This is the time of year when many people contemplate contacting a psychologist. It may be the drop in mood that occurs in winter, the lingering stress of the holidays, or perhaps it stems from a New Year's resolution. Whatever the reason, psychologists' offices become a bit busier this time of year. To assist those of you who are trying to figure out which factors are most important in searching for a good psychologist, the following list will hopefully assist you in the decision-making process:
1. Is the person actually a psychologist?
This might sound like a silly question, but in many states and provinces, you can call yourself a therapist with almost no training! States and provinces regulate most of the important health care professions. In order to call yourself a physician, for example, you must be licensed within the state or province you are practicing. In my province of Quebec, not just anyone can call themselves a psychologist or psychotherapist -- these titles are legally protected. In order to hold one of these titles a person must meet certain standards and requirements (ie., a doctorate in psychology, sufficient knowledge of the laws and ethics of the profession).
However, not all mental health titles are regulated. For example, anyone can call themselves a "therapist" in Quebec and in other districts that do not regulate this title. This does not mean that these people are necessary charlatans or untrustworthy. However, if you are going to work with someone in an unregulated health role, do your homework. Talk to someone that has worked with the person (if possible) and definitely learn about their credentials. Also -- many insurance companies will only reimburse you if you see a registered professional.
One of the main benefits of working with a regulated professional is that it gives you protection. If the person is unethical or unprofessional, you can contact their professional regulatory body to make a complaint and seek advice.
2. Do they specialize in your problem?
When psychologists are trained, they learn how to work with lots of different types of people with a variety of problems in all kinds of clinics and hospitals. When a psychologist is finished their training, and along the course of their careers, they will usually gain more experience and expertise with certain types of problems (or certain types of people!). Some psychologists specialize in learning disorders. Others become experts in depression and mood disorders. Still others may specialize in assessing and treating anxiety disorders or eating disorders.
It is possible for professionals to have expertise in more than one area, but be wary of someone who claims to be an expert in a wide range of disorders and problems. At the very least, if someone is claiming to specialize in a particular area, they should be willing to explain or demonstrate why they are so qualified in that area.
Don't be shy. Send an email or a phone call (or check their website) and ask about the person's background. If they say they specialize in treating depression -- have them prove it to you.
3. What type of treatment do they offer?
There are literally hundreds of known psychological therapies. Trust me -- not all are equally effective and some are even harmful. It can be confusing for consumers (and even for psychologists!) to know about all of the different treatments and whether they are useful for given problems.
One of the more popular treatments in the modern era of psychology is cognitive-behavioural therapy (or CBT). Randomized controlled trials (the best kind of research for finding out if one treatment works better than another) are not only used in testing medications like Prozac -- they are also used to test whether psychological treatments are effective. CBT is probably the most tested psychotherapy in existence, and the research generally shows that it is very effective for a number of disorders including depression, anxiety, eating disorders and chronic pain management.
However, not all CBT therapists are equally effective (i.e., you can have a poor CBT therapist). Psychodynamic therapy can also be helpful, as can interpersonal therapy. There is no formula for knowing which therapy is best for you.
My advice? Try to find a psychologist with expertise using CBT as a first option, and if that approach is not working for you, consider trying a different therapy. Alternatively, you could learn more about these different therapies by doing some homework (for example, contact and ask some mental health professionals, find sources online or books) and make your own informed decision.
4. Do you know anyone who has worked with a psychologist?
The devil is often in the details. Is the psychologist nice? Sense of humour? Flexible? Smart?
These personality qualities and others might be important to you -- not to mention whether the psychologist is actually effective. You can find out this information by speaking with someone that has personally worked with the professional. Unfortunately, unless you actually know someone who has worked with a psychologist, this information can be difficult to get. However, consider asking your GP or psychiatrist for information about a good psychologist, or other health professionals (for example, a social worker or physiotherapist). You can also tell a fair bit about a person by talking with them over the phone, and even through email. (Are they prompt? Considerate?) Plus, if you find that you don't mesh with the first psychologist you see, you can always try someone else.
5. What is their connection to the world of research?
Psychology is probably one of the least understood professions out there. Most modern psychologists do not talk about penis envy and Oedipal complexes while the client lays on a couch. In fact, most pyschologists don't even treat patients! Many people do not realize that the practice of psychology today is guided by research in laboratories. Psychologists study a lot of things related to mental health -- how do people process information? Can we use computer software to assist in treatment? Which emotion regulation strategies are effective and which are harmful?
Psychologists stay aware of changes in research that could affect their practice by attending conferences and workshops, and reading research articles and books. Many psychologists who practice even conduct their own research part-time. This is important information to consider because even if a psychologist has 30 years of experience, if they are not informed about the latest research developments and standards of practice, they are probably not as effective as they could or should be. To put this into perspective, who would you want performing your surgery -- the surgeon who stays up to date on the most state-of-the-art practice, or the one who does thing they way s/he "always has"?
One final piece of advice. It takes more than empathy and having some good advice to be an effective mental health professional. Private psychologists are typically not cheap -- if you are going to invest your time and money in therapy, do your homework.
For more by Roger Covin, Ph.D., click here.
For more on mental health, click here.