Nov 3, 2020
I’m sick of seeing so many couples and friends be completely lied to by their therapists. So, I figured it’s finally time to lay out some seriously-needed education.
Therapists are the people we trust with our deepest, darkest, most personal and oftentimes shameful secrets. They’re supposed to help us navigate the most turbulent and challenging times in our lives.
We trust their counsel explicitly and without question because, well, they’re professional counselors.
But there’s something the therapist community rarely talks about that you should absolutely know before choosing a therapist! A good therapist will let you in on the secret, but most won’t… because if they tell you they might lose your business.
To understand what I’m about to reveal, you have to understand how a therapist becomes a therapist.
Where do Therapists Come From?
Most people don’t know there are at least half-a-dozen different ways you can become a therapist. You can become a Licensed Clinical Social Worker (LCSW), a Licensed Mental Health Counselor (LMHC) often referred to as a Licensed Professional Counselor (LPC), a psychologist, a psychiatrist, or a Licensed Marriage and Family Therapist (LMFT).
Even though each of these degrees will provide you the title “therapist,” the stuff they teach you in each program is completely different.
It’s similar to the way doctors work: You’ve got ear nose and throat doctors, pediatricians, cardiologists, pulmonologists, orthopedics, etc. They all call themselves doctors, and they probably took the same courses in their first year of med school, but the specialized training they receive is just that: specialized. The patients doctors serve and how they apply their skills is completely different based on their training.
The same is true for therapists. They have specialized training.
Here are a few examples:
Some therapy grads might get most of their training on how to work with patients in a hospital system, while others learn to counsel students inside the school system. There are therapists who get lots of their education helping adolescents overcome substance abuse, eating disorders or addictions, and some who learn specifically about treating entire family systems, while others learn how to help couples overcome struggles in their marriage.
Now, back to the doctor analogy... if you have a bad case of pneumonia, I’m guessing you wouldn’t want to see a gynecologist. You’d want to see a pulmonologist, right?
The same should hold true for your mental and emotional health!
Mothers with postpartum depression shouldn’t be meeting with a therapist who specializes in helping teenage boys overcome their addiction to adderall. It wouldn’t make any sense, and the therapist likely isn’t qualified to properly treat such a patient.
A therapist “mismatch” can be really harmful… and it does happen quite frequently.
But it doesn’t stop there!
Treatment Methods
Beyond the differences in training a therapist receives in school, and even the types of struggles they’ve trained to help people through, there’s another layer of differences which might be the most important:
Different therapists specialize in different treatment methods called “modalities.”
For example, one therapist might use equine therapy (therapy with horses) to help a client learn to build trust, while another therapist might use recreational therapy (physical exercise and training) and have their client exercise in a group setting to achieve a similar outcome.
Some therapists use art therapy, some prefer music therapy, a lot of therapists use emotionally focused therapy (EFT) which focuses on how people form emotional attachments to and bond with others. A lot of marriage therapists will likely use the Gottman Method, which focuses more on teaching skills and techniques to practice in parenting and marriage.
Mastering many of these modalities require hundreds of hours of study and training. And different treatment methods work better for different people.
Do you see how if you’re not familiar with this industry, it can be really misleading and very confusing?
And I’m not even finished yet! There is one more bit of crucial information that many therapists won’t tell you about.
If you know me, you know spend nearly every waking hour studying, writing about, or thinking about marriage and relationships. I was shocked to find that of the 500,000+ therapists in the US, only a tiny percent (less than 10%) have any formal training or education specific to couples or marriages.
And...
Of those who do work with couples, only a tiny portion have any training or education around... wait for it... sex! (Not trying to put myself on a pedestal, but simply from my own curiosity and voracious reading, self-directed research over the last few years, and attending a dozen seminars from the world’s top sex experts - even without grad school - I probably have more training and education around sex and marriage than most therapists.)
If all that wasn’t enough...
Here’s the icing on the cake - any therapist can call themselves a Relationship Therapist or Sex Therapist!
There isn’t any title control in the industry.
That means right now, it’s completely possible for a therapist who has only ever studied and worked with anxious toddlers to wake up one day, decide to switch gears, change their title to “Sex Therapist” and, that very afternoon, label a client a “sex addict” . . . when they themselves have had no specialized training in sex, intimacy and sexual addictions!
That absolutely boggles my mind.
(This is exactly why I’ve paired up with Certified Sex Therapist, Kristin Hodson to spend an entire season talking about sex on the next season of my podcast, The Loveumentary. You should absolutely check it out.)
Despite all the complexity and nuance in the therapy world, I think it’s important for you to have someone to talk to - especially about you relationship - so I’ve put together a list of tips to help you find the perfect therapist for you.
How To Choose A Therapist
How on earth are you supposed to choose a good therapist with so many variables in play?
Finding the right therapist can take a little work and a lot of time. If you’re smart, you’ll find an awesome therapist before you actually need one.
To help you out, I’ve put together a few tips to help you find the right therapist for you:
Do your research
Most therapists have a profile on Psychology Today. Their specialties will be listed right on their profile. If they say the specialize working with kids, and teens, and couples, that’s not a great sign.
Look for someone who has spent their career helping people just like you. If you need help with your marriage, do you want to work with the guy who has helped hundreds of couples improve their marriages or the guy who wants to mix it up a little from all the substance abuse cases he sees every week? The more specific their profile is, the more specialized and trained they’re likely to be.
If they don’t list the modalities they use, call or email them and ask! If you’re not sure what the differences in modalities are, ask. Ask how they work, what the experience would be like for you, and what kinds of results their clients have had in seeking healing through the various methods.
Ask for a free consultation, even if it’s not advertised. A good therapist knows they’re more likely to gain your business if they can gain your trust.
Know What You Want
Some people want a therapist because they need an emotional safe haven where they can work through their struggles every week. Other people want to address a problem, fix it, and never see their therapist again.
Neither one of these is right or wrong, but being clear about what you want or need out of a therapist will impact which therapist you choose.
Would you prefer to talk to a man or a woman?
Is it important to you that they understand your religious background, cultural upbringing, or sexual orientation?
Is their career experience more important than having good therapist/patient chemistry between the two of you?
Do you need someone who will stand up to you and push back on you if you need some tough love, or someone who will be a gentle guide, and provide a safe space for you to unload your hurts?
The more clear you are about what you need, the more likely you’ll be to find it.
Ask for Referrals
The people you love the most probably share some of your preferences for food, movies, music and more likely than not, therapists. If you’re in need of some help or support, someone you love might have already done the work of finding the perfect counselor for you!
Ask around. See if anyone you trust has a recommendation. It might save you a lot of footwork and stress.
Talk to them before you meet for a session
Think of your search for a therapist like you’re interviewing someone for a job. You hire a therapist to help you get a certain result in an important area of your life. So, have a conversation with them before you fork over $150+ to sit on their couch for an hour and share your deepest struggles with them!
Here are some good “interview questions” that will help you hire the right therapist:
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What kind of clients do you love working with the most?
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Can you give me some examples of clients like me (us) that you’ve helped in the past?
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Why did you become a therapist?
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Tell me about what you specialize in. What’s your background and training?
Give them a chance to prove themselves to you. If it feels right, trust your gut! Which leads me to...
Trust Your Gut
Really, your intuition is the most important thing. If you look at someone’s photo and you get a weird vibe, or you have a conversation with them and they make you feel awkward or uncomfortable, don’t hire them!
It’s ok to say, “I don’t think this is going to be the best fit for us, thanks for your time!”
This is one area of your life where you should absolutely be picky.
Research actually shows the factor that most strongly influences a successful outcome in therapy is the therapist/client relationship, not the type treatment method they use.
There are two things you never want to skimp on when it comes to quality. Toilet paper, and a therapist. Choosing the wrong one will just leave you in a worse mess than when you started.
So, trust your gut. You’ll know when you’ve found the right one.
To Summarize
The world of therapists is vast, complex and can be really confusing… especially if you’re in dire need of talking to someone.
Remember, some therapists try to cast a wide net by saying they specialize in working with everyone in a desperate effort to snag any client they can. Other therapists invest in highly specified training so they can effectively serve a clear-cut subset of people with very specific needs.
And ANY therapist can call themselves a Sex Therapist or Relationship Therapist, so make sure you ask them about their credentials and training. (A highly-trained sex therapist will almost always be AASECT Certified, and the Gottman Referral Network is a great place to start looking for a marriage therapist.)
Finding the right therapist is important, and it might take some legwork. It can be the difference between a marriage succeeding or failing, or struggling with an issue for weeks and struggling for years.
It requires a little work and investment, but the support a good therapist provides can last a lifetime and transform your life.