The process of entering counseling can be very complex for people. For one thing, you want to know that the therapist you choose is someone who will connect with you, and knows the best path to get you where you want to go.

Rapport

Multiple studies have concluded that the single most important aspect responsible for successful therapy is the connection the person feels they have with their therapist. With good rapport, the client finds it easier to open up and tell the therapist what has gone on in his or her life. It needs to be present early in the therapeutic relationship so that the more important therapy goals can be accomplished. When rapport is not established, it is difficult to speak openly. If you do not feel a good connection after 1 to 3 visits, you owe it to yourself to try someone else. (see: The Therapeutic Process)

Qualifications

This initial assessment phase is actually a two-way street. During an initial consultation, the therapist is listening to you as you describe your issues and determining whether they feel competent to help. A good counselor can usually determine rather quickly whom they can and can’t help.  If they feel unqualified to help you, they will give suggestions for a more appropriate match. An example might be discovering your child has an Autism Spectrum Disorder and the therapist is not properly trained in this area. But most therapists are qualified to help with the most common issues addressed in treatment. (see: Why People go to Therapy)

 Costs

Besides rapport and the qualifications of your therapist, you must consider the financial aspects as well. Whether considering full fees or co-payments, here are some things to you should know.

• Using insurance benefits

When you make the important decision to see a therapist, you may find the perfect provider, or were referred to a specific therapist by someone you trust, only to find out that the therapist does not take your insurance. You may spend hours getting a referral from your doctor; calling the insurance company to find a provider; authorization numbers and letters; figuring out and paying copays; and calling the insurance company to check on problems. Choosing not to use your insurance gives you the freedom to find the therapist you would like to see and begin work, without these added complications. When you use your health insurance, your therapist must justify your need for therapy, which means giving you a ‘mental disorder’ diagnosis and sharing sensitive personal information about your therapy. This information will go into health insurance files and a computer database that can be accessed by numerous people and for multiple reasons, i.e., insurance companies and, possibly, to future employers. It is also a consideration if you think you may want to be self-employed in the future. Past mental health diagnosis and treatment records may be treated as a pre-existing condition, which will make private insurance more difficult and expensive. Bottom line, when you apply for any insurance in the future – medical, disability, or life insurance – your diagnosis will be a factor in determining your acceptance and your rate. This is a real problem. I have had clients turned down for insurance because of a diagnosis and others bumped to a higher premium. Also, more and more skilled, qualified mental health therapists are choosing NOT to take part in Managed Care Networks – reimbursement rates are too low, the paperwork time-consuming, and the coverage tightly managed.

• Paying out-of-pocket

I often hear people complain that therapy is too costly. But consider the gains and the investment you’re making. Take a moment and calculate the amount of money you spent last year on things that you thought would help you feel good about yourself – cars, clothes, food and alcohol, gadgets, vacations, hair and nail salons, gifts, etc. Think about how much more you’d enjoy those things if you reached your full potential and were able to set aside all the obstacles holding you back. Yes – that is what therapy can do for you. Or compare the cost of therapy with taking a college course. This course can be titled: “My Life – What works and what doesn’t work, and how to get there”. Depending on how often you go, you may be able to forgo some immediate pleasures for the long-term gain of mental health. And many times rates can be negotiated – something in between what your insurance company would have paid and the full fee for your therapy can be arranged. Which ever way you choose pay, you are worth the investment.

Time Commitment

In general, most psychotherapists schedule weekly. But sometimes it is more prudent to schedule more, like twice a week; or less, like twice a month. In order to build a good connection, however, once a week should be the minimum for a while.