Answers to Consumer Questions
Question 1. Do you have any
suggestions for choosing a counselor or therapist?
First suggestion
is to become familiar with
the various levels of counselor certification in Washington State.
If a counselor is advertising his private practice without using one
of the listed credentials, she or he is hiding his qualifications
and doesn't want you to know. And by hiding his/her true
qualifications, the counselor is misleading you and thereby acting
in an unprofessional and unethical way. Run like hell from
such a counselor. There are plenty of highly qualified
counselors out there. (see the menu on the left margin).
The State of Washington
provides
a pamphlet for persons looking for a counselor: "What to Expect from your [Licensed Counselor]."
Download it and print it out for easy reading.
[ In addition to reading the official response (below), may I suggest that you
take a look at the CounselingSeattle.com page on misleading acronyms and
initials used by unprofessional counselors and unethical counselors--initials
and therapists to avoid. ]
Be aware of what
this webmaster considers to be a misleading label used by some
professionals:
Diplomate
Status = You may find
persons who identify themselves as being a "Diplomate in Something"
[Diplomate in Behavioral Medicine, Diplomate in Professional
Psychotherapy, Diplomate in Professional Counseling, or
Diplomate in Chemical Dependency Counseling.] It sounds
impressive--like a doctorate--but consumers should ignore this
particular "credential" as it generally has little meaning.
Supposedly, persons who receive this designation must have some
state-issued credential and some designated level of education and
experience, and take an exam (which not required during the
"grandfathering period"--a vague period that often seems to mean the
first 199 years in which the diplomate is offered). While it
boosts the ego of the recipient, and is a money-making activity for
the issuing association, it should be ignored (neither a plus or
minus) in the process of selecting a therapist or counselor.
There are a few diplomates that have high requirements, but it is
unfair to the consumer to expect them to know which is which.
[This is written with full understanding that one or two "Diplomate"
credentials actually require very special achievement, but--for what it's worth--this
represents my personal and professional opinion and my interest in
serving the public. Floyd Else, MA, LMHC, NCC, Webmaster.]
Otherwise, the
following material offers some
Suggestions for Choosing a
Counselor or Therapist:
1. Ask yourself some questions:
Are you looking for group or individual therapy? Couples therapy? Family therapy? Are you looking for brief, solution-focused
therapy or long-term, in-depth work?
What issues do you want to work on? What do you
hope to accomplish? Do you have a preference as to what therapeutic modality
(such as verbal therapy, art, movement...) you want to work in?
Do you prefer a male or female therapist?
Does it make any difference to you?
Are you available during the day or do you need evening/weekend sessions? What locations are convenient for you?
What fee can you pay? Do you need a sliding scale?
2.
Make a list of possible therapists and their phone numbers:
Talk to friends, family and others who may be able to refer you to a therapist. Additional sources for finding a therapist are
advertisements, referral services, and local schools and
CounselingSeattle.com.
(See: Niche Specialty Index)
3. Contact the therapist you want to know more about. Let them know you are shopping around.
Some therapists will talk with you on the phone and you can get a sense of them and their work. Others prefer to talk on the phone
briefly and then begin regular sessions. Still others offer one session at no charge.
4. Whatever the therapist's initial policy, you can help yourself get a good match. You have the right to ask questions.
Some questions you might ask are:
What is your training? How long have you been in practice?
Do you have Washington State certification, or license, a Washington State unified business number and a city business license?
How much do you charge? When do you see clients? How soon could I get an appointment?
Have you ever been in therapy?
What issues do you work with? What do you specialize in? What experience do you have with the issues that I want to work on?
Can you help me? If not, will you refer me to another therapist?
How would we work together on issues? How long will it take?
5. As you make your decision, TRUST YOUR GUT INSTINCT! No amount of training, paperwork or government regulation can ever
substitute for your own personal sense of what is best for you.
Do any of these therapists seem to be right for you?
Do you feel safe with him/her? Do you sense you could connect with and work with this therapist? Is he/she comfortable with you and your issues?
6. On-going evaluation of your therapy process:
As you continue in therapy, talk to your therapist about your progress. You have a right to ask questions and to receive answers to them.
You, the client, are always in charge of your process. You have the right to refuse what your therapist is offering you. You
have the right to change therapists and/or modes of therapy.
Sexual conduct and/or contact between therapist and client is NEVER acceptable conduct.
Outside relationships such as business, friendship and socializing with your
therapist are also not acceptable because they create barriers to the
therapeutic process.
Do you feel that you are connecting with your therapist? Feelings of discomfort are to be expected in therapy, but feeling unsafe with your therapist is a major warning sign to you.
* * * * *
This material on choosing a therapist was prepared by the following Seattle area counselors & therapists:
Jay Schlechter, MA, Ph.D., Myra Rosen, MC, LMHC,
Hazel Johnson, MA , RMTP, and
Dean Allan, RN, MA
Additional Suggestion:
"If you are looking for a therapist and have mental health insurance coverage, be sure to
consult the insurance company's list of preferred providers." (Hilarie Cash, PhD)
Also see:
Dr. Helen's Blog--Commentary on popular culture and
society, from a (mostly) psychological perspective,
an
article titled:
How to Tell if Your Therapist Sucks Like a Bilge Pump.
QUESTION: I
know several counselors who are well-respected
in the community whose names are not listed on
Counseling Washington's list. How do you choose who is listed? Is
there a fee to be listed?
SUBJECT: Why are
some counselors listed on Counseling Washington and other are not?
Dear Shelley:
Counseling Washington offers free listings to those counselors
throughout the State of Washington who:
(1.) are authorized mental health providers for the
Crime Victim's Compensation Program;
(2.) are counselors who are fluent in a foreign language;
or
(3.) are counselors who are available as authorized supervisors for counselors working toward
full licensure.
Counseling Washington supports it activities with
advertising fees charged for
displaying a counselor's private counseling practice listing, therapy groups,
ads for
counseling office space, counselor workshops, employment
opportunities, etc. See:
http://www.counselingseattle.com/advertise.htm
Counseling
Washington
competes with some really heavy-hitting national websites that spend hundreds
of thousands of dollars each year to advertise their services to
counselors. Counselors who respond to the lure of flashy
handouts end up spending three times as much to be listed on
websites that don't perform as well as Counseling Washington.
Many counselors have told me they
obtained as much as a third of new clients from
Counseling Washington.
Counseling
Washington
is your local, Washington based source for counselors who have at
least a masters degree, are certified or licensed as a counselor,
therapist or clinical social worker and have no license restrictions
preventing practice in Washington State.
Yes, Shelley, there are counselors who are well-respected in
Washington State
whose names are not listed on the Counseling Washington
web site.
That does not mean they are less
worthy or less talented. They are just missing an effective
and inexpensive opportunity to connect with potential clients, such as
yourself, on the Internet.
Sincerely,
Floyd Else, MA, LMHC, NCC
Webmaster:
http://www.CounselingSeattle.com
Counseling Washington
PO Box 6714, Bellevue, WA 98008-0714
QUESTION about
fees: i love your site! so informative.
But i can't find any info regarding fees or rates for therapists. in
particular, who sets the fees? (is it the government, is it an
association, etc.) and is there a difference in cost among and
between disciplines (i.e. do LCSWs charge more than LMFTs, etc.)?
Since money is such an integral part of my relationship between me
and my therapist, it should hold a significant place on this site,
dontcha think? :-) Thanks for listening! Walter.
Walter:
Thanks for your good words. With regard to the fees charged by
counselors, therapists, and clinical social workers in private
practice, fee setting is an example of capitalism in action.
Neither the government nor professional associations regulate or
determine fees charged for counseling services. In 20 years of
counseling I cannot recall ever being in a professional group where
counselors were discussing how much to charge for their professional
services. What to charge is a big question for counselors
although it is difficult to determine the effectiveness of free
market forces in setting fees.
Generally speaking, counselors, therapists and clinical social
workers are Masters level counselors and charge less than mental
health professionals with PhD or MD degrees. The American
Association for Marriage and Family Therapy estimates that the usual
fees for marriage and family therapy are about 60% of that
psychiatrists charge and about 80% of what psychologists charge.
I would consider fees of $100 to $120 an hour to be average in
metropolitan areas of Washington State—and somewhat less in more
rural areas where the cost of living is less.
Many counselors offer reduced fees based on income (sliding scales);
however, counselors who are preferred providers with Health
Maintenance Organizations or insurance companies generally don't
offer sliding scales because they are prohibited by their contracts
from charging any client less than they charge the insurance company
clients.
One of the peculiarities of the American psyche is the belief that
if an article or service costs more it must be better. But the
most important factor in the success or failure of counseling is the
quality of the relationship between the counselor and the client.
When choosing a counselor, the most important consideration should
be whether you feel comfortable with the counselor and the counselor
inspires your respect and confidence.
In closing let me say that I appreciate your focusing my attention
to the lack of fee/cost information on the site. We are going
an extensive redesign of the counselor listings this year and we
will be sure to include information about counselor’s fees as an
added service to our viewers.
Best wishes,
Floyd Else, MA, LMHC, NCC
Counseling Washington
Connect with us us with your question or comment.
Return
to Consumer Questions Index
