How to Choose a Therapist to Treat Your Anxiety Disorder

Many people struggle to find an appropriate therapist to treat their anxiety disorder, and so I thought I'd write this article and give some tips for how to go about finding a therapist with whom you can work. There are three areas to consider when choosing a therapist: 1) what qualities to look for regarding experience and/or training; 2) where/how you can find a therapist; and 3) once you have chosen the kind of therapist you want and know where to find one often times there are insurance issues to be considered as well. These three topics will be addressed in the paragraphs below.  

When choosing a therapist it is almost always a good idea to seek somebody who has been licensed by your state – which usually means seeking help from a Psychiatrist, Psychologist, Licensed Clinical Social Worker, Psychiatric Nurse Practitioner or Licensed Professional Counselor. If you are seeking medication to treat your anxiety then your two choices from the above list are a Psychiatrist or Psychiatric Nurse Practitioner, but for the purposes of this article I'm going to assume that what you are seeking is a therapist to provide therapy for your anxiety and we will leave how to find a medication referral for a future article. Generally you will find that Psychologists have the most extensive training in providing the kind of therapy that you will want to seek out for your anxiety disorder, but there are, of course, exceptions to this and you may be able to find a very well-trained practitioner in the other professions listed. This brings me to the second criteria – experience. Though again there are exceptions to this rule, in general you want to seek out a therapist who has as much experience as possible treating the kind of anxiety are suffering from. The third criteria is whether or not the therapist you're considering is a specialist not only in anxiety in general, but also specifically in the type of anxiety with which you struggle. Many therapists list multiple specialties such as depression, attention deficit disorder, marriage counseling, etc. and I think you are better off seeking somebody who specialize in treating only anxiety and doesn't spread their efforts across multiple diagnoses. A fourth criteria is whether or not the therapist you are considering uses "evidence-based" therapy in their practice. What this means is that if a therapist uses evidence-based treatments then there is some research which supports their treatment techniques being effective. Rather than just relying upon their opinion about what works in therapy, they have consulted the research literature to find out what works best. The best researched therapy and most effective therapy for anxiety disorders is Cognitive Behavioral Therapy so be sure to ask your therapist if they provide this kind of treatment. Finally, in some ways the most important criteria is whether or not you feel comfortable with your selection. Many of the above criteria can be discerned from a website and don't require any person-to-person contact. However, this criteria would involve at least a phone call and perhaps even a face-to-face meeting and could involve even the very first session of therapy. It's important that the person you choose to work with is somebody that you feel confident about, trust, and whom you believe can be of help with your anxiety.

Now that you have some idea of the kind of therapist that you are seeking, the next question is how do you find someone who meets your criteria? This can at times be rather challenging. There are at least five different organizations each of which has a website with a therapist locator service that you can consult when trying to find a therapist. Here in Oregon, we have the Oregon psychological Association (www.opa.org) and there are at least four national organizations which may be of some assistance as well: The Anxiety and Depression Association of America (www.adaa.org); The Association for Behavioral and Cognitive Therapies (www.abct.org); The Academy of Cognitive Therapy (www.academyofct.org); and finally the Association for Behavioral Contextual Science (www.contextualscience.org). Other possible sources for therapists with whom you can work would be your primary care doctor, your insurance company, and finally you can ask among your family and friends for a therapist that they may have worked with themselves. Be cautious when using your insurance company as a referral source, because it is been my experience that the recommendations insurance companies make may not always be appropriate.

Finally, there are often insurance issues which will greatly influence which therapists you decide to work with. Just because you have insurance does not mean that your insurance will cover every therapist. Some therapists have chosen to join the panels of many insurance companies, some therapists choose to be on only a few panels, and some therapists choose to be on no panels whatsoever. Most insurance companies have a panel of providers and if you see somebody who's on their panel you get reimbursed at a higher rate than if you see somebody who's not on your insurance panel. Most insurance companies, though not all, also have called an "out of network" benefit. Which means that you can still see somebody who's not officially on your insurance panel, but once again you'll pay a higher rate for that person than you will for somebody who's on your insurance panel. Being careful and thoughtful about this insurance issue can prevent you from getting a large bill which you didn't expect. I recommend talking to both your insurance company and to the potential therapist so you know going in what your out-of-pocket costs are going to be.

Spending some time to select an appropriate therapist can help ensure that your therapy experience will be a good one. You want to choose a licensed therapist who is a specialist in and experienced with your kind of anxiety disorder. It's also important that you feel comfortable with your therapist. There are a number of both local and national organizations which you can consult to try and find the names of appropriate therapists, you can talk to your primary care doctor, insurance company or ask family and friends. Finally, it's important that you make sure before you start therapy that you know what your out-of-pocket costs are going to be.