It’s taken a few decades. Since I started studying Psychology in 1993 when mental health issues were still fairly taboo, mental health has finally started to be taken seriously. Celebrities and Royals talk openly about their struggles. Politicians specifically mention mental health when discussing healthcare. And the idea of seeking therapy is no longer stigmatised like it once was.
However, mental health has also become overly medicalised, and some people think of mental health as being just like physical health, yet there are some key differences. Of course, mental and physical health are intimately connected. However, selecting a therapist is not the same as choosing a medical doctor.
Here are some key points that might help you find the right therapist for you.
1. Diagnosis is more subjective
Medicine looks for a cause, attempts to address the cause, and moves on. Mental health diagnoses won’t usually follow this formula. No matter how much the health department, the insurance industry or our Western culture demands correct identification of mental and emotional health problems, mental health diagnoses are simply descriptions of how someone appears or experiences things.
There are no definitive tests for mental health disorders, and descriptions of common mental health disorders have changed over time. Some people find medicalised diagnoses such depression, anxiety or an eating disorder helpful. People who want a diagnosis should ask their therapist about it, and if their current therapist is not able to offer a diagnosis, they can seek a therapist whose approach is pinning down and working with diagnoses.
Many clients want help with managing stress, making decisions, identifying and communicating their needs in relationships, or getting motivated to make changes, and will do better with a therapist who takes their self-diagnoses into account.
2. Treatment must be customised
While many people experience unusual or difficult-to-diagnose medical conditions, the majority of diagnoses and treatment paths are relatively clear. If you have a bad cough and go to the doctor, they’ll test to see if it’s bacterial or not. If it is, they prescribe antibiotics. If not, you’ll get advice on how to tolerate the discomfort until it passes.
Mental health diagnoses can be difficult, with a host of possible causes, but no physical tests or definitive scans. Different practitioners will approach reducing symptoms in very different ways. Medications, meditation, talk therapies, and exercise have all been shown to be helpful in improving mental health, often in combination. But, what’s life-changing for one client may not help another.
As with diagnosis, when it comes to different talk therapies, these vary in terms of philosophies, approaches, and techniques. While we fortunately have some broad information about how certain approaches are effective, the most important thing is that your therapist’s approach works for you.
3. Personality matters
Back to the bad cough analogy: You feel dreadful, so you seek out urgent care. While you’d prefer to see a doctor who’s genuine and caring and gets that you have a full week ahead of you, a looming deadline, your kids’ school concert, and you don’t have time to be sick, it ultimately doesn’t matter if the doctor has poor interpersonal skills. You just want to know: Will antibiotics help me or do I need to cancel my life for a few days and rest?
Mental healthcare is totally different. In addition to connecting to your therapist’s approach, the therapist must be someone you can connect with as a person.
I’ve met people who persisted with therapy that wasn’t very helpful because they didn’t think they could actively change their mind and choose someone else. Some people thrive with a therapist who confronts and challenges them. Others need warmth and empathy to open up vulnerable areas and work through their feelings. Some people appreciate humour, whereas others will feel that their concerns aren’t being taken seriously if the therapist makes a joke. You are allowed to tell your therapist what works or doesn’t work for you.
4. Culture and context
Western psychology emerged in a culture that focuses on measuring causes and effects, and prioritises individual responsibility. This has led to assumptions about both the causes and options for treating mental health issues. However, we don’t experience our lives outside of our context and our mental health is heavily (but not completely) influenced by social circumstances.
This is particularly true for people experiencing marginalising or distressing things, such as poverty, systemic racism, homophobia, or domestic violence, in their everyday lives. It’s important that therapists can look beyond what the individual is doing about their internal experience and see how their life context might be contributing to their mental health.
5. You decide when you’re done
Returning to the bad cough analogy, maybe the doctor decides to prescribe antibiotics. You must take the full course, then you’re done. For more serious medical diagnoses, tests identify the problem and tell you how a disease is progressing, or how well treatment is working. There are some objective data points that the doctor uses to tell you when you’re better.
In therapy, clients set the goals (with the therapist’s help) and ultimately decides when they’ve come to a place that’s workable for them. Even with very challenging mental health problems that have somewhat clear diagnostic criteria and medication treatments, such as bipolar disorder, psychotherapy is only useful if the client finds it helpful.
Therapists should regularly check with clients about how their progress is going, if it’s as helpful and necessary as when they started, and if they need to adjust some things. Although therapists can offer their experiences of what’s been helpful to others, they should welcome clients’ decisions to take breaks, leave therapy, or carry on until the client feels done.
Finding the right fit
Whatever you’re trying to manage – anxiety, depression, addiction, a difficult relationship, parenting, work, or navigating a major life change – therapy can be helpful, but finding the right fit is key. Every person deserves a therapist who collaborates on defining the diagnosis (if necessary) and therapy goals and who customises their approach to the client’s needs. A therapist should be personable and respectful of a client’s goals and assessments of how things are going, taking their context and culture into account.
I hope that this guide is able to help you find the right therapist for you. North Brisbane Psychologists have a range of psychologists with different approaches and specialties. You can get to know our psychologists here or book an appointment here.