Emotional problems deserve good care as much as physical ills. Unfortunately, a cultural cloud hangs over psychological issues, preventing some people from seeking professional help.
To avoid confronting a problem, people often try to convince themselves that “it isn’t all that serious.” Many, not knowing where to turn, do nothing. Others worry about finding the time or money to pay for counseling. Or they might avoid contacting a psychologist, because they are embarrassed by their feelings or are afraid to discuss their situation with anyone, much less a stranger.
If these issues seem like familiar obstacles, you might try putting your problems in a different context. People with toothaches or broken bones promptly seek treatment. So why should you neglect emotional pain? Feeling well is always worth some re-scheduling and, with or without insurance coverage, most people can afford enough time with a therapist to start taking better care of themselves.
You might see a psychologist once or twice in a lifetime for help during major life shifts: raising young children, adjusting to the “empty nest,” coping with relationships or grief. Talking to an objective person may be all you need to manage on your own.
Finding a psychologist is not hard. Your real focus should be on identifying a qualified counselor with whom you feel comfortable and whose strengths match your needs. Research shows the most important factor in successful therapy is the relationship between the psychologist and the patient. Therefore, as you seek a psychologist, think like a consumer, with no hesitation about asking questions and setting up a schedule that will suit you.
The only time you should not shop around is when you have a full-blown crisis on your hands. Psychological emergencies have the same urgency as medical ones. In an emergency, call a crisis center, generally an emergency room. Most are equipped and staffed to deal with psychological crises. If not, they will locate the necessary resources.
For a psychological referral, friends and relatives are generally the best source. Second best is a doctor you trust. You may also be able to find a good contact through advocates such as a cancer support group, a group for gays or teens, or an Alzheimer’s care program. Another good resource is the New Jersey Psychological Association.
Your managed care company may refer you to someone you will like. But you might also feel unnecessarily limited by the company’s choices. Remember that your coverage does not restrict you to psychologists in your neighborhood. Ask for an expanded list, as you would in seeking premium medical care. It may mean extra travel, but the trip will be worthwhile if it leads you to the right person. Alternatively, if you identify a good psychologist who is not under your company’s coverage, talk it over with him or her. You may be able to make special arrangements for payment.
If you have decided to contact a psychologist, you probably realize that, unlike psychiatrists, psychologists cannot prescribe medication. Psychologists do “talk therapy,” without a psychiatrist’s focus on medication and medication management. A psychologist should be willing to work with your doctor to help you manage any medications you need.
In your first phone call, you will probably not reach the psychologist directly. Just leave a brief message and don’t attempt to describe your situation. In the return call, ask the psychologist whether it is a good time to talk. If it is not, set up another time for an interview. And don’t rush it. The interview is a perfect opportunity for you to gather information and get a feel for the relationship between the two of you.
As a potential client, you should already be thinking of yourself as a consumer. You have located the psychologist, but what do you know about his or her background, licensing and other special approvals, such as drug and alcohol counseling. Ask about these credentials. Remember that anyone can advertise as a “therapist,” but it is illegal to say you are a psychologist without the proper licensing.
Tell the psychologist why you want help, even if you only suspect what your problem may be. If you are looking for marriage counseling or family therapy, ask how much of his or her caseload this represents. Most psychologists have preferences and strengths: some specialize in families, some in working with young children or adolescents. Some will appear in court; others will not. It is fair to ask if they deal with domestic violence, or whether they have the special training necessary to work with a child who may have been the victim of abuse.
If you are concerned about a child’s emotional health, ask whether the psychologist will go to school to meet teachers, sit in on classes, or talk with the child study team. You should inquire which other family members the psychologist will want to meet – the siblings and parents, or just the child alone.
You should discuss how he or she works and how you can get in touch in a crisis. Shut-ins may want to know if therapy over the phone is possible. Also, discuss fees and insurance coverage. At the end of the interview, you may feel comfortable about setting up an appointment. Inquire about setting up a preliminary session, without further commitment. This will provide an additional opportunity to evaluate the chemistry between you.
Alternatively, you may realize sooner or later that the relationship doesn’t “click,” or the schedule seems unmanageable. Even if you become dissatisfied after a few sessions, do not give up! You should not hesitate to discuss your reaction with your psychologist, and ask for a referral to someone else, with a different style.
Your first positive step comes when you decide to seek help from a psychologist. Knowing that, you can persevere with confidence as you research professionals, make the initial contact, and conduct your interview. With this strong start, you are sure to benefit from any subsequent meetings with the psychologist you select.
Dr. Alexander is a licensed psychologist with offices in Lawrenceville and Philadelphia. He specializes in adolescent and marital therapy. He is a member of the Mercer County Psychological Association, which contributes the monthly Living Well series.
For information or a referral, call the New Jersey Psychological Association at (800) 281-6572.