Before I start, let me say that the subject of "Psychotherapy" is vast, so I can address only a few issues in this article. Another reason for me to pause in writing is that for nearly every statement I make (and for most people as well), there are exceptions, lack of clarity and your interpretations of what I say--not always what I mean. The complexity of communication will be the topic for another article, which will also be based not only on my years as a psychologist and clinician, but also as a son, husband, father and grandfather, as well as a human being.



In this article, I'll focus on some common concerns people have about psychotherapy. When I became a psychologist over forty years ago, many more people had misconceptions about psychotherapy. Some felt it was only for those with serious emotional and behavioral problems. Others believed there was a stigma attached to seeing a therapist. Then there were those who thought they shouldn't need help in solving their problems. Another hindrance was financial--psychotherapy coverage was excluded by many insurance companies or limited to psychiatrists. The media also contributed to misconceptions by often portraying therapists in bizarre ways-being miracle workers or more disturbed than the people who came to see them.

Today there is a greater understanding and acceptance of psychotherapy. Most people realize there are times when they can benefit from getting help with emotional and relationship problems. But many people still have questions such as, "Do I really need therapy?" "Could I benefit from therapy?" "Which kind of therapy would be best for me?" and "How do I pick a therapist?"

I believe that the most important issue for people considering therapy--or resuming therapy--is the personal qualities of the therapist. Studies show that these qualities--along with experience--are most crucial, even more important than the therapist's school of therapy (most therapists consider themselves eclectic, utilizing a variety of techniques, hopefully suited to the particular person).

We make instant judgments about people, often correct but sometimes wrong. But consider the first contact with the therapist, which is usually by phone. Does the therapist pick up or if you leave a message,, how soon is your call returned? Of course the therapist may be busy but if on vacation, does the message tell you that? Or if there is a legitimate delay, does the therapist mention that on the return call? Does the therapist listen to you during your call? If you have questions, are they answered? If the therapist is busy and can't be on the phone for long, is the therapist at least polite? If you want an appointment, can you be seen reasonably soon? If the situation is an emergency, can the therapist make special arrangements? For example, if I have no open time, I tell the person that if there is a cancellation, I'll call them. I also tell them that I understand if they need to contact other less busy therapists.

Let me mention now that first impressions, while crucial, may be wrong. Therapists, like the people who come to see them, may be very busy or just having a bad day. Consider that when making the telephone call or sitting in the waiting room. With that in mind, you've made the appointment and are now in the waiting room. Is it comfortable and does it show consideration for those waiting? For example, besides the magazines (recent ones, not five-year-old ones!) I have a fish tank (studies show that helps people relax). I also have toys for children. And how prompt is the therapist? Does the therapist respect your time as much as the therapist expects you to respect the therapist's time? If the therapist is delayed, does he or she step out to tell you?

Next, how does the therapist greet you? Is it friendly as well as professional? Does the therapist face you (the couch was given up by most therapists years ago)? Let me insert here a warning, related to my hesitancy in making generalizations: if you are interested in psychoanalytic therapy, the couch and free association are appropriate.

I believe the therapist should present himself or herself as a person, avoiding appearing oracular, as if coming from another planet or revealing all of his problems. Other questions to consider are: Does the therapist listen to you? Does the therapist reflect an understanding of your situation and ask appropriate questions? Does the therapist explain (if you haven't already asked), how you can be helped? But you have to be realistic and not expect to have your problem(s)--generally many years in the making--resolved in the first--or first few--sessions.

After you've left, consider if you felt comfortable and helped (or at least were your concerns clarified). Did the therapist answer your questions without being defensive? For example, if you had asked, "How long will therapy take?" rather than being dismissive or noncommittal, do you get an answer such as, "I know you want to solve your problems as soon as possible, but I need to get a better understanding of-" and then mentions what those are. Has the therapist reasonably explained in layman's terms how he or she will help you, as well as what is expected of you in therapy. I believe that therapy is a collaborative effort with necessary adjustments and revisions on both parts.

Again, I don't want to generalize. Perhaps your situation is so complicated that several sessions are required for the therapist to understand them. If the therapist believes certain approaches will help, does the therapist mention them (e.g., stress reduction techniques for anxiety, cognitive therapy to correct misconceptions about oneself and others)? Does the therapist--regardless of how serious or complicated your problems are--give you a sense that you can be realistically helped?

Just as a therapy session has a time limit with many issues not addressed, so does an article like this. I plan follow-up articles (e.g., family and work relationships, stress and mood problems). And of course there are many other sources for you continue finding the answers to the questions you

have.