EP. 6: How Do I Find a Therapist?

[00:00:00] Alefyah: But listening to your body and listening to your intuition, if something just doesn't feel right, is this making me feel uncomfortable? You have a right to feel that way. [00:00:06] Michelle: Absolutely. [00:00:07] Ty: If you feel icky at the session, it's probably a red flag. [00:00:12] Intro: Welcome to Threads of Connection, the podcast where three licensed therapists listen to your stories and help strengthen relationships. We believe in the power of connection, whether it's with your partner, family, or friends. Join us as we dive into real stories and offer expert insights into human relationships. Now let's get connected with Alefyah, Tyana, and Michelle. [00:00:42] Alefyah: So we don't have a letter this week, but we wanted to talk about a question that we get asked often, which is, how can you tell if a therapist is. Is a good fit for you? [00:00:56] Ty: We're going to help our listeners figure out how to find a therapist that matches well with them and maybe try to help them figure out what may not be a good match for them. Is that kind of accurate? [00:01:14] Alefyah: Right. I feel like I get that question all the time from friends and then even getting new referrals and then I, you know, that I don't have space for, but trying to make sure they get the right match, because just navigating that process of finding a good therapist or finding a good fit can be so daunting. Do you guys get that question a lot from people that I get that. [00:01:38] Michelle: Question so much is I can just tell. People feel frozen when it's time to find a therapist. They know they want one, but they. I think when you're not in this world, it's overwhelming. People have all kinds of letters behind their name, and you don't know what that means. A lot of people don't know the difference between a psychiatrist, a psychologist, a social worker, and a therapist. So maybe we should talk about that. [00:02:06] Ty: Yeah, that's a good. [00:02:07] Michelle: And then just how do you. How do you figure out the right person? Because it is important. There are a lot of hacks out there and there are a lot of really good people out there. And how are you supposed to know? So how about if I start with the difference between all of those different sorts of helpers? So, and. [00:02:30] Alefyah: And for overwhelming. Is there any other profession that has 30 different people that are all doing the same thing? [00:02:36] Michelle: Well, and for anybody who doesn't know the difference, you were in really good company. I think people feel maybe a little embarrassed by that. I think it's really common not to know. So a psychiatrist is a medical doctor. There are psychiatrists who do talk therapy, say, on an ongoing Basis, an hour at a time, but that is rare. By and large. Psychiatrists prescribe medication and check in with you at different intervals, almost always, I think for way less than an hour. It really isn't about improving your life circumstance or your relationships. It's way more about the medication management. There are also nurse practitioners who do that. Sometimes they'll work for a psychiatrist. Clients have had really good luck with that with nurse practitioners who I think are less expensive, a little easier to get in with because it can be really hard to find a psychiatrist. So I think that's a viable option, that they have good training and experience. A nurse practitioner, a psychologist also usually they have a PhD or a PsyD, which is roughly the same. So they have an advanced degree and psychologists a lot of times do testing or diagnosing. So again, they aren't necessarily doing ongoing therapy for say, relationship issues. They're more targeted. You might see them, I don't know, between two and five times to get an appropriate diagnosis or something like that. Again, some psychologists do therapy because they have a higher degree. They're probably going to be a little bit more expensive, but ask. Then you have master's level practitioners, which are social workers, marriage and family therapists, and counselors. Ty and I are counselors. Aletheia is a social worker. We are all licensed. So what happens is that a person gets out of school with their master's and then they spend a certain amount of time working, being supervised in their work and then they're given a license. So a licensed person has a master's degree and probably at least somewhere north of two years experience, if not more than that in the field that's been supervised. You also can see pre licensed people and those have different names in different states. But it should say pretty clearly in their credentials they're being supervised and that just means they're newer into the field. They do have somebody that's helping them out to make sure that they're doing good work and you can make decisions based on your comfort level and recommendations. If you want to work with somebody pre licensed, I know some really great pre licensed folks and some not so great pre licensed folks and I know great licensed folks and not so great licensed. So that's the breakdown. Counselors tend to be trained in theories of how people change in different specialties, like maybe relationships or trauma. Social workers can be trained in therapy, but sometimes they're trained in other areas. So you just want to make sure. So what I'm thinking of is I have two friends who are Social workers who got no training in therapy when they were in school or getting license, but they're both outstanding therapists. [00:06:15] Alefyah: Good. [00:06:15] Michelle: Because they got what they needed. They just paid on their own to be supervised. So I don't want to say social workers aren't trained in therapy because that's not. I think that's misleading. So I don't know if that's an important distinction. [00:06:29] Alefyah: Well, in my social work school, we had different tracks. So when you do social work, there's a lot of different types of social work versus counseling psychology. It's more of a narrow field. Right. So I had to pick. Pick a specialty. There's people who did the macro track, who wanted to do more policy stuff, and then they got trained in that versus I picked a track for clinical social work. My whole second year was just doing clinical work. All my internships were doing actual therapy. So I don't know if all social work schools are like that. I think there are. I've heard of schools down here where it's just base degree. Yeah, it was. It's very different depending on what school you go to. But all of this, I, to me, almost can sound overwhelming. Okay, what the hell does this mean for me? There is a million different hats and then, oh, okay, a social worker is good for this. Oh, but maybe not this. Social worker or counselor is good, but license is better. But actually, some people who aren't licensed are wonderful. So where do you begin? So I would love to help narrow this down a little bit for people of. First, when do you go to a psychiatrist versus when do you say, I need therapy? Right. And that's almost the easiest base distinction if you really need a diagnosis. A psychiatrist is a medical doctor. They are really, really good at assessing if there's a medical issue going on and what medication would be best for that. Right. So if I have people, especially with like a severe mental illness, anything with like bipolar disorder or schizophrenia, anything that you're having severe issues with or severe anxiety or depression, that you know, there's something organic going on that you need a right diagnosis and medication. Going to a psychiatrist is great. They spend an hour, sometimes 90 minutes with you that first time to really get your history and understand and be able to do the medication. And I especially try to recommend if you have something where you've had psychotic issues, had hallucinations, you've had lesbilizations, if you had something severe, I really, really recommend going to a psychiatrist even before going to nurse practitioner, maybe following up with them later. But they're really skilled at understanding the nuances of how to diagnose you. There's like 10 different types of bipolar disorder. So to be able to piece that apart, it's, it's really helpful to go to a psychiatrist, but they're not going to give you ongoing therapy. I. [00:09:00] Michelle: So I do want to bring up when you're having lower level symptoms. I know a lot of people will get prescriptions for medications from their general practitioner or their internist and that's between you and your doctor. If that seems like a sufficient level of care. I will say for my folks, if we're starting to talk about needing more than one medication, I think it's really a good idea to go ahead and go to a psychiatrist because now we're talking about medication interactions, adjustments here and there. And typically your, you know, family doctor isn't going to have the expertise and honestly a lot of them will decline to do that anyway because now we're starting to talk about mixing things. [00:09:47] Alefyah: So in an ideal world, yeah, we would all. You'd go to a psychiatrist first and get that really, really thorough assessment and intake. I know, especially in where I live, I don't know where, you know, you guys live. Sometimes it's just really hard to get in. [00:10:03] Michelle: My goodness, so hard. [00:10:04] Alefyah: So I would say if you can get in with a psychiatrist and you really need a real clear cut, good diagnosis, if you can't, go to a nurse practitioner who specializes in psychiatric issues and then if not, then you really have to go to a general practitioner, then work with a counselor as well. So sometimes kind of mixing, like go to a therapist, kind of get their assessment. A lot of times I'll write a letter to the general practitioner, kind of giving my impressions, diagnostic impressions, or you go to a psychologist who's really good at diagnosing, get a letter from them and then go to your general practitioner. Also for women, OB sometimes are a lot better trained at doing the psychiatric piece than a primary care doctor because when, you know, women are pregnant, like they all care is from that doctor. So they a lot of times have a lot more training. So that's another option. [00:11:03] Michelle: Okay, so yes, all very good points. Should we talk about how to dive into. How do you, what are the different places to go to look for a therapist? [00:11:15] Alefyah: Yeah, I think that's a good idea. That was clear on if you really need a diagnosis and doctor, that's kind of the route you need to go to. Now how do we navigate the whole therapist world with the social workers and counselors and psychologists and what you need, where do you start? What do you look for? [00:11:31] Michelle: I think it's a good idea to ask around if you feel comfortable. You know, ask people you feel comfortable. Like hey, I'm really struggling with my relationship. Do you know of a therapist? I know that's sensitive and so you may not want to do that but you so asking friends, asking people that you worship with like in a church or a synagogue or, or even your, you know, the staff at wherever you worship, a lot of times they will be connected and, and I will I say that knowing sometimes those are the last people you want to tell. So I, I am saying use description and you get to keep this private if you want to. But sometimes they will have good resources in the community if this involves a child. A lot of times guidance counselors at schools, we'll have good recommendations for people who specialize in working with kids and do a good job with kids. Sometimes physicians have good recommendations. If you have a psychiatrist, they tend to have good recommendations. So asking people who already know you and know a little bit about your personality and what might feel comfortable for you, that is one place to start. Another is that there are websites. I always suggest Psychology Today but I. [00:12:53] Alefyah: Mean Psychology Today has feel like the most comprehensive like listing of everybody. [00:13:00] Michelle: True. [00:13:01] Alefyah: So it's yes, it's important to know what you're looking for but then I think it's vetting them after the fact too of like what, what do you specialize in and have you had what was your training like and what you specialize in. [00:13:15] Michelle: So I think it's a good idea before you even look to get an idea of your non negotiables. Do you is really important to you that they see you by telehealth. Is it really important to you that they not do telehealth and you get to see them in person because that will determine the geography of where you can look, what issues are most important to you that they're trained in. So if you have any kind of trauma, I recommend looking for somebody who has experience and training in trauma. If this is anything to do with relationships, of course all three of us are going to say look for somebody who knows about attachment because we think that's what's really important in relationships and you can take that for what it's worth. That's, that's our bias. So if you go to a Psychology Today or you could just google therapists in my city who specialize in trauma, you will get hits and you can look at their websites and start to get an idea for the training that they have, the experience that they have. Some people will have a picture of their office or a picture of themselves. They may have videos of themselves. Just you're starting to get a feel for. Am I going to be comfortable with this person? Any. Anything else about where else to look? [00:14:37] Alefyah: Actual psychology today has a lot more comprehensive so you can check off. Oh, I have this issue. I have, you know, trauma. I have this. I have that. And it's a really good filter system and you can kind of get a base of who you're looking for. But then if you want to verify it, like, say you see, oh, I see three different couples counselors who all say emotionally focused therapy. Let me go to the emotionally focused therapy website and that will actually show you who's re. Actually trained through that route. Let me. Okay. There might be 10 people who have checked off internal family systems as something that they do. Is this something that they kind of just do, like know about or is. Are they really trained in it? Let me go to that actual website for that and go to their specific directory. Then it'll. It'll show you who's actually really trained in that field. But I know it's like we. I know all this stuff off the top of my head. Oh, I need this. I need internal family systems. I need emotionally. Like a layperson doesn't know even what to look for. Right. So where, where do you start? Like when I'm looking for a therapist, I already know the therapies I'm looking for. I'm not really caring about, are you a social worker? Are you a counselor? I'm like, are you trained in this model that I need, that I know works for my issue. But how would you begin to give that advice to a layperson? [00:15:50] Michelle: Well, and here's what's interesting about that. I, not so long ago was looking for a therapist for myself and I didn't care about the approach as much as I cared about the demeanor. [00:16:07] Alefyah: Yeah. [00:16:07] Michelle: So it's. It was really important to me to find someone a little warmer. Other people don't want that. So I'm not saying that's the only way to be a good therapist. It's not. But I just knowing myself, and I did find somebody who's really soft and warm and happens to be incredibly knowledgeable. And it's amazing. It's a perfect fit. I think so. [00:16:29] Alefyah: I'm so happy to hear that. But that's such a great point. I mean, I heard Gabber Mate talk about this the other Day too. And just so it's so much research backed of. It's just the relationship between the therapist and the client that is the most impactful. Like, forget everything else. Forget about the number of letters they have behind their name or what training. It's like that attunement between the two people in the relationship between you and your therapist. And if you feel safe and you really feel heard and understood and not judged in that room, that is going to be the biggest determinant of your growth. So, I mean, I 100% agree with you and I've done the same. I like find people who are really trained in something and there was just something that didn't fit. So I always start off, my approach is starting off with a base like, I need to know that you're kind of knowledgeable, you have like a framework of attachment or you understand trauma and then finding my fit. And I guess for you, Michelle, it's like the fit is just so much more important that that's where you're really gauging. First of, like, do I feel comfortable with you, Ty, what's your approach? Like, how do you. For yourself or when you're giving advice to other people? [00:17:36] Ty: I think I will probably encourage people to find someone and I use the word that they like, which goes back to your word alifia of attunement. You know, finding someone that, that, that they can connect with. Oftentimes, let's say if someone calls a new client, calls and wants to get scheduled, but, you know, our schedules don't match or, you know, my wait is too long, helping them navigate. Right. How to find another therapist or a different provider. So I'll ask them, like, are you looking for a man or a woman? Like, does. Does gender matter to you? Does ethnicity matter to you? Are you looking for someone from a particular religious background? Right. Some people are looking for those things. And I think because we live in the south, we probably would hear that maybe a little bit more often than in other areas of the United States. But so I think that will. That has helped individuals kind of clarify what they're looking for. Sometimes people don't have a preference. Sometimes people really are seeking out a preference. I want someone who is similar, that there is a sameness there, which helps on a foundational level maybe be able to connect a little bit easier to open up and share. So that's. [00:19:04] Michelle: I think that's especially true, Ty, if you're talking about race or culture or LGBTQ status, you really need to make sure. Or I would want to make sure that this person is open, accepting, knowledgeable faith background as well, that somebody won't be judging or on the other hand trying to persuade you. I want to say, in case I forget, no therapist should be persuading you to change your faith to it, away from it, within it. They need to honor and meet you where you are. Same with your sexuality, same with any. [00:19:42] Alefyah: Aspect of you, any identity yet. [00:19:45] Michelle: And that is a. And we'll get to red flags. That is a huge red flag if a therapist is trying to persuade you in a direction that isn't your, your desire, your goal for therapy. Especially when it comes to things like faith or sexuality values for sure. [00:20:06] Alefyah: But yeah, understanding what your. What would feel like a good safe match for you and what sameness like you were saying Ty. And a lot of the site, like Psychology Today, all those site, they do have good filters for those things. [00:20:19] Michelle: Right. [00:20:19] Alefyah: Is there any other questions? You know that I, I really encourage people to interview therapists, interview multiple therapists, find a good match because somebody might be great for your friend and that won't be a good match for you. Right. Like that happens so much all the time. Yeah. [00:20:36] Michelle: So could we talk about just briefly. A lot of therapists will offer a consultation, maybe a 15 minute or 20 minute phone consultation to help assess whether it's a good match. [00:20:50] Alefyah: Right. [00:20:51] Michelle: I really want to encourage our listeners to use that time wisely. I have encountered quite a few people who conceptualize that as the time to tell their whole history and there just isn't time. And I know it's tempting because you want to know if the person gets you and understands and is non judgmental. But I would really recommend using that time to give a. What are your goals? So my goal is to not be so anxious anymore. My goal is to do better at my job or be a better parent or whatever your goals are to kind of lead with that, maybe to talk about what you've already tried. I had a therapist who didn't work for me because blank. Because they weren't warm or because they were too soft. So what's your goal? What have you already tried? And then maybe kick it to them to say, does this sound like something in your expertise? What questions do you have for me? Because they will know how to ask are you open to emdr, for example. That is something I really do. They should know how to lead you and, and maybe ask some relevant background questions about past treatment or something like that. [00:22:05] Alefyah: That is such a wonderful advice. You're so right. Because you might feel like, okay, I need them to understand me or hear my whole story to see if they can help me. And that is, yeah, you don't have time for that. And that's not the best use for the time. You're, you're trying to see if this is a good fit. [00:22:21] Michelle: Right, right. [00:22:22] Alefyah: And that's really important. [00:22:23] Michelle: And I think that happens because people don't know. I mean, why would you know how to do a consultation call? [00:22:29] Alefyah: Yeah. [00:22:29] Michelle: As the client. Sure. [00:22:31] Alefyah: Right. So, yeah. What are your goals? [00:22:36] Ty: Yeah, clients will reach out because they may not even know what they go, what the goals are for therapy. They just know life is hard right now. I mean, oftentimes people will say, well, I'm dealing with grief or I'm dealing with a difficult relationship. Sometimes people just don't have any clue because there are so many things that are up in the air per se. Let's get to know one another, of course, in a therapeutic sense. And at the end of three visits, then you can decide, is this a good match or is this not a good match? And I think that allows both the client and the therapist the opportunity to figure out, is this a good match? Yeah, sometimes in. I don't do consultations, but I don't know if you could even kind of gauge that in a 15 minute consultation, like from a therapist perspective, like, can. [00:23:36] Michelle: I, is this workable? [00:23:38] Ty: I mean, I could do some stuff with them, but is it going to be a good match? You really don't know to sit down with them either via the computer or sit down face to face and have that and start having a couple of sessions in order to decide. This is another, that's really good advice too. This is another good point. I want to make sure that we get across to our listeners. You cannot see two therapists at the same time for the same concern, for the same concern. Let's, let's sort of stretch that out. If I am involved in individual therapy to work on anxiety, depression, grief, loss, trauma, I cannot see another therapist for anxiety, loss, depression, relationship issues. That is super confusing as a client to be able to try to do that. And so you're setting yourself up for potential failure at therapy if you try to get two therapists to help you on the same concern. Now if you're seeing someone for individual work and you also are seeing a family therapist for you and your child or a marriage counselor for you and your partner, that's perfectly fair and acceptable. But please do not go out there and try to find two or three different therapists to Help you with the same concern, please. [00:25:11] Alefyah: It's just confusing and overwhelming. So I want to get back to the first point that you made though, before this, because I thought it was really good of, like, considering the first couple of sessions as just an assessment on both ends. I think that's really good advice so that when you start therapy, you don't just feel like, I'm locked in. That's it. I'm just committed. Let me just do this. Like, you can mentally think of the first three sessions as like, I'm trying to see if this is a good fit and listen to myself and my intuition and stuff, and I can still switch. I. I think that's. And then the two. [00:25:44] Ty: Yeah, I've had the. I've had sessions where on the third session, either one of us will say, I'm not sure that this is going to work. And I think clients appreciate that a great deal, knowing that they have the choice to say no, that they are not committed to this particular therapist, and that as therapists, we also can say, I'm not sure if what I can offer will be beneficial to you. That's a real gift to give to clients as well, you know? [00:26:19] Alefyah: Yeah. And that's a good way to gauge a therapist too, if it feels safe to be able to say, I don't know if this is a good match and they can take that feedback if they're overly trying to convince you that they're going to be your cure all or whatever. Like that to me is a red flag too, right? [00:26:37] Ty: Yeah, definitely. Red flag. [00:26:40] Alefyah: And I like what you're saying about the two therapist thing. Is that something you've encountered a lot? It's not. When you first said that, I was like, oh, I have a lot of people with two therapists, but it's not for the same. Like, I, you know, I'm a couples therapist or you have. I need you. You're. I don't specialize in substance abuse, so I'm like, if you have that issue, I need you to take care of that with this other therapist. If you might have a personality disorder, I might need you to have a completely different therapy on the side doing that while I do this other work with you. And then we usually work together. So I, I like utilizing kind of having a treatment approach and different therapists all the time. But yeah, we're all working together. We all have different goals that we're working on. But if it's one person's tackling this issue and the same issue in like two different ways, it's just going to get confusing, right? [00:27:25] Ty: Super confusing. [00:27:26] Michelle: So I'd like to talk about real fast just how to, how to fire or end the relationship with your therapist. Whether it's after those three sessions and you feel like it's not working, or at any point along the way, it is okay to stop therapy at any point you want to. It is certainly appreciated by a therapist. If you're not going to come back, it can be a fairly easy process to just say, I think I'm ready to take a break or to try someone new. And any decent therapist will make that easy on you. They, they should not get mad, they should not blow up at you. Whatever your fear might be, that shouldn't happen. If by some chance you are concerned that they're going to give you a hard time, then you're probably making the right decision to leave. And it is okay to give a call later if you don't want to have that confrontation in person or send an email to say thank you so much for your help. I think I've decided to go a different direction and that is perfectly fine. If you want to give them feedback, by all means. If you don't want to give them feedback, you also don't have to do that. I've just, I'm thinking this because I've known people who see therapists who they really don't want to see anymore, but they're afraid they'll hurt the therapist's feelings or the therapist will get mad at them. And I just want to say very clearly, this is our job and part of our job is that people will decide it's time to go a different direction. And that should never be cause for being angry or hurt if someone needs to, to try something different. [00:29:09] Alefyah: And so I'm kind of double minded on the approach for all this is too, because it might be your intuition that's saying, oh, I don't feel safe. And maybe you are sensing something where that therapist is going to take it personal and you just got to take care of yourself and write an email or just stop going or whatever. But even in my experience, I've had those hard conversations with somebody and it's been so growthful where maybe some of their relationship patterns are coming up. Like a lot of times your relationship patterns that you have out in the world with your friendships, with your romantic relationships, they're going to get mirrored again with your therapeutic relationship. And it can be so healing to confront that in a different way. So if you're somebody who's afraid of conflict or afraid of disappointing somebody or afraid of having these conversations. It has been healing to be like, hey, I don't know, for a good fit, or something's coming up in me about therapy. And sometimes I've had really great conversations there where, hey, you can tell me this and I'm not going to get mad at you. Maybe mom used to get mad at you when you would confront her and you have an instinct to just run away or send me a quick text or just stop showing up. But, like, I can be a safe person, say, hey, we're not a good match. And I, this is still great. Like, I can still help you and do what's best for you. Or, hey, what just came up here, Maybe this isn't an end to therapy. Maybe there's. You got too vulnerable and it felt scary and can we create some safety or can we explore that a little bit? There can be so much healing in that, leaning in and trying to have that inter. Like in that relational conversation with your. [00:30:43] Ty: Therapist that, yeah, I think saying that, you know, if you have that conversation with your therapist about maybe I don't feel comfortable or something is maybe triggering for me. If you have that conversation with your therapist, it can sometimes lead to a healing conversation where you gain maybe some additional awareness around how your therapeutic relationship could be mirrored in your personal relationships. [00:31:15] Alefyah: Like, what do we do when conflict shows up in our lives? What do we do when we're scared we're going to hurt someone's feelings or disappoint them? What happens to us? You know, it's a good question to ask yourself. [00:31:27] Michelle: What about red flags? Could we talk about some flags that would maybe tell you you need to ask more questions? Or maybe your therapist. [00:31:38] Alefyah: What are some of the questions? You know, we talked about doing the interview, and you're like, make the 15 minutes. What are your suggestions for what to ask to make that effective? I know one of you said about goals, like, ask what your goals are. And then maybe if you don't know your goals, maybe that's something you can process before you have the interview, I guess. But what. What other suggestions do you guys have of what to assess, what to ask? [00:32:04] Michelle: Do you have experience with what I'm going through? What's your approach? Maybe some practical. Will our schedules line up? [00:32:15] Alefyah: Yes, I think that's a good one. [00:32:17] Michelle: You know, if you really need afternoon appointments, do they have those free? Anybody who sees teachers or people with kids or who sees kids probably won't have a lot of afternoons free. So some of those Details. [00:32:30] Alefyah: Right. [00:32:30] Michelle: Because it's a real bummer to find a great match and then find out you can't. [00:32:34] Alefyah: Yeah. [00:32:34] Michelle: You can only get one session in. [00:32:36] Alefyah: And then you have to come in a month. Yeah. So that's a really good point, too. Can you see me regularly? And then would you say therapist will. [00:32:43] Michelle: Know to say, hey, let me just make you aware I only do mornings or I don't work Mondays or something. But I think it's a good thing to ask. [00:32:52] Alefyah: And I liked your other two questions too, of like, what is your experience with this issue that I have? And then what is your approach with that? I think those are two great questions to really gauge their expertise in it. Right. [00:33:10] Michelle: The other big, big question is about finances. So if you're wanting to use insurance, do they take your insurance? If you aren't wanting to use insurance, how much do they charge? If they don't take your insurance, it can be helpful for them to provide you a documentation called a super bill that you might be able to turn into your insurance to get a little bit of reimbursement. And so you might want to ask about, do they do financial arrangements? [00:33:37] Alefyah: Yeah. [00:33:37] Michelle: If finances are tight for you, some therapists do offer a sliding scale. [00:33:42] Ty: Well, they'll. [00:33:43] Michelle: They will charge you less based on what you earn, so you can. [00:33:46] Alefyah: But I would like really, really understand all the finances, how much you're going to have to pay, know that all ahead of time and think about how frequently am I going to have to go? A lot of times people can't really afford to go regularly at the price point of a therapist that they're going to pick. And then they end up coming very inconsistently due to finances. And that's not the best therapeutically. It's better to find somebody who's within your budget, who you can actually see more consistently. [00:34:14] Ty: Yes. [00:34:15] Michelle: And I want to acknowledge that there will be listeners who are really restricted in their choices of who they can go see because of finances. They may need to go to a community mental health center, or they may have to go to somewhere that does sliding scale, or they may have to go to somewhere that takes their insurance. When that is the case, I think do the best job you can at getting the closest fit that you can and then be prepared to have some honest conversations to ask for what you need to say. I heard about this really neat approach on the Internet. Could we talk about that or. I noticed we're talking a lot about trauma in my childhood, but I would really love to talk about this trauma that happened to me two weeks ago or I've got some concerns, some multicultural concerns that are. Can we talk about that? It is not only fair, but a great idea to say, gosh, we're just not hitting on what I would like to hit on. And that can happen regardless of how many choices you have of who to see, but especially if you're maybe having to make it work a little bit. [00:35:30] Alefyah: That's such a good point. Yeah. Like, if this is not the ideal match for you because of all the practical barriers that you have, you can still advocate for yourself. [00:35:40] Michelle: Absolutely. I think when it comes to red flags, therapists, no matter whether they are a social worker, a counselor, an mft, a psychologist, a psychiatrist, no matter who you're seeing for mental health concerns, they are not allowed to have dual relationships, Meaning they may not be your friend. They may not socialize with you outside of the therapy session. They also cannot be friends or business partners or anything like that with somebody very close to you, like your spouse, your child, your parent, your sibling. There are a lot of guidelines even around who else they can do therapy with. So if you are seeing someone individually, they should not also be doing therapy with your brother, for example. I bring this up because it still happens a lot in the therapy world, and I want you to consider it a red flag. I want you to ask about questions because that can go wrong a lot. So that's, I guess, number one also to know they aren't going to allow you to follow their personal social media. And that is not a rejection of you. That is. That's our ethical rule. They may have a professional online presence, and that's completely fair game and wonderful if they have that that you can follow. But just so you know, it is a different relationship, and sometimes it feels a little like a friendship. And so I've had clients be confused about what's okay and what's not okay. And that's our job as therapists, to keep track of. Of what's okay. But I do want for clients to be well informed that those dual relationships are. Are not okay and can be a flag that you may have a therapist who's bending rules. And what we know in therapy is there are some real slippery slopes. So. And I've heard horror stories. I'm sure the two of you have also. And people end up getting hurt or feeling betrayed by therapists who let things get too loose. [00:37:49] Alefyah: Yeah, that's so fun there. Now, that's really good advice. And I think that feeds into something that I hear a lot of the Therapist starts talking more about themselves. [00:38:01] Michelle: Yeah. Or I was just gonna say that. Yes. [00:38:03] Alefyah: Right. And so, and this is again, there's no such a rigid rule of like, there's a spectrum about self disclosure. And I don't want to say all self disclosure is just wrong. They know nothing. They're this blank slate late. Because sometimes that doesn't make you feel safe either. It kind of increases that power dynamic that you're feeling in the room. You want that relationship again with your therapist. And sometimes knowing something about them and feeling like they're human and in this struggle with you is. It can be a good feeling. But where's that line of who this doesn't feel like it's, you know, just a friendly rap report that we're having versus there. This, this. What. What would you guys say is the line? And I've way too much heard that line cross. So unfortunately. [00:38:52] Michelle: So I'm going to answer with an example. I was in session just last week with someone and I was teaching him a relaxation technique, kind of checking in with your body, checking in with your emotions and how to. And we were doing that in the session and he asked me a question about it and I said, well, when I do this, and then told him kind of the modification I do. And he said, you do that? And I said, I do. When things are hard, it really helps me to regulate. And he said, I love knowing that. It just makes me feel like I'm not the only one that has these issues. So that was great. That helped him feel more normal, which he is incredibly normal. At that point, though, the conversation went back to him. It was not at all important or relevant for him to know why I would need to use that or when I used that specifically. So I felt like it was enough disclosure to let him know, hey, I've actually tried this out, but not so much that now we're talking about my personality. [00:40:00] Alefyah: That's such a great example. That's a great example of balancing it. Yeah. [00:40:04] Michelle: And again, I'm with you. I think you might learn that your therapist has kids or doesn't have kids or is going out of state for Thanksgiving. I don't have a problem with any of that. But the focus needs to be on you as the client. And if you're starting to get the feeling that you're supposed to be comforting your therapist or you know more about them than you would would want to know. [00:40:30] Alefyah: Right. I think that is the key to where it feels like you're having to take care of that emotion to some Extent. That is a line for sure. And you and people have different lines when it comes to this. Like some people don't want to know any. That makes them feel safer. Like they want that full hour. They get that attention. I'm paying for this. Some people have more of a comfort of no. And I see cultural differences with this too. When I'm working with people in my community, they're tending to like, want more self disclosure, less like the boundaries. I can see it kind of at different levels, but a therapist should be attuned with you enough also. [00:41:10] Michelle: Yeah. [00:41:11] Alefyah: Where they're able to see the discomfort. Maybe I don't know if that's fair or that's asking too much. I don't know. But listening to your body and listening to your intuition. Right. If something just doesn't feel right, I think asking yourself, wait, is this normal? Do other people do this? That's just the wrong question. Right. It's like, do. Is this okay? Is this making me feel uncomfortable? You have a right to feel that way. [00:41:33] Ty: If you feel icky at the end of the session, it's probably a red flag. Um, you know, this isn't necessarily a therapist red flag, but I do want to sort of put it out there or name it. I think oftentimes clients may be feel as if, or maybe they don't recognize us therapists as humans who have lives, who have families, who have some challenges. And so I think that's important too. We are held at a higher standard, I think because we do hold so much of what's important to them. Please try to keep in mind that your therapist is not just your therapist. Your therapist is a therapist or about 50, 60 other people. And that we are also humans as well. And so sometimes if things just like if your, if your child gets sick and you have to cancel your session, that could happen for your therapist too. And so trying to just be mindful of that. I know sometimes we're looking forward to seeing our therapist, but sometimes that does happen. We can't always be there in that. So just something, just another point. [00:42:56] Alefyah: Yeah. [00:42:56] Michelle: So can I say two kind of unrelated things, but two things I wanted to say, one of flag or something to be just a little bit wary of with a therapist is if they are diagnosing people who aren't you, that's something that we're not supposed to do. So if you are talking to a therapist about your mom and they're telling you your mom is a narcissist, that's actually a problem. If they haven't met your mom. I'm not saying don't ever see that therapist again, but please keep in mind that that is not something that we're supposed to do for, for really good reason because a diagnosis is complex and personal. Now, if a therapist were to say, gosh, it does sound like there are some traits that are similar, let's talk about how that impacted you. I think that's fair. I think that's helpful. But they should not be diagnosing somebody who's not in the room. The other thing I wanted to say is to normalize that. If you are not able to make a session, even if it's for a really, really good reason, your therapist may expect you to pay for that session anyway. That is normal in the, in the industry. And the reason for that is that that is our. We, that is our paycheck. We have set aside an hour that is for you and counted on that in our budget and in our resources. And so most therapists will ask for somewhere between 24 and 48 hours notice, one to two business days notice. And if you cancel with that much notice, they can typically find somebody to take that spot and then everybody's good. But if they can't and they do want you to pay for it, that's why, and I know that can be a little hard to understand because if you didn't get the service, why should you have to pay? But what you're really paying for is that hour that they're not allowed to give to somebody else. And so they may ask you to pay for it. Typically, the first time somebody does that with me, I do not make them pay the first time because life happens and I'm a softie. And so I'll say, especially if it's somebody who rarely, if ever cancels, I will cut them a break. But over time, I can't do that too often because I have a family to feed. So I just wanted to normalize that. That is not unethical. That is actually pretty typical. [00:45:23] Ty: Hope our listeners have enjoyed what it is that we've shared about finding a therapist and red flags. I just want to maybe give our listeners a couple of takeaways that they can take with them after this is over. The first would be if you are seeing a therapist and it feels icky. If your gut is speaking to you that this doesn't feel right, follow it. And then the second would be to advocate for yourself. Make sure that you're getting your therapeutic goals met in the therapy room. Use your voice because your voice is powerful and this is your time. So I think that would probably be maybe we could probably come up with a few more takeaways, but I want our client, our listeners, to trust their gut and use their voice. Thank you everyone for listening to today's episode and if you have any questions, anything that you would like for us to answer in a next episode or a second episode, feel free to reach out to us and send us an email. Reach out to us on Instagram and we would be more than happy to answer those questions in another podcast episode. Take care. [00:46:47] Alefyah: Thanks for joining us today on Threads of Connection. If you have questions or stories you'd like us to discuss, email us@lettersthreadsofconnection podcast.com Follow us on Instagram and Facebook at Threads of Connection Podcast for updates. Don't forget to subscribe, review and share our podcast with your family and friends. Your support helps us build more meaningful connections. We look forward to hearing from you. Until next time.