Patented Q & A Database

How do you go about finding a quality doctor? My 16-year-old daughter doesn't speak to anyone, is angry at the world, and often has no interest in going to school. My husband and I just went through a divorce and she hates her father, though I am not encouraging that. If your advice is to go for family/individual counseling, I agree. My problem is that until we are in counseling do we get to understand if the counselor is any good. This is especially true for my daughter. It is hard enough to get her to go for help, but if the professional is not any good - then I have lost ground on getting her help. I am not talking about qualifications, I am talking about quality. How can I know who is good?

Peter Hanfileti, MD Replied: You may be able to get a general idea about who is a good counselor in your area by asking other parents, family friends, school personnel, clergy, etc., but the bottom line is the most important person to consider is your daughter. In the counseling relationship, rapport between the professional and the client is the key to success. Unfortunately, this is not something you can guarantee beforehand, so I would have to recommend finding someone that has experience with teenagers, working with families with divorce histories, and an understanding that young people like your daughter need to be given some latitude and responsibility in the decision-making that affects them directly. At 16 years old, your daughter is a mere few years away from independence and adulthood, and now is a better time than any to enlist her participation in helping to move forward in her life. I would make it clear that it may take a few tries to find the right match as far as a counselor goes, but be sure to give her some say in the matter, otherwise it will not work and it may backfire. See if you can help her to list the qualities and characteristics of a counselor she would likely get along with the best: man or woman, structured or informal, open minded or meticulous, advice giving or self encouraging, younger versus older, you get the idea. Even the topics of inquiry should be open for discussion. This way she will have an understanding from the beginning about what to expect and what kind of therapeutic counseling relationship she is getting into. In this way, it will be your daughter who will know whether or not the counselor is good, based on her own feelings of accomplishment and sense of improvement within, not coming from anywhere or from anyone outside of her own self.
Posted On 2010-06-21 23:38:02

Trish Booth, MA Replied: A good therapist can outline a counseling plan at the end of the first, or intake, visit. In your case, this assessment would include what part of your daughter's behavior is best addressed by her having someone to talk to (individual counseling); what part, if any, is a systems issue that requires family counseling; and what behavior is normal behavior for a teenager. In addition, you will want a counselor who has considerable experience working with adolescents. You can ask about the therapist's experience with adolescent clients and whether a counseling plan is offered at the end of the intake session when you are contacting mental health professionals in your area. At the intake visit, the therapist will spend some time with your daughter alone as well as time with the two of you together. During her time alone, your daughter will get a feel for whether she is comfortable talking to the therapist. After the session, you and your daughter can go home and talk about whether she can work with this person. If not, she needs to explain why, such as the person is too old, or she would prefer talking to a person of the opposite gender. If you need to find someone else, you can use your daughter's preferences to find one other professional. After the initial visit with that person, you can decide between the two counselors. Two should be enough; you don't need to come up with a lot of alternatives. The teen years, even in the best of times, can be trying. Adolescents can be angry and non-communicative with their parents as they strive for autonomy. When there are family changes or divorce, the anger, sadness and numbness that is part of a grief response can magnify a teenager's anger and troubling behavior. Getting support and advice from a mental health professional can be reassuring to a parent as well as a relief to the teenager who now has someone to confide in. You are wise to seek help for yourself and your daughter.
Posted On 2010-05-04 15:09:28

Dr. Vicki Panaccione Replied: Great question. Choosing quality care for her is going to be very important. That being said, there are no guarantees that there will be a good fit between a particular therapist and your daughter. What I would suggest is that you pose this question to folks in the area who are ‘in the know' of teen practitioners. Try your family doctor, guidance counselor at the high school, youth leader at your place of worship, etc. DO NOT rely on the yellow pages, or any sort of advertisement. Other parents are also a great source of information; I actually get most of my referrals from word of mouth---so ask around. Additionally, I encourage you to share this dilemma with your daughter and involve her in the process; she actually may have friends who have talked about their therapist. It is crucial to find a professional who specializes in working with teenagers. When you do, chances are that s/he would be skilled enough to work through your daughter's anger/resistance and establish some rapport. This may take several sessions. Keep in mind that your daughter may not find anyone agreeable---so, the key will be that she will return for another session, even under protest. Some of my best work has been with teens who find me the b---- they love to hate.
Posted On 2010-05-03 00:35:50

Elinor Robin, PhD Replied: Tell your daughter that you are going to interview some therapists together to find the right one. Make a few appointments and conduct interviews. At the interview you will be able to tell who she feels connected to. And, her feeling connected will be more important to the success of the therapy than credentials. However, make certain that the therapist is licensed as either a psychologist, marriage and family therapist, clinical social worker, or mental health counselor. Additionally, if you can find someone with some training in art therapy that may be a good first stop since you say your daughter doesnt speak to anyone. She may however be able to express herself better in art then in words.
Posted On 2010-05-03 00:08:20

Amy and Charles Miron Replied: A good place to start is a referral from a trusted friend and/or other professional (like your pediatrician, OB/Gyn, etc.) We recommend that you interview the names given to you over the phone. Some basic questions to ask are: 1. What is your orientation? (We strongly recommend a cognitive behavioral approach...but that's just our opinion.) 2. What is the average length of stay in therapy? (If they say years, we'd consider someone else.) 3. Do they have an area of expertise in working with resistant adolescents and children of divorce? These are starters to get a feel for the person. We believe that the "chemistry" is important. While you may not be comfortable with the topics you or your daughter may talk about, we believe it's vital to feel comfortable with the person you're talking with. Do you feel safe? Understood? Listened to? It might be a good idea to explain to your daughter why you're seeking services. Then tell her that while she doesn't have a choice "if" she's going, she sure has a choice about who she feels OK with. Then listen to your (and her) guts. Wishing you both the best. Amy and Charles
Posted On 2010-05-02 22:53:04

Amy Sherman Replied: There are a few things you can do. Ask for referrals from friends, co-workers, family, etc. This will give you a good recommendation from someone who is satisfied with their therapist and has had good success. The second thing is to not discount qualifications. Someone who specializes in teen and or/family issues for many years, probably has a good track record and a lot of experience. Just remember, that no matter how good the therapist is, nothing will matter if your teen is not willing to cooperate. I suggest that perhaps a female therapist may be able to relate better to you daughter, if some of her issues concern boys.
Posted On 2010-05-01 10:39:21

Dr. Tom Greenspon Replied: This is an excellent question, which as you might imagine has no clear-cut answer. The success of psychotherapy is known to depend heavily on the goodness of fit between the therapist and client, whether in individual or family therapy. For this reason, it will never be possible to know in advance whether a therapist will definitely be helpful to you. There are two ways to improve the odds, though. Begin by getting references from people you know, whether friends, relatives, clergy, or other professionals. Ask if they have had direct experience with a therapist, or if they know of someone, perhaps in a situation similar to yours, who has had a successful therapeutic experience. Sometimes, for example, a clergy person will have had several parishioners who have had good experiences with a particular therapist. Therapist qualifications are very important, but as you rightly suggest, there is more to it than that. The more trustworthy the referral source is to you, the better. Next, give the therapist a call to see if they will hear briefly about your concerns and tell you over the phone if they think they can help. Sometimes therapists will offer a free in-office consultation, but you can tell a lot over the phone. The general guideline is this: if you feel listened to, respected, and understood (even though admittedly the therapist knows little about you at that point), then that is at least a good place to start. If not, there are many good therapists out there, so don't hesitate to move on. Assuming that your daughter is willing to go to therapy, you might explain to her that you honestly hope you will be able to find someone she likes, but that you hope she will be open to alternatives since you have no way to guarantee success on the first try. Incidentally, if she is reluctant to go, ask if she will go to a session just to help you. Best of luck in your search!
Posted On 2010-04-30 12:02:44

Todd Johnson, JD Replied: I would have two suggestions to try and find a good counselor. First, ask friends if they have any knowledge of who might be a good family counselor. Your friends must know some of the problems you are having and I would think that they would be glad to help if they have any information. Second, if your friends are not aware of anyone who might be able to help, you can make an appointment with a few different counselors and tell them when making the appointment that you are trying to find the best counselor for your family's needs. You don't need to bring your daughter to these sessions since you are merely trying to find the best choice. After you have found someone that you believe you can work with, then you can get your daughter involved and actually start the counseling. I hope that helps. Good luck.
Posted On 2010-04-30 11:30:28

Jim Taylor, Ph.D. Replied: This is a common question: How do I find a competent therapist? This is challenging for a layperson because it's not like buying a new TV where you can look at the reviews on cnet or amazon. And often, laypeople don't know what questions to even ask. Here's what I suggest: 1. Do a Web search for your city's local psychological association. Most cities have them. 2. In the Contact Us page, find the email address or phone number of the current president or other association official. 3. Contact that person describing your situation and ask for several referrals of professionals with training and experience in that area. Emphasize that you want a referral that this person knows personally and can vouch first hand for their competence. 4. Get 3-4 therapists' names and contact information. 5. Call the most recommended therapist first and just talk them. Explain the situation including all the difficult issues. Describe your daughter and some of your concerns about her. As about their experience with this sort of issue. Then just listen. See what the therapist says. Listen to the tone of his or her voice. Is there confidence, warmth, empathy? Does the therapist have a specific approach they would take? A big part of choosing a therapist is just by feel; all therapists are likely going to be well trained and qualified. Does this person sound trusting? Does he or she feel "right?" Ultimately, you just have to go with the best choice you can make (a combination of credentials, experience, and gut feeling) and take them for a test drive. Direct interaction between therapist and your daughter will be the real test and there is no other way to find out.
Posted On 2010-04-30 10:38:29

Rosalind Sedacca Replied: Excellent question! You are right to be careful before making a decision. I would ask around for referrals. Contact your school guidance counselors and see if they have suggestions of counselors they highly recommend. Ask local clergy for recommendations. Friends who are divorced. Mental health association. Ask those who were referred to you if you can have an initial meeting to get acquainted and "feel them" out so to speak. Ask tough questions that concern you and see how their answers resonate with you in your gut. Trust your gut feeling and go ahead with that choice. You can always change your mind if the fit isn't good. But no one knows your daughter better than you -- so trust yourself in making that decision. Don't put it off! This can be a turning point in your family's well-being.
Posted On 2010-04-30 10:06:47

Charlie Seymour Jr Replied: You question touches my heart as a father and as a marketer who always faces the question, "How do I SHOW people I'm really good." First: ask the doctor for people you can talk with. Though many of their patients are confidential, they should understand your concern and find SOME way for you to get first-hand knowledge from other patients. Second, schedule a time for YOU to meet the doctor. Tell him/her this is just a meet and greet and because you care so much about your daughter, you want to be certain that there is a great fit. If the doctor won't take that time, move on to someone else who will. This is SO personal that no two people will feel the same thing about a new doctor. Find out what others feel and then get your own mind wrapped about this doctor before taking your daughter. And I hoe it works out well for all of you.
Posted On 2010-04-30 08:39:11