How do I find a good CBT doctor in NYC?
June 24, 2011 10:56 PM   Subscribe

I have dystemic depression and I'd like to try CBT. I found an in-network doctor but he doesn't push me at all. Im looking for someone who will give me structured exercises and be tough on me. Im tired of just talking about things all the time. I have United Healthcare Insurance and I've found plenty of doctors in the directory, but I have no way of knowing if they are any good. Any ideas?
posted by blunt_eastwood to Health & Fitness (7 answers total) 3 users marked this as a favorite
Any decent therapist will be happy to talk to you briefly to give you an idea of their treatment style. Explain to them what you're looking for and come up with a couple of questions that will get at what's important to you in a therapist. You may also want to schedule an appointment or two to see if you two work together; if not, there's no shame in saying "sorry, this isn't meeting my needs" and finding another therapist.
posted by asterix at 11:05 PM on June 24, 2011

Asterix's response covers it, but I wanted to mention: keep in mind that CBT isn't designed to be "tough on" a client or "push" a client (it's designed to work on the interconnectedness of thoughts, emotions, and behaviors). If you're looking for a therapist who will do that, it's more of a personality/therapeutic style issue. And the vast majority of therapists are not "tough on" people nor do they "push" them, so if you want that, you should ask for it up front to save yourself some time.
posted by so_gracefully at 12:30 AM on June 25, 2011 [1 favorite]

Response by poster: Thanks for the replies.

I know CBT isn't exactly designed to be "tough" as a method. I meant I would like to find someone who has a structured process that will force me to the exercises and such. Right now if I don't so what my doctor asks me to do , it never gets mentioned. There's no agenda or anything. That lack of structure forces me to do all of the work, which is difficult to do when depressed.

As for speaking to doctors, I could try calling, but setting up appointments isn't simple when dealing with insurance. I thought there might be a doctor or clinic that's well known for doing CBT in NY or maybe a personal recommendation.
posted by blunt_eastwood at 6:20 AM on June 25, 2011

If you're constrained by insurance, one approach is to look through the list of practitioners approved through your insurance, narrow it down by geography and then start making some calls or looking their online profiles up. It can be overwhelming, but it's do-able.

Another way to go about it is to call a referral line for say NYU or Columbia. They may be able to find someone who fits your order. I strongly recommend this approach. (Here is the Columbia referral line.)

One institute known for CBT in NYC is the Albert Ellis Institute. I have no personal experience with them, but the organizations was founded by the creator of Rational-Emotive Behavioral Therapy, a type of CBT. I don't know if your insurance would cover it, but I believe they have sliding scale fees. Keep in mind that if you have non-HMO insurance, you can often get partially reimbursed for out of network care.

Finally, I want to point out that good therapists are responsive to the needs of their patients, but you have to voice your concerns. CBT is traditionally a highly directed therapy, often involving homework assignments. You have to do the work, but your therapist should be holding you accountable for your end of the work. If your relationship with your therapist is otherwise good, you might want to discuss your dissatisfaction with him or her before you move on.
posted by reren at 8:17 AM on June 25, 2011 [1 favorite]

You probably do know this, but by "dystemic" you mean "dysthymic".

Therapy is something that demands a good fit between patient and therapist, and not getting it right on the first try is common. While there are elements of actual skill involved, that's generally not something you as a patient are qualified to judge. What you need to do is keep trying until you find someone who helps you.

I would especially make sure that you ask the ones you are 'interviewing' about how you expect the CBT and exercises to go and how much structure they will give you as that is an important element from your point of view. This is how you become a participant in your own treatment and advocate for yourself.
posted by dhartung at 1:10 PM on June 25, 2011

I would also be direct in conveying your desire for structure/accountability either to your current therapist or first thing on the phone as you look for your next one. Therapists aren't mind readers so you have to be clear about what you want, and address the problem with your therapist when you're unhappy with treatment as provided. In general though it's hard for a therapist to "force" a client to do anything. In my opinion, the main aim of the process is to figure out what is inhibiting personal agency in the first place. All this is to say is that you might be disappointed.
posted by amileighs at 2:10 PM on June 25, 2011

Response by poster: Yeah I meant dysthymic. I was doing all this on my Droid.

Anyway, thanks again for the new responses. This is something that I discussed with my current doctor and we both agreed on this course of action.

I will definitely try to Albert Ellis place since I'm guessing they have some kind of rankings for CBT doctors.

Other than that I guess I will try to call up some doctors and ask about their methods and if it sounds structured and useful I will go for it. That's the only thing I can think of.
posted by blunt_eastwood at 9:16 PM on June 27, 2011

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