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After the decision to seek therapy has been made, an individual may feel unsure about how to choose a therapist. People seeking therapy often find that they have no standards to use in evaluating potential therapists. There are many competent therapists of varying theoretical persuasions. The purpose of this guide is to provide you with information that might be useful in selecting a behavior therapist. No guideline can provide strict rules for selecting the best therapist for a particular individual. We can, however, suggest questions you might ask and areas of information you might want to cover with a potential behavior therapist before you make a final decision. What Is Behavior Therapy? There is no single definition of behavior therapy. Although some common points of view are shared by most behavior therapists, there is wide diversity among those people who call themselves behavior therapists. The definition that follows is meant to give you a general idea of what behavior therapy is. It is not, however, an absolute definition. The particular behavior therapist you select may agree with some parts of it and disagree with other parts. The following definition is adapted from "Behavior Modification: Perspective on a Current Issue," published by the National Institute on Mental Health: Behavior therapy is a particular kind of therapy that involves the application of findings from behavioral science research to help individuals change in ways they would like to change. There is an emphasis in behavior therapy on checking up on how effective the therapy is by monitoring and evaluating the individual's progress. Most behaviorally oriented therapists believe that the current environment is most important in affecting the person's present behavior. Early life experiences, long-time internal psychological or emotional conflicts, or the individual's personality structure are considered to be less important than what is happening in the person's life at the present time. The procedures used in behavior therapy are generally intended to improve the individual's self-control by expanding the person's skills, abilities, and independence. Qualifications and Training Necessary for Particular Mental Health Professionals Behavior therapy can be done by a number of different mental health professionals. Competent behavior therapist are trained in many different disciplines, and the distinction between different types of mental health professionals can sometimes be confusing. Therefore, we have listed below a brief description of the training received by different types of professionals who offer behavior therapy. Psychologists Psychologists have doctoral degrees (Ph.D., Ed.D., Psy.D.) from graduate programs approved by the American Psychological Association. Clinical psychologists also have a one-year clinical internship, and one to two years of post-doctoral supervised experience is generally required for licensure. Psychologists who have Board certification in behavioral psychology have had five years of post-doctoral experience practicing clinical psychology, and must have passed an examination given by the American Board of Professional Psychology. Licensing or certification procedures vary from state to state. Clinical Social Workers A clinical social worker must have a college degree, plus at least two years of graduate training in a program accredited by the Council on Social Work Education. Certified social workers have a master's or doctoral degree in Social Work (MSW, DSW, or Ph.D.) from a program approved by the Council on Social Work Education, have had two years of post-degree experience in the practice of social work, and must have passed an examination given by the Academy of Certified Social Workers (ACSW). Licensing procedures vary from state to state. Psychiatrists A Psychiatrist must have a medical degree. Although technically an individual can practice psychiatry having had four years of medical school and a one-year medical internship, most psychiatrists continue their training in a three-year residency program in psychiatry. Psychiatrists who have Board certification have had two years of post-residency experience practicing psychiatry and must have passed an examination given by the American Board of Psychiatry and Neurology. Professional Counselors Professional counselors possess master's (M.Ed., M.A.E., M.A., M.S.), specialist (Ed.S.), and doctoral degrees (Ph.D. & Ed.D.) from a regionally accredited university. They are licensed in most states (LPC or LMHC) and/or certified nationally as a National Certified Counselor (NCC) or a certified clinical mental health counselor (CCMHC) by the National Board of Certified Counselors (NBCC). Although requirements vary slightly from state to state, licensure and national certification typically require graduate training in counseling, the passing of a written examination, professional references, an adherence to a strict code of ethics, and two to three years of post-degree supervised clinical experience. Consumers can obtain more information by contacting the American Counseling Association's website at www.counseling.org. Practical Information About Therapists You have the right to obtain the following information about any potential therapist. This information may be obtained from the referral person, over the phone with the therapist, or at your first visit with the therapist. Although you may not feel that all this information is relevant, you will need a substantial amount of it in order to evaluate whether a particular therapist would be good for you. Your first session with a therapist should always be a consultation. This session does not commit you to working with the therapist. The goals in the first session should be to find out whether this particular therapist is likely to be helpful to you. During this session you may want to discuss with the therapist any values which are particularly important to you. If the therapist's views are very different from yours, you may want to find a therapist more compatible with you. An important aspect of therapy for you will be the relationship between you and the therapist. This first session is a time for you to determine whether you will feel comfortable and confident working with this particular therapist. The following are things you need to know about a prospective therapist: Training and Qualifications You should find out whether the individual therapist is licensed or certified by your state. If the person is not licensed or certified by your state, you may want to ask whether the person is being supervised by another mental health professional. Because behavior therapists vary in types of training, there are no set rules on which professional qualifications would be best for any given person. It is common, though, for clients to want to know about the qualifications of a potential therapist. Questions to Ask When Deciding on a Therapist A behavior therapist will devote the first few sessions to assessing the extent and causes of the concerns which you have. Generally, your therapist will be asking quite specific questions about the concerns or problems causing you distress and about when and where these occur. As the assessment progresses, you can expect that you and your therapist will arrive at mutually agreeable goals for how you want to change. If you can't agree on the goals of therapy, you should consider finding another therapist. Fees Many people feel uncomfortable asking about fees. However, it is important information that a good therapist will be willing to give a potential client. The following are financial questions you may want to cover with a therapist. This information may be obtained over the phone or during your first visit. You will want to know:  How much does the therapist charge per session? Does the therapist charge according to income (sliding scale)? Does the therapist charge for the initial session? (Since many therapists do charge for the initial session, you should get this information before your first visit.) Is there a policy concerning vacations and missed or canceled sessions? Is there a charge? Will your health insurance cover you if you see this therapist? Will the therapist want you to pay after each session, or will you be billed periodically?Other Questions The following are other questions you may want to ask a potential therapist: How many times a week will the therapist want to see you? How long will each session last? How long does the therapist expect treatment to last? (Some therapists only do time-limited therapy, whereas others set no such limits.) What are some of the treatment approaches likely to be used? Does the therapist accept phone calls at the office or at home? When your therapist is out of town or otherwise unavailable, is there someone else you can call if an emergency arises? Are there any limitations on confidentiality?As Therapy Proceeds Once the initial goals are decided upon, you can expect the therapist to discuss with you one or more approaches for helping you reach your goals. As you continue therapy, you can expect your therapist to continually evaluate with you your progress toward these goals. If you are not progressing, or if progress is too slow, your therapist will most likely suggest modifying or changing the treatment approach. At each of these points you may want to ask yourself the following questions: Do you understand what the therapist has asked you to do? Do the therapist's instructions seem relevant to your objectives? Do you believe that following these instructions is likely to help you make significant progress? Has the therapist given you a choice of alternative therapy approaches? Has the therapist explained possible side effects of the therapy? Do you know what the therapist's own values are, to the extent that they are relevant to your problem?What to Do If You Are Dissatisfied With Your Therapist Talk With Your Therapist People often feel angry or frustrated at times about their therapy. If you do, you should discuss these concerns, dissatisfactions, and questions with the therapist. A good therapist will be open to hearing them and discuss your dissatisfaction with you. Get a Second Opinion If you feel that the issues and problems you have raised with your therapist are not being resolved, you may want to consider asking for a consultation with another professional. Usually the therapist you are seeing can suggest someone you can consult. If your therapist objects to your consulting another professional, you should change to another therapist who will not object. Consider Changing Therapists Many people feel that it is never acceptable to change therapists once therapy has begun. This is simply not true. Good therapists realize that they might not be appropriate for every person. The most important thing you need to ask yourself when deciding to continue with a particular therapist is, "Am I changing in the direction I want to change?" If you do not feel that you are improving, and if, after discussing this with your therapist, it does not appear likely to you that you will improve with this therapist, you should consult another therapist. How to Get the Names of Behavior Therapists If you don't already have the name of a therapist, you might try some of the following suggestions: Ask for recommendations from your family physician, friends, and relatives. Call us, the Association for Advancement of Behavior Therapy. AABT is not a certifying organization, and not all members offer behavior therapy. However, AABT provides lists of all full members by state, including information on specialties and populations served. You might call persons listed to ask for a referral. Call your state psychological association or district psychiatric association, and ask for a referral. You can locate your state psychological association by writing or calling the American Psychological Association, 750 1st Street, NE, Washington, DC 20002; phone: (202) 336-5500. Only certified or licensed persons will be referred by these organizations. District psychiatric associations can be found by calling or writing the American Psychiatric Association, 1400 "K" Street, NW, Washington, DC 20005; phone: (202) 682-6000. Call the university psychology, social work, or medical school psychiatry departments in your area and ask for a referral. Ask to speak with someone in clinical or counseling psychology, or the chairperson of the department of psychiatry. Call your local community mental health clinic. The clinic may have a behavior therapist on the staff or be able to give you a referral. Look in the directories of the American Psychological Association and the American Psychiatric Association. Copies of these directories should be in your public library. Members in these organizations will often be able to give you a referral. Look in the National Register of Health Service Providers in Psychology, published by the Council of National Health Service Providers in Psychology, 1120 "G" Street, NW, Suite 330, Washington, DC 20005. Persons listed might be able to give you a referral. Look in the National Association of Social Workers Register of Clinical Social Workers published by the National Association of Social Workers, 750 1st Street, NE, Suite 700, Washington, DC 20002. Persons listed might be able to give you a referral. What Is Behavior Therapy? |
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