How do I know if I need to see a mental health therapist and how do I choose a therapist?
I get lots of questions from people asking me how to know when someone needs to see a mental health therapist and what kind of therapist should I seek out? These can be very vulnerable questions for most people. Talking to someone you don’t know about the most difficult things in your life can cause all sorts of anxiety or fears. Will I be judged? What if it is a bad therapist? What if my problem is too big? While the perception of mental health is getting better, there still is a lot of stigma surrounding seeing a therapist. Remember, you are not alone. Mental health issues affect every social class, education level, income level, faith, age, gender, or status. It could happen to anyone. However, not everyone who has symptoms needs treatment. There are several things I suggest.
First, passive suicidal or homicidal thoughts are not abnormal, but if these thoughts ever cross your mind in a serious manner, treatment is strongly recommended. These are life threatening conditions. Sometimes we struggle to see them as life threatening because they are “all in your head,” but it can be just as serious as heart disease or cancer. Just like if someone is having chest pain it is good to check it out, if you are having serious thoughts about hurting yourself or others you should check it out as well.
Second, is to ask yourself - are your symptoms or daily functioning getting worse and/or are your efforts to work through it working? This can be a hard, soul-searching question that requires one to be honest with themselves. One of the struggles with mental health issues is that often it is a debilitating condition that drives you to avoid the things that make it better, and it drives you to do the things that make it worse. These conditions can lead us to isolate ourselves, avoid other people and situations, or to neglect self-care. We can become irritable, discouraged, and feel hopeless. These behaviors and thoughts then become entrenched in a downward spiral as the emotion becomes stronger, the more we believe our thoughts and behaviors are correct. The sooner these issues are treated, the better the prognosis and the easier it is to effectively treat.
Third, the decision to utilized medication should always be made with the help of your doctor. However, there is strong evidence that medications for mental health disorders are far more effective when used with effective talk therapy approaches. Dismissing your doctor’s recommendation to seek mental health treatment is much like having knee surgery and skipping out on the physical therapy because the pain meds are working fine. Some mental health issues are lifelong genetic or biological conditions that may necessitate long term use of medication much like a diabetic takes insulin. Regardless treatment can help a person to better manage their condition and to cope better long term.
Fourth, what kind of therapist should I choose? This is a difficult question flooded with a lot of unclear “it depends” answers. It is important to find a good fit with your therapist. Most therapists can accommodate the needs of most individuals, but no therapist can help and connect with everyone. A poor fit can lead to discouragement and lack of faith in mental health. Perhaps some questions to ask are: What kind of person would you most be willing to open up to? Do you prefer a male of female? Next, ask about the therapist’s approach to working with individuals and his or her experience and specialization and training. Ask around to see where others had a good experience and see whose names come up more often.
Finally, be willing to switch therapist, but use caution. I tell all my clients that if, for whatever reason, therapy is not working, let’s talk about it and we can switch therapist if needed. I do add here to use caution. This is because sometimes the conditions or symptoms that are being treated are the barrier not the therapist. In such a case, it is better to work through the issues not to avoid them. This is why most agencies require a person to talk with their therapist before they are transferred to another therapist. Do keep in mind that sometimes symptoms become worse for a short period of time before it gets better as you work through the issues that brought you into therapy.
As said earlier therapy can be scary or intimidating, but there is hope in reaching out to work though the challenges you face.
Brent Westover, M.S., Licensed Marriage and Family Therapist