How Should I Choose a Therapist?

How can I choose a therapist when there are so many different kinds? Just to start, there are a bewildering number of professional degrees associated with therapists — L.C.S.W., M.D., M.F.T., Ph.D., Psy.D. to name a few. More on the different degrees and what they mean in part two

There are many different ways of practicing individual psychotherapy. Regardless of the degree of training a psychotherapist has, they tend to fall in a couple of broad groupings in terms of how they think about cases and work with their clients. Each of these broad groups include many different varieties.

Behavioral Therapy. Broadly defined, these therapies focus on behavior. In fact, the early behaviorists thought that since we can never know exactly what goes on in the brain (they called it “the black box”) that thoughts and feelings are unimportant. We should only work with observable behaviors. Behavioral therapy can be very effective for discrete behaviors such as phobias and bad habits. A behavioral analysis can be very effective in isolating causes of behaviors in children.

Cognitive-Behavioral Therapy. At some point the hard-nosed scientists were joined by some people who decided thoughts at least might be relevant. Cognitive-Behavioral Therapy, also known as CBT, tends to focus on how our beliefs influence our thoughts, and how certain thoughts can really distort our view of the world in ways that make us unhappy. In CBT thoughts are often actively discussed, challenged, and slowly modified. Therapy often includes homework.

Psychodynamic Therapy. This type of therapy focuses on formative experiences, inner conflicts, and character structure. Its roots are in psychoanalytic therapy, but it incorporates more than just Freudian psychoanalysis. Jungian Analysis, Adlerian Psychoanalysis, and other “depth psychologies” are drawn upon in psychodynamic therapy. Psychodynamic therapies tend to be sensitive to issues of identity, patterns of family interactions, and questions about what it means to be in relationship with others.

Research supports the idea that different therapies are effective in different areas. Overall, the largest study done concluded that no one therapy was more effective than any other, despite many claims to the contrary.

My own belief is that “goodness of fit” is probably more important than what kind of therapy is being practiced. It is important that you feel comfortable and confident in your therapist’s abilities.


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Clinical Psychologist practicing in the Los Feliz neighborhood of Los Angeles, California.

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