» CHOOSING THE RIGHT MENTAL HEALTH THERAPIST

Why is this choice so important? Therapy is a collaborative process, so finding the rightmatch-someone with whom you have a sense of rapport-is critical.After you find someone, keep in mind that therapy is work andsometimes can be painful. However, it also can be rewarding andlife changing. Can a therapist share what I have said during therapy? You can rest assured that all mental health professionals areethically bound to keep what you say during therapyconfidential. However, therapists also are bound by law toreport information such as threats to blow up a building or toharm another person, for example. What are the steps for choosing a therapist? See your primary care physician to rule out a medical cause ofyour problems. If your thyroid is "sluggish," for example, yoursymptoms-such as loss of appetite and fatigue-could be mistakenfor depression. After you know your problems are not caused by a medicalcondition, find out what the mental health coverage is underyour insurance policy or through Medicaid/Medicare. Get two or three referrals before making an appointment.Specify age, sex, race, or religious background if thosecharacteristics are important to you. Call to find out about appointment availability, location, andfees. Ask the receptionist: Does the mental health professionaloffer a sliding-scale fee based on income? Does he or she accept your health insurance or Medicaid/Medicare?Make sure the therapist has experience helping people whoseproblems are similar to yours. You may want to ask thereceptionist about the therapist's expertise, education, andnumber of years in practice. If you are satisfied with the answers, make an appointment.During your first visit, describe those feelings and problemsthat led you to seek help. Find out: What kind oftherapy/treatment program he or she recommends; Whether it has proven effective for dealing with problems suchas yours; What the benefits and side effects are;How much therapy the mental health professional recommends; and Whether he or she is willing to coordinate your care withanother practitioner if you are personally interested inexploring credible alternative therapies, such as acupuncture. Be sure the psychotherapist does not take a "cookie cutter"approach to your treatment-what works for one person with majordepression does not necessarily work for another. Different psychotherapies and medications are tailored to meetspecific needs. Although the role of a therapist is not to be a friend, rapportis a critical element of successful therapy. After your initialvisit, take some time to explore how you felt about thetherapist. If the answers to these questions and others you come up withare "yes," schedule another appointment to begin the process ofworking together to understand and overcome your problems. If the answers to most of these questions are "no," callanother mental health professional from your referral list andschedule another appointment. What is the difference betweenpsychiatrists and clinical social workers?Two kinds of therapists warrant special note: psychiatrists andclinical social workers. Psychiatrists are medical doctors and can prescribe medication.Clinical social workers are trained in client-centered advocacyand can assist you with information, referral, and direct helpin dealing with local, State, or Federal government agencies. As a result, they often serve as case managers to help people"navigate the system." Clinical social workers and many othermental health professionals cannot write prescriptions. However,nurse practitioners that specialize in psychiatry and mentalhealth can prescribe medication in most states. And, under a newlaw, psychologists in New Mexico can prescribe medications afterreceiving training (New Mexico State Legislature, 2002).