Match Made in Mental Health Heaven

May
Written By Michelle Hansford

How to hire and fire a therapist

“You should talk to someone.”  These words are easier said than done when it comes to speaking with a mental health care provider these days.  As a busy mom, not only are schedules impossible, but finding a therapist or practice that accepts your insurance, is taking new patients, and is in close enough proximity to you all present challenges – all compounded by the current shortage of therapists.  And once you do find a therapist, there is no guarantee that this professional relationship will work out, and if it doesn’t – well, finding a new one would bring you back to square one. 

With these challenges and possible setbacks looming, many moms put seeking out a mental health care professional on the backburner, where the overwhelming task is often abandoned until it boils over.  Think of it this way: if it was your child who required this very same assistance, you would not stop until you found a therapist who checked every box on this seemingly impossible list, and if that person was not 110% a match, you would start the process over again (and again, if need be), without hesitation.  We moms need to prioritize our mental health the same way we prioritize every facet of our children’s health care needs, because let’s face it, if we aren’t mentally fit and aren’t taking care of ourselves, we can’t properly care for others, either.

To make your life a little easier, we’re exploring why it’s so hard to find a therapist, what to look for in a compatible therapist (including information on what distinguishes different types of mental health professionals), and how you know if you’ve found a match made in mental health heaven (or if it’s time to break up).

 Mental Health Crisis in America

 In the U.S., 1 in 3 people lives in an area with a shortage of mental health care workers, and according to the American Psychological Association (APA), “60% of psychologists report no openings for new patients” in a 2022 survey.  What’s the deal here?  Are that many more people in need of mental health care than in previous years?  According to two local therapists, Kimberly Solo, a Licensed Independent Clinical Social Worker (LICSW) based in Medfield who specializes in treating adult women; and Elizabeth Zaccardi, a Licensed Independent Clinical Social Worker (LICSW) who is co-owner of River & Stone Counseling & Wellness in Hingham, the short answer is yes and no.  Yes, because Covid brought a lot of issues to the surface surrounding struggling marriages and disorders that were easy to be distracted from during “normal” life, and that the rate of substance abuse went way up during the pandemic as well.  And no because now seeking mental health assistance is no longer as “taboo” as it once was.  Zaccardi said that she used to see mostly women coming into her practice but more recently she’s seeing a bigger range – dads, first responders.  “It’s more normalized to seek treatment now,” she said.  “I see more women in their 50s coming in now and saying that they’ve been struggling all their lives but are just now seeking help,” said Solo. 

Although it’s positive that so many people are now seeking the help they need, it leaves the demand higher than the current supply of therapists. There are, however, tips when it comes to finding one who is right for you despite that high demand.

How to Find a Therapist

Both Solo and Zaccardi encourage those seeking a therapist to first and foremost be honest with themselves as to why they want to attend therapy.  That way, people can search for a therapist who is best suited to match their specific needs - although identifying someone who is a “perfect” match isn’t always a simple task mastered on the first go, as many factors come into play.  A good place to start is to identify what you feel you are struggling with and determine the best type of therapist for your current situation.  (Read on to learn more about the various types of mental health care professionals.)  Once you have established the type, a google search of those types of therapists in your area is helpful, who you can then contact for availability, insurance coverage, etc.

Another way to find a therapist is to ask those you trust for recommendations, although what works for someone you know may not work for you. According to Solo, often times new clients will come in as referrals from a friend or neighbor, or they will approve of her qualifications online, but that they still might not be a good fit.  Solo stated: “I tell people when they call me that you may like my qualifications, your neighbor may have loved me, but if you get in here and don’t feel comfortable with me or that something feels off, you do not have to come back.  You have to feel like there is a connection.”  Although there may be a little trial and error involved in finding a therapist who meets your complete set of needs, both Solo and Zaccardi recommend being as honest with yourself and mental health care providers as possible is a great place to start. There are many types of mental health professionals, many “someones” with whom to speak, which we will outline below as a starting point for anyone considering making contact.  

What are different options (social workers versus psychologist or psychiatrist, etc)

You want to seek out a mental health professional to meet your individualized needs.  One assumedly seeks out a mental health professional to assist with personal challenges, so adding the challenge of finding the right kind of therapist – in the right neighborhood – who accepts your insurance and new patients – can be exasperating and leave any mom feeling like she doesn’t have time to deal with it.  However, here’s an excellent starting point.

 How to find the RIGHT therapist (for you!)  

Medical News Today provides a list of questions that you can ask during your initial conversation that may assist you in determining if you have found the right therapist for yourself.  Please note that not all the following questions may apply to you or your situation.  Some questions include: What are your areas of expertise? What experience do you have in discussing my condition or culture? What treatments do you use, and have these methods been effective? What fees do you charge? Do you accept insurance, and will you bill directly to my insurance company? Do you prescribe medication if necessary?

NHS inform recommends that people “treat the initial assessment a bit like an audition.” In fact, Solo offers new potential clients a 15-minute screening consult to see if she and the would-be client are a good match, and Zaccardi’s practice asks any potential new client a series of questions to “screen people out” and “assess them for risk.”  As previously mentioned, there are certain conditions that both Solo and Zaccardi will not treat, which demonstrates the value of being as upfront and honest as possible right from the start. Solo will also not take on a new client who can only come every other week or once a month at the beginning because it is a critical “relationship building stage” for her and the client.  So let your therapist know what you can commit to. 

Even if all parties involved have done their homework to ensure that a good match has been made, both Solo and Zaccardi admit that often times clients come in for one issue and reveal other issues as they become more comfortable and/or aware of the issues, which can mean that they are better suited for another therapist or type of therapy.  Solo said that it’s “not so much the questions you ask the therapist on the phone but whether you are being transparent in the struggles you’re having so they can let you know if they can handle and treat your issues.”  For example, if you are having marriage issues but don’t divulge that it has to do with a substance abuse issue (which Kim would refer out), that’s not starting the relationship off on good footing.

Zaccardi, who specializes in relationship counseling (including parenting and divorce), as well as grief, anxiety, and mood disorders (amongst other specialties), agrees with Solo: If the person is someone their practice can take on, he or she is assigned to the therapist who best fits his or her needs - based on the initial information provided.  Both Solo’s and Zaccardi’s feedback demonstrates why it is so important to be as transparent as possible during that initial call – even if it’s uncomfortable – to ensure that you are receiving the best treatment for yourself.  Moms don’t typically have time to waste, so don’t waste yours by providing half truthful answers. 

How to know if you need to let go of your therapist and find a new one.

Medical News Today recommends trying up to five sessions with a therapist to get a good idea of their style and if it will work for you.  NHS inform also raises an excellent point of distinguishing “if you think you would feel more comfortable with a different type of person [or if] you think you would feel uncomfortable no matter who the therapist was [because then] your concerns may be more about the situation than the therapist themselves.”    Therefore, it is important to access whether you have a) given a therapist relationship enough time; and b) are you making yourself emotionally available to a productive therapist relationship?

If you have given ample time and have made yourself as available to help as possible - and it still feels like it isn’t working - should you let your therapist know?  Both Solo and Zaccardi say yes, although just as finding a therapist may be easier said than done, the same can be said for letting one go.  Often, a client may feel worried about her therapist’s feelings and how he or she may react; Solo explained that “the relationship with a therapist is a microcosm of how we relate in the bigger world.  If you have trouble establishing boundaries with your friends, you will have trouble establishing boundaries with your therapist.  But the hope is that your therapist can handle the feedback better than your friends and take feedback in an emotionally mature way.”  Solo encourages clients to give their therapists feedback and to talk to her if something isn’t working.

Zaccardi encourages clients to engage in at least three sessions before deciding if the relationship is a good match, during which a lot of questions are presented so that an effective treatment plan is developed.  She also stressed the importance of a client knowing what she is looking for in a therapist, i.e. are you looking for a more laid-back approach, or are you looking for something more structured?  A client needs to know what she is looking for before any therapist can fit that bill.

“Breaking up with your therapist can feel just as difficult as ending a relationship with anyone else in your life.  You might be tempted to just cancel future appointments and go elsewhere without explanation, but [professionals] urge you to talk honestly with them first.”  Solo echoes this sentiment, explaining that “If you don’t tell your therapist what you need, that’s part of the reason you’re in therapy anyway.” 

For those clients who show up but are a little more difficult to work with, Zaccardi approaches these tougher client relationships with empathy, stating that she “uses empathy to dig deep and try to learn what’s behind some of the more unlikeable qualities, and it’s usually hurt.”  When she feels like a client relationship isn’t easy, Zaccardi tries to find the reason why. 

If your therapist is digging deep, and you’re digging deep but still feel that you would be more comfortable in another professional relationship (rather than uncomfortable in any relationship with a mental health professional), then it might be time to cut ties and say goodbye. 

Forbes lists 10 reasons why it might be time to cut ties with your therapist

1)     You’re not seeing improvement (after giving it time)

2)     Therapy feels too impersonal (shouldn’t be a friend relationship, but shouldn’t be cold and awkward, either)

3)     It’s hard for you to be honest with your therapist (you need to feel safe opening up)

4)     They don’t have the experience you’re looking for (if you have a specialized issue, such as an eating disorder, you will want to find someone who is an expert in that specialty)

5)     They’re acting inappropriately (yes, in the romantic sense)

6)     Your therapist takes up more space than you (shouldn’t only be giving advice but helping you work through an issue, too)

7)     You have a hard time talking to them (talking should be comfortable and easy)

8)     You feel like they aren’t really hearing you (even when you clarify and correct what you are saying)

9)     You’re too dependent on your therapist (you need to function without him or her)

10)  You feel like you no longer know why you’re going (goals evolve over time but you should have a good understanding of why you are attending therapy)

Therapy has a lot to do with honesty, so you need honestly reflect on your professional relationship.  “The relationship has to work for the client,” Zaccardi said.  Regardless of whether a therapist checks all the right boxes, he or she may still not be a great fit for you.  Solo commented that, “you have to feel like there’s a connection.  It’s like dating.” 

So go ahead and put yourself out there.  Start the dating process.  You will find your therapist match – although speed dating may not be the approach to take with this relationship.  Take your time, take your honest feelings into consideration - and take a breath. 

 Additional Resources

Mental Health America provides the following list of organizations that offer search tools to help people find specialized therapists in a specific area.

Michelle Hansford is a writer, editor and proud mom of two boys, Caleb and Sam, and her dopey coonhound, Scout. She and her husband live on the South Shore, where they frequent hockey rinks, soccer fields, and baseball fields, depending on the season. In addition to being her boys’ biggest fan, Michelle enjoys exercising, reading and cooking.  Michelle is also an OG Mama Beast and led Mama Beasts South before taking her workouts online. Watch for her new blog coming soon!

Michelle Hansford
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