Getting A Therapist

Several people have emailed me asking for advice finding a therapist, and I worry I haven’t been much help. One of the advantages of being a psychiatrist is not having to worry about finding a psychiatrist. I know a few people in southern Michigan personally and can give some advice if you live there; outside that I’m stuck.

Luckily Gruntled and Hinged just wrote a good series of articles on how to find and contact a therapist for mental health problems. I’ll be referring those kinds of questions there in the future.

But I’ll also open up one question to anyone who can help: anyone want to volunteer the name of a good therapist whom they would recommend to other readers? Clearly geography is an issue here, so I would be most interested in knowing about tele-therapists or people in the Bay Area / New York City where a lot of SSC readers tend to congregate.

Bay Area:
Dr. Judith Sachs (recommended by David Chapman)

New York City:
Deb Shapiro (recommended by jayshap)

Greater Boston:
Integrative Psychology (recommended by Hibiscus)
Life Changes Group (recommended by Hibiscus)

Ann Arbor:
Rebecca Hatton (recommended by Paul Torek)
[Ask Scott privately for psychiatrist recommendations in Ann Arbor / Detroit]

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33 Responses to Getting A Therapist

  1. 阀门 says:

    Therapist psychotherapy is necessary

  2. Philo says:

    I’m currently shopping for new therapist in the NYC area after being informed that my current one will be moving, and while I have some promising leads, I don’t personally know of any good therapists through first-hand experience.

    I’ll be curious to hear what others have to say.

  3. Anonymous says:

    >One of the advantages of being a psychiatrist is not having to worry about finding a psychiatrist

    Eh? You’re allowed to prescribe yourself stuff?

  4. Julia says:

    As the Gruntled & Hinged post partly explains, “licensed therapist” is not a specific thing. When I looked into who does mental health care in Massachusetts, the names of the professions I could find were (in order of frequency): social workers, psychologists, psychiatrists, various kinds of nurses, licensed mental health counselors, licensed marriage and family therapists, and licensed clinical mental health counselors. I assume that none of the nurses and few of the psychiatrists are doing talk therapy, though. It seems that social workers do the plurality of psychotherapy (at least where I live).
    http://thewholesky.wordpress.com/2013/06/26/who-does-behavioral-health-care/

  5. Handle says:

    I have a different request:

    I very rarely go to see a doctor, and I move around a lot, and so when I see a physician I am almost always essentially a stranger to them.

    My interactions with various medical professionals almost always start in a very patronizing and condescending fashion, with them talking to me as if I am a child.

    I understand there are perfectly good reasons for them to do this, I don’t fault them for it.

    But I do want them to stop it with me as quickly as possible.

    I want them to treat me as – if not as an ‘equal’ – then at least an intelligent, educated professional with some decent lay understanding of medicine and biology, capable of understanding nuances (do this, unless this, except when that) and reliable in terms of complying with simple instructions. Basically, I want them to understand that I am not in the category of patients that justifies the elementary school approach.

    My question for you is whether you have any good advice about the quickest, most effective, and most polite way to accomplish this goal. I once tried to be frank and direct about this and I judges that this was not well-received, which is of course typical and predictable. I’ve had more success with immediately dropping or hinting about my profession. Professional dress – business casual or above – also seems to matter.

    Where I’ve had the least luck, no matter what I do, is anything dealing with OB / Maternity. The docs in those fields just don’t seem to be able to snap out of patronizing mode. But if you know any tricks, I’d be very grateful if you could share them with the group.

    • Anthony says:

      Working for the institution seems to help. My wife is in IT at (major medical group) and gets the sort of treatment you’re asking about from her doctors.

    • Scott Alexander says:

      I really sympathize with the question, but I don’t have a great answer.

      There’s no reason being frank and direct shouldn’t work beyond the doctor being a rude person. A site like ratemds.com or healthgrades.com might help you find less rude doctors.

      And I’ve never tried this, but most doctors follow a standard medical history format. If you write up your history in the standard format and hand it to them, it might save them some time and signal that you’re pretty experienced with this. But this is just a guess, and again they might be needlessly rude and say “that’s not the way we do things here”.

      • Ialdabaoth says:

        And I’ve never tried this, but most doctors follow a standard medical history format. If you write up your history in the standard format and hand it to them, it might save them some time and signal that you’re pretty experienced with this.

        Note that this has a pretty big failure mode. I used to try this, until I asked a friend who was training to be a medical professional why they thought that it seemed to generally INCREASE the level of condescension. I will paraphrase their explanation:

        “Well, my resident says that there’s ultimately two kinds of patients – the kind who don’t know anything about medicine, and the kind who know too much about medicine. The first kind are dumb but easily manageable, and the second kind you need to get rid of as quickly as possible, because they’re just shopping around for drugs or treatment or attention or whatever.”

        • Scott Alexander says:

          Possible. Almost all my experience has been in a hospital, where there’s usually a presumption of “actually sick”. It’s possible in a clinic setting the lack of that presumption might cause different responses.

    • Deiseach says:

      Luck of the draw seems to be it; out of four consultants I had appointments with for various matters that all hit me at once, one of them treated me like a human being.

      The others ranged from ‘conveyor belt’ (get her out of here as fast as possible) to pig-ignorant (I don’t say boo to a goose in public, but this guy was so bad I did indeed storm out after ten minutes).

      And yes – the gynaecologists were the worst, not necessarily in attitude, but plain not listening:

      Scene: Examination room
      Persons: Consultant, nurse, the patient (me)
      Location: In the single most embarrassing position possible – on the flat of my back with my legs in the stirrups and the doctor preparing to go in .

      Me (because I’ve been down this road before): Um, you’re going to need the large speculum
      Him (not even listening but attempting to force implement in)
      Him: Nurse, this isn’t working. Do we have the large speculum?
      Nurse: They’re on order, but they won’t be here till Monday

      Exit doctor and nurse to find some implement they can use, leaving your obedient servant naked from the waist down on public display.

      Yeah, that wasn’t at all an unpleasant experience!

    • Kate Donovan says:

      Stepping in to second Scott–the single thing that has worked best for me is repeatedly using the language at therapists back at them. I got both my undergraduate degrees in effectively applied psychology and theoretical psych. Barring that fairly unreasonable suggestion, here are some ideas:

      -books for professionals (ie, training manuals, textbooks, guides). They use the language and phrasing you’ll be imitating
      -walking in with your health data already. I mentioned this in the Guide already, but showing up with answers to questions before they were asked forced the practitioners to regroup and seemed to jar them out of patterns of talking (the same patterns that felt condescending. The ability to say flatly “actually, I’ve got the answer to that right here” worked great at disrupting the repetitive and patronizing habit.
      -I am not entirely sure how much of this is just making people perceive me as older, but getting excessively formal has served me well. “Actually, I was given to understand that…” rather than “the nurse told me…” etc etc etc.

  6. Shmi Nux says:

    Unrelated to the topic, but: something seems wrong with this study:
    Non-Celiac Gluten Sensitivity May Not Exist.

  7. In the Bay Area, I would recommend Dr Judith Sachs (415-346-1302).

    She has an informal specialization in Aspergers-y folks, helping both with romantic relationships and work issues (corporate politics, etc).

    For readers of this blog, one difficulty in finding a good therapist may be discovering that you are smarter than most. That’s pretty unlikely in her case!

    She has offices in both San Francisco and Oakland. I don’t remember exactly, but my memory is that she’s a PhD clinical neuropsychologist, if formal qualifications count, and has been practicing for about 20 years.

    Disclaimer: she’s a friend, and I haven’t been treated by her. However, she’s given me a great deal of good advice about interpersonal situations over the years, and she’s insightful and caring.

  8. hibiscus says:

    I have recommendations for Greater Boston: Integrative Psychology (http://integrativepsychologist.com/contact/) in Arlington, and Life Changes Group (http://lifechangesgroup.com/) in Cambridge. I’ve had good experiences with intelligent, insightful, non-condescending therapists at both (although Life Changes is a group of them, so I haven’t had personal interactions with all).

  9. Paul Torek says:

    My wife is a licensed psychologist in the Ann Arbor, Michigan area. Here’s the most informative page of her website. Besides having the smarts to marry me :D, she’s committed to helping people improve and move on, rather than spending a fortune on perpetual maintenance.

  10. Thomas says:

    Unrelated, and I don’t know how much you want to mess with your website. Another blogger I read found that adding a “Confirm you are not a robot” checkbox reduced spam significantly.

    • Kevin P says:

      Spambots might try to check/uncheck checkboxes randomly, but I found that a custom text field with the answer beside it (“Are you a spambot? Hint: say no“) cut out 100% of my spam. Obviously it wouldn’t work against manual spammers or anyone writing a spambot specifically aimed at your site, but all of your spam seems to be general-purpose bots so that doesn’t matter.

      • Scott Alexander says:

        So I was about to ask if there was a WordPress plugin for this.

        Then I realized that if there was commonly used plugin that all WordPress sites had, then spambots would be programmed to understand it and check the box.

        Then I decided that there should be a couple hundred different plugins, and people should try to choose one of them at random.

        Then I realized it would be too easy to just make a list of all hundred plugins and give that to a spambot. You would have to come up with some novel way of having a couple of systems that nevertheless interacted in a different way for each blog.

        Then I realized I was reinventing the HLA system.

        I wonder how long it will be before computer security companies start recruiting immunologists.

  11. J Madden says:

    Dr. Elke Rechberger is an excellent Psychologist located in the Los Angeles area. (626) 394-3015

  12. Parker Brown says:

    I’m putting out a request for NYC therapists to help manage anxiety and depression if available. I’m finding that it’s a really hard maze to navigate in Manhattan.

  13. Looking for a therapist in Chicago for Asperger-y issues.

  14. Imzadi says:

    Seattle recommendations?

  15. Esquire says:

    I’ve occasionally thought therapy might be nice with a really great therapist, but finding someone “really great” seems much too difficult to offset any benefit. Anyone know a therapist with a very high IQ and very “no BS” approach? I’m in the NYC area but would be willing to Skype. “No BS” is really really important – I am kind of “triggered” by pop psychology.

    Also, for a friend: recommendations in the NYC area for a therapist-type professional for six year old girl going through a tough time with illness in the family and acting out.

  16. PSJ says:

    Princeton/Central Jersey

    Psychiatrist – Joseph Salvatore

    Therapist – Carol Blum

    Have been the best of the two or three i’ve seen for both

  17. Faradn says:

    Any recommendations for Salt Lake City?

  18. Linch says:

    Any recommendations for motivation training, etc. in the Madison area? I’m pretty lazy and will like to get less lazy (ideally CBT or something like CFAR but insurance-paid would be great).

    Also for a friend of a friend: Looking for a psychiatrist who’s competent in dealing with schizophrenia cases, also a government-funded institutionalized place that wouldn’t treat him too shittily (He was in a halfway place for a week or so, where his roommates were all convicted felons, and the manager, who had a criminal record, sided with the felons*)

    *I do not know the other side of the story.

  19. Middlesbury says:

    Any Seattle/WA recommendations?

    • IntoTheSky says:

      I visited with Dr. Lisa Hardebeck several times while I was struggling with low self esteem and social anxiety and really appreciated her personality and professionalism. She practices primarily in Tacoma though I imagine she could provide a reference to someone closer if you contacted her.

  20. Arthur Bludgeford says:

    Does anyone know either of the following:

    – If there are any therapists who are comfortable communicating over email or, failing that, videochat? Or does it make billing basically never work?

    – Where one can find a practitioner of the Writing Process Training mentioned in [this paper](http://ei.yale.edu/publication/efficacy-cognitive-behavior-therapy-writing-process-training-alleviating-writing-anxiety/) I considered emailing the paper’s author, but he has since become President of Yale. Or, does anyone have any recommendations for overcoming writing anxiety?

    I realize that these questions seem …contradictory.

  21. Bresler says:

    I know this is a long (loooong) shot, but I’d love a recommendation from someone in Brazil. Finding a therapist in São Paulo have been an impossible task.