Brad seemed worried about leaving the therapist he saw in Minnesota. Tall and confident in his career as a human resources manager for a Fortune 500 company, Brad managed to carry himself elegantly despite his constant anxiety, depression, and acid reflux.
Plagued by ulcers for much of his adult life, Brad had found that talking with his therapist had calmed him down and helped him think straight. However, after five years of weekly therapy, the anxiety and depression that plagued him continued unstopped, and the acid reflux still required ongoing medical attention.
When he and his wife relocated to the Delaware Valley, she had encouraged him to seek therapy that helped him to cognitively master his anxiety and depression, in addition to talking gently about whatever seemed to be wrong.
Although Brad liked the idea of structured lessons on how to outthink depression, he was fearful about changing therapists and the style of therapy. When Brad and his wife and I met, Brad asked some legitimate questions about how to know when to switch therapists or try new forms of therapy.
“My therapist in Minnesota explained that therapy takes a long time, and that I needed to understand how my family growing years impacted my anxiety and depression,” Brad said. “My therapist was pleased with the progress we made in five years and said these things are very hard to measure, so I shouldn’t worry about the research that says that cognitive therapy is the treatment of choice. That confused me even more, and I do not know how to decide what to do next.”
“It makes me anxious,” he added. “How do I know if therapy was working?” His steady gaze met my eyes as he asked me to help him figure out what to do next.
Skills-based Credentials:
Therapy has often been called the “talking cure,” since the exchange of words between the client and therapist can appear to be the most obvious form of communication that is going on. In reality, therapy can offer a richer experience than an exchange of words, and is far from simple talk about general topics.
Psychotherapists tend to be trained in clinical nursing, psychology and social work. Since anyone can hang a shingle and advertise themselves as a psychotherapist, it is crucial to know how to recognize credentials.
These include substantial knowledge in their field, experience in clinical practice, membership in professional associations that require skills for entrance, academic publications in an area of expertise, and business skill.
Other values include integrity, sound judgment, enthusiasm for their work, and ability to connect with others.
What is therapy worth?:
A Ph.D. with 15 years of training may charge locally, and receive up to $300 hourly for their skills while a less credentialed clinician may work for the $40 paid by the insurance company for brief managed care work. As in other professional realms, greater training, skill, and experience is often more costly for the consumer and is sometimes valued highly.
How do you know whether therapy is worth the investment?
Evaluating therapy: To help Brad evaluate his earlier therapy, I encouraged him to ask himself these questions and suggested that the answer to each question needed to be a firm, “yes.”
- Did you set therapy goals for the first year of your work and did you achieve them within the first year of work?
- Does your therapist indicate solid and deep expertise in the specific area you need to address? For example, if you seek couples work, is your therapist trained in this work? Is this indicated through publications or credentials?
- Does your therapist offer you specific intervention techniques and strategies to address your concerns both in the session and at home? Does therapy seep into the corners of your life, your heart, and your values?
- Do you find that you implicitly trust your therapist’s judgment in helping you find answers to your concerns? Is your therapist the catalyst for your growth? Does your therapist “get it” quickly and deeply as you speak with him/her?
- Does your therapy bring you closer to who you are inside – to the person you want to be with those you love, and to the fullness that your life can bring you? Can you see these changes within the first six months of work?
The gift of a life-time:
Psychotherapy is a major investment of money, time and energy. It needs to bring you ongoing benefits that enhance your life month after month, or it is not worth your investment.
Like Brad, I invite you to ask the questions he asked in evaluating the avenue to personal growth and fulfillment. You may be glad you did.
ED. NOTE: Dr. Coche practices clinical psychology in Stone Harbor and Philadelphia. She invites responses through her website, www.cochecenter.com
