So much has been done to reduce stigma around seeking psychological help, and that is truly wonderful. But there’s a small knowledge gap that probably needs a little bit of time - that little question of “how?”. I would say 90% of the calls I receive from family, friends and colleagues seeking my professional advice, is something along the lines of “[person I know] has been thinking about seeing a psychologist, so what do they do now?”.
I will spend some time addressing various considerations below (in the context of Australian healthcare), but if you don’t have the time for a long-winded explanation, then the simple instruction is this: see your GP. A GP should be your primary healthcare professional who can suggest/recommend/refer to other allied health practitioners, including psychologists. A GP can also rule out medical issues, and talk about medications, if applicable.
Your GP will either refer you to someone specifically, or they’ll encourage you to find someone yourself. If the GP makes the referral in the form of a Mental Health Care Plan then you will be able to claim either the full-fee, or a portion of the fee, with Medicare. It’s important to note that you do not necessarily have to see the psychologist that your GP refers you to. You might find it easier to go with the recommended practitioner, or you might decide to do some research and find someone yourself.
If you decide to go down the find-someone-myself route, there are several things you may want to think about when choosing a psychologist. Here’s my list of considerations, but it is by no means exhaustive:
How serious is it?
Sometimes the point of help seeking is quite critical. Maybe there are suicidal thoughts, or feature of psychosis. This is really the point to see a doctor, or even make a trip to emergency. It’s not always the best path to phone around and book in with a psychologist, who may not be able to see you for a few weeks. If you’re at all worried about the presence of suicidal thoughts or other symptoms, phone a service like Lifeline (13 11 14) or Beyond Blue (1300 22 4636) for some immediate advice and action steps. And if it's really critical, go straight to emergency.
Where to look?
You can always google something like “Psychologist in [my area]” however this is unlikely to present you with all of the options. Alternatively, there are several online directories that are searchable by location, as well as other detail such as issues or working hours. Here are some of the directories I recommend:
Do you like them?
This is more important than you may realise. Research shows that one of the most important factors in clinical outcomes is the relationship between the therapist and client. There is a lot of guidance around this for clinicians, but from the point of view of the client - you should like them. You should either trust them or feel as though you might be able to. You should feel somewhat comfortable opening up to them.
So, how will you know this? You can look around their website and see how they present themselves, but if you have the courage my best recommendation is to call. Ask for 5 minutes on the phone before you book, and ask questions. Try to get a feel for them, and use your gut. I have heard so many stories of people building up the courage to seek help over years and year of pain, only to find they they do not gel with their therapist, and they never return again (to anyone). Like relationships, there is someone for everyone. And if you decide to try someone new after a few sessions that aren't feeling 'right', that’s ok too.
As with most things, it’s great to have someone you trust recommend a therapist to you, however it’s worth noting that in some cases this can be problematic in terms of ethics. Most psychologists will not see close family members or friends of their existing clients, for privacy reasons. However this is a discretionary decision, so it is worth checking first. Let the psychologist know about the connection, and ask them if they envisage any conflict, or if it’s still ok to see them.
I am a member of the Australian Psychological Society (APS), which is the largest member group of psychologists in Australia, and comes with a whole heap of additional standard and expectations. For this reason, I usually recommend people see a psychologist who is registered with a professional body. It gives an extra level of accountability that I feel is important. However, by no means must it be the APS specifically. There are several other professional bodies for psychologists, for example the AACBT, or ACPA. This is something you can ask your prospective psychologist when you have that brief chat with them.
Most psychologists in Australia will practice CBT (see here for an explainer). However, many will also incorporate other modalities, such as ACT, DBT, Schema Therapy etc. There are many different techniques, with plenty of overlaps, however from experience I can say that some clients suit certain techniques over others. If you know what your prospective therapist’s primary modality is, have a look and see if you feel like it will suit you (both your personality, and your specific issue/s). I'll eventually add an article to this blog with descriptions of the common treatment modalities, but in the meantime good ol' google should help you out here.
I suppose this is very much related to the therapist-client relationship, but it’s still worth a specific note. Some therapists are directive, some are collaborative, others are more client-led. Some are pragmatic, others are more reflective. Some use humour, some like to gently challenge, some are soft and compassionate. Many are a little bit of everything. While this is an important factor, it might be hard to gauge without attending a session. In any case, it’s worth thinking about; and, if you feel brave, you can ask about it in the first phone call or session.
Schedules and location
This is an important consideration because what might not seem a big deal at the point of booking in, might turn out to be quite important later on. You might use all of the above to find yourself the perfect-sounding therapist for you. Problem is they’re 20mins drive away and only work business hours. While your motivation is high, this might be fine. You might be thinking, “not ideal, but it’s worth it”. But later on, after several sessions, when motivation reduces (as it often does) and sessions become more challenging (as they may do), you might find yourself more inclined to cancel appointments if it’s that little bit too hard to get there. My best advice is, if possible, consider convenience too.
This both matters, and doesn’t matter. It’s last on this list because of all of the things I’ve listed, I think it’s the least important. But that said, it matters if it matters to you. Someone at a particular life stage might really struggle to feel understood by someone at another life stage. And it works both ways - the young client with the older therapist, or the young therapist with the older client. I will say that from the therapist’s perspective, this is usually something well handled, and far less of an issue. However if you feel strongly that you just wont feel comfortable with a therapist of a certain age, go with that feeling. You need to feel comfortable, and it takes a lot to offend a psychologist, so you can ask how old they are (if you don't already have an idea). Don’t feel bad, this question comes up a lot. It wont be the first time that therapist has been asked.
Ok, so if the above list does anything, it illustrates how many variables there are in finding the right fit. If you’ve had the wrong fit in the past, please don’t consider it over. You might be thinking, “hey I’ve tried therapy, it didn’t help me”. And maybe it didn’t, but maybe it just wasn’t the right therapist. Try again. The right therapist is out there for you, don’t give up.
B Psych (Hons), M Psych (Clin), MAPS
Content note: Unless otherwise labelled, all blog posts are intended as discussion pieces, and are not academic texts. Articles pertaining to research or making an academic argument will be labelled as such and include supporting evidence/references.