When we enter a grocery store or our primary care physician’s office we generally know what kind of service we will receive. For most of us this is not the case when we begin treatment with a mental health provider. Over my 45-+ year career I met many frustrated clients who complained that their previous mental health practitioner failed to offer medication, recommended medication, talked too much, or too little. Unfortunately, we are poor consumers with respect to mental health care. We spend more energy researching a purchase for a household product than selecting our mental health provider.
In truth, the mental health field is certainly confusing and, should I say it–crazy. Providers primarily are psychiatrists, psychologists, nurse practitioners, marriage and family therapists, counselors, social workers, and, more recently, life coaches. Basic forms of treatment include psychopharmacology (medication), psychoanalysis, family of origin work, family therapy, behavior therapy, EMDR, and coaching. Obviously, it is quite confusing for the typical consumer to differentiate among the various providers and therapies.
To make matters worse, there are four basic approaches or perspectives regarding the definition and treatment of mental health issues—the biological, analytic, cognitive, and behavioral schools. Each school has its own view on how psychological issues develop, how they are sustained, and how they should be treated.
Mental health practitioners typically follow the perspective that was prominent in their graduate training. They tend to become more eclectic in their approach with time and experience. I submit most providers offer the form of therapy that best suits their own personality. Consumers usually have little knowledge regarding these four perspectives and very few providers advertise their professional orientation.
If someone was seeking services for anxiety, a common referral issue, for example, and saw a professional who subscribes to the biological school (a psychiatrist or nurse practitioner) the patient likely would receive a prescription for medication. If they saw a provider who adheres to the analytic view (typically a psychiatrist or psychologist), they would spend much time discussing their childhood.
If the client connects with a cognitive therapist (psychologist, therapist, counselor, social worker) they would be helped to identify and change their negative, self-defeating thoughts. Finally, if the individual sees a provider who identifies with the behavioral perspective (psychologist, counselor, therapist, coach), they will be taught to face their fears.
Research has not found that one approach is consistently better than another. What seems to be critical is the proper connection between the client/patient and the provider. I recommend the following:
Do some research on the four schools of thought and try to determine which approach is most appealing to you.
Check out your prospective provider on the Internet to see if their professional orientation is described. If it is not available, call the office manager and request it. Don’t be surprised if the manager is unaware of the provider’s perspective but then ask the manager to get it and get back to you. (This could educate the office, too.)
Make an appointment with a provider that you believe will be a good fit. Just because a clinician is located around the corner does not mean they will be best for you.
If the treatment does not seem to be helping, speak about it with your provider; that discussion could be quite therapeutic. Don’t just stop coming if you are dissatisfied with the process. If no progress is made after that discussion, find another professional. (We usually try a few mechanics or hairstylists before we find one we like; the same may be true with mental health providers.)
Be a good client/patient: Keep your appointments, come on time, do your homework, pay your bill, and communicate with your provider.
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