Monday, September 15, 2014

How to Find a Good Therapist

One of the most common questions I'm asked is, "How can I find a good therapist?"

Well, it's a multi-step process, so let's get going.

Types of Therapists
First, it's important to think about the type of therapist you think is best for your presenting issues. There are many kinds of mental health therapists, but sometimes understanding "who does what" can be confusing. Here is a list to help identify the specialties and degrees therapists can hold.


Psychologists generally have a Doctor of Philosophy (Ph.D.), Doctor of Psychology (Psy.D.), or Doctor of Education (Ed.D.) and must complete at least four years of post graduate school, however, only those who have been licensed can call themselves Psychologists. Licensed practicing psychologists are specifically trained in the mind and behavior as well as diagnosis, assessment and treatment of mental, emotional, and behavioral disorders. Generally speaking, most psychologists do not prescribe medication.

Social Workers

Clinical Social Workers (C.S.W.) usually have earned at least a Masters' Degree, which is two years of graduate school, and some Social Workers obtain a doctoral degree (D.S.W. or Ph.D.). Clinical Social Workers credentials may vary by state, but these are the most common: B.S.W. (Bachelor's of Social Work), M.S.W. (Master's of Social Work), A.C.S.W. (Academy of Certified Social Workers), or D.C.S.W. (Diplomate of Clinical Social Work). Although there are exceptions, most licensed clinical social workers generally have an "L" in front of their degree (L.C.S.W.) communicating that they are a Licensed Clinical Social Worker. Clinical Social Workers also receive training in the prevention, diagnosis, and treatment of mental, behavioral, and emotional disorders. Their goal is to enhance and maintain physical, psychological, and social functioning in who they treat.


A Psychiatrist completes a medical degree (M.D.) like any other physician, followed by a four-year psychiatry specialty. Psychiatrists prescribe medication yet sometimes do psychotherapy with patients. 

Marriage Family Therapists, Mental Health Counselors & Professional Counselors

Licensed Marriage and Family Therapists (L.M.F.T.), Mental Health Counselors (MHC) and Professional Counselors (L.P.C.) usually have two years of graduate school and have earned at least a Masters' Degree such as: M.A. (Master of Arts), M.S. (Master of Science) or M.Ed. (Master of Education). Marriage and Family Therapists have additional specialized training in the area of family therapy.

Certified Counselors

Certified Counselors are typically trained in drug or alcohol abuse specialties. A Certified Addiction Counselor (C.A.C.) or a Certified Alcohol Counselor, (C.A.C.) may have a I, II, or III added to their degree signifying the level of training in counseling (CAC-I, for example). A C.A.C. Counselor may or may not have a master's degree. Counselors are trained for supportive therapy. C.A.C's work within the field of alcoholism and substance abuse, providing education, consultation, counseling, aftercare, recovery and advocacy.

Religious/Theology/Pastoral Counselors

These are counselors who are clergy, pastors or who have a Master of Divinity (M.Div.) degree, or a Doctorate in Theology (Th.D.) from a seminary or rabbinical school, with additional training in therapy. These spiritual counselors are trained in both psychology and theology and thus can address psychological, religious and spiritual issues.

Counseling Nurses

Psychiatric Nurses and Nurse Practitioners comprise a growing segment of mental health treatment professionals. They display the credentials R.N. (Registered Nurse), R.N.P. (Registered Nurse Practitioner) or M.S.N. (Masters of Science in Nursing). A Psychiatric Nurse is a registered nurse with a master's degree who has been trained in individual, group, and/or family psychotherapy. The Psychiatric Nurse and the Nurse Practitioner generally prescribe medication.

From Word of Mouth To Yellow Pages

Now that you know the kind of therapists to work with, how do you choose one?Well, here are a few ways that can provide leads to a good therapist.

  • Word of mouth: Asking a friend or relative that you trust can be a great way of finding a reliable therapist. When a clinician is highly regarded, there is usually a buzz in the community about him or her.
  • Professional referrals: Contacting your general physician, or inquiring with pediatrician, school guidance and special service staff if you're looking for someone to work with your child are good ideas. Contacting local psychological, psychiatric or counseling organizations can be very helpful in pointing you in a direction as well.
  • Online resources: Many professional organizations and grassroots organizations offer referral resources. There are also mental health websites like Psychology Today's Therapist Directory that can help you narrow down a search.
  • Insurance company: Your insurance company carrier often has an online search engine that can allow you to find a mental health specialist. Not very computer savvy, just call them directly and ask them to give you some referrals. 
  • Religious organizations: Many churches and temples have outreach programs that can help you find a therapist in the community. 
  • Yellow Pages: Many times I get calls from people who "look me up" in the Yellow Pages. With nowhere else to turn, people cold-call therapists with the hopes of finding a good practitioner. But, in truth, this experience can be frustrating and may lead you down a bumpy road of contacting therapists who don't truly specialize in what you need. If possible, try one of the other strategies listed above to help you find a good therapist.

The Initial Phone Call
Once you have a few names, find the time to call each one and talk on the phone with him or her. 

You can get a great feel for a professional during this informal chat. If you make a connection on the phone, arrange for an appointment to consult with the therapist. I call this "the meet and greet" consult where I get to meet the potential patient, assess the symptoms and issues and make sure that my training and expertise are appropriate for the necessary treatment. 

This is a time where the potential patient gets to know me as well, how I will work and also learns about my approach to treatment and the parameters of therapy. Though comfort and connection are necessary factors, so too are making sure that the therapist of your choice is educated, seasoned and a specialist in what you are seeking.

Questions to AskMost therapists will welcome the opportunity to answer any questions you may have. Here are some of the most important ones to consider:

1. What's your professional training and degree?

2. Are you a licensed mental health practitioner?

3. What theoretical school of thought do you follow?

4. How long are the sessions?

5. What is the cost of each session?

5. How does insurance work with mental health therapy?

6. What's your policy on cancelled appointments?

7. Have you been in therapy yourself? If so, how long?

8. How do I reach you in the event of an emergency or crisis? 

9. Do you receive regular supervision on your cases or belong to a peer supervision group?

10. What professional organizations do you belong to?

Enjoy the Process

Once these bases are covered and you settle into treatment, you should slowly begin to feel connected to your therapist. In time, talk therapy will help widen your awareness and help you make meaningful life changes.

Tuesday, September 02, 2014

September 10th is World Suicide Prevention Day

Every 40 seconds someone dies by suicide. 

Every 41 seconds someone's left to make sense of it.

That's over 1 million people who die by suicide each year. And millions more who grieve and mourn the loss of their loved one.

Suicide is THE most preventable kind of death. Education, resources, intervention and outreach can help children and adults who struggle with staggering sadness, hopelessness and despair.

World Suicide Prevention Day is September 10th sponsored by The International Association for Suicide Prevention, The World Health Organization, The United Nations and many more grass root health organizations and agencies world-wide.

This is the 10th anniversary of the World Suicide Prevention Day. Ten years of research, ten years of prevention, ten years of education and dissemination of information. This year's theme is "Suicide Prevention: One World Connected across the Globe."
  • To learn about the warning signs for suicidal behavior go here.
  • For suicide resources in the USA use this link - and for global resources go here.
And remember, there's always someone ready to talk to you any day, any time at 1-800-273-TALK

Friday, August 01, 2014

Gallup Poll: State of Well-Being in the U.S.

A recent 2014 Gallup Poll cited levels of well-being in the USA. Research was done with over 85 thousand Americans and focused on 5 levels of well-being: Purpose, Social, Financial, Community and Physical. Below are more detailed definitions of these categories.

  • Purpose well-being is composed of questions about having an inspiring leader, daily activity, goals, and strengths.
  • Social well-being includes questions about relationships with friends and family, personal time, and received encouragement and support.
  • Financial well-being is made up of questions about standard of living, ability to afford basic necessities, and financial worry.
  • Community well-being includes questions about community pride, involvement, and safety and security.
  • Physical well-being includes questions related to alcohol, drug, and tobacco use; current disease burden and past diagnoses; exercise; and eating habits.
Gallup reports that half of Americans are thriving in only one well-being element or none at all. And fewer than one in five U.S. adults are thriving in four or five elements, which indicates that many individuals are not experiencing well-being. 

When it comes to enhancing your own well-being, remember that there are aspects you can and cannot control. For example, while you may not be able to make more money to increase your financial well-being, but you can improve your social, community, physical and purpose well-being. 

Set realistic goals and make sure to appreciate the meaningful connections you experience.

Tuesday, July 01, 2014

The Myths that Society Holds About Mental Illness

It is an undisputed fact that individuals who experience mental health issues are often faced with discrimination that results from misconceptions of their illness. As a result, many people who would benefit from mental health services often don't seek treatment for fear that they will be viewed in a negative way. The World Health Organization agrees and says that in the 400 million people worldwide who are affected by mental illness, about twenty percent reach out for treatment.

Take a look at the common myths society holds about mental illness. 

MYTH: Mental illness is not a true medical illness like heart disease and diabetes. People who have a mental illness are just "crazy."
FACT: Mental illness is a physiological illness, like heart disease and diabetes. Research shows there are genetic and biological causes for mental health illnesses, and that they can be treated effectively.

MYTH: Mental illness does not strike the "average person."
FACT: Anyone can potentially develop a mental illness, no matter sex, age, race, or economic status.

MYTH: If someone looks or acts odd it means that you need to be concerned about the potential for violence.
FACT: Contrary to popular beliefs, individuals with mental illness are no more prone to violence than the general public, and in fact, are more likely to be the victims of violence than the perpetrators.

MYTH: Mental illness is a result from a personality weakness or character flaw, and people could just snap out of it if they tried hard enough.
FACT: Mental illness has nothing to do with being lazy or weak. It results from changes in brain chemistry or brain function. Medication and psychotherapy often help people to recover.

MYTH: Depression is a normal part of the aging process.
FACT: It is not normal for older adults to be depressed. Signs of depression in older people include loss of interest in activities, sleep disturbances and lethargy. Depression in the elderly is often undiagnosed, and it is important for seniors and their family members to recognize the problem and seek professional help.

MYTH: Depression and other illnesses, such as anxiety disorders, do not affect children or adolescents. Any problems they have are just a part of growing up.
FACT: Children and adolescents can develop mental illnesses. In the United States, one in ten children and adolescents has a disorder severe enough to cause impairment.

MYTH: Most people with a mental illness are receiving treatment.
FACT: Only 1 in 5 persons affected with a mental illness seeks treatment.

MYTH: If you have a mental illness, you can will it away. Being treated for a psychiatric disorder means an individual has in some way "failed" or is weak.
FACT: A serious mental illness cannot be willed away. Ignoring the problem does not make it go away, either. It takes courage to seek professional help.

MYTH: Mentally ill people cannot lead productive lives.
FACT: People with a mental illness who receive treatment with therapy and/or medication can live full, enjoyable and productive lives. In fact many high profile people, including Abraham Lincoln, Patty Duke, Sheryl Crow, Hugh Laurie, John Leguizamo, Buzz Aldrin, Bruce Springsteen, George Stephanopolous, Michaelangelo, Halle Berry, Dick Clark, just to name a few, have been very successful in their chosen professions.

Sunday, June 01, 2014

Is It Ever Right For a Therapist to Cry?


During my morning surf for psychology stories, I came across this one at the BBC asking "Is it ever right for a therapist to cry?"

I wondered as I sipped my English Breakfast Tea (a perfect coincidence) why this was a worthy subject the BBC felt needed covering. Surely, people know that therapists cry. Especially if a patient's narrative is moving, upsetting or emotionally tragic. Right? The article, though, reported that some patients were surprised that a therapist might tear up in a session, finding the response off-putting and even unprofessional.

The BBC article brought into view a recent study by San Diego psychologist Amy Blume-Marcovici, PsyD, who wrote that approximately 75% of the psychologists surveyed cried at least once while with a patient. Of these psychologists, 30% had cried within the past four weeks. This data didn't surprise me, being a trained psychoanalyst. Empathic attunement and countertransference are but a few of the psychoanalytic principles I've spent hundreds of hours studying as a training analyst, experiencing as a practicing therapist and writing about as an author.

A lot of multitasking goes on in therapy. As a therapist, you listen deeply with your patients, index your own thoughts and feelings as they talk, register what threads to grab to explore further, and dwell in the experience of it all as it unfolds in real-time. Sometimes, a patient's narrative moves you. Sometimes it takes your breath away. Other narratives may upset you, make you laugh or raise a sense of worry, just to name a few. Whatever the emotional response, therapists are trained to deal with them in productive ways for the patient being treated. Sometimes therapists may share them, sometimes not. But when they do, it's with the intention of sharing a genuine experience to empathize, connect and validate.

Tearing up while bearing witness to a patient's unimaginable loss or a painful memory is not a rare event for me. Because I specialize in depression and trauma, I often work with individuals who have endured unimaginable events. As my patients and I work in sessions toward recovery,  I consider the range of ALL my emotional responses to be an integral part of the therapeutic process. And so does research. 

While many think it's unprofessional that a therapist cries, being emotionally open is often just what a patient needs from a therapist.

So, the answer to the question of is it right for a therapist to cry, is a resounding, "Yes."

Thursday, May 01, 2014

May is Mental Health Awareness Month

I'm Blogging for Mental Health.

In honor of May as Mental Health Awareness Month, I'll be giving away 2 autographed copies of my award winning book "DEPRESSION AND YOUR CHILD: A GUIDE FOR PARENTS AND CAREGIVERS."

Research shows that children, even babies, experience depression. The clinical term is called Pediatric Depression, and rates are higher now than ever before. In the United States alone, evidence suggests that up to 1% of babies, 4 percent of preschool-aged children, 5 percent of school-aged children, and 11 percent of adolescents meet the criteria for major depression.

Suicide is significantly linked to depression, so early diagnosis and treatment of Pediatric Depression is not just extremely important – it is life-saving. 

Depression is a serious, but treatable condition, but only 38% of adults with diagnosable mental health problems and less than 20% of children and adolescents receive needed treatment.

Learn the signs of pediatric depression and ways to get help. Treatment offers recovery, healing and most of all, hope.

Goodreads Book Giveaway

Depression and Your Child by Deborah Serani

Depression and Your Child

by Deborah Serani

Giveaway ends May 31, 2014.
See the giveaway details at Goodreads.
Enter to win

May 31, 2014 Update: Congratulations to the winners named by Goodreads! 
I am sending your books out in Monday's mail.