Question: I am a principal in a girls' elementary school. I found your past two columns about therapy very informative and although I have never been a believer in therapy, I'm beginning to rethink my attitudes and wonder if therapy can help different students who are struggling socially or in other ways, as well as some parents who come through my door. So here is my question: How do I know how to find the right therapist for a student or parent? This question is very important because if I send a reluctant parent or student for therapy, convince them to finally go, then I feel I have only one chance to make it work. If the students or parents get turned off from the therapist in some way, they will never go back—not only to that therapist—but to anyone after that. As a principal making referrals, or encouraging my students and their parents to find a therapist, and knowing how I have felt about therapy before reading your columns, and this is how most of my students and parents feel, I know I need to utilize this one-shot opportunity to guide them most efficiently to the most appropriate therapist so that this venture will not backfire. How do I do this?
The purpose of my columns it to demystify and de-stigmatize (I think I just made up that word, but I think it's a good way of expressing myself!) the therapy experience and make it accessible to all people. That in some small measure, I have succeeded with you, especially in your capacity as a principal is most gratifying; and I will try to address your question in a way that can be as helpful as possible.
There are many things you need to know about finding a therapist. Let me list those things, not necessarily in order of importance because for every individual different things matter.
Most therapists work with specific populations. Some therapist treat primarily children and some only adults. Different populations have different methods of treatment. A child therapist will have toys in her office and use play therapy. A therapist for teens may use board games, art supplies, or talk to engage an adolescent; or any combination of those. A therapist for adults will use different types of treatment depending on the presenting problem, including talk therapy, EMDR (eye movement desensitization reprocessing), sand, or art therapy.
Although therapists treat a wide variety of problems, sometimes you may want someone who specializes in a specific area because of the extreme nature of the problem. Some specializations are treatment of eating disorders such as anorexia, at-risk adolescents, grief and bereavement, or trauma.
A person choosing to go to a therapist needs to think about which gender is most appropriate for him or her. In our community, especially when working with children, we prefer a female therapist for female children, and teen boys work well with male therapists. Of course, this is not across the board, and there may be different reasons to use a therapist of the opposite gender. Some males specifically want female therapists as they feel threatened or ashamed to talk to a male. Some women feel more confident in the abilities of a male clinician than a female due to the (sometimes) cultural idea that male doctors are “better.” There is no wrong or right answer in this case; it's a matter of feeling comfortable with one's choice.
Then there is the very real aspect of money. Different therapists charge different amounts for their services. It's important to ask about the price before beginning therapy because once therapy begins, it is very detrimental to stop or pull out a child from therapy because of monetary concerns. Some therapists offer a sliding scale; some not. Sometimes when you pay more, you are getting a more skilled and experienced clinician; sometimes not. The amount you pay does not necessarily reflect the quality of the therapeutic experience you will receive; although, sometimes it may.
There are two agencies Jewish Board and Family Services (JBFS) and Tikvah at OHEL, located in Borough Park and Flatbush respectively that have excellent therapists practicing in a warm and welcoming environment in which clients can receive treatment that is either completely covered by their insurance or at low cost. Although privacy is compromised a bit because of the public waiting room where all clients sit until called into their private therapy session, quality of services is most assuredly NOT compromised. However, when going to a clinic like these two, there is a chance you may be assigned to a student intern, a beginning therapist, unless you specifically request a licensed clinician. I will confess that I began as an intern in Tikvah at OHEL, and I do not feel my clients' care was compromised in any way; on the contrary, my idealism and willingness to seek out supervision and continuously acquire the necessary tools and information when confronted with my clients' issues, made me an effective clinician despite my relative inexperience.
Location of the therapist's office, cultural/religious background of the clinician, wheelchair accessibility, age, and education/training of the therapist are all factors that may or may not be relevant to an individual; but must be addressed if they are.
The most important aspect of any therapy experience is the actual rapport that is established between client and therapist. If you send your students or their parents for therapy, definitely discuss how important it is to simply like the personality of the therapist they are seeing and to immediately cease therapy if after the first or second session they do not feel comfortable with the therapist. This will avoid the problem you are describing in which they give therapy one chance and then that chance is ruined if they are disappointed.
After the first session, maybe after two or three with a child or adolescent, clients should have established a rapport and connection with the therapist, developed faith and hope in the ability of the therapist to help them, and feel comfortable with the non clinical aspects of therapy (although everything in therapy is connected somehow to therapy!), like payment plan, office location, ambiance of the office, and the appearance of the therapist, among others.
As a principal, it is prudent to interview therapists to whom you may want to refer your students and parents in order to get a feel of their personalities and treatment modalities; and to see if you can establish a working relationship with them. Eventually you will get feedback which therapists are effective for various issues, and which do not seem to work for your student body's needs. Referrals from rabbis, other satisfied clients, and community leaders are all good starting points. RELIEF Resources is an orthodox, mental health referral agency that personally interviews all therapists thoroughly before giving referrals. They too are an excellent resource for therapists.
Here's my final piece of advice. Whenever you seek referrals, it's crucial that you know the right questions to ask in order to make that good fit between client and therapist. I hope that this column has given you the tools to ask those questions.
Okay, now I have a question. Now that I've won you over to the world of therapy, how do I get my kid in your school?
FIRST PUBLISHED IN ADVICE COLUMN OF JEWISH ECHO MAGAZINE
My book, Therapy, Shmerapy, can be found in bookstores or online