Consumer Guidance for Seeking Professional Help

There came a time when the risk to remain tight in the bud was more painful than the risk it took to blossom. ~Anais Nin

People typically seek professional help when their best attempts to cope with and/or adapt to stressful life events have failed; when feelings of overwhelm and/or defeat, coupled with disabling physical, emotional and behavioral symptoms, interfere with their ability to effectively do life, i.e., participate in work, school, relationships, sleep, capacity for enjoyment and other activities of daily living. (See section “What is Trauma”) 800px-lucy_and_the_psychiatric_help_booth1_edited-

Irrespective of one’s choice of clinician, program or type of therapy, the ultimate goal of trauma treatment (in fact, the goal of all psychotherapy) is to help improve one’s quality of life; to feel and function better on a somewhat sustainable basis. This doesn’t mean that therapy will not be difficult or painful; it means that the therapy process includes the development of safety, support and skills for stabilization for managing those difficult and painful times.

Where to Begin  

Even for a well-resourced, healthy consumer, navigating the mental health system is a significantly challenging task, but for a traumatized person, it’s often an overwhelming one. So, if there is someone you trust, who is willing and able to assist you, accept the support.  You may also find the general information provided below regarding trauma treatment, the clinicians providing it, and the modalities most frequently employed helpful at the outset.

Getting Ready

Lots of folks hate this advice (it’s particularly difficult to heed for those who have been traumatized), but, here it is anyway. If you do not have a primary care physician, now is a good time to find one, as a complete physical examination is warranted prior to beginning therapy. There are a host of reasons, but here are my top two:

  1. Medical conditions must be ruled out in order to perform an accurate psychological assessment- a prerequisite to offering an appropriate treatment recommendation.
  2. If medication is or becomes necessary, a complete physical examination is usually required.

And a few foundational statements regarding trauma therapy:

Inherent in the medical model lies a significant risk factor for anyone with a trauma history: the doctor/patient relationship, itself. What?! Why?! Unfortunately, that relationship is a hierarchal one. It’s as if an all-knowing, all-powerful, presumably healthy expert has taken on the burden of healing a frightened, much less powerful, not-so-knowledgeable, sick patient. Even if that ridiculous premise were true, due to the disempowering nature of trauma, survivors are poorly-served that type of relationship.

Take Away: redflag1-copy-1.jpgWhether choosing a psychiatrist, psychologist, social worker or counselor, steer clear of authoritative clinicians.

Unlike the medical model, the trauma model is an empowerment model that recognizes the therapeutic relationship is requisite to healing.  Although the clinician should possess and provide many things-professional training, skill, useful information, empathy, insight, intuition, etc.-it is the client who is the expert on the client  and the primary agent of change.

Take Away: The therapeutic relationship is paramount to successful treatment. If it isn’t collaborative it’s doomed to failure.

Choosing a Clinician

Screen out the Unavailable and Unaffordable

Be advised that during your search you will find that for various reasons-full caseloads, scheduling conflicts, prohibitive fees, insurance issues, etc.-many clinicians will be unavailable to you. Although it is almost never personal, it can be disheartening. So, if possible, try to keep a certain level of detachment until you’ve located and met with one-or several-available qualified clinicians.

When seeking advice on How To Choose a Clinician the following are standard suggestions:

  • If you are comfortable and they are available, it’s best to begin your search with personal references, i.e., ask trusted relatives, friends, neighbors and co-workers about personal experiences with particular clinicians.

  • If you are not comfortable asking, or there are none available, you might ask your (regular or newly found) primary care physician for a recommendation.
  • Psychology Today’s website (as do many other websites) has a Find a Therapist search page.
  • Regardless of whether you will be using an insurance plan to offset the cost of therapy, anyone is free to search out clinicians from insurance companies’ panels.

All perfectly appropriate suggestions - adequate for most inquiries. Unfortunately not an inquiry into a relatively esoteric field. Hopefully this is a temporary situation, but presently within the field of psychotherapy, there remains a dearth of knowledge, education and training in the treatment of trauma; trauma therapy remains a specialized treatment. Over the past few years, I’ve received hundreds of calls and emails from across the country requesting contact information for clinicians skilled in working with trauma. Sadly >95% of the time I was unable to provide that information. Consequently, I’ve begun to compile a national registry. Perhaps it would be of value in your search.

seal-of-approval-w-logo_edited-2.jpgRecommended Trauma Informed/Trauma Sensitive Clinicians   

Take Away: Trauma therapy is a specialized treatment, necessitating more training and skill than many clinicians currently possess. 


Screen out the Unqualified

It should go without saying that the combined abilities of hanging a shingle and collecting cash in no way qualifies a person to be a clinician, BUT in many states, anyone with those abilities is free to do just that, AND to refer to him/herself as a therapist or counselor. Happily, I haven’t worked directly with any of those people, but have worked with hundreds of clinicians. They come from myriad backgrounds, education and disciplines. Some started in medical school, got licensed in their state (M.D.’s and D.O.’s), then specialized in psychiatry. ....

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