The decision to ask for help is important, and the search for the right psychotherapist can be confusing. Making good decisions when you are feeling depressed, anxious, scared, or otherwise distressed can be difficult. This article is designed to help you with the search for the right therapist.

Practical Questions

People sometimes feel embarrassed by the questions they have about psychotherapy. They may feel it is insulting or crass to ask about fees or hours of service. Not so! Psychotherapy is a service you purchase. No service is useful if it is inconvenient or too costly to use. Here are the 'nuts and bolts' concerns people often have:

	Location. It is important to find a psychotherapist whose office is easy for you to get to.
	Accessibility. This refers to two types of accessibility.
		One is accessibility of the therapist. You may wish to ask how the therapist handles emergencies and vacations. Some therapists are available by pager 24 hours/day, some are not. Most of us arrange for a colleague to take emergency calls when we are on vacation.
		The other type of accessibility is physical. People who have difficulty walking or who use a wheelchair are concerned with whether the therapist's office is accessible to them. If you have a hearing impairment, you will probably want to know if the therapist has the skills to communicate with you and the equipment needed to take your calls.
	Safety. You may want to ask the therapist if the office is on a well-lit street, if parking is well-lit and safe, and if the building is secure after daytime business hours are over.
	Fees. Some people feel uncomfortable asking therapists what they charge. Don't be afraid to ask about money issues: you are paying for a service and need to know what it costs. Also, some therapists have a sliding scale for fees, which means the cost of therapy depends to some extent on your ability to pay. The therapist's policy about missed sessions is also important:
		Many therapists charge for sessions you miss if you do not give at least 24 hours notice.
		You may also wish to ask (1) if the therapist accepts insurance and (2) if the therapist is willing to bill the insurance company directly. Some therapists ask that you pay in full each time. These therapists will give you a receipt to send your insurance company. Other therapists will bill insurance directly and ask you to pay only the part of the fee that insurance does not cover.
		It will help if you find out what kind of mental health coverage you have as part of your health insurance. You will need to know what part of the cost will be yours, and if there are any restrictions on who you can see or how much therapy you can have. If you have health maintenance organization coverage (Kaiser, for example), you will probably be required to use therapists employed by the HMO. Some health insurance plans require you to use a therapist from a list of health care providers who are part of a preferred provider list. Finally, some insurance plans let you choose the therapist. However, even when your insurance lets you choose the therapist, it may pay only for services provided by a licensed therapist or someone working under the supervision of a licensed therapist.
	Sessions. When people make the decision to look for a therapist, they may feel a sense of urgency. One important question to ask is how soon you can schedule your first session. Other questions people often ask are: does the therapist have times available that fit my schedule? Evenings? Weekends? Lunchtimes? How long are the sessions? Most therapists work a 45, 50, or 60 minute hour. Group therapy sessions are usually longer. Another important question is how often you will be seeing the therapist. Weekly? Biweekly? More often?

Therapist Qualifications

There are good and bad therapists in every licensed profession, and there are good and bad unlicensed psychotherapists as well. You may want to ask therapists where they were trained and in what specific therapeutic approaches. There are many ways for therapists to learn additional clinical skills once they have their degrees. Thus you may want to ask therapists about both their original training and their continuing education activities.

You may also want to ask how much experience they have with your type of problem.

You may want to ask what training the therapist has had in working with clients from diverse racial and ethnic cultures. Lesbians, gay men and bisexuals may want to ask if the therapist has been trained to work effectively with their concerns. You may be interested in whether the therapist is trained to work with people with disabilities. Other frequent questions are about the therapist's training in and attitudes toward marriage, gender roles, spirituality, and the use of medications.

Author and psychologist Gail S. Bernstein, Ph.D. has a psychotherapy practice in Denver, Colorado. Dr. Bernstein speaks and writes about gay, lesbian and bisexual people for both general and professional audiences, and is the author of the new audiotape, NOT HETEROSEXUAL: An Educational Program About Gay, Lesbian and Bisexual People.