The search for a good therapist (Svali Blog Post)

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Searching for a good therapist “You aren’t DID,” the therapist announced. I felt immense relief. This was a specialist in working with PTSD and DID, and the referral for a large Christian counseling group in Southern California. “You couldn’t be,” she continued, “because I lose time when I become uncontrollably angry, and I’m not DID.” I blinked at looked at her. She then proceeded to disclose during the next half hour about her childhood of torture by her older brother, including sexual abuse, and his forcing her to help him cut up small animals. Knowing that children often learn from their parents, I asked her the logical question. “What were your parents like?” “I don’t know. I don’t remember them at all. It’s a complete blank.” I went home that day, and told my husband I had decided not to see this specialist in DID anymore. He angrily asked me if I was avoiding therapy. “No, I’m just worried when I’m healthier than the therapist”, I answered.

This is a true story from much earlier in my healing process,

and shows the problem that faces survivors of severe childhood trauma when they are looking for a qualified therapist. The “experts” may not be as good as claimed. Large full page ads in the phone book proclaim a therapist’s expertise, while others are given as a referral from an organization when called. Telephone numbers can be gathered from the net, from professional organizations, and from friends. But how does the person dealing with a wounded psyche know which is the competent therapist? To complicate the process, how does the survivor believe that they DESERVE good therapy, or recognize it when it is present (or its absence)? This article is an attempt to help answer some of these questions.

First, the problem of insurance needs to be addressed. If a person has insurance coverage, they may need to contact their provider first for a referral. Often, there will be several options given, and the client will need to choose one.

Others survivors have no insurance. In this situation, which is all too common, they may be at the mercy of a MHMR system that in some localities (but not all) refuses to treat DID, or free clinics where the quality of care may vary from marginal or poor to excellent. Sometimes, therapy can be received through Medicaid, or Medicare if the person is on disability, and the survivor can contact therapists who take these plans for reimbursement. Okay, insurance is looked at, now how do you find a therapist?

Try asking friends who have been HELPED by therapy, and are getting better. This is a great credential for any therapist. You can also try contacting the ISSD (link is available under “links” here) for a list of therapists in a locality. The ISSD does not guarantee that the therapist is competent in working with DID or trauma, only that they are a member of their organization, but it is a starting place.

Organizations that work with survivors of trauma may also be able to give a referral, as well as hospitals and/or units dedicated to DID and trauma. Therapists who are well known and respected, and known to be safe, can be another source of a possible referral.

Think about whether you would be more comfortable working with a female or a male therapist, before starting to interview one, since this may narrow your choices down.

The next step is the phone interview. Before seeing a therapist, try doing a brief interview with them, and ask a few questions. Your goal should be to do a phone interview with at least 3 therapists initially. Questions you might ask on the phone should include: *Are they accepting new clients? How long is the wait before being seen?

  • What about fees and how insurance claims are handled? Check whether the fee is paid up front and the client contacts their insurance for reimbursement, or the therapist handles billing. You may also need to contact your insurance company for PREAUTHORIZATION in order to be reimbursed. This means the insurance company wants to approve the therapist first, or they won’t pay you if they see them. Does the therapist have a sliding scale if there is no insurance? How long are sessions? Does the therapist ever go over, or give extra sessions, and if so, how does he/she handle billing? How far away is the therapist’s office from where you live?
  • Experience: what kind of credentials does the therapist have? Experience working with survivors of trauma and/or ritual abuse? Do they understand DID? What kind of license do they hold (LPC, MSW, marriage and family counselor, etc.)? What school did they go to? How long have they been a therapist?
  • How available is the therapist? How does he/she handle crisis situations, or after-hours calls? Suicidal ideation in the client? Does the therapist work alone, or with a group that has rotating call? How does he/she view hospitalization? The role of medication? How far ahead should appointments be cancelled (24 hours is usual)?
  • Discuss their personal philosophy of healing: how they became interested in working with survivors of trauma, how they view the healing process, and how they help clients work towards this goal. What is their belief/faith system? Do they pray with clients? How do they view spiritual warfare? Are they directive or nondirective ? What do they do when a client disagrees with them, or the direction therapy is going? Do they believe that ritual abuse is real? How do they help clients deal with flashbacks? What does he or she feel about integration (or not)? Does she respect the client’s wishes in this area? How does the therapist feel about switching during a session? Are they willing to learn more? Go to conferences?

If the phone interview goes well, and both of you feel that you could work together, then the next step would be a personal interview at the therapist’s office. Here, you can see the therapist in his or her working ambience. Remember, the therapist is working for YOU, not the other way around, and it is okay to go with your gut instincts. You deserve to find someone that you feel comfortable working with. At this point, you might want to ask: How does the therapist take care of his/herself to avoid burnout? Do they have supervision, or others they can vent to? Do they have a sense of humor? What are their views on boundaries? Giving hugs? Confidentiality? What will they do if you see each other in a public place?

Is the office comfortable? Private?

Ask yourself: how is the therapist relating to me? Do I feel I could become comfortable working with him/her? Am I treated wiith respect? Does the therapist listen non-judgementally?

Once you have found a therapist that you feel comfortable with, as time goes on, it also helps to have realistic expectations of the therapy process. Ritual abuse is a severe type of abuse, and the therapy process is often long and involved. It is important to not expect that the therapist will be able to “fix you” or “make it all better,” instead, the client needs to realize that THEY will be the one making changes, with the therapist as a supportive facilitator. Also, a therapist cannot and should not “reparent” the survivor, who may have had an emotionally deprived childhood. Instead, the survivor will need to learn new self-nurtering skills, and practice them while at home and between visits.

A good therapist is an invaluable aid to the healing process, and it is well woth the time and effort to find one. The therapist I mentioned at the beginning of my article only lasted two visits, but later, I learned to ask the questions above, and to be careful in screening who I saw. I am glad I have, because over the past few years I have met excellent professionals who are competent, caring, with good boundaries, and who have made a huge difference in my own healing process. I believe that all survivors deserve good therapy during the process of healing from ritual abuse. My hope is that this article will help others in their search for a therapist, and that they can avoid the pitfalls that I went through early in my own search.