Is the therapist you like right there in front of you?


Perhaps you haven't tried therapy or been to a psychiatrist before.  Or it's been awhile.  Either way, if and when you get there be forewarned: it's a jungle out there!

Unless you have money to spare and can pay out of pocket for these services - the American Psychiatric Association estimates 30% of mental health professionals take no insurance - you are like most, 'taking a number' when it comes to securing an appointment with any mental health professional, regardless of whether or not they take insurance.

Many complain: why is it that most practitioners have long waiting lists or no openings at all?

For those of us in the Baltimore region, I can tell you, there IS a shortage of providers.  Provider supply hasn't kept up with demand in this area.  The Baltimore region is growing as more move to the area for the good (mostly professional) jobs in this area.  For example: I hear that, in the last 40 years, population in the Baltimore-Towson-Columbia Metropolitan Area* has grown from two to eight million residents.  Get on any road in the region and you'll feel it I can guarantee you!

Having been a therapist for decades I can tell you that probably my number one pet peeve with insurance companies is their lack of sophistication when it comes to matching clients with therapists.  Now, I will cut them some slack: the mental health field isn't as mature as medicine.  

At least when it comes to the left brained side of thing: making sure the credentials or the certifications are checked off.

It's a relationship thing.  They don't do it.  Now, I'm not even talking about verifying that at they don't closely vet the expertise of therapists enough. And I don't mean merely a certification check. They leave it as a too basic checklist, especially for outpatient (non emergent) services, even though outpatient care is just as important, given the idea that the more we can treat people early on and/or prevent more serious illness, the better.

For example: I still get calls for children and for PTSD therapy, even after I've told each company, that's not my focus.  I could gripe and say 'there they go again, those insurance companies, just worried about money over care'.  And it's somewhat true. It's obvious insurance companies could build a much, much better relationship with the provider community, not out of punitive reasons (which they too often focus on) but in a positive, trusting way.

In my humble opinion, the system needs to drastically improve it's 'matchmaking' of clients with helpers.  Maybe a single payer payment system could improve upon that?  Who knows.  Mental health issues ARE complicated and not as cut and dried as medical problems.  There are, for example, different types of PTSD, anxiety disorders and depression, and different potential specialists for each.  

For example, I am not a therapist that treats severe, vegetative depression.  Why? Because people with this issue are usually too tired and/or de-motivated to use therapy, at least not when they are in this phase of their disorder. They need a more intensive therapy and medication treatment program now.

The mental health industry still needs to become more evolved on helping identify specialties and sub-specialties, provide proper training for each AND then make it easy for the public to better identify helpers in their area that have availability and are affordable for them now, not with a two month waiting list.


It's another interesting adventure entirely finding a provider you like.

I'm involved in my profession currently to help address the above and related issues, such as opening up a national, simple registry and licensure for therapists who practice tele-therapy so we can increase the supply of availability for clients in need.

In the meantime, finding a therapist you love going to see is like most things in life: it's up to you!  But there IS help, if you keep at it.  Don't give up, advocating for yourself is important, both in finding a therapist you 'click' with, getting healthier AND the practice it gives you for doing many things in your life better.

If you have a therapist you wish you liked more, for example, consider telling them you want a better working relationship with them.  In fact, they should be checking in with you to see how satisfied you are.  Don't be afraid to tell them.  Finding a therapist you like might be the one you have.  Don't just retreat.  Try first to make it better.  Most counselors are at least average and have adequate enough training to work on this with you.

I use tools for asking you frequently how well our sessions are going, called feedback informed treatment (FIT).  Why? Because the research is clear what makes therapy go best for you and your therapist.  Sometimes FIT can help identify really dangerous issues in clients that can save lives too.