I have had too many therapists to count, over the last 22 years. Some were more helpful than others.
Bottom line --
-- you usually (but not always) get what you pay for
-- insurance companies like to keep you on medication and out of therapy, even if it means you never make any progress and are caught in the same traps for years, getting more and more miserable
-- Therapy with the right therapist can be one of the most important investments you ever make
-- YOU are in control of the process. If you feel like your therapist doesn't "get" you, or doesn't feel right, then find another one.
Pardon the brain dump... It's not well-organized, but I hope it helps.
The trait in my current therapist that made my work with him so successful is that he is smarter than I am and he calls me on my own bullshit. For years I went to therapists (paid for by insurance) who were too willing to let me feel sorry for myself and had low expectations for me. They would tell me that it was okay to stay home from work if I was upset about having nightmares -- under the guise that it was "taking care of myself". I understand that there are times when going to work is not a good idea, like when I can't stop crying. But this approach wasn't helping me.
My current therapist really pushes me to be a person who has a rewarding life. That means I have to make myself go to work even if it means I take an Ativan first, and it means I don't get to feel sorry for myself. It took me a long time to understand the difference between feeling sorry for myself and doing constructive work with old feelings. At first I thought that any talk about things that upset me in the past is useless and feeling sorry for myself, but I found that it was necessary to understand why I feel so traumatized all of the time, and to understand that people at work aren't really going to attack me because they're not unreasonable. What
is feeling sorry for myself is complaining that things will never get better and no one will love me and I will end up like that hunched old lady that I saw in the grocery store... you probably get the idea. He won't listen to it, not for a minute.
When I found my current therapist and discovered that he didn't accept insurance and that I'd be on my own with submitting any claims and covering the difference between what they would pay and what the therapist charged, I was hesitant. This last round of therapy has been very expensive and at first (when I was stalled at work and not making much money) I was apprehensive about the cost, but it has been worth every penny. The end result of the last five years of therapy is that I am doing very well at work and in my personal life. I am on my way to stopping medication for the first time in 16 years.
My current therapist is also a psychiatrist, which means he prescribes my medication. I also believe that this has been crucial to my recovery. He has seen me on good days and bad days and everything in between, which is much more than I can say for the psychiatrists that I saw during the 15-minute med-check sessions where I would be asked if I was eating, sleeping, or having thoughts of harming myself. If my answers were yes-yes-no, I was on my way with more prescriptions. Any questions about whether I'd have to stay on the medication were met with a vehement "Yes!", and I think that in itself made me more depressed.
I thank my lucky stars that I made the decision I did and found the therapist that I did.
Suggested Reading: "Healing The Soul in the Age of the Brain" by Elio Frattarolli (
http://www.amazon.com/exec/obidos/tg/de ... 0140254897)