How do I find a therapist who doesn't suck?
October 15, 2013 9:21 AM   Subscribe

I want to go back to therapy, but the last two people I tried were just terrible, and I am sick of blowing my outrageous copays on people who seem incapable of relating to me. How do I find someone who will actually help me?

Some background: I did talk therapy before, around age 22, and it was life-changing. So my standards are high, perhaps too high. That therapist was warm and empathetic, professional yet clearly made an effort to relate to me on a personal level, understood what I was 'really' saying and was willing to call me out (gently) on my bullshit. He really helped me to like and believe in myself because he seemed to genuinely like and believe in me.

That was back in my home state. Now I'm in NYC, and I want to get back to it. But the last two people I tried, ugh. The first one I did about 2 months with, the second, 2 sessions.

Neither of them seemed to want to talk to me like a person. The first one, who I found through Psychology Today, barely spoke at all, to the point where I had to ask her several times to please react when I spoke, because it was like talking to a wall. She would then respond to emotional revelations by doing this gesture of sympathy where she like... put her hand on her chest and leaned forward, and it just seemed extremely fake to me. She also badmouthed my previous therapy experience because she doesn't think CBT is any good (she seemed to think that my old shrink merely put a band-aid over my problems, but as I said, he changed my life and I felt it was pretty shitty of her to be openly critical of something I said was helpful to me). I figured I'd 'grow into' her, but I finally dropped her when she just completely failed to understand why I was upset when I found out my boyfriend was very racist. She did not believe me when I said that most of my friends would judge me harshly if they ever found out I was dating him. I was just like "this woman does not understand me or my life."

The second one I found through a 'sliding scale' place I saw recommended here. (They charged me $50 a session, the same as my copay with insurance.) With the woman there, our conversations would typically go like "Work is making me so mad!" "Why do you say that?" "Well, because [problem]." "How does that make you feel?" Well... I told you it made me feel mad like three minutes ago! Almost every word she said basically could have been generated by that Eliza program. It was not a conversation. It was like she was there to Practice Doing Therapy, not to... help me. She was also 100% clueless about LGBT issues. That's not my main problem, so I'm not looking for a person with an LGBT focus, but I expect more than total ignorance.

Also, neither of them would show any response whatsoever when I tried to make a joke. That might sound douchy, as if I was trying to perform for my shrink, but... humor is a huge part of how I communicate, and if I make a bunch of jokes and you just blink and stare at me, I feel like we're not even speaking the same language. How can I expect a person to understand the inside of my head if they won't acknowledge the things I say?

(They were both young, and my first therapist was in his 60s, but I don't want to discount young people just because they're young. But I'm wondering if I should?)

So, yeah. I would love to find another therapist. Really. But now I'm gun-shy of blowing another $50 copay on some idiot fresh out of grad school who will just parrot back the thing I just said without actually helping me in any way. I found my first, amazing therapist by googling "therapy [my town]"; that won't work here, there are thousands of them. So what do I do? How can I find someone who will actually hear what I say?
posted by showbiz_liz to Health & Fitness (30 answers total) 20 users marked this as a favorite
What insurance do you have? What neighborhoods are convenient for you? Just to narrow down the field a bit.
posted by Obscure Reference at 9:29 AM on October 15, 2013

I might be able to make some suggestions. And yeah, I think experience is super important. I'd also like to know what locations are convenient, etc.

But also consider that this might be depression talking a bit.
posted by the young rope-rider at 9:33 AM on October 15, 2013

Response by poster: I have United Healthcare/Oxford Freedom. But my employer will be shopping for a new provider via the NY Health Exchange soon.

I live in Crown Heights and work in FiDi, but would travel pretty far for a great therapist.
posted by showbiz_liz at 9:34 AM on October 15, 2013

Recommendations..... If I were in your position I would ask anyone you have a relationship with (and whom you trust) if they could recommend someone they've had direct experience with. The range of skills in the field of therapy is huge.

Since you were successful with CBT you may want to specifically seek someone that specializes in that modality.

The age factor IS a significant consideration... an older therapist has life experience that someone much younger has no clue about....

If you can't get a great recommendation, call around, ask a lot of questions and, on your first appointment interview the therapist, find out who they are, how they work, what they are comfortable with, what troubles them, and see how they communicate... Be prepared to burn through a couple of false leads before you find the right person.

Good luck...
posted by HuronBob at 9:34 AM on October 15, 2013 [1 favorite]

Oh man, I hear you. I had an excellent therapist when I was also about 22 and have never been able to find anyone remotely as good.

I found her through a referral from a university psychiatric day program I was in. Perhaps you could reach out to some of the day programs in NYC and explain what you're looking for and see if they have any good recommendations. They will likely recommend one of their staff, but at least you can describe what you're looking for and get a more targeted referral than a google. Or, how about asking around among your friends?
posted by imalaowai at 9:36 AM on October 15, 2013

Sorry, my sentence about depression came across really strangely.

I don't mean your feeling that the therapists were unhelpful was wrong--I believe you that they were--! I meant that if you feel really, really shitty and hopeless about this, it might be helpful to talk about with the next person that you try about whether this might be a symptom of depression for you.

I'm sorry this process has sucked so hard. I hate therapists a lot, personally, but there are definitely great ones out there who do amazing work and I hope you find another one.
posted by the young rope-rider at 9:36 AM on October 15, 2013

So while the most recent therapy experiences sound crappy, they are in line with what is being taught in mainstream professional therapist education these days. They react minimally, and let you fill the silence.

The older therapist you had earlier in life sounds like he was more personally involved in your emotions. How long were you seeing him? Was he as you describe at your very first session, or did it take time for him to develop that relationship with you?

It sounds like you might enjoy a Hakomi therapist. I see some listed in NYC. Two of my friends go to one and they say the therapists are more willing to involve more of themselves in the relationship.

But really, ALL of these therapists should be willing to do a free (or cheap) 20-30 minute session where they explain their approach to therapy and you can see if it sounds like it aligns with what you want. But you need to be able to express what you want.
posted by MonsieurBon at 9:36 AM on October 15, 2013 [1 favorite]

Response by poster: But also consider that this might be depression talking a bit.

I have considered that, and I'm keeping it in mind... but I was far more depressed when I went to see the first guy. Currently my problems are more along the lines of "dumb quarter-life crisis angst re: jobs and dating" than "crushing depressing and self-hatred."
posted by showbiz_liz at 9:36 AM on October 15, 2013

Is there any way you can contact your former therapist and see if he has anyone he might recommend? I ask because mental health professionals meet each other at conferences and other ways All The Time and so he might have hit it off with someone who has his same style.

And I'm going to say that 2 duds sounds about par for the course. It's very very lucky that you got a great therapist right out of the gate, but it may take another 6 months or a year of searching before you find the right fit.

Do not be embarassed about bringing a list of questions to your first appointment (or better, asking them on the phone or by email) about things like racism and LGBTQ issues. I don't know how you might want to word those questions, and that might be somethign a future ask could help you with.
posted by bilabial at 9:39 AM on October 15, 2013 [2 favorites]

I found my therapist here on AskMe and he's great. Hopefully this question will help you find the perfect one for you. If not, maybe come back with your next question and be specific in your title that you're looking for a great talk therapist in NYC. Good luck.
posted by rabbitrabbit at 9:42 AM on October 15, 2013

Many therapists will give you a free phone consult or even a quick 15-minute in-person meeting to see if you would be a good match. In fact, I would venture that most of the best therapists are quite happy to do so, because it's important for them to know how you would/could interact before you enter into an official working relationship.

If you can gather the courage and tenacity to do a few of these over the span of a week -- it's a bit like a job interview, so fairly stressful -- I'm confident that you will be able to find a warmer, more compassionate therapist without having to shell out another useless copay expenditure. You could specifically mention that you prefer a more interactive approach, one that minimizes the neverending spirals of "how does that make you feel?" If there is a particular book you found helpful, you could ask if they've heard of it or what sort of books/resources they usually draw from. Then it's down to scheduling matters, which can be tough if you find someone who already has a solid client list.

If CBT was helpful to you, just try searching "CBT therapist [your city]," using whatever therapeutic modalities you think you might find helpful. Many sole practitioners have a limited web presence that leaves them off of insurance provider lists and stuff like Psychology Today. I'd also recommend opening up your search to include social workers (MSW/LCSW) in addition to psychologists. Here's a massive list of psychotherapy styles that might give you a leg up in your initial search.

Good luck!
posted by divined by radio at 9:45 AM on October 15, 2013 [1 favorite]

Recommendations from people who know you, e.g your former therapist, should help, but finding a therapist has many of the pitfalls of dating only costs a lot more. Some people might give you a free consultation (it never hurts to ask). I could suggest people but, like being set up on a date, they might suck too, but they'd suck less than random.
posted by Obscure Reference at 9:45 AM on October 15, 2013 [2 favorites]

I think the treatment orientation is a key variable here. It sounds like you did well with CBT, so another round of CBT, or a related therapy like DBT or ACT, or another very practical approach like SFBT might be best for you.

You may have been dealing with therapists who took a more psychodynamic approach or perhaps an interpersonal approach, and perhaps that doesn't click with you or address your issues.
posted by Ouisch at 9:49 AM on October 15, 2013 [1 favorite]

You are not crazy. At least, not in terms of NYC therapists. Both of those are particular schools of therapy that suck, but are becoming more prevalent here.

Personally, I found good luck in seeking therapists from inside my own community - people who were going to understand my life, without me having to explain it, and who were more naturally inclined to be involved. I also found good luck seeking for older therapists - around the 40-50 year old range, though that was some years ago, so you might want to expand a little higher. Essentially, you want someone who was trained when getting involved and laughing with your patients was a good thing.
posted by corb at 9:49 AM on October 15, 2013

My therapist is only a few years older than me and I'm really happy with him. I don't think age and experience matters ALL that much (that said, he's in his late 30s so not like 24).

I did phone consultations with EIGHT people to find him. It was just a lot of work, which you might need to do, too. You know what you don't like - people badmouthing your previous therapist, lack of reaction, stock answers/questions like How Does That Make You Feel, not getting LGBT, etc.

Personally I've referred friends to my therapist successfully, but they are only people who I thought would be a fit. One friend had referred me to her therapist once but that was a disaster- I was new to therapy but found out pretty quickly that maybe that guy was good for my friend, but absolutely not for me.

I'd write a list of everything you want in a therapist, and hit them all up via email/phone for a quick consultation. They should do this for you, just to go over the basics of their methodology and practice before you make a financial commitment.

In NYC you can't walk two feet without tripping on therapists. No need to settle for someone who's not a good fit.
posted by sweetkid at 10:06 AM on October 15, 2013 [2 favorites]

hit them all up via email/phone for a quick consultation

Yes, this. You're looking to hire somebody; it's reasonable to request an interview before paying for services.
posted by kmennie at 10:07 AM on October 15, 2013 [1 favorite]

Response by poster: I do worry that I'll do a phone consultation with someone who will say "oh yeah, yeah, I totally fit your needs" when they actually don't. It's hard for me to imagine me saying "I don't like it when therapists do X" and them saying "oh I do X all the time!" Especially when there's money at stake. Perhaps they are mostly more ethical than that, though?
posted by showbiz_liz at 10:08 AM on October 15, 2013

So here's the thing. You don't set up your phone session to be a session - you set it up to be a chat. If they are willing to do that, and you get a good read off them, you can take the next step. If not, kick them to the curb.
posted by corb at 10:10 AM on October 15, 2013 [1 favorite]

Look for a therapist who incorporates a lot of Humanist psychological theory and technique into their practice, and who considers Carl Rogers to be one of their primary influences. The Humanist school of therapy, as pioneered by Rogers, is one that emphasizes the importance of empathy and "positive regard" (what one might call believing in one's client's capacity to be great) as foundational elements in the therapeutic relationship. It sounds like the therapist you liked so much had a lot of that, and that it served you well.

Individual therapists incorporate different therapeutic schools in their practice to differing degrees, and some schools work better than others for some people. I think that doing some research into the theoretical underpinnings of various schools of psychological therapy, and Humanism in especially, might serve you well in identifying a therapist who works well for you.

Good luck.
posted by Scientist at 10:11 AM on October 15, 2013 [2 favorites]

Yeah, they really should be honest with you about what they do and don't do. Be really specific about what you want and ask them specific questions about their experience - how long have you worked with LGBT, what do you think the specific challenges there are, how do you usually interact with patients - lots of talking, little talking/sounding board (rather than saying you don't like when therapists do X, ask them what they DO do.)
posted by sweetkid at 10:11 AM on October 15, 2013

Therapists are human. They want to believe that they can meet your needs, and like most people, they don't always realize that they are overselling their expectations or abilities. 99% or people will loudly yell that they are not racist when you bring up topics of racism directly. But when you get into it even many therapists harbor these implicit beliefs.

Weeding that out is going to be very tough. But, you might ask "how would we work to handle my learning something about a loved one that was difficult for me but that you didn't feel was a problem?" This way you don't have to bring up the bit about a former therapist being on the side of the racist dude, and you can get an idea of what the process looks like.

You can also ask your therapist to collaborate in goal setting and tell you what success looks like from their end. Discuss what success looks like to you also. Some examples that I'm pulling out of my ear:
  • Is it being more comfortable confronting people who say offensive things?
  • Is it getting more done/procrastinating less?
  • Is it being more comfortable in your body?
  • Is it not having flashbacks when (something triggering) happens?

posted by bilabial at 10:27 AM on October 15, 2013 [3 favorites]

Neuro linguistic programming is a really refreshing thing for people who are irked at then 'how does that make you feel' sort of therapy. It is entirely about how you look at things and is more of a set of skills for you to learn than a type of therapy. I find that the NLP therapists I've met are more LGBTQ aware (and more kink-aware) than not, as a rule. I am not sure how NLP works with insurance in the US, as I am in the UK.
posted by Mistress at 10:28 AM on October 15, 2013 [1 favorite]

It's hard for me to imagine me saying "I don't like it when therapists do X" and them saying "oh I do X all the time!"

I have gotten around this by asking more open-ended questions that don't make it obvious what you want. For example, Disorder A doesn't benefit at all from long-term therapy. When I asked someone how long prior patients with the same issue had been in therapy with him, he said "oh, 10 years!"

You could also say "how would you respond to someone asking X" or "what do you think about cognitive behavioral therapy" or something general that would give you an idea.
posted by the young rope-rider at 10:49 AM on October 15, 2013

I would also be really wary of picking a therapist based on their orientation (psychoanalytic/psychodynamic, CBT, etc.) A lot of studies have been done on these kinds of designations and more experienced therapists tend to use a variety of approaches. Plus, different approaches are helpful for different problems. If you had, claustrophobia you probably would not benefit from the same therapy you'd want for difficulty with intimacy. This is, again, where experience and openness to various approaches is important.

Psychoanalytically trained psychologists and psychiatrists can be really defensive about CBT because a lot of people--especially laypeople--consider it useless and silly. That said, their defensiveness shouldn't intrude on your therapy with them, so I'm sorry that happened. I wouldn't throw out the psychoanalytically trained baby with the bathwater, though. I have known multiple therapists who were trained as psychoanalysts and who embraced a lot of the better things about CBT with open arms.
posted by the young rope-rider at 10:57 AM on October 15, 2013 [1 favorite]

I live in Virginia now, but sometimes I want to move back to NYC just so I can seem him. Highly recommended.

Glen Heiss
5 Patchin Pl
New York, NY 10011-8314
Phone (212) 243-2228
posted by orsonet at 1:42 PM on October 15, 2013

Just want to chime in to say it was really hard for me too. I wish I'd given up on some therapists earlier than I did, but I kept thinking I was just wanting to run away from my problems! Hang in there. When it clicks, it clicks, and it seems like you've already had that experience. Ask for as many recommendations as you can.
posted by barnone at 2:51 PM on October 15, 2013

The only *seriously great* therapist I've seen in NYC is one I found through a coworker. I just Googled her now, and she seems to be in practice still? I don't know how recent the address/phone is, though, as I last heard (from the coworker) she was moving out to Long Island. I also know she took United Healthcare forever ago.

Stephanie Despins-Daly
53 Boerum Place #8
New York, NY 11201
(718) 522-1282
posted by unknowncommand at 5:28 PM on October 15, 2013

Have you tried contacting local universities and asking for outpatient referrals?
posted by oceanjesse at 5:59 PM on October 15, 2013 [1 favorite]

I second that you should be allowed to do some kind of mini-interview/session/chat before you have to commit to a shrink. At the very least, I talked to the winning shrink over the phone ahead of time and got the feeling that we'd hit it off nicely. It is a job interview for them and by rights they should be honest with you about what they do.

But my advice is that you need to hit it off with them pretty quickly. If you don't, then don't keep giving them another chance. Ms. Stonewall and Ms. Reflection...if you get more people like that, then don't see them!
posted by jenfullmoon at 8:31 PM on October 15, 2013

My own life-changing, laughed-at-my-jokes therapist from when I lived in Brooklyn:

Susan E. Sukenik, LCSW
640 19th St
Brooklyn, NY 11218
(718) 871-8991
posted by Majorita at 8:21 PM on October 16, 2013

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