This is a description of psychotherapy and a guide for selecting a therapist. As a kind of consumer guide, it provides valuable information about some of the variations that can be expected and a list of questions to ask a potential therapist. It also includes a rationale for utilizing therapy and describes important elements of the process.

Personal Change

Throughout life we continue to grow and develop in many ways. Changes occur around us: jobs change, we move house, children grow up, the economy varies, the seasons shift. The only constant is change itself. At times we donât ask for changed circumstances and are forced to adapt. At other times we long for change and seek it out. We can find ourselves stuck in patterns that severely limit our potential for a satisfying life.

 The question is not whether change occurs, but how. How can we understand and fully participate in our personal change in a way that is most fulfilling and rewarding? Taking the time to envision life at its fullest and to picture oneâs fully developed self can provide guidance and inspiration for action.

 Some important elements of personal change: Finding and accepting who you are and then naturally allowing yourself to blossom. Reminding yourself of your goals and using them for steady direction. Caring enough to be loyal to yourself, like the gardener who nurtures her plants daily and exults in their growth and change, no matter how gradual. You let yourself settle on the absolute importance of your evolution. You joyfully decide to do what it takes to thrive, not simply survive. When discouragement sets in, you accept it as part of the journey, replete with challenges and surprises. You know that you are learning about yourself and finding strategies for productive and joyful living.

Why psychotherapy?

For many, change is made easier and more satisfying by getting professional help at certain "stuck points" of growth and development. Such help is an opportunity to get another perspective, some new insights, and fresh motivation to continue. Importantly, psychotherapy is a collaborative effort. You and your therapist work together to help you gain the self-awareness and skill you need to make your life work more effectively. Therapy can range from short-term crisis intervention to extended work on self-understanding and personal development.

Who does psychotherapy?

There are a number of mental health professionals with different kinds of training and expertise. They may each work with individuals, families, children, groups, or businesses. The different professions have licensure requirements and governing organizations.

A psychologist has a Ph.D. level of education in psychology and two years of supervised training in psychotherapy. A psychologist also develops, gives, and interprets tests of mental abilities, aptitudes, interests, personality characteristics, and motivations.

Psychiatrists are medically trained and licensed by state medical boards. They use limited counseling therapy and are authorized to prescribe drugs.

Licensed Clinical Social Workers typically work in governmental or hospital settings, but may be in private practice. They can't do psychological testing or prescribe drugs. Master's degree required for license.

Marriage, Family, and Child Counselors. MFCCs can provide counseling regarding marriage, family, and child issues. They can't prescribe drugs and have strict limitations in doing psychological testing. Master's degree required for license.

Licensed Educational Psychologists. LEPs work in schools and provide educational counseling services, such as aptitude testing. They can't do psychological testing that is not related to educational services, and they can't prescribe drugs. Master's degree required for license.

Psychiatric Technicians. Provide counseling and related medical services in state hospitals. They can't do psychological testing, and they can't prescribe drugs. Undergraduate degree required for license.

Priests, ministers, rabbis, or other members of the clergy. May provide spiritual guidance. May not treat for emotional or mental disorders, do psychological testing, or prescribe drugs.

When should you consult a therapist?

A therapist can help when you are having a difficulty in your life, when you want to make a significant change, or when you want to enhance your effectiveness as a person. You do not have to consider yourself "crazy" or incompetent. Most people who seek consultation are well adjusted people. Statistically, most adults in Western societies will get some kind of counseling over the course of their lives.

Therapy may be useful in addressing any of the following:
    •      Pain, stress, anxiety, or depression
    •      Marital and family problems
    •      Working through traumatic experiences
    •      Releasing habitual beliefs and behavior patterns
    •      Treating dependency, addictions, and eating disorders
    •      Fears and phobias, shyness, or social problems
    •      Sexual difficulties
    •      Children's emotional and behavioral problems
    •      Working through grief and loss
    •      Developing greater self-confidence, self-esteem, and creativity
    •      Overcoming religious or other indoctrination
    •      Increasing inner direction, energy, and joy of living

Life can be very stressful. Psychotherapy can give you the time and support you need to focus on your personal well-being. Sometimes an unexpected crisis is the stimulus for getting help. It could be a death in the family, a divorce, a job loss, or some other traumatic event. The goal might then be to restore balance. However, a traumatic event can also be an opportunity to reassess your life and grow as a person. You can undertake psychotherapy as a commitment to a constructive change process instead of simply recovering. Indeed, many life transitions can also be opportunities for growth (e.g., becoming a parent, moving to a new community, the "empty nest," retirement).

As part of personal development, many people also find that they want to understand and heal wounds of the past. Psychotherapy is one way to work through "unfinished business" and get on with life. Additionally, relationships are a real challenge for most people, and an appropriate focus of attention in psychotherapy.

How does therapy work?

A therapist begins by talking with you and helping you to assess your individual needs and circumstances. A therapist may then draw from a variety of approaches and techniques to provide the best form of assistance. Usually you will make an agreement with your therapist about the number and frequency of sessions that initially seem appropriate. Periodically, this should be reassessed.

There is no formula for psychotherapy. A therapist uses professional judgment which considers the client, the issues, timing, the therapist's training, and other factors. The course of therapy usually goes through stages of initial exploration, work on specific concerns, and termination. The time involved can range from one session to several years. It can be very intense for a period of time and then transition into more occasional "check-ups."

In therapy sessions, your therapist may offer listening and support, information, or alternatives to consider. The therapist may actively teach skills, intervene in a crisis, or make an appropriate referral. In addition to talking through issues, some therapists will use role playing, hypnotherapy, guided imagery, art therapy, breath work, and other methods. The individual style and personality of a therapist is quite variable. A therapist's work is also affected by their theoretical approach to human behavior and beliefs about personal change.

An important point is to realize that there is nothing "wrong" with you because you enter therapy. Many times the "change" that a person needs is to become more compassionate and self-accepting. Your therapist can help you discover and use the inner resources you already have. You can also learn to maximize the network of support you have in your everyday environment.

While it can be satisfying, therapy is rarely easy or fun. Important work can be quite painful and difficult. With persistence however, the reward is well worth the effort.

What is your role?

You are expected to take an active part in therapy, exploring your concerns openly and honestly. Your commitment to the growth process will enhance progress in therapy. This means caring about yourself on a daily basis, not just when you are in a therapy session. You may have important "homework" to do, such as observing yourself more closely, trying on new attitudes, or experimenting with new behaviors. As part of this work, you write in a journal, draw, attend a meeting of some kind, talk with a certain person, or any number of other activities.

A therapist does not "fix" or "cure" you, but rather, becomes a partner in your journey, providing support and expertise to help you find your way. Ultimately, your goal is to become more skillful in managing the challenges of life yourself. You might say you gain tools for your own "toolbox" of life skills.

The first step is to find a therapist who will be good for you. This process may take some persistence but is worth the effort. Often the hardest part of getting help is making the initial contact.

What should you look for in a therapist?

When you choose a therapist, you need to find someone whom you can trust and respect. Psychological healing and growth flourish in the context of good human connection. You will need to be patient in the selection process and find someone with whom you will have rapport.

A therapist is also a person. There are many motivations for being a therapist and many different kinds of people who are therapists. A good therapist is one who attends to her own health and growth as a person. She tries to practice what she preaches. She is not above you and does not try to be superior. She is open and honest, willing to answer your questions about therapy and her own qualifications. She is comfortable with the limits of her helping abilities and can make a referral to someone else when necessary. She is able to admit mistakes, make changes, and has a healthy sense of humor.

A good therapist is one who is dedicated to your well-being. He does not foster dependency or prolong therapy; neither does he suggest an end to therapy before you feel you have completed your work. He is loyal to you and genuinely cares.

When psychotherapy is effective, you feel empowered. You feel supported and strengthened in your ability to manage your own life. At times your therapist may confront you or ask you to consider difficult questions, but you always feel like she is "on your side." At a fairly early stage in your relationship, you feel comfortable with disclosing your important thoughts and feelings. Neither one of you is afraid of the other and neither is trying to please. Your therapist is attentive to the progress you make and patient when progress is difficult.

Listed below are various questions to consider asking a therapist with whom you may work. You can choose among these or use some of your own.

•  What are your qualifications as a therapist?
• Do you have any areas of specialization?
•  How long have you been in practice?
•  Are you licensed?
•  Why are you a therapist?
•  What is your approach to working with people?
•  What is your theoretical orientation (in lay terms)?
•  Do you use any special techniques other than talking?
•  How do you suggest we approach my issues in particular?  What experience do you have with other clients who have these kinds of issues?
•  How will you react if I disagree with you?
•  What will you do if I do not make any progress?
•  What kinds of cases have you referred on to other therapists?
•  Have you been in therapy yourself?
•  What was your experience?
•  What can you tell me about yourself as a person that contributes to your ability as a therapist? (e.g., experience with parenting, divorce, religion, trauma)
•  How do you see my role in the therapy process?
•  What are your views on _______?(e.g., abortion, gay lifestyle, drugs, etc.)
•  Can you tell me your policies about making and canceling appointments, being late, hours of availability, emergencies after hours, telephone contact, holidays, etc. How do you handle needs for medication or hospitalization?
•  What happens if I have financial problems?
•  How do you handle the ending of therapy?
•  How will we know when I am finished?
•  What kind of grievance procedure is available to me if I feel I have been damaged by therapy?
•  Has anyone ever had a grievance or brought charges against you?

What protections do you have in therapy?

Therapists follow strict ethical guidelines, which are set out and supervised by groups such as the American Psychological Association or the American Medical Association. These guidelines include an assurance of confidentiality and prohibitions against abuse. Complaints can be lodged with the professional societies mentioned or state government regulatory boards such as the California Board of Psychologists.

How do you get started?

Think about what kind of help you need (e.g. family issue, career, eating disorder) and look for a therapist with experience in that area. Consider whether you prefer a male or female, or if that matters. Ask friends or relatives for recommendations. You can also get referrals from other professionals such as your family doctor, a teacher, minister, or priest. Also check with your health insurance company for a list of authorized providers. You can call the national, state, and local mental health associations.

You can look in the Yellow Pages under "Counseling Services," which will give you a number of options, including categories such as alcohol treatment, career counseling, psychologists, social workers, or coaches. Emergency services of many kinds can be found in the "Community Services" part of the phone book. This is important for any immediate help you may need for a dangerous situation involving drugs or violence.

Many therapists will grant a complimentary interview in which to get acquainted and assess the potential for working together. Some will discuss your questions over the phone. In any case, be sure to find out what you want to know. Do not schedule another appointment if you do not feel confident. You might want someone who is older, younger, or of a different ethnic group. It is quite normal to interview several therapists before commencing therapy. Also, remember that later in therapy you are still free to stop and find another therapist.

However, remember that you do not need to like your therapist as a personal friend or feel good about every therapy session. A good therapist is willing to discuss problems in the therapy relationship, and this can be very productive. In the final analysis, your experience with therapy should be an experience with a healthy relationship. If you care enough about yourself to embark on the work of therapy, you owe it to yourself to find the best therapist that you can. You will never find a perfect therapist, just as you will never find a perfect relationship. But you can find someone who cares enough and is skilled enough to help you in the process of personal growth.