I am a licensed psychologist in Washington & Oregon, and I focus on longer-term counseling for adults, couples, and older teens. I am not currently taking new clients, but check out my blog & self-help section while you are here for some things that might help. -Will
I have found from my time being a psychologist (as well as a client) that it can be stressful and confusing to get started with counseling and figuring out how to make it worthwhile. So to help with this, I wrote some basics of getting started with counseling and having success with it (1. how to choose a therapist, 2. how to make the most of therapy, 3. types of providers), which you will find below. I hope that you find the following valuable, and wish you the best in your search and counseling process.
Part 1: How to Choose a Therapist
There are a lot of articles on the web about how to choose a therapist. Most of them focus on different degree levels (MA, MSW, Ph.D., Psy.D) types of training, titles (psychologist, psychiatrist, therapist, marriage counselor), and theoretical orientation (cognitive-behavioral, Psychodynamic, Mindfulness, etc), and matching these to your concerns (relationships, depression, anxiety, ADHD, relationship problems, bipolar, etc). Although it is important to be educated about these things, and you can read more about them below, it is not the most important part of choosing a therapist. Additionally, there are many psychologists, counselors, and therapists in Portland, OR and Vancouver WA with any mix of these specialties and qualifications, making the choice more difficult.
So how do you pick? I would suggest you do this based centrally on the "fit" between you and the therapist. In more detail, that might mean that the person seems competent, professional, trustworthy, friendly, and has something to offer you. Like someone you feel good about entering into a personal/professional relationship with.
Research has shown there to be a variety of reasons for this, most notably that the therapeutic relationship is the best predictor of success. Additionally, there is a line of research on people dubbed "super shrinks". These are people that create exceptional outcomes for all sorts of clients with a wide range of problems. Being a super shrink has nothing to do with credentials, experience, or demographics (age, race, sex, etc). It has more to do with subtle things they do during the course of therapy.
It is very hard to know who these people are without meeting them or knowing someone that has worked with them, but sometimes just looking at a website or materials can just feel different. They may feel friendlier, more personable, more competent, more trustworthy, more professional, or like a safer bet. This can be a nice indicator of "fit" ahead of time. That means that looking for the "best counselor" or "best psychologist" in Vancouver would not be as important as the best one for you.
My advice is to read the websites or materials from some therapists, and the one you can see yourself sharing comfortably with and learning the most from should be at the top of your list. Then, either talk on the phone for a few minutes or exchange a few emails, and also see if the person would agree to a free 30min consultation. After this, you will probably have a good sense of whether the person will work for you. Of course I hope that person would be me, but if it is not, then I hope this helps you on your continued search.
Part 2: How to Make the Most of Counseling
The following information are some ideas for making the most of your counseling sessions If you are just starting counseling, or want to improve your current counseling experience, the suggestions below are research support ways get better outcomes and they are instrumental in giving you the greatest chances of meeting your therapy goals quickly.
1. Come to each session with a goal: If you arrive at each session with your counselor with an agenda for the session that contains a goal or something you'd like to get from counseling that day, then you are setting yourself up for success. This can help you and your therapist stay on track with your purpose for coming in, and make sure you are getting what you want from each counseling session. If you struggle to create a goal, I suggest starting with the overall reason that brought you to counseling, and then translating that into a statement that sounds something like:
"I want to get better at..."
"I want to learn how to..."
"I want to understand why..."
"I want to change..."
2. Think about the session during the week: Another element that predicts success is how much time people spend during the week focusing on the things that came up in the previous session and planning for the next one. Essentially, the more time you spend outside of the session involved in the work you are doing in counseling, the more powerful the sessions will become, and the faster your therapy goals will be met. Spending just one hour out of 168 per week on your counseling goals usually does not achieve the outcomes people hope for.
3. Tell your counselor what you like: All therapists work with different methods and counseling approaches, and each also has a unique interpersonal style. If your therapist is doing something that you don't like, or don't find helpful, then I recommend telling him/her. All psychologists and other types of therapists that are on their game will listen to your preferences and make adjustments to suit your style. A way to start this conversation with your counselor might be "I'd like to start our session today by talking about what has been working for me in counseling, and a couple of things that haven't been as much..."
4. Be honest with your counselor: When you first enter counseling you may be unsure about discussing some topics, either because they can be embarrassing or because of some thought that it may make the therapist uncomfortable. The things counseling clients have the most difficulty bringing up or being completely honest about is their substance use, sex life, traumatic past experiences, feelings about their therapist (positive and negative), their religious beliefs, self-harm thoughts and behaviors, and relationship decisions that others have disagreed with. If you can trust your therapist, then being really honest with what is happening in your life is the best way to make progress. Hiding important things, or the level of certain activities can complicate how your counselor will work with you, and likely slow you down. If you don't feel comfortable sharing because of something with your therapist, you may want to bring that up first.
5. Try new things out: There are often parts of counseling that are focused on changing behaviors or trying new things. If you have some homework or ideas to try new things based on your counseling session, giving it a real try will help you find out very soon whether what you are doing in therapy is working. In my experience, clients that are more willing to try new things both interpersonally in counseling, as well as in their regular lives, meet their goals more quickly.
Part 3: Types of Providers
Psychologists: a "psychologist" has a Ph.D. or Psy.D. degree in clinical or counseling psychology, has the most extensive training (5-7 years), and can specialize in a wide range of issues (social issues, PTSD, substance abuse, divorce, parenting, career or work problems, adolescent psychology, bipolar, couples therapy, anxiety disorders, etc). Psychologists also frequently do psychological testing.
Counselors: a "counselor" has a Masters degree (2-3 years training), is licensed (LC, LPC), and specializes in mental health counseling, marriage family and couples therapy, or substance abuse (drug and alcohol). They often identify themselves as "marriage counselor" or "family counselor". Counselors in Vancouver and the rest of Washington used to have a very easy route to get licensed, but the state has now made it more strict.
Therapists: a "therapist" is a general designation that many types of providers can use, but is not standard terminology beyond people who are licensed marriage and family therapists (LMFT), who fit the above description for counselor. Essentially, any mental health provider can call him/herself a therapist. You may also see a practitioner refer to him/herself as a "psychotherapist", which is also not a formal type of provider.
Psychiatrists: have MDs and are trained physicians that specialize in mental health. Many psychiatrists do some limited form of counseling, with some being trained in deeper counseling approaches. Most treat mental health issues through medication.
Coaches: are a relatively new type of provider that as of this writing, are not regulated by state licensing bodies. That means that pretty much anyone can call themselves a "coach" and give some type of life advice, guidance, or counseling, although they are not legally allowed to practice the type of counseling that any of the above providers can.
Part 1: How to Choose a Therapist
There are a lot of articles on the web about how to choose a therapist. Most of them focus on different degree levels (MA, MSW, Ph.D., Psy.D) types of training, titles (psychologist, psychiatrist, therapist, marriage counselor), and theoretical orientation (cognitive-behavioral, Psychodynamic, Mindfulness, etc), and matching these to your concerns (relationships, depression, anxiety, ADHD, relationship problems, bipolar, etc). Although it is important to be educated about these things, and you can read more about them below, it is not the most important part of choosing a therapist. Additionally, there are many psychologists, counselors, and therapists in Portland, OR and Vancouver WA with any mix of these specialties and qualifications, making the choice more difficult.
So how do you pick? I would suggest you do this based centrally on the "fit" between you and the therapist. In more detail, that might mean that the person seems competent, professional, trustworthy, friendly, and has something to offer you. Like someone you feel good about entering into a personal/professional relationship with.
Research has shown there to be a variety of reasons for this, most notably that the therapeutic relationship is the best predictor of success. Additionally, there is a line of research on people dubbed "super shrinks". These are people that create exceptional outcomes for all sorts of clients with a wide range of problems. Being a super shrink has nothing to do with credentials, experience, or demographics (age, race, sex, etc). It has more to do with subtle things they do during the course of therapy.
It is very hard to know who these people are without meeting them or knowing someone that has worked with them, but sometimes just looking at a website or materials can just feel different. They may feel friendlier, more personable, more competent, more trustworthy, more professional, or like a safer bet. This can be a nice indicator of "fit" ahead of time. That means that looking for the "best counselor" or "best psychologist" in Vancouver would not be as important as the best one for you.
My advice is to read the websites or materials from some therapists, and the one you can see yourself sharing comfortably with and learning the most from should be at the top of your list. Then, either talk on the phone for a few minutes or exchange a few emails, and also see if the person would agree to a free 30min consultation. After this, you will probably have a good sense of whether the person will work for you. Of course I hope that person would be me, but if it is not, then I hope this helps you on your continued search.
Part 2: How to Make the Most of Counseling
The following information are some ideas for making the most of your counseling sessions If you are just starting counseling, or want to improve your current counseling experience, the suggestions below are research support ways get better outcomes and they are instrumental in giving you the greatest chances of meeting your therapy goals quickly.
1. Come to each session with a goal: If you arrive at each session with your counselor with an agenda for the session that contains a goal or something you'd like to get from counseling that day, then you are setting yourself up for success. This can help you and your therapist stay on track with your purpose for coming in, and make sure you are getting what you want from each counseling session. If you struggle to create a goal, I suggest starting with the overall reason that brought you to counseling, and then translating that into a statement that sounds something like:
"I want to get better at..."
"I want to learn how to..."
"I want to understand why..."
"I want to change..."
2. Think about the session during the week: Another element that predicts success is how much time people spend during the week focusing on the things that came up in the previous session and planning for the next one. Essentially, the more time you spend outside of the session involved in the work you are doing in counseling, the more powerful the sessions will become, and the faster your therapy goals will be met. Spending just one hour out of 168 per week on your counseling goals usually does not achieve the outcomes people hope for.
3. Tell your counselor what you like: All therapists work with different methods and counseling approaches, and each also has a unique interpersonal style. If your therapist is doing something that you don't like, or don't find helpful, then I recommend telling him/her. All psychologists and other types of therapists that are on their game will listen to your preferences and make adjustments to suit your style. A way to start this conversation with your counselor might be "I'd like to start our session today by talking about what has been working for me in counseling, and a couple of things that haven't been as much..."
4. Be honest with your counselor: When you first enter counseling you may be unsure about discussing some topics, either because they can be embarrassing or because of some thought that it may make the therapist uncomfortable. The things counseling clients have the most difficulty bringing up or being completely honest about is their substance use, sex life, traumatic past experiences, feelings about their therapist (positive and negative), their religious beliefs, self-harm thoughts and behaviors, and relationship decisions that others have disagreed with. If you can trust your therapist, then being really honest with what is happening in your life is the best way to make progress. Hiding important things, or the level of certain activities can complicate how your counselor will work with you, and likely slow you down. If you don't feel comfortable sharing because of something with your therapist, you may want to bring that up first.
5. Try new things out: There are often parts of counseling that are focused on changing behaviors or trying new things. If you have some homework or ideas to try new things based on your counseling session, giving it a real try will help you find out very soon whether what you are doing in therapy is working. In my experience, clients that are more willing to try new things both interpersonally in counseling, as well as in their regular lives, meet their goals more quickly.
Part 3: Types of Providers
Psychologists: a "psychologist" has a Ph.D. or Psy.D. degree in clinical or counseling psychology, has the most extensive training (5-7 years), and can specialize in a wide range of issues (social issues, PTSD, substance abuse, divorce, parenting, career or work problems, adolescent psychology, bipolar, couples therapy, anxiety disorders, etc). Psychologists also frequently do psychological testing.
Counselors: a "counselor" has a Masters degree (2-3 years training), is licensed (LC, LPC), and specializes in mental health counseling, marriage family and couples therapy, or substance abuse (drug and alcohol). They often identify themselves as "marriage counselor" or "family counselor". Counselors in Vancouver and the rest of Washington used to have a very easy route to get licensed, but the state has now made it more strict.
Therapists: a "therapist" is a general designation that many types of providers can use, but is not standard terminology beyond people who are licensed marriage and family therapists (LMFT), who fit the above description for counselor. Essentially, any mental health provider can call him/herself a therapist. You may also see a practitioner refer to him/herself as a "psychotherapist", which is also not a formal type of provider.
Psychiatrists: have MDs and are trained physicians that specialize in mental health. Many psychiatrists do some limited form of counseling, with some being trained in deeper counseling approaches. Most treat mental health issues through medication.
Coaches: are a relatively new type of provider that as of this writing, are not regulated by state licensing bodies. That means that pretty much anyone can call themselves a "coach" and give some type of life advice, guidance, or counseling, although they are not legally allowed to practice the type of counseling that any of the above providers can.
