How to Find a Competent Therapist

by Dr. Elinor Greenberg

Here are the basics of what you need to know to find a competent therapist. Some of what I am saying may shock you.

1. You can practice psychotherapy in most states without having studied how to do psychotherapy as long as you have a mental health license of some kind.

2. They do not teach Psychiatrists, Psychologists, Social Workers, etc. very much, if any, psychotherapy during our studies for our degree. 

3. We do 2-year internships in which theoretically our supervisor will help us learn therapy. But..we are not systematically taught how to do psychotherapy in our internships and very few Supervisors are trained psychotherapists themselves.

4. We also sometimes end up doing internships in places that are irrelevant to doing psychotherapy in private practice—school settings with children, mental hospitals on wards with psychotic patients, etc.

5. Many therapists set up practice and only take a few continuing education classes a year (required to keep their license) in some form of psychotherapy. This is not enough to become competent.

6. Those of us who care and can afford it, do a 3 year program in a post-graduate training Institute that teaches us a specific form of psychotherapy, such as psychodynamic, Gestalt therapy, Cognitive Behavioral Therapy, Self Psychology, or some modern offshoot of psychoanalysis. These programs involve classes, assigned readings, and appropriate supervision. The person is also required to have personal psychotherapy as well. They also usually require a written Case Study on a client as a final paper. Upon completion, you are given a certificate to frame and hang on your office wall and can then say: “I am certified in this specific type of therapy.”

7. Very few programs include personality disorders. The 3 years are intended to ground the therapist in the basics of how to do a specific form of psychotherapy.

8. Therapists generally only do the type of therapy that they are trained to do, whether or not it is best for your problems.

So..Here ideally is what you need to ask therapists over the phone before you come to see them:

Some therapists may be too busy to want to answer a lot of questions, but  you should be at least able to find out if they did postgraduate training and in what type of therapy.  Most therapists who have openings in their practice will be willing to answer questions in order to possibly get a new client.

1. Did you do post-graduate training in a specific type of therapy?

2. Did you train in an Institute? (As opposed to taking a class here and there for continuing education required by some States).

3. What type of therapy do you do?

4. Do you have any training in the diagnosis and treatment of personality disorders? Have you any experience treating people who have been the victim of Narcissistic abuse?

5. How many years have you been in practice?

The more serious your problems, the more important it becomes that your therapist be well trained and have more than 8 + years experience.  

If the person gets defensive when you ask them about their training and cannot or will not give you specifics, they are unlikely to be well trained. Well trained people are proud to tell you where they trained and in what and for how long.