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Finding the Right Therapist

Posted 2/11/2015

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  Three weeks away from the office has meant some re-entry adjustments and observations. As I sat yesterday and talked with women in my office, I was struck--all over again--by the intimate and intense and unusual relationships that we share. They are not friendships, but neither are they more common doctor/patient relationships. I feel incredibly honored that I am welcomed into their lives, and I try to respond with full appreciation and respect.

Many people going through cancer find, for the first time in their lives, that talking with a therapist is helpful. Although you may be surrounded by family and friends who love and support you, those covnersations are different. You are trying to some extent to protect one another with your words, and it can feel impossible to be brutally hones. Also, someone who has not gone through a similar experience likely finds it hard to fully understand and empathize. This is not to say that the only therapist who can be helpful is a cancer survivor, but I will admit that my own experience and prejudice suggests that can be a bonus.

I am thinking primarily here about individual or couples work. Let me say a bit, however, about finding the right support group. It is rather surprising that so few support groups are available; with the incidence of cancer being what it is, one would assume it would be simple to find a group. As you explore, you likely will find many groups listed that aren't actually meeting. When you do identify an active group, here are some questions to ask:

1. Who faciliates the group? You probably don't want a group that is self-run or peer-led. Feelings about cancer are too strong, and you need someone there who can manage any difficult moments and dynamics.

2. Who is coming to the group? For example, a breast cancer group may include women who completed treatment five years ago but remain worried, women who are newly diagnosed or going through first time treatment, and women who have had a recurrence and are coping with metastatic disease. My personal bias is that those experiences don't mesh well, but you ought at least to know who and what will be in the room. 

As all therapists and anyone who has ever seen a therapist know, at least half of the work depends on the human connection. That is to say, chemistry matters. This is the primary reason that it is sometimes suggested that you meet with more than one therapist before making a decision. You will know who feels right.

When I talk with women about looking for the right person, I also remind them to ask about the therapist's experience with other breast cancer patients/survivors. You don't want to spend your time and dollars educating someone about treatment and side effects and normal reactions. Frankly, you also don't want to deal with someone who has her own issues about cancer and may be tempering her own anxiety. Geography, schedule, and insurance matter, too. (and the first two are sometimes reasons why I am helping someone identify a therapist in the community rather than working with her myself).

Sage Bolt, MSW, PhD responded beautifully and fully to this question for LBBC:

Question: Can you please review what a counselor can do for a person, and where I should

go to find one?

Dr. Bolte: A mental health professional can be helpful to an individual, couple or family in a

variety of ways. This professional can help assess and identify coping skills to help you better

manage thoughts, feelings or areas of your life that are creating or reacting to stress and

decreasing your quality of life. For example, if you are experiencing increased anxiety around your

diagnosis, or if fear of recurrence is interfering with your quality of life, a counselor could help you

identify triggers that may be increasing these fears. The counselor can then work with you to

better manage these fears and improve your overall quality of life.

There are different kinds of mental health professionals. The most common are: licensed clinical

social workers, psychiatrists, licensed clinical psychologists, licensed professional counselors and

certified sex therapists (who help address sexual health issues after cancer). It is essential that

you verify the professional is licensed by your state licensing board to practice individual therapy.

You can identify an oncology-certified social worker by going to the Association of Oncology

Social Work directory. You can find other mental health professionals through your insurance

provider list, word of mouth or a list of professionals recommended by your oncology team. It is

important to remember that you can interview a variety of therapists to find the right fit. Whether

this is a short- or long-term relationship, it is important that you feel comfortable with the

professional's model of practice.

Questions to ask your mental health professional include:

1. Do you take insurance?

2. Do you bill the insurance company or provide me with reimbursement papers?

3. What is your hourly fee?

4. What is your practice model?

5. Are you comfortable working with individuals who have or have had cancer or other illnesses?

6. Are you familiar with how cancer and its treatments may impact my quality of life?

7. Do you work with individuals, families and couples of all ages?


Add your comment



  • Rosalie Weener said:
    2/12/2015 5:10 PM

    As an active group attendee, I have listened and shared experiences with living with breast cancer now part of my history. It is an ooen and secure environment to express how this has impacted our lives, side effects both physically and emotionally. I am able tonattend at tge same hospital where my caretakers are and feel tge continuity in my post treatment, it was imoortant, too, to be in a groupnwhike treatmment was in progress. Now I am active in tge group that is post treatment. Yesterday some group members shared dilemmas on post treatment meds and otgers close by who are ill. Tge changes that have impacted us.