How to find/choose a therapist/psychiatrist

siniang

Policy Enforcement
I recently moved states in the US and as a result need to find new medical everything, including a new therapist and Pdoc. I've been feeling incredibly stuck and defeated. This may seem super stupid, but I just don't know ... how.

How does anyone find a therapist, Pdoc, primary care, ... anything, if not through referrals (no choice) or recommendations from within your social circles (not an option in my case)? Good faith? Luck? Trial and Error?

I have severe trust issues, anxiety, and a history of repeatedly not having been taken serious by medical professionals for a variety of things.
I also have chronic fatigue and burn out and very very few spoons, and being presented with pages of pages online of Docs who take my insurance is just completely, disablingly overwhelming.
I also have a number of very pronounced (negative) core beliefs that I need to be mindful about when working with mental health professionals specifically. Aka, their approach and personality are kinda really a big deal.
 

whiteraven

MyPTSD Pro
I have severe trust issues, anxiety, and a history of repeatedly not having been taken serious by medical professionals for a variety of things.
Oh yeah. Me, too. For most everything.
How does anyone find a therapist, Pdoc, primary care
It's really trial and error. I found mine online using key words that were important to me. Others before him I just looked in the phone book (yeah, long time ago) and picked. Some were ok, and some were not.

For primary care (which I don't really have now because I have been harmed one too many times), I read through dozens of bios on websites and just went with the ones that were the least objectionable. Many of those (and those of therapists) talk about their approach and what kind of therapies they use.
 
For me, it has to be a trauma therapist, and now it has be someone who does EMDR.

I agree that unfortunately it pretty much has to be trial and error if you can't get word of mouth recommendations. Some places have subreddits or Facebook groups where you could ask.

I would definitely lead with what you wrote in your third paragraph when soliciting recommendations and also when meeting a new T/pdoc for the first time.
 

Weemie

MyPTSD Pro
After Romeo Dallaire it took me 16 years to find a competent clinician. I ended up finding 2 in the same time span. I checked their resumes and looked over their experiences. So already I had a sense that these people would be at the very least capable of helping me -- and that one would be familiar with the types of modalities that assisted me as a child.

I was lucky because they were willing to take me pro bono, but before that I was stuck in an endless cycle of public health && untrained social workers. I would always have a lengthy interview process & I was very picky and conscientious of malpractice. I've had therapists behave in completely unprofessional and inappropriate ways over the years.

Mostly my process was to go in and very bluntly and honestly discuss what brought me there. The type of trauma I'm dealing with, what I expect from them and the process, and my boundaries regarding it all. Almost nobody was willing to respect my boundaries so I would always leave. Sometimes they would yell at me, accuse me of lying, or kick me out. Those times were more harmful.

All I can say is that if you have the option to go private and see a psychologist, not a social worker, take it. Look over their resume and see what they list their experience as. Don't just take "trauma-informed" at its word, specifically ask them what experience they have with patients with your trauma.
 

siniang

Policy Enforcement
Thanks, guys!

Are there any databases aside from recommendations in reddit/local FB groups? Other than my insurance's one. Which has more search options, including on their actual specific expertises etc.?

What I'm also wondering...previously, my PDoc didn't really do therapy. We only had 20 minutes check-in sessions and if at all talked about medication needs/adjustments. So I *had* to have both a PDoc and a T. I'm not sure if that is standard or whether other PDocs actually also do (talk/EMDR/...) therapy? I just don't know enough about any of that, I guess.

Aka, do I need two again or could I try to find a good (trauma-focused, neurodivergent-focused,...) PDoc and just skip the T? Especially considering that I'm not actually particularly interested in medication, actually? But need the ADHD meds, so "just a T" isn't exactly an option, either?

Because I'm no longer in a closed system where T and PDoc directly work together, I feel like this is almost redundant, as I suspect they wouldn't necessarily inform each other and then I basically have to work on the same things, twice, just with different approaches because necessarily PDocs and Ts *are* different on many levels?

I read through dozens of bios on websites

I checked their resumes and looked over their experiences

That's what I'm mostly stuck with, currently. I absolutely do not have the spoons, I already tried several times over the last couple months.

What I also noticed - and what I remember from back when I looked into my two previous ones, not that I had much of any choice and it was more of an "at all" issue than a "who" issue, is that when you look at enough of those...they all kinda sound the same. They all kinda use the same buzzwords. Which does not necessarily mean anything, as you probably all know.

what I expect from them

Yeah.... that continues to be a head scratcher for me...because... frankly... I don't actually know. I've blahblah'ed about this in my diary before. In my head, it's *their* job to know what I need, that's why I'm coming to them. If my car breaks down, I take it to the mechanic for them to figure out what's wrong and how to fix it. I'm not going to the mechanic already knowing what's wrong and telling them what and how to fix it. Because then I could just as well just do it myself and save the money.

Sometimes they would yell at me, accuse me of lying, or kick me out. Those times were more harmful.

Holy banana! 😳🤬

All I can say is that if you have the option to go private and see a psychologist, not a social worker, take it

Yeah, definitely staying very very clear of any types of those or any sort of "counselor". Been there, done that, was eye-rollingly ridiculous. ("Oh, you have trouble concentrating? Eat an Apple")
 

Weemie

MyPTSD Pro
If my car breaks down, I take it to the mechanic for them to figure out what's wrong and how to fix it. I'm not going to the mechanic already knowing what's wrong and telling them what and how to fix it. Because then I could just as well just do it myself and save the money.
@siniang

Oh yah. I feel you there. That's a logical approach, but the problem is that unfortunately, human beings aren't cars. So in order to check under the hood, you have to open yourself up and dig up all those pieces. So it is a lot of back and forth work. I liken my current therapeutic process more towards construction.

This is the construction team, we're building, remaking, shaping, molding. And I have a hand in that. It's not just about going to the professional designated to treat my problem -> the problem is a systemic problem. So it needs a systemic solution, over all areas of your life. && a professional can help you get there! If they're competent.

Not sure if that made any sense at all! Weemie brain breaky today, heheh.
 

whiteraven

MyPTSD Pro
Are there any databases aside from recommendations in reddit/local FB groups?
There are a lot of different databases. Search "finding a therapist." Some are based on how they do therapy (online vs in-person), some on type of therapy, some on geographic locations. Psychology Today has both a US and International database, but don't expect to find one that covers everyone. I usually look locally at clinics and private offices that have websites.
 

siniang

Policy Enforcement
So, I gave the Psychology Today search a try.

For ADHD, 5 pages pop up.
For PTSD, 14 pages.

Most of them clinical social workers and/or counselors. A lot of them significantly younger than me.

When I narrow it down to non-religious, I'm left with 2 and 4 respectively. People, not pages. All social workers. All of them only doing online sessions.

Yeah, big nope.

When I look for psychiatrists instead of therapists, I only get nurse practitioners...

Back to square one.
 

siniang

Policy Enforcement
Don't automatically discount nurse practitioners. I have one and she's the greatest thing since sliced bread.

I don't, usually. I had a GREAT Gyn NP before. But are they allowed to prescribe medication, especially controlled meds?

Also, I think my specific flavor of messed-up really needs a specific level of practical experience as well as making sure to keep up to date with the latest research (I'm not sure NPs have that time?). Also, and I really truly hope this doesn't come across completely wrong and arrogant, but I do think for me in that specific case (mental health) it's better to have someone who's been through the challenges that are academia (aka have a PhD), before.
 

whiteraven

MyPTSD Pro
Don't automatically discount nurse practitioners. I have one and she's the greatest thing since sliced bread.
I agree with this! For one of my specialists, I have a nurse practitioner, and I will never go back to a doctor. NPs have a different sort of training, but they are much more likely to be willing to think outside the box AND to really listen to what you say.
 

siniang

Policy Enforcement
I just checked my school's services. They offer Psychological (including ADHD) evaluations, and weekly therapy sessions. The eval alone is $275 and they don't accept insurance. And that doesn't even guarantee me anything because they're not requesting my medical records. Nor does it say anything about subsequent medication.
 
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