If I were choosing a therapist for myself or someone close to me, there are four main questions I would want to ask: 1) What Are Their Qualifications? 2) Are We Compatible? 3) Are They A Top-Notch Therapist? and 4) Are They Using the Highest Quality Treatments?
Qualifications
Qualifications are especially important because most people are confused about the variety of titles in the therapy world: psychiatrist, psychologist, psychotherapist, social worker, counsellor, etc...how do I know which one is right for me?
The first thing to note about credentials is that only certain professions and titles are regulated. You definitely want to see a regulated health professional. This ensures they have formal education, supervised experience, and meet training requirements. These include: Psychiatrist, Psychologist, Registered Psychotherapist (RP), and Registered Social Worker (RSW). These titles are regulated by rigorous training programs, Codes of Ethics, and Professional Practice Standards. Here's a brief overview to help you learn about the specialties within each profession:
Psychiatrist: Psychiatrists are trained Medical Doctors (MD) with a specialty in Psychiatry. They are the experts when it comes to managing medication.
Psychologist/Psychological Associate: Clinical Psychologists have either a Master's degree or Ph.D. in Clinical Psychology, and extensive training in research and clinical practice. They are the experts at providing clinical assessments, and most are trained in psychotherapy.
Psychotherapist: Registered Psychotherapists typically have a Master's Degree in either Counselling Psychology or a closely related discipline. They specialize in talk-therapy treatments and often have the most extensive training in marriage and family therapy.
Social Worker: Social Workers vary in education ranging from a 2-year college diploma (SSW), to a Bachelor's Degree (BSW), up to a Master's Degree (MSW). Typically, only MSWs are formally trained in psychotherapy. When seeing a Social Worker, it's essential to ask whether they've attended post-graduate training in psychotherapy, since some Social Work programs include little to no psychotherapy training.
Be very suspicious of any title not included in that list, such as: Counsellor, Life Coach, Talk Therapist, Mental Health Worker, Addictions Worker, etc. These titles are unregulated, meaning anyone can use them without any training, education, or proven competency. They probably won't have proper liability insurance and are very limited in how much they are legally allowed to do. This can get confusing because many regulated therapists include "counselling" or "coaching" in their services. That's usually just their way of saying, "I also help with everyday stressors."
Are We Compatible?
The second criterion I would want to consider when choosing a therapist is compatibility. It can be hard to determine this before meeting someone, but typically I recommend looking at their website and Psychology Today profile if they have one. Do they fit your situation? Do they seem relatable? Do they seem professional? Do they seem genuinely interested in and passionate about their work? You won't know all of this until you meet someone, but often you can get a sense through their online presence.
Compatibility also includes things like: values, spirituality, intelligence, inclusivity, and stage of life. If you're looking for something in particular, I recommend calling a few different therapists to chat about your situation. It's essential that you find a good fit where you feel heard, understood, respected, and valued.
Are They Top-Notch?
Proper ongoing training is crucial to maintaining skills as a top-notch therapist. The truth is, getting a Master's Degree or a Ph.D. is only the beginning of a therapist's education. I've heard it said that being a "good" therapist is easy, but "great" therapists are rare. Most therapists are good listeners, caring, and friendly, but most people seeking therapy need more than just a friend. Being a great therapist requires being a dedicated student who learns from their experiences, stays up to date on the latest research and treatments, actively pursues the best knowledge available, implements their knowledge effectively in sessions, and is passionate about their work beyond their working hours. Some essential questions to ask are: what do they read to improve their knowledge, how many trainings per year do they attend, are they in touch with modern research trends, and how often do they consult with other professionals to improve their practice?
There is A LOT of misinformation about human psychology out there. Even trained therapists get swept up in self-help fads that are based on bad science. Personally, I would want a therapist who is a sharp thinker that knows how to scrutinize bad ideas. That's why I look for whether a therapist uses evidence-based treatments and whether they read credible authors who are leading experts in their fields.
Are They Using the Best Treatments?
Therapists have many treatment modalities to choose from. The first thing to note is whether your therapist uses the most up-to-date, evidence-based treatments or not. Evidence-based practice is "the integration of best research evidence with clinical expertise and patient values." It can be a warning sign if a therapist does not advertise that they use evidence-based treatments.
The treatment modality of a therapist is often overlooked by clients, but it can say a lot about a therapist. Just to give you an idea, there are over 500 psychotherapy modalities out there, with more created every month. I could create my own modality tomorrow if I wanted to. The point is, not all modalities are equal. Some have been vetted and "put to the test" far more than others. Most are outdated and are simply "pet" theories with little scientific rigour.
Why evidence-based treatments? Because we are all susceptible to biases and assumptions, therapists included. Just take a few examples like: confirmation bias, Dunning-Kruger effect, attentional bias, selective perception, hindsight bias, illusion of control, illusory correlation, overconfidence, Semmelweis effect, Hot-cold empathy gap, and salience bias. Given that we can be easily deceived by our intuitions we need a stricter criterion to separate the "wheat from the chaff." We need to know what really works. Clear reasoning, research, and evidence are the best tools we have for correcting these biases and assumptions. Otherwise, you're just getting someone's opinion.
Conclusion
In conclusion, if I were seeking a therapist, I would want a qualified, regulated health professional, who seems genuine and is a good fit for my situation, takes their personal and professional development seriously, and uses only the highest quality treatments available.
I realize it's not always possible to "vet" every therapist, that's why I typically chat with clients about all of their options before deciding whether my services are the best fit for them. I want you to know all available options to ensure you're making the best decision possible.
If you have any other questions or concerns feel free to contact me, I'm always happy to chat.
Hope that helps!
-Ricky G
