HAMS: Harm Reduction for Alcohol

Finding a Good Therapist

There are all kinds of different schools of therapy out there ranging from purely Cognitive Behavioral (CBT) approaches which concentrate on action in the here and now to purely psychodynamic approaches which will explore your past history to mixtures of the two. All these different schools of therapy can be effective. Researchers on the topic of effective therapy have found that the most important factors seem to be the personality of the therapist and the fit of the client and the therapist.

If you find that your therapist bullies you and tries to force you into changing in ways which you do not want to change then it is likely that you are working with the wrong therapist. If your goal is harm reduction but your therapist insists on abstinence then it is also likely that you are working with the wrong therapist. Many therapists are very poorly educated about substance abuse issues and are not familiar with the research which demonstrates the effectiveness of harm reduction approaches. Many therapists are also misinformed about the religious nature of AA and all too often have been told to ignore their clients' objections to AA's religious content. If you encounter a therapist who wastes each session by trying to bully you into attending AA then we suggest that you run, not walk, in the opposite direction. Go find yourself another therapist.

A good therapist should be flexible and put the client's needs first. A good therapist should be attentive to what the client is saying. Sometimes therapy can be hard work and might delve into difficult issues. However, if every therapy session leaves you feeling emotionally abused then you probably have the wrong therapist.

You should feel free to shop around and talk to several therapists before picking the one you actually want to work with. After all, you would do this if you were renting an apartment or buying a car--how much more important to do so when hiring someone who will work on your mind.

In America there is no law that you have to be properly licensed or certified to put up a shingle and call yourself a therapist--anyone can do it. However, insurance companies will only pay for the services of properly licensed and certified therapists. We suggest that you ask if the therapist takes insurance. If the therapist does not take insurance then run, do not walk, in the other direction. In HAMS we believe that lay-led groups can be helpful--but we do not believe that lay leaders should charge a fee or call themselves therapists.

There are also many different kinds of therapists in the United States, ranging from MSW (Master of Social Work), MFT (Marriage and Family Therapist--usually a masters level degree), Chemical Dependency Counselor (CASAC, CADAC, etc--most of these have less than a masters degree), Psychologist (requires a PhD or PsyD), Psychiatrist (requires an MD), or Psychoanalyst (requires special psychoanalytic training). Any of these people can be a good therapist. If you require some sort of psychiatric medication such as an antidepressant or antianxiety drug then the odds are that the person who prescribes this will be different from the person with whom you are doing talk therapy. If this is the case then the prescriber and the talk therapist should be in touch with each other about what and how you are doing.

Please also visit our page The Alcohol Harm Reduction Therapist Finder to see if we know of a good therapist in your area.

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