Do You Need a Therapist

Recently, I got a phone call from a young man who said:

“A friend of mine told me that he was tired of hearing me bitch all the time about the same problems over and over and that I should see a therapist.  I’ve never gone to a therapist:  what exactly do you do?”

I recommended to him that he consider therapists as personal trainers for the mind.  For example, when you work out at the gym, hit a plateau and can’t progress any further, if you’re smart, you stop doing the same old unproductive routine and get a trainer to help you move to the next level.  A therapist does similar work for your mental state:  when you’re “stuck” and can’t progress mentally, you need some expert help.  Friends, relatives and lovers can be helpful, but they have neither the training nor the objectivity and confidentiality that a good therapist does. 

Therapists (psychotherapists, psychologists and psychiatrists) are regulated and licensed by the rules and regulations of your state.  They usually have rigid continuing education requirements and can lose their licenses if they misbehave (e.g., have sex with a client, violate your rights to confidentiality. etc.). 

If you have a problem that is not going away, for example, your self-esteem continues to be low after years of trying to feel better about yourself, or you can’t get over your ex, or you feel depressed or panicky and often anxious, a therapist may be helpful. 

A psychotherapist is specifically trained to do psychotherapy, that is, therapy for your psychological issues.  They do not issue prescriptions for any medications and rarely do psychological testing.  Psychologists are also licensed by the State to do talk therapy (like psychotherapists), but they often do psychological testing as well.  These folks often have the initials Ph.D. after their names.  Psychiatrists are medical doctors (MDs) who specialize in mental health.  Their primary focus is usually in doing psychological evaluations and dispensing medications (antidepressants, anti-anxiety medications, etc.).  You can go to any of these for “therapy”, but note that each has their own specialty.  Psychiatrists are usually the most expensive, psychologists and psychotherapists usually charge less. 

How do you find a therapist that you like and is able to help you with your problem(s)?  Well…how did you find your doctor, dentist or chiropractor?  Most of us ask our friends, family and co-workers for recommendations.  Once you have some potential therapist candidates (sounds like “American Idol”, doesn’t it?)  I recommend that you come up with a list of questions to ask them before you call them up.  Some therapists will speak with you on the telephone before your first appointment, others will not.  If this is your first time in therapy, I recommend talking with a therapist on the phone before you make an appointment; here are some questions to consider asking them:

“Are you comfortable working with (gay/lesbian/bisexual/ transgendered) men/women?” 

“I am looking for help with --------------------“.  Do you have experience with this?”  “If not, can you recommend someone who specializes in this area?”  (Note:  some therapists are generalists and others specialize).

“How would you help me?”

“How often would you want me to come in?”

“How long would our sessions last?”

“How many times do you think I’d need to see you?” 

“How much do you charge for your sessions?” 

“Do you take my insurance?” 

“Do you have a sliding fee scale?” 

“Do you have evening/weekend/early morning appointments?”

If someone is too expensive for you, ask:  “Can you recommend someone else who is more affordable for me?  I can afford to pay ($ amount) per session.”

This is not an exhaustive list, but it’s a good start.  Interview several therapists over the phone before you choose one to see in person.  Remember, this is how they make their living, so keep your telephone interviews as focused as possible...ask your questions but don’t waste their time.  

Once you have done your telephone interviews, pick one or two therapists and schedule an appointment.  Tell them during your appointment that you are looking for a therapist and may see another therapist (or two) in order to find a therapist that you really click with.  Don’t feel guilty if you don’t click with the first (or second) therapist you meet.  You may need to meet with two or three to find the right one.  It’s your time and money, so make sure you feel comfortable with who you choose.  Then, get ready to face your problems and change your life! 

Brief Bio

Born in Northern Ohio (the oldest of four children), I grew up in a small town of two thousand sassy farmers.  I was named after my great-grandfather Michael, who reportedly had the first Ford dealership in the State of Ohio (he ran it out of his hardware store).  In 1971, I escaped the farm and made it to the big city of Cincinnati, where I earned a B.A. in Personnel and Group Development from the University of Cincinnati.  In the 1970's, I worked in Louisville, Kentucky; New Haven, Connecticut and London (England) in personnel and human resources.  In 1980, I earned a Master's Degree in Developmental Psychology from Sarah Lawrence College while interning for "Sesame Street" in New York City (yes, I know Big Bird).  

After moving to San Francisco in the 1980's, I was Clinical Director for the Homeless Children's Network and Clinical Consultant to Children of Lesbians and Gays Everywhere (aka "COLLAGE") while earning my second Master's Degree from San Francisco State University  From 1996 to 1998, I worked as a Middle School Counselor in the San Francisco Public Schools.  I came to San Diego, California in 1998, where I maintain a private psychotherapy practice and offer workshops for the Southern Californian LGBT community. 

I am currently editing my first book: "Life Beyond Therapy" (LGBT non-fiction).  The book has been picked up by a major American publisher and is expected to hit the bookstores sometime next year.  I can be reached through my website (



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