IN THE BEGINNING it was simple. If you had an emotional problem you made an appointment with Dr. Freud. But those were the days when a) Freud was the only game in town, b) the town was Vienna, and c) stress was something you measured in pounds per square inch.
A hundred years later, things - life and psychotherapy among them - are a lot more complicated. According to the National Institute of Mental Health, one in five Americans these days needs some form of mental health help. And in the Salt Lake Valley alone there are more than 200 mental health professionals to choose from.
-Psychiatrists have a medical degree and must do a three-year clinical residency. Psychiatrists are more likely to look for the medical/genetic causes of emotional and behavioral problems and are more likely to prescribe drugs. They are the only psychotherapists permitted to prescribe drugs.
-Psychologists spend at least four years getting a doctorate in clinical psychology and then do a supervised internship for one to two years.
-Clinical social workers have a two-year master's of social work degree (MSW), plus must complete a supervised clinical internship.
-Marriage and family therapists must have either a doctorate or master's degree in marriage and family therapy, plus must have three years of supervised professional experience; or a graduate degree in a field of religious study that includes instruction and supervision in marriage and family therapy.
-Psychiatric nurses have a master's degree in nursing, including field work in psychotherapy.
-To legally call yourself a psychotherapist you must have one of the above licenses.
*****Finding a therapist is easy. But trying to find the right therapist is enough to drive some people crazy.
Mrs. Zxxyzxy (not her real name) was in a crisis a number of years ago and decided to seek the help of a psychiatrist. She choose him on the recommendation of a friend.
"He was the silent type," she remembers. "He just sat there and said `hmmm.' " Mrs. Zxxyzxy had wanted a good listener, but she also wanted someone to give her some advice. She was not totally satisfied with her treatment.
Recently she decided to go back into therapy. This time though, remembering the hours spent with the silent, nodding psychiatrist, she took her time finding a therapist who would be a better match.
From the Self Esteem Center, where she had taken parenting classes, Mrs. Zxxyzxy got the names of three therapists - all of them women - and set up appointments with them.
"I told them: `I want to interview you to see if I want you to be my therapist.' "
Mrs. Zxxyzxy was not looking for someone to fix her car, after all, or even to fix her gall bladder. She was looking for someone to tell her life story to.
Shopping for a therapist makes sense, says Dr. Don Strassberg, a clinical psychologist and associate professor of psychology at the University of Utah. "You're investing your time, your money and, mostly, yourself. . . . People will call around to see if they can save $40 on a new set of tires. They need to spend at least that amount of time on something that may turn their life around."
He suggests asking people who are already in therapy why they like their therapist. But he warns that just because someone else is happy with a particular therapist, it still might not be the right match for you.
He suggests asking the therapists themselves certain questions (see the accompanying box), either in a short interview by phone or a longer interview in the therapist's office. A face-to-face meeting is useful to gauge whether you and the therapist seem to have a rapport.
But be careful, notes Salt Lake psychologist Marcia Mendelsohn, to distinguish between the kind of discomfort that comes from a bad rapport and the kind that comes from being forced to dig through the buried garbage in your psyche.
Some therapists will allow a half-hour interview without charge, but that's the exception, not the rule, says Strassberg, who adds: "How many dentists will do a filling for free?"
Therapy is a "very personal thing," he notes. "The therapist's style and personality are important, as well as his technique of therapy."
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