How to Determine IF a Psychologist/Mental Health Professional Is a Good Fit for You BEFORE Committing Too Much?

Hi,

Long story short…I've got issues. They've been there for a long time and are due to a lot of bad stuff.

Yesterday I went to my GP (NSW) and asked for a Mental Health Care Plan (MHCP) to be drawn up - or rather told me where my mind was at - and then based on questions from him, he drew a MHCP up for me. he also recommended a person to contact to deal with on the basis that he got good feedback on them.

My concern is I had a MHCP drawn up about a decade ago - and was recommended a person, went to them - and in the first session I caught them viewing their phone while I was talking and generally got the vibe they weren't a fit for me. So I illogically tossed the baby out with the bathwater - and didn't see anyone - as my caveman instincts told me to suck it up and 'be a man!'(Marlon Brand Godfather voice).

How do I avoid this happening again? You have to spill a lot of stuff - and really don't know if they're going to mesh with you easily - so what should I find out and how should I find it out before I commit am 4 sessions in and feeling deja vu?

I also fear that if I ask a bunch of questions of them upfront - which I suspect people DO NOT OFTEN DO - I'll get the proverbial red mark against me before I come in the door as a control freak or worse - needing them to justify if they're suitable for me.

Alas there's no Yelp or productreview.com for Mental Health - so appreciate constructive feedback.
Thank you.

Comments

  • +1

    It’s hard to know. I went a counsellor years back and then to a free subsidised uni clinic. Had a few sessions and then and then the person changed over, and then I’d had enough; I didn’t want to hell my life story again. Paying for it would be beneficial but it’s not the be all and end all. I know some people who enjoy going to see their therapist etc and for them, it validates some of the ridiculous ideas they have which to me seems like a waste of money. I’d go with the GPs recommendation: and if they are bad, tell the GP and try someone else. Then I suppose if they become all bad the problem is you haha.

    • +10

      Then I suppose if they become all bad the problem is you haha.

      I don't think that's really fair. To have your mental health treated you have to be able to talk to communicate what's in your head, and if it is hard to talk to the person that's treating you they can't do much. Mental health should be seen the same way as physical health and not have such stigma. If you had a physical issue and the doctor couldn't figure it out you would go to different doctors until you found one with the right experience to know what was going on. And that isn't your fault that the first doctor couldn't help you.

        • +13

          Someone doesn't have empathy - if you were suffering depression, anxiety, or something like that how would you take a comment saying that if no one can help you it is your own fault. I don't think you would laugh.

          • -6

            @Quantumcat: Like a dagger through my heart. Why do you hurt me like this

            • -1

              @Awoke: Even Op has a better sense of humour that the bleeding hearts

      • It reminds me of a few friends who are now diagnosed as bipolar. After 10 years of stating every boss and person is a (profanity), well, guess who it really is. Diagnosis is only part of the solution

        • +2

          Having bipolar isn't their fault though, and the associated behaviour doesn't reflect who they are or their worth as a person. They still need to find the right professional who can help them.

        • +3

          There's a funny saying I heard a while back which your story remind me of.

          'If you run into an a$$hole in the morning, you ran into an a$$hole. If you run into a$$holes all day, you're the a$$hole.'

          Suffice to say I'm a bit of an a$$hole - but that doesn't preclude others I run into from being one as well. :-)

      • Psychology is a science, you can't just conjure up a hundred thousand good ones out of thin air, and just hope that they all want to work in clinical psychology in the first place.

        • +2

          Agree - hence whats the mechanism or methodology to find the 'good ones? Seems 'suck it and see' is the recommendation, which is less than ideal but perhaps reality.

          • +1

            @Daniel Plainview: It's a personal fit so recommendations might not be very useful.

            Read about them. Their profile on their work page. Their masters or PhD thesis (or just the abstract) if you can be bothered.

            Best advice: Pick one manageable issue in your life to work on with a new psych. If that works out, raise a bigger issue. But DON'T lead with your life story. It's too much to unpack in one go. And you'll get bored of telling the story.

    • +4

      I didn’t want to hell my life story again.

      Frequent flyer tip: Make a cheat sheet.

      Write your clinical history down (in chronological order). That way you can get through it fast and without missing anything. Clinicians understand the idea of clinical notes and are used to working with them.

      Also, make an agenda. If you're going into a session it is very easy to get stuck in the weeds. Having a clear idea what you want to talk about up front helps to minimise that.

    • OP should discuss concerns with thier GP

  • +6

    If only they had a money guarantee…

    Hard to say, it's like finding a 'good' GP that you feel does the right things, than just ask you to take Panadol and rest when you have a problem.

    You might just have to try a few until you find one… good luck tho.

    People in those profession should be seen as good listeners. I believe they are not directly fixing you, but they listen, give you guidance to help you fix yourself.

  • +3

    imo, it is all about are you feeling heard. It can take time to build a therapeutic relationship with someone but I think your initial gut feel is correct more often than not. Like with many things in life, some things work and some simply don't. I don't feel bad at all if my clients go to a different therapist.

    Also, good on ya for giving it another go.

  • +12

    I'd make it one of the first things I said to them when unpacking the baggage, maybe even using the same words in your post. e.g. "A few years back when I went to get help under a plan I caught the professional using their phone while I was talking, and that made me (at the time) very disengaged and disappointed with the process, and I feel I now have trust issues with how a professional would engage with me. That's something I'm nervous about now. Do you know a good way to deal with that?"

    They'll likely engage with you and propose a way that the meetings can be held with an openness that makes ongoing discussions more of a safe area with you. Well, they will the
    second they figure out today's Wordle, anyway.

  • +7

    Finding the right one is not much different to finding a husband/wife. Sometimes, things just don't work between two people. It doesn't necessarily mean that either is wrong. It just means that they're not compatible with each other. You might need to go through a few to find one that suits your own needs the best.

    • +3

      ^^ this.

      At one point (unbeknownst to me) my girlfriend and I were seeing the same psychologist, we both knew we were seeing psychs but it wasn't until she walked out of my psychs consult room to spot me in the waiting room. My psychologist was having a good giggle from her door (having matched the first names and personality descriptions)

      I found her quite helpful and useful but my she wasn't the right person for my girlfriend and she ultimately switched to a different person at the same practice.

      • +2

        Wow. That's unethical.

        Most psychologists and psychiatrists will not knowingly take on both partners.

        Marriage guidance excepted, of course.

  • Maybe they were checking their phone for the title of a book to recommend to you or something. I can't wait for augmented reality glasses that let us secretly "check our phone" without the person we are pretending to talk to noticing.

    • Or because a good health professional dealing with really serious mental health stuff has responsibilities to other patients and doctors as well .. it's actually a GOOD sign that they don't ignore their phone entirely (as for all you know it's another doctor saying "patient xyz is on a ledge and we need you urgently".

      It is also a thing that sometimes people who are not really as ready to get help as they want to be (caveman instincts) will find any old excuse and hit the ground running … I'm only guessing, but I would suggest that OP might need to lighten up a bit and realise that if they are after a "perfect" therapist (or human in any role at all including themselves) it will never happen and they need to make do with what is available now. Or they will get no help at all instead.

      We humans can find a lot of good in terms of help in almost any scenario. Even when someone is only helping a bit, it's more than you had before. Work with it, look for the good. Learn how to learn.

  • +3

    Establishing a strong therapeutic alliance is so important in the early stages of a counselling relationship, and a therapist who doesn't give you their undivided attention was never going to be helpful for you. If you don't feel comfortable with your therapist or don't 'click', it's perfectly ok to try someone else. For example, finding a therapist with lived experience of the issues you're going through is in a better position to understand and help you.

    What makes you feel asking a bunch of questions upfront would be received negatively? As the client, it's important that you have your questions answered to establish trust and to believe the therapist is credible.

  • What makes you feel asking a bunch of questions upfront would be received negatively?

    I don't think they're accustomed to it - and my perception is that it's likely to skew negative - think a 'first impressions' type scenario - but I'm essentially almost asking 'why should I use you"? I think thats fair - but I think they'll find it odd.

    I've seen a few people in the past but that was a very long time ago - and am intelligent enough about both this area and myself to concur that wrong person is going to likely do more harm than good - if only as it will feed into my 'well tried again, so f&ck it' falasy.

    FWIW we're off to a rough start - this therapist that is - as I left msg to make appt at 0930am today and no response. :-/

    I don't think there is a magic solution or approach - I know in many areas you just have to trust - but generally there will be reviews, or industry standard questions to ask etc - therapists seem like total word of mouth - and even then you're looking at minimum 3 sessions before knowing much - unless like the one I had, they're a complete drip.

    Seems less than ideal - maybe an opportunity for someone to make a site folks can use for feedback on such intangible services. Heck I know (not from using) but just being a stickybeak that even Adult Escorts have sites where people will give feedback on how 'satisfied' they were with their service etc.

    • I read stickybeat. There is something wrong with me 😂😂😂

    • +1

      I don't think they're accustomed to it - and my perception is that it's likely to skew negative - think a 'first impressions' type scenario - but I'm essentially almost asking 'why should I use you"? I think thats fair - but I think they'll find it odd.

      I agree, doesn't seem like an unreasonable request, but do you know for sure they'd find it odd? Maybe an assumption that could be tested ;)

      but generally there will be reviews, or industry standard questions to ask etc

      I think it would be hard to use client reviews to judge a therapist's competence - the experience is so subjective and dependent on a therapist's area of specialty. Reminds of review sites for tradies, might help weed out the really bad ones, but doesn't really tell you how good they are compared to others.

      • +1

        There's very little in life any of us know 'for sure'. Don't get me wrong I don't mind being seen as odd, infact where appropriate I wear it as a badge of honour to zig where the masses zag. But I don't want to get off on the wrong foot with them - and I fear on some level that would. Hard to put the toothpaste back in the tube sometimes, e.g first impressions etc.

        I agree that you can't just have a therapists YELP site etc - as I said it's just an observation as everyone agrees a good one & good dynamic is critical - yet even finding out basics from them (as they now have a 4 page or so document on my issues etc via the MHCP) is very hard.

    • +2

      I don't think they're accustomed to it - and my perception is that it's likely to skew negative

      And that's the first test of whether they're any good or not. A clinician that cannot explain and defend their thinking in a convincing manner when questioned is useless. They're telling you that they don't know how to do a proper differential diagnosis.

      Secondly, as a frequent flyer: I interrogate my clinicians to within an inch of their lives. Psych or other clinicians, it doesn't matter - these people are in a position to ruin you should they make mistakes in your treatment. This is the self advocacy portion of your treatment - they're seeing you for an hour, you have to live with yourself 24 hours a day. You have different levels of investment in the situation.

      The other side of asking questions is education. You need to know as much as possible about your particular situation, the treatments available, etc. You've got a problem, probably one that many others have too, so asking "How did they make their lives better?" is a pretty logical start to your investigations.

      Yes, it sucks that you have to be the one aggressively driving your own treatment. It especially sucks when your brain is completely smashed and you're drooling and you still have to be the one pushing the process. But you know what? The squeaky wheel gets the oil.

      Failing everything else, the template here is simple: ask "What else do you have to offer?" and then let them speak. Be comfortable with long silences. That's not a psych specific technique, that works almost everywhere there's a customer service interaction. A great deal of interactions are based on placation, you deny that placation and people immediately increase the offer they're making. You may come off as a prick but you'll also likely walk out of that interaction with better outcomes than all the non-pricks did.

      • Nice reply - right in my wheelhouse for tone - I agree and appreciate the input. :-)

  • +5

    Huh - when I went through this I really just wanted someone to fix me.
    Sadly, that couldn't happen - and it didn't.
    So, after a couple sessions I stopped going.
    I didn't need to be heard, I didn't need to be reassured. I wanted someone to flick the switch that would get me back to normal.
    Instead I learned I just needed to manage, and that was about all I could ask for.
    However I understand for others it can be different. Horses for courses I suppose.

  • +2

    Most psychologists are not very good from my own experiences. You can get better feedback just by creating a dummy social media account and just ranting about random things about what is wrong about life.

    e.g. I rant a lot about people not following actual science. (Laughs at the fact the CDC recommended certain health procedures when there was no evidence it was efficacious)

    I also drink a lot because I read about cases where people got stiffed. Sometimes you even have clients where the law was incorrect, but they had no money to appeal…

  • +4

    Getting good help is f(king hard and unfortunately may not happen. I got lucky and got a good psychologist that was paid for by work,. but friend I know are still trying to find a decent one after two years and about 5 or 6 different ones.

    I have been to really good psychologist that help and have seen ones that I did not think anyone should pay for.

    My advice is to try to figure out what they specialize in if you can find this out and if it seems to be like the issues you have or even if the feedback is very good then go for it as they may refer to some one who is better suited for your issues.

    Be aware that psychologist's costs come under medicare when you use the MHCP and if/when you ht the medicare net you get back 80% of the fees, so if you hit the net milk it if you can (book extra sessions under medicare).

    There are ways of getting more sessions under medicare if you need them, but I cannot remember what it is called.

    Good luck and hope you can find a good psychologist.

    • +1

      Good response, alarming and a bug bear of mine is that someone neg'd you (WTF?). So I've neutralised that - I really despise the anonimity of the OzB voting system - I think it'd be a lot better if it were visible. Gof figure.

      FWIW spoke with my wife about it and oddly despite her having a psych background she had no ideas either though acknowledged it was one of the only fields were there's very little to no ability to critique or assess a therapist before commencing with them.

      So atleast that validates my concern to a degree, in that it's a good thing to want to ensure you're 'a good match' to the therapist but also this is near impossible to do without commencing with them.

      Haha oh and no call back from the therapist from my 0930 or so msg. It does not bode well.

      • +1

        I did some snooping and I would call the main RSL number in town, not one of the sub branches and during business hours (10m to 4 just to make sure the person is hopefully there) and see if you can find out who they recommend as a psychologist in town or ParkB or at the Jetty or etc etc up or down the coast. It's changed allot since I left and moved to Sydney. Before making the call check the web site out to see if you can figure out what to askl for when you all, but the web site has allot of options (I check it out every few years to see if there are any new places to holiday at cheaply).

        My my good psychologist that was very helpful has a background in treating PTSD even though I did not have PTSD he tried to understand what I was going though and tailored the session for the issues I had and it helped. This is the reason I am point you in the RSL direction.

        If the RSL cannot help or too hard to figure out how to get the answer then speak with some of the old WW2 or Vietnam vets if you know any or can find any and ask them who in the area is good for helping out with mental health issue.

        As there is an acute lack of heath resources in the area you may not get in for a while.

      • You can go onto beyond blues site from memory and you can use the map to view different types of professionals in your area (clinical psyh vs psych etc). This assists if you're interested in a certain type of treatment.

  • +1

    Ask your questions. You're the customer. Better you ask the questions and know if they're a good fit for you, than stay quiet, nodd your head and continue doing things that make you feel stuck and then give up on the counselling. But your concern is real and valid… it's hard to find someone you gel with for such personal stuff! Ask your questions and see it like an interview, where you're the interviewer.

  • +1

    I've had three crap and one good psychologist. Definitely ask questions up front, just remember they're human too so coming in guns a blazing isn't a good plan. But you won't be the first person they see who has needed help and hasn't gotten it.

    It's like a first date with the added benefit you can tell them what went wrong in other dates and what you're looking for. So I guess it's like a first date with a prostitute?

  • +2

    Hi OP. Do some research on types of therapy CBT and find someone who specialises in one that sounds good.

    Also research professionals in your area - do you want to see a man, woman? Younger, old? I remember being matched with some old Lebanese woman who worked at my GP and she was a terrible fit - she just seemed so down the straight and narrow. I felt bad sharing my deepest darkest secrets.

    Tell your GP who you want to see. And if you don't gel, get them to write you a new referral.

  • +2

    I was referred to a pschycologist on a plan like that and the dude had a bizarre email address where the domain didn't even have a website and the whois info was dubious, his personal named website was a cheap template crap job, his phone message had a female voice stressing they don't take new clients and how only the very privileged few accepted patients could leave a message or something, and then I was told to just fill in a form online which went on and on and on and seemed to totally focus on $$ and paying and insurance, wanted credit card details upfront… and after 20 minutes sweating on that form (I'd assumed it would be a 1 minute Medicare number and name job) I lost it. The good man then send me a 19 page pdf which was clearly amateurish and he apologised that it didn't translate well into pdf… faark, I was a mental mess by just having to deal with all that…

    I still agreed on a tele meeting as he was recommended by xyz… but he is now very very low on my respect scale. And I didn't complete the form - out of principle almost … I dont think he'll get back to me since I didn't complete form….

    Oh and 2 yrs ago I went through a similar referral with a local professional and I found her useless and expensive and the waiting period for appointments ridiculous for just a friendly chat with someone who just agrees and nods.

    Easier to just deal with life's curve balls alone.

    Good luck with yours!

  • -1

    If I had to add my informed opinion to the thread, does it prove I used to be a 'former' nutcase?

  • +1

    Why does your doc think they would be a good fit…has the good feedback the doc received come from person with similar issues to u (most important) and similar age/situation to you? Might be good to run those question past doc.

    • I thought I stated it but perhaps not - he sid he'd gotten 'good feedback on them' - that was the sole basis he conveyed to me. yeah alas running by the doc more is kinda hard, he's actually changing practice and TBH getting in to see him was a nightmare for a bunch of reasons and what should have been handled in 1 appt was already drawn out of several…but I digress.

      I am 99% certain as he said it's just based on a few other patients coming back and saying they were happy with this person. Literally nothing more. Hence I'm not exactly expecting they're 'tailor made' for me. ;-)

    • +1

      Good starting point. My GP's clinic has a couple of tried and true psychologists they work with, who have different specialisations for a range of therapies. The first one I tried was big on hypnotherapy, but I couldn't get into it, but the second does CBT and a few other therapies and it's been very helpful.

      I would say that you can see pretty quickly whether you click or not and the ways they frame their reasoning and explanations makes sense to you.

      It's not a passive process. You have to practice the strategies, learn new ways of thinking, and sometimes have your perceptions challenged which can be hard at first. It can take a while for things to click, and there will be good and bad days. Very worthwhile, though, as you start to make progress. The goal is that you learn to manage as much as you can yourself, depending on the condition, of course.

      It's great that you have the courage to seek help to change. I hope it goes well for you.

  • +1

    Approach this with an open mind and try not to predict how it should go. You may hear things you don't want to hear, but need to hear. Good luck!

  • +3

    You should ask how they work, what type of therapy they use. Many therapists will have an information sheet - you could ask for that in advance. A counselling or clinical psych has done extra training. Your concerns are very normal, and a good therapist should be attuned to your uncertainty about what to expect, and be clarifying their approach with you. Just say how you are feeling up front, that you have some uncertainty, and they shouldn’t find that at all unusual - it’s part of the work they do every day. It’s their role to help feel comfortable enough to disclose, and it is super common for clients to disclose slowly as they become more comfortable. As one person above said - there may have been a genuine reason for looking at their phone - but in my work I never did anything without telling my client first - eg - I’m going to make a few notes while we talk, I think there may be some good resources that may help, I can look those up for you, I have some leaflets on xyz in my bookcase, etc.
    Don’t be concerned about expressing any concerns or discomfort you have - they need to help you with that before you can make any progress with your issues. If they can’t, they should be attuned enough to ask if you would feel more comfortable with someone who has a different approach and even be willing to help you find a good match.
    But most of all, you’ve already started doing something to change by seeing your GP - keep going!

  • Good luck getting an appointment with a psychologist.
    I don't know what the situation is in NSW, but there is a very long waiting list in SA.
    They are blaming it on the pandemic.

  • +5

    Heya

    I'm one of those dreaded psychologists. I haven't read all of the responses as I was too busy scrolling on my phone!!

    A lot of psychologists are happy to have a chat with you on the phone when you are making your first appointment. I also had a number of people ask me questions to see if I would be a good fit for them and I saw this as a positive thing. Remember that if you don't feel comfortable with them after your first session or even after the initial phone call, you can change treaters

    I hope the person you see will be helpful and supportive for you. :)

    • +1

      I'm one of those dreaded psychologists. I haven't read all of the responses as I was too busy scrolling on my phone!!

      Psychology's gain was clearly the stand up comedy worlds' loss! ;-)

      Good response, appreciated it thank you. :-)

      • Smiles, my pleasure.

  • +1

    Dunno if this is helpful, but it occurs to me that maybe you could broaden your options (outside your town) by looking on Health Direct for providers who do Telehealth?
    https://www.healthdirect.gov.au/

    I started doing my sessions thru Health Direct video calls (in a web browser) during COVID lockdown. We are out of lockdown now, but I'm still doing Telehealth as it's more convenient and "my guy" has moved out of town.

    Anyway, best of luck.

    • That reminded me that many health funds offer Telehealth support for mental health, and they can do evaluations, explsin appropriate therapies, recommend and put you in contact with MH professionals, dieticians, etc.

      It's usually free, and can be a good starting point for people.

  • +6

    Counselling Psychologist here, using my real name. Therefore responsible for everything I say here under AHPRA guidelines. And none of what I say here should be taken as professional advice on any person's specific condition or needs. For that you need to consult a registered practitioner individually.

    This is such an important question.

    I really should write a longer blog post about this, but as I have my first appointment of the day in 8 minutes, this is all I can manage.

    I definitely vouch for the approach of whoever said question your psychologist within an inch of their lives before starting with them. This isn't like getting a mechanic, where you can just pay another practitioner to undo any damage and the only cost is money.

    It's worth investing the time and effort both in initiating the relationship and in the work that you'll put in during the course of your therapy.

    We can't 'fix' you. [Mainly because you're not 'broken' even though you might legitimately feel that way.]

    What we can do is train you in skills that help you see you, your problems and your world in a different way that allows you to experience some or all of peace, joy, confidence, freedom, fulfilment. Your symptoms may reduce at the same time, but we can't promise that in an individual case.

    What we do know is the following:
    - most (about 70%) of people who attend counselling will feel better sooner than people who don't
    - most who attend will improve somewhat in 6-10 sessions. Significant improvement usually takes longer.
    - attending longer leads to better outcomes than attending for fewer sessions. (This is why the COVID-19 'extra 10' Medicare sessions are so helpful)
    - the therapist qualities most likely to be helpful are warmth and competence. As perceived by you the client, not so much by the therapist and their peers.
    - therapists who express uncertainty are more effective than those who express certainty
    pay attention to this one Therapists who routinely monitor progress objectively and seek client feedback, tend to produce better outcomes than those who don't.

    As others have pointed out your new psychologist should:
    * be able to explain what they do and why they do it that way
    * why they plan to use that approach with you i.e. how this approach specifically makes sense in your case, not just because "that's what I'm trained in"
    * be able to offer alternatives - other approaches and other therapists - if you are not making progress, not just more of the same.

    These are some of things I think you should look for in a therapist.

    • +1

      Julian, much thanks for your thoughtful and thorough post. I wish I could say more than JUST thank you - but thats the best I have at present.

      Hopefully others will join me in UPVOTING (as silly as that is) your comment so others might see it as well. I've noted all you've said and very much appreciate you taking the time to post it - I am sure it will help many, sincere thanks. :-)

  • +2

    @Nikko I hope you have found some helpful information in this thread. Thankyou for asking what is such an important question and opening up an informative discussion.

    With kindness
    Mel :)

  • Something to consider may be the way their consulting room is set up.

    Some have their desk against the wall with you sitting right beside them at the end of their desk with no physical barrier between you.

    This set up makes me uncomfortable.

    Others will have their office set up so that you sit on one side of the desk and the therapist sits on their side.

    I like this one because of the barrier between us.

    Would one of these seating arrangements make you more comfortable than the other? It makes a big difference to me.

    Also, the therapist's disposition. Do they sit still and calm, listen to what you have to say and respond in a controlled manner with helpful suggestions or guidance?

    Or do they scoot back and forth across the office on their wheelie chair, zipping around you, causing you to feel unsafe and distracted (this is worse when you sit beside the specialist.

    Good Luck

    • Interesting thought. I'd have thought being on opposite sides of the table would make it seem like a power imbalance compared to an open conversation. I've been on the search for someone to see but all fully booked :(

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