the rest were just awful.

The one I have now keeps everything going. Even if I walk in and don’t have anything burning on my mind that I want to talk about and haven’t had anything really interesting happen in the past week or whatever, she’ll find something. She has a whole collection of books and worksheets and kind-of-hokey activities and such. If I stop talking, she makes me draw my self-perception as a tree or some shit like that. Which is kind of dumb, but then we have something to talk about.

Ones I had as a teenager tended very much to be totally useless. They’d ask how I was. I’d say I was fine. We’d sit in silence for an agonizing hour because I didn’t trust them and they did nothing to try to change that. If I did talk, they wouldn’t respond in any useful way- it was just “how do you feel about that?”. If they did say anything else, it always just struck me as completely clueless.

I find that it’s not really hard to tell if you like someone and they’re going to be good if you talk to them for an hour. The thing I would say is just don’t be afraid to fire a therapist and find a better one. Bad ones are abundant and worse than useless and you’re wasting time and money. Good ones are out there, though. If you talk to someone and get the impression that he or she isn’t really hearing you, move on. If you think he or she is dumb or creepy (even if it’s just because she has porcelain dolls on display in her office or too many fake flowers or something), move on. With a six-year-old going to a behavioral therapist, he should like going. He’ll shut down if it’s a torturous experience for him. He doesn’t have to love it or beg to go, but if he cries every time, find a different therapist.

If possible, find someone you know and ask for recommendations. If they have a good therapist, their good therapist probably knows other good therapists. So they can refer you to someone who does what you’re looking for. I found mine through a friend and it’s worked out better than calling people off lists or whatever.

I agree with this.

The issues that your son’s having are consistent with ADHD, so you should look for someone who’s at least familiar with the disorder. You may also want to bring up with your husband that he could have it–it’s a very highly genetic disorder, and blowing up about his kid’s school issues doesn’t really sound like the behavior of someone with good impulse control, does it?

You must be a fantastic psychiatrist! You just diagnosed 2 people with ADHD, based on a couple of sentences.

Do you understand what the phrase “consistent with” means?

It’s also consistent with a completely normal kid.

It’s kind of hard to be a normal kid when there’s inconsistent discipline because dad flies off the handle at the slightest provocation. Not to be insulting to the OP, of course (nobody’s perfect, and they’re trying to fix the problem, which is great!), but how can you view this kid’s behavior as normal?

The only thing she said about her son was this:

That could describe a normal kid, or a deeply troubled one. There just isn’t enough information to make a judgment. The OP wasn’t asking for people to analyze their behavior, just advice on getting a therapist.

This is the husband we’re talking about, folks. I’m not surprised the son has anger issues.

This thread is about finding a **family **therapist. That indicates the husband is wanting help and wanting to change. Dragging him through the SDMB mud is not going to help anyone here.

OP, I don’t live in the same country as you, so don’t have any good advice to give, but I wish you well in your search! If you find your first therapist isn’t working for you, don’t give up, try another. It can take a while to find the right type of person who can help youl.

Right, but I don’t want to see the kid dragged through the mud either.

I don’t know about family therapy, but I would recommend that your husband sees someone about his anger issues separately. It looks like he has enough problems to warrant someone dedicated to him.

No he didn’t. And here’s the point behind what he recommended: if the kid’s behavior is consistent with ADHD, it is hardly a bad idea to consult somebody who is an expert on ADHD and would presumably know the difference between ADHD and a normal angry kid who needs a different kind of counseling, instead of someone less familiar who might just say “Wow, yeah, that kid acts like he’s got ADHD, let’s put him on some meds!”

My other concern is that, if the kid does have ADHD, any therapy which doesn’t involve treating that is not going to work, and there are a lot of therapists out there who aren’t familiar with ADHD at all.

Overall, just trust your gut. A therapist should be someone who feels trustworthy, knowledgeable, and safe to confide in. They might or might not be someone you’d be friends with outside of therapy, but they should be someone you (and the rest of your family) can comfortably work with. If they seem dumb, unpleasant, or full of crap, keep looking. The certificate on the wall means that they completed college courses, it doesn’t endow them with mystical ‘I am the doctor therefore you can’t question what I do’ powers.

If after several sessions the therapy doesn’t seem to be changing anything one bit, go find someone else. Therapy isn’t supposed to be pleasant at all times - you’re dealing with deep emotional issues, after all - but it should provoke thoughts of ‘Hm, that’s a new way of looking at that’, ‘Crap, I have to change my behavior in that situation’, ‘That approach sounds like it’s worth trying,’ and similar.

Do specifically ask about family therapy and experience with six year olds. You want someone who says yes, they specialize in family therapy and little kids make up a substantial part of their practice.

Concur that starting point #1 is to consult your insurance provider, assuming you have one. As FlyByNight alluded, it’s OK to “shop around” a bit. Don’t feel like you’re stuck with the first one just so you don’t hurt their feelings or something* although it’s not like you’re trying to find the one who says what you want to hear, either.

Good luck to all of you.

  • You would be surprised how many people continue dragging themselves to an incompatible therapist because of exactly this.