i've been gone from the forums for months and i will definitely disappear again immediately after posting this but it was something i was thinking about and i wanted to talk about it. seeking out mental health help can be really difficult especially when you don't know what you should be looking for in a therapist so i thought i would share some things that i've learned throughout my courses and my degree in case anyone would find it of use.

1. do not go to your general practitioner for a diagnosis

if you are seeking help your family doctor or any other general practitioner should not be who you go to for a diagnosis (but a referral is ok). general practitioner don't have the training hours necessary to correctly diagnose patients with mental health disorders and they don't have the assessment or interview skills to do so. there is a high chance that you may be misdiagnosed and prescribed medication you don't need.

2. assessment vs treatment

all clinical psychologists do assessments and treatment however depending on the field they work in or the organization they work for, their jobs may require them to do more assessment than treatment or more treatment than assessment. as such this might be an important thing for you to consider and you might want to ask about how much time your potential therapist spends doing either of these activities. if they spend more time doing one or the other it doesn't necessarily mean that they're incompetent at the task they spend less time with, but naturally you're going to be more proficient with whatever you've got the most experience in.

3. licensure and training

if it's not stated somewhere, ask them what kind of degree they have, if they've got a PhD they've devoted equal time to clinical and research settings and if they've got a PsyD, it means they've got extensive training in a clinical setting but are still critical consumers of research. one isn't better than the other but some people may have a preference for one over the other. you might want to check where they've gotten their education to see if it's an accredited college, you want to ask what board they're licensed with to ensure they're legitimate. also remember that research has shown that there is statistically significant difference in diagnosis between those with a masters compared to those with a doctorate. this sounds like common sense but the amount of people out there who claim to be licensed in a mental health related field only for it to be bogus is actually pretty high

4. what type of therapy they've been trained in

if you've already got an idea for what your diagnosis might be, it would benefit you to do some research on what the kind of treatment for that diagnosis includes and ask the clinical psychologist if they have training in any of those methods. many psychologists will have experience with one kind of clinical population and providing treatment for them and will be ill-equipped to deal with other clinical populations. if they do not meet the experience for the needs you have then it's easier for you to look somewhere else because even if you go in and if they confirm what you've suspected, they're ethically obligated to refer you to someone else or there is a risk of incompetency. if they list something you're unfamiliar with it would be in your best interest to do some research into it yourself or ask someone who you know who would know about these treatments. there's a lot of pseudoscience out there or treatment with little empirical evidence to support its use and it could end up being harming you.

5. number of visits

you want to ask them about the number of visits that would be completed for whatever type of therapy treatments they're trained in. most of these therapies have a set number or range of sessions that you can expect to engage in. and if they're qualified, they should know the answer to this question. you should ask how much it'll cost per visit and check with your insurance to see how much they'll cover and what the requirements are for your insurance to pay for the visit.

6. testing measures

if you decide on a therapist and at any point in time they suggest the rorshach inkblot test or any other kind of projective tests: find another therapist. these tests have low validity and low reliability and they're not appropriate for use. i only mention because i know in the US the rorshach is used but i promise you're better off without it. your therapist should be well equipped to administer, score, and interpret any personality tests or cognitive measures that you complete. if you complete any sort of personality questionnaire it will have no effect on your treatment outcomes (they're mostly used for assessment purposes).

7. treatment feedback

your therapist should be asking you for treatment feedback at the end of your sessions to see what works for you and what doesn't so that they can adjust accordingly to provide you with the best service possible.

8. psychiatrist vs psychologist

your psychiatrist is responsible for monitoring your medication and little else. if you're looking for therapeutic treatment you will need to see a clinical psychologist. if you need both behavioural intervention and medication, your psychiatrist and psychologist will be working together to monitor your improvement

9. treatment outcome (this is more of an expectation)

treatment outcome is dependent on how many comorbid diagnoses you have. the more mental health problems you have, or higher severity i guess, your treatment outcomes are going to be poorer than someone who has fewer issues AND it will take you longer to solve them. for example someone who has GAD, bipolar disorder, and a substance addiction is going to have poorer outcomes than someone who only has GAD.

10. collaboration (also an expectation)

a lot of people complain that they just want their therapist to tell them what to do. the problem is people don't like being told what to do. and also ethically they are required to ensure your sense of autonomy in your treatment. your therapist is required to form a treatment plan in collaboration with you, you have to have a say in the kind of therapy they engage in, what problems you want to address etc. 

11. last thoughts that didn't really fit in anywhere

not everyone can afford professional medical help so self-diagnosis is pretty common. while i discourage against self-diagnosis, if you're going to do it, the DSM criteria for different disorders is available online you just have to look for it (the problems with the DSM are a whole other topic i know but bear with me). or you can use the ICD i would recommend searching using ncbi or pubmed instead of random websites on the internet. your therapist is required to take any thoughts you may have on what your possible diagnosis is seriously and discuss it with you. if at any point in time you feel like you've taken the role of therapist and the mental health professional is dumping on you, you're allowed to stop seeing them. if you feel that you're worse off than when you started therapy, you should report them to the licensure board. if you're being mistreated, report them to the licensure board. as a stringent as higher education institutions are about who they let into their masters and doctorates programs, there are still plenty of awful therapists out there who don't deserve their license. and if you feel that the diagnosis you've received doesn't feel quite right to you, you're encouraged to receive a second or third opinion.

this is obviously not an extensive list and i'm obviously not an expert but these were just the kinds of things that were on mind today and i wanted to share. peace.