How to know if you need therapy


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“I don’t know (or I’m not sure) if I need therapy”…  I hear this a lot- and understandably, when I speak with someone for the first time, it could be the first time they have talked to a therapist.  In fact, many people think about it for quite some time before they take the leap.

Why wouldn’t we know when we need help, or why would we be reluctant, you ask?  Well, first of all, stigma.  Historically it’s been “weak” to ask for help, much less to call a therapist (especially if you’re a guy).  Many of us were brought up to believe that we should be able to handle everything by ourselves, which of course we can’t always do.

But… it’s not weakness at all.  We all have our limits of what we can handle, and sometimes life throws more at us than even the strongest can manage.  Is it weak that you can’t fix your heart or kidneys by yourself?  Is it weak that you can’t heal a broken leg?  Then why the double standard when it comes to the brain?  I have never gotten that!

Another thing to think about is that we’re not all trained mental health professionals– so how could we possibly know all about mental health and how to manage certain issues or treat a potentially serious problem?  I have learned a bit about carpentry, electrical work, and auto mechanics over the years, but I have no problem admitting I don’t know it all, or calling in a professional for some assistance.  I can pretend I know all about cars, computers, or plumbing- but that’s not always going to turn out well.

A second reason, and the focus of this post, is that we don’t always know when we need help- or when something has crossed the threshold into a problem too big for us to handle alone.  Where exactly is the line? For some people this means a crisis, requiring immediate action.  For others, it might be a chronic issue they have either ignored or have not had success in handling (and they’re tired of spinning their wheels trying to do it their own way- or tired of other people suggesting they get help!).  While for others, it might just be something bothering them enough that they want to discuss it with someone else- a professional who specializes in these things, or just an unbiased person they don’t know who isn’t going to gossip all over town about it.

So how do you know if you need therapy?  Well, “need”, is a somewhat of a subjective term.  Let me start by defining what a disorder is (in the context of behavioral health).  Something becomes a disorder when it is distressing to the person, and/or it is impacting his or her functioning in important areas.  Common disorders include anxiety, depression, ADHD, or alcohol abuse.  We know when something is distressing to us, or bothering us so much that we have difficulty not thinking about it, and we know what things make us feel bad about ourselves of our lives.  In terms of impact, I’m referring to things like our relationships; our ability to go to work or school and do what we need to do there; our ability to function in the community without issues; or even our ability to take care of ourselves.  We don’t always see these things right away, and it might be difficult to admit, but most of us reach a point where we feel like one thing or another is too much.

It’s worth mentioning that all problems or issues exist on a continuum or a spectrum (as in the Autism “Spectrum”)- not only whether or not something qualifies as a disorder, but when it is a disorder, how severe is it (i.e. how much is it impacting the person’s life).  If a person has a more severe disorder, such as bipolar disorder, schizophrenia, or major depression, we might say the person has a serious mental illness (SMI).  And I will say that someone with a SMI or with another disorder that seriously impacts their life- for example, with symptoms like suicidal or homicidal thoughts; hallucinations; or that otherwise put themselves or others at any kind of risk, treatment is crucial.  And the best treatment may involve medication in addition to therapy.  Consulting with a professional would be very important.  But, there are plenty of less severe issues too.

As a professional, I will tell you that anyone with a diagnosable disorder, especially a severe one, could benefit from therapy.  As someone who values insight and having a variety of tools to cope with life’s challenges, I’ll tell you that anyone can benefit from therapy.  When it comes to insurance reimbursement; however, some diagnosable disorder is important in order to support “medical necessity” of therapy.  That can be a problem in today’s health care system, because there are plenty of life issues we could benefit from counseling for, but the good thing is that there are many recognized disorders, many not requiring the degree of difficulty or impairment that others might.  For example, an individual grieving from a death or loss might have a diagnosable mental health condition, or similarly, someone having difficulty adjusting to a life change, such as marriage, a new baby, a move, or even retirement.

The important thing, when deciding if you need or could benefit from therapy, is whether or not there is some issue that is bothering you to the extent that you might like to consult with a professional about it.  You could benefit from understanding the problem better, or learning new ways to cope with or manage it.  If so, it couldn’t hurt to find the right kind of professional, contact him or her, and seek their professional opinion.  He or she might provide a phone consultation, or perhaps you could schedule an initial appointment.  This gives you the chance to speak to someone who doesn’t know you, but has experience working with individuals with similar situations; and he or she should be able to give you some direction on what to do next.  This may or may not mean therapy, and if you do end up participating in therapy, it could be in a short or a long-term context.  This, of course, is dependent on the issue, as well as what you are looking for and the particular therapist’s approach.

So to recap, here are 3 things to think about if you are considering talking with a therapist:

  1. Is there a problem in your life that is bothering you that you have been unable to put out of your mind or resolve yourself?
  2. Is this problem impacting your functioning in some way?
  3. And, would it benefit me to understand the problem better or to learn some new ways of dealing with it?

If your answer to any of these is yes, get in touch with a therapist.  For more information on this, check out some of my other posts.  And if you want to find a referral, you can look here.  Take care!

– Dr. Matthews


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10 signs of an unhealthy relationship


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Relationships are something I see many clients for in my practice- individually and as couples.  More often people are reporting many unhealthy aspects of their relationships.  Some are well aware of it, while others may not be.  I thought I would talk about some of the signs of unhealthy relationships here- specifically, enmeshed relationships.  I’m not talking about relationships that are necessarily abusive (verbally, emotionally, physically, or sexually)- but relationships of an intense, addictive, or dependent nature.

Being a psychologist and somewhat of an expert on human development and healthy relationships, I wanted to discuss some common factors I regularly observe.  Alone, or more often in combination, these things suggest that a relationship is problematic.  A healthy life is balanced, where you spend enough time in different areas (at work or in school; with a partner; with family; with friends; doing hobbies; and so on) to feel happy and fulfilled.  And thus, a healthy relationship is one where you are with another person, but you have the space (and support) to continue to grow as an individual as well.

Certainly there are more, but here are 10 signs to consider (in no particular order):

1.You or your partner have no friends of your own (or they were kicked to the curb at some point in the relationship).

If you or your partner had no friends before getting together, or if either of you did, but you no longer spend time with them or don’t consider them friends (usually due to being constantly together), this suggests something may be missing from your lives.  It is healthy to maintain friendships, or to have some friends apart from mutual friends or those of your partner.  If you meet someone who has no friends or who says he or she doesn’t need any, I would ask myself why.

2.Your or your partner have no hobbies or interests (or these became less important or fell by the wayside at some point in the relationship).

Most of us want to be stimulated through talking to and spending time with people we find interesting.  I think hobbies and areas of interest certainly add to a person’s personality, and make a person seem like someone we might want to be around- whether or not we’re into those same things.  If you’re in a relationship with someone who has no interests, their only interest may be you- which would make it hard to spend any time doing the things you like.  You might also come to regard the person as boring, without much to talk about.

3.It is assumed that you will be together 24/7 (and forever).

“Absence makes the heart grow fonder”.  Ever heard that before?  I need not say more (but I will).  Healthy relationships aren’t only balanced, with time spent doing other things too, but when you’re not with someone 24/7, you have the chance to miss each other.  It’s kind of nice to anticipate your next date or time you will hang out, right?  On the other hand, when it’s predictable, this can get boring.  And if it’s expected that you will always be together, you may feel resentful or guilty for seeking alone time or time with friends or family.  And is there frequently talk of being together “forever”?  When you’re not married or in a long-term (multiple year) relationship, it’s nice to talk about being together “forever”, but ultimately it takes both parties to determine that.  In high school or college it’s cute to say that, but probably not constantly.

4.Your happiness is entirely based on the other’s.

This one is very important.  If you are in a relationship with someone, you certainly play a role in their happiness.  But- you need to think of your own as well.  If your partner is having a bad day, or for some reason is just in a crabby mood, it doesn’t mean you have to. What if he or she is upset with you for a ridiculous reason- or something that is not at all your fault?  In a healthy (equal) relationship, you might let the person know that, then go about your business.  Ultimately, he or she should come around later and apologize.  But if you let other people govern how you feel, or if you decide you can’t be ok unless someone else is ok, then you’re setting yourself up for misery.  Oh, and also, some people (i.e. abusers) will be happy to take advantage of that.

5.You do (or do not do) things out of guilt.

Guilt should not be the primary motivator for any decision you make.  Sure, we do things when our parents make us feel guilty- or a friend, partner, or our conscience… I’m not talking about that.  But when you do things like- stay with a person because you feel guilty; avoid hanging out with friends or pursuing hobbies because you feel guilty; or avoid communicating something to your partner because you feel guilty- then, that’s a problem.  If your partner truly cares about you and not only him or herself, then he or she will understand- even if the initial reaction is not positive.  You have a right to express how you feel and to do things you want to do (provided you are not hurting the other person somehow).

6.You find yourself resenting or hating the other person.

When relationships with any of what I’ve discussed so far go on long enough, this is how you come to feel.  You resent the person for not “letting you” hang out with friends, for not having any time to yourself, or for wanting to be with you every waking moment.  Sometimes the sight of the person repulses you.  And this is certainly not how a partner should make you feel.

7.You wish the other person would just break up with you.

See #6.  When you start to feel that way, and as in #5 you would feel guilty breaking up with the person, you would love to have a way out- especially an easy one like the person just breaking up with you.  It’s unlikely, though, so chances are you will have to assert yourself and talk about how you feel.  The sooner you do this (and hopefully before you’re thinking of breaking up) the better!

8.You feel like you have lost yourself or your identity.

If you feel like you don’t know yourself anymore, or you have difficulty remembering what you like or are into, or who you were before you were in your relationship, then chances are you are in an unhealthy relationship.  Either you forgot about it, by devoting 100% of your attention to your partner, or perhaps you’ve changed your identity somehow so your partner would like you more?  Not healthy, nor is this sustainable.  Ultimately you will be unhappy.

9.You hold yourself back from doing things you want to do or pursuing dreams.

Are there things you have wanted to do, but haven’t because you felt your partner wouldn’t approve, or it would conflict with his or her agenda?  Are there goals or dreams you find yourself not to be pursuing- or not pursuing in the same manner that you would have been before?  If so, you might ask yourself why.  For example, if you are into golf and used to go even once a week, but you find yourself not doing this at all, you might not like this.  Or, if you are applying to colleges, but find yourself only applying to colleges your boy or girlfriend is applying to, then you might feel resentful about this too.

10.The relationship starts to feel more like a burden than something that adds to your life.

Human beings have an inherent desire/need to be close to others.  In our society we date, live together, or get married.  The goal is to add something to our lives that would otherwise be missing- but definitely not to take away who we were before.  And so a relationship is something that should make you feel good.  Yes, relationships are work, but if they are only work, and the positives start to be few and far in between, then you need to ask yourself if it’s worth it.

These 10 things are definitely not the only signs of an unhealthy relationship, but they are certainly things to think about.  If you aren’t in a relationship, take these as red flags, should you meet someone in the future.  If you are in a relationship, then think about what is and is not going well.  If any of this sounds familiar, I would recommend doing some reading on assertiveness or healthy relationships.  And if you decide professional help could be useful, I would recommend contacting a psychologist or another type of therapist.  You could find a referral here.

And here are a few additional resources:

Take care!


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Do just one thing…


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I speak with people all of the time, frustrated with themselves for being unable to make a change, or unable to stick to anything to get the results they want.  Sure, life gets busy, or things happen, or our motivation waxes and wanes.  Or maybe the actions we need to take are too hard, it’s not the right time, or we decide change isn’t that important.

Whatever the case, we usually end up feeling bad.  There’s at least one reason for this.  Our society teaches us that everything is a dichotomy: good or bad, perfect or flawed, sane or crazy, and so on.  Turn on the TV or go online and you’ll see this.  And when it comes to improving our lives, if we’re not winning, we’re losing- or, if we’re not perfect, we’re failing.  For many people, they get up the motivation to do something, form a plan, and get going.  And sometimes things go well for a while- and you feel good.  Maybe you lose a few pounds, get some things done, or you start thinking more positively.  But then, something happens, you slip up, or you stop being perfect- and boom!  You’ve failed.  And not only that, YOU are a failure!  We feel bad about ourselves, decide we’ll never be able to change, or we don’t care anymore- until we then get motivated again.  And so the cycle goes on.  But until you can learn to think more flexibly, this is going to continue to be a problem.

In school, most people think of a 70, 80, or a 90% as a good grade- especially on a hard test or in a hard class.  But in our own lives, we’ve decided that anything less than 100% is a failure- and that’s a tough standard to live by!  100% is unrealistic, or at least not sustainable in the long run.

If you want to end the cycle, you need to have not only realistic goals (learn about SMART goals here, or check out some of my other posts), but you need a realistic plan.  This means being able to tolerate being less than perfect, avoiding specific pitfalls, and being able to recover (and quickly) from setbacks.

One strategy you might use is to do just one thing, as noted in the title of this post.  This can help you to get started if you’re having trouble, and it can set a realistic goal at least in the short-term.  If your goal is to lose weight, be sure to exercise today or to track what you’ve eaten.  If you can do both, great- but in this way, you will have done one thing today to work toward your goal.  So if you’ve exercised, but maybe you didn’t eat well today, you can say, “Ok, well I did exercise today.  And I’ll do it again tomorrow”.  If you give yourself permission to do just one thing, then you’re not allowed to be angry or upset that you didn’t do more.  But if you did, then that’s a bonus!  The idea is then to continue doing this, until you feel comfortable adding something else.  And you can do this in two different ways- either start with the thing that’s easiest, so as to build some momentum; or, you can work on the biggest priority first, provided it’s not too difficult.  Take it a step at a time, and you’ll likely have much greater success than if you try to do too much at once.  I usually use weight loss or leading a healthier lifestyle as examples, since they’re near universal- but this strategy and others I discuss can apply to just about anything.

Dichotomies are rarely a good thing, and I find that in therapy most people need to learn to recognize- and accept, that there are a lot of gray areas- and to be there is totally ok.  You’re on the right track.  And if you’re doing just one thing today, chances are that’s 100% more than you did yesterday- and that’s a step in the right direction.

As always, if you find this difficult, or if you’ve had limited success on your own, try contacting a professional.  A psychologist or another type of therapist can help you to address your challenges and get on the path to success.  Click here to find a referral.

Take care,

Dr. Jesse Matthews







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Do you REALLY want what you say you do?

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You might say, “What kind of question is that?”  It’s a serious one, though.  We all want things, and we all say we have goals, but how clear is our picture of what these are- and how do we get there?  It’s hard to get somewhere if you don’t know.

And what are we really doing about it?  My wife often quotes me as saying, “Are you willing to do what it takes?”  You need to know what to do- and then you have to do it.  And that’s the raw truth.  Anything worth accomplishing isn’t easy.  It takes work- and a consistent effort, to make it happen.

To get to the point of this post, I wanted to talk about 4 related concepts: vision; goals; a plan; and execution.  These aren’t new, but they’re worth thinking about in order to clarify what you want, know what it takes to get there, how you get there, and then what you have to do to make it happen.  Without all 4, I would tell you that the answer to the question in the title is “No”.  And I’m serious.  So here goes…

1. Vision: We all should have some vision of where we see ourselves in 5 years, 10 years, and so on.  What does life look like?  What do you see yourself doing?  What do you want to be doing?  Most of us have some vision of the future, but it’s a good idea to spend some time thinking about it and to try to make it more specific.

Ask yourself the following questions: How does this fit with my beliefs, morals, or worldview?  Is this likely to be fulfilling?  Is this what I want, or what someone else wants for me?  You may ask yourself different questions, but it’s important to be able to articulate your vision as much as possible and that you be true to yourself in creating it.  And it’s ok if it changes over time- that’s to be expected.

Many people confuse a vision with goals, but they are not actually the same thing.  And some people don’t really have a vision.  Their vision is vague, like “be happy” or “be successful”, or they’re ok with just letting life happen to them…”everything will work out”.

2. Goals: Keeping in line with your vision, what are your goals?  What are some specific things you would like to accomplish?  What will it take to achieve my vision?  Your vision will likely include several goals- short and long-term.

Long-term goals might include: getting a degree; having a career; owning a home; getting married; or having children.  Short-term goals may be: getting into a particular college; getting A’s and B’s for the marking period; getting a desired SAT score; sleeping more; getting a better job; or finding a date.  The difference between short and long-term (you guessed it) has mostly to do with how long they take to accomplish.  This post has more to do with achieving long-term goals, although these are not achievable without short-term goals.  For example, if your long-term goal is to graduate from college, you might have short-term goals of registering for classes; paying tuition; getting enough sleep; going to your classes; doing class readings; and studying for tests (among others).

Some people don’t have goals, while others would say they do, but could not articulate them if asked.  And others’ goals are just too vague.  Whatever the case, the chance for success is low.  I would encourage anyone to have at least 1 long-term goal and at least 2 to 3 short-term goals they’re currently working on.  For a primer on how to set goals, check out this post.

3. Plan: A vision and goals are great, but you can’t stop there.  What exactly are you going to do?

Take this example… I live in Pennsylvania.  If I want to get to Seattle or San Diego I can jump in my car and start driving west.  I could end up in either place, but I could also end up somewhere else.  And that may or may not be anywhere I want to go.  But with a plan- a well-thought out, comprehensive one, I know I could get wherever I want to.  A plan may not prevent every possible setback (to keep with this example- running out of money, a flat tire, blown up engine, or injury), but it can help you to prepare for setbacks, deal with them, overcome them, and continue on your way.  A plan outlines the steps necessary to accomplish your goals and achieve your vision.

Many people don’t have a plan.  They may have a vision and even an idea of goals, but no plan.  Sure, goals sound good, but without a plan, you’re not likely to get any farther.

4. Execution: Simply, this is what you DO.  Using your plan, you take the steps and exert the amount of effort necessary to reach your goals and realize your vision.  And to make this possible, you do this consistently, every day.  To quote my wife quoting me again, the question is, “Are you willing to do what it takes?”  If you are, and you have a vision, goals, and a plan, this is where execution comes into play.  If you really want what you say you do, then you’ll make the commitment and do the work necessary.  If you don’t, it’s unlikely you’ll execute, at least with any consistency.

This is certainly not to put anyone down or to criticize anyone’s motivation.  You certainly are the best judge of whether you really want something or not.  On the contrary, my goal here is to have people think about these concepts, so when they do have something they hope to accomplish, they will be better-situated for success.  It’s critical to think about this and to be honest with yourself.  And are there any things holding you back?  There may very well be- either things you’re doing or not doing, circumstances you’re up against, or even people who are not supportive or even detrimental to your success.  All important to thin about.

If you find that any part of this is difficult or that you are not accomplishing your goals or getting to the place you want to get to, perhaps a professional can help.  Consider contacting a psychologist.  For a referral, click here.

Take care,

Dr. Jesse Matthews






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The joy of long-term goals


On May 1st, 2016 I ran the Pittsburgh Marathon.  I had never run one before, and a year ago I had no desire to.  I played sports and was always active as a kid, but I never got into running until college.  I’ve been on and off with it, though, running much more in good weather than in the winter.  It was always a means to an end, though- to lose weight and to feel better.  I liked it at times, but considered it something I had to do.  I still run for the same reasons, but last spring (2015) I just really started to enjoy it.  I work inside and spend a lot of my day sitting, doing paperwork, and staring at a computer.  I’m more of an outside person, though, so running means time I get to spend in the outdoors, as well a great way to get exercise.

So I signed up for a half marathon last July.  I did well and it was fun.  I kept running, and after watching a recap of the 2015 Pittsburgh Marathon, I decided not only could I probably run a marathon, but I wanted to run that one.  Pitt is my alma mater, so I had a chance to live in Pittsburgh for a few years.  I love it there, and I enjoy any chance I get to go back.

Why am I telling you this?  Well, first, this post isn’t really about running.  Some people like it, some don’t, and I’m not here to get anyone into it or to change anyone’s mind.  But, other than going to college and grad school, this was a really difficult goal and one that took me a long time to accomplish.  But I ran steadily through winter this year (a first), 4 to 6 days a week, although I didn’t technically start training until February.  It got easier as time went on, but it was still hard!  And the hardest part wasn’t the running, but planning and finding the time.

As the title suggests, this post is about long-term goals.  Just what constitutes a long-term goal?  Well “long-term” varies from person to person, but simply put, these cannot be accomplished overnight.  A long-term goal could take a month (losing 5-10 lbs), a year (successfully changing your diet or sleep schedule), or even a number of years (getting a degree or starting a successful business).  Long-term goals require a sustained effort, which is hard to do.  Things get in our way, motivation waxes and wanes, or maybe we just lose interest.

Long-term goals have a few things in common, though: they give us direction; a sense of purpose; help us understand potential roadblocks and our own unhelpful behaviors; they can have a long-term positive impact; and they help us to see the big picture.  Unlike dreams or wishes, long-term goals are more concrete and specific.  A long-term goal can be described as a roadmap.  Without one, we could just be wandering through our lives, right?

Here are a few examples of long-term goals:

  • Train for and run a marathon that takes place on X date
  • Lose or gain 20 lbs
  • Save $5,000 for a trip to Europe
  • Get a master’s degree
  • Write a book
  • Get cholesterol to a healthier level

Although these contain different levels of specificity, none could be accomplished overnight, they would all require sustained effort and self-discipline, and there would be a defined cut-off for when the goal is achieved.  On the contrary, here are a few goals that might be more difficult:

  • Get rich
  • Get skinny
  • Be happy
  • Be the best at _______

You get the point.  There would be nothing wrong with striving for any of these, though they’re vague and it would be hard to know when we’ve had any success, let alone completed the goal.  And “be happy” for instance, is more of a process than a point we would be able to get to.

Back to my story about the marathon.  I think it accomplished a lot of things for me.  Of course I completed the race- and even met my goal of the time I wanted, but more than that I proved to myself that I could work toward a difficult physical goal and accomplish it.  Side benefits were that it made me think more about my health and forming some better habits, and through the process I came to love running even more.  I have no plans to run another marathon anytime soon, but I have continued running, and having achieved this it makes me think about what else I might do.  Hopefully I can apply that same level of discipline to other areas of my life and work toward something else.  I think formulating a goal and working on it over a period of time is a great exercise in self-discipline, self-reflection, and in getting to know yourself better.

I encourage you to think of a long-term goal, or to be more specific about one you have had in mind.  Not only might you have more success, but it really could change your life.  And if this is something that has been a struggle for you, perhaps the help of a professional could get you going.  Click here or here for a referral.

Take care!

Dr. Matthews

If you want some resources or more information on goal-setting, check these out:






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“We all want the same things, for pretty much the same reasons”

This is a phrase I use from time to time, whenever I feel myself getting caught up in other people’s emotions or annoyed by their behavior.  I read it in an article on the subject, which essentially talked about having compassion for others- even when it might be hard to do so.  In a time marked by a seemingly never-ending stream of anger and hate, and when everyone feels not only entitled- but obligated to share his or her opinions, I find this kind of phrase really useful.

In my work with clients I sometimes refer to this as a grounding phrase.  This concept is nothing new, as I think a lot of people have mottos or mantras that they try to live by.  I call it a grounding phrase because it can do just that- bring us back to Earth, grounding us in the here and now or reminding us of what’s really important.  And I like this one in particular, because I find myself either spending too much time reading about ideas and stances I don’t particularly agree with, and feeling baffled about how anyone can think like that.  And further, I sometimes feel compelled to counter these with my own ideas or something that, in my mind, would prove them wrong.

But, of course, I know three things here: 1) this will never work, because people are invested in their ways of thinking and it would take a lot more than simple logic or even data to change their minds; 2) I have no more right than they do to share my own opinions and spread them wherever; and 3) we all want the same things, we just may have different ideas about how to get them.  Maslow’s Hierarchy of Needs comes to mind here, which, if you’re not familiar with it, is a model discussing 5 levels of basic human needs.  My point is that as humans we all have these needs, even though our ideas about what they mean and how to achieve them may be vastly different.

This is not to oversimplify some important nuances- for example, some may believe that for them to be happy, they need transgendered people to be legally barred from using certain bathrooms.  Or others assert that you must believe in a certain religion- and only that religion- if you are to be happy or to live a life that is meaningful.  But this post is also not about politics- or religion, or any other hot button issue.  As another example, some people believe that buying things is the key to being happy, while others prefer to save all of the money that they can.  The point is that when we avoid getting swept up in our emotions and can successfully bring ourselves back to the important things about life, we’re much better off.

I understand that people feel differently about “inspirational quotes”.  Some love them, read them all of the time, post about them, or live by them- while others think they’re corny.  Whatever your position, I suggest you find at least one that resonates with you and that can serve as a reminder to you- about who you are, who you want to be, or what is important to you.  Keeping this in mind can help to keep you grounded, which is something we all need.

And as always, if this is something that’s really difficult for you, or if you find yourself often feeling angry, sad, or frustrated by others, you might find it helpful to talk to a professional like a psychologist.  Although this is serious, I actually bought a shirt a while back, seen here:


image courtesy of:  

Very true statement indeed…  If you would like a referral, you can click here or here.

Take care!

Dr. Matthews

Posted in For Professionals, For the Public, Helpful Resources, Psychological Concerns and Treatment, Uncategorized | Tagged , , , , | Leave a comment

How to Choose a Therapist

Photo courtesy of stockimages/

Photo courtesy of stockimages/

Since I have been a therapist for a number of years now, I have often been the first therapist a person has seen.  Other times I’ve heard about people’s difficulties and frustrations in finding the right therapist.  And since a certain match and the right expertise are essential, I may not always be the best therapist for some people.  So I thought I would put together a short list of things to look for in your search.  These may not be the only factors, but I believe they are some of the most important.

1.Cost.  It’s true that therapy is an investment in yourself, so it’s likely to pay dividends in the long run that you just can’t put a price on.  Still, the reality is that not anyone can afford to see just any therapist.  Some take insurance, while some do not.  Some take your insurance (are in-network with) and some do not (are out-of-network).  And some insurance plans offer out-of-network benefits and some do not.  So, when it comes to cost, here are some factors to look at:

  • Do you need to use health insurance?  If so, is the person you’re considering in the network (which means lower cost to you)?  And do you have mental health benefits and do you know what they cover?  For example, is there a deductible you need to meet first, or do you simply pay a flat copay or percentage of the visit?  If the person is out-of-network, will your insurance cover any of the cost?  Call your insurance company to get the answers if this is important to you.  Though a potential therapist can look into this ahead of time, it’s up to you to be informed so there are no surprises later.
  • What are the therapist’s fees for the services you are looking for?  How often might you need appointments?  If you can’t afford it, does the therapist have any flexibility in those fees?
  • Do you have a Health Spending Account (HSA) or Flex Spending Account (FSA) that could help pay for your services?

2. Was the person recommended to you?  Oftentimes I’m recommended to a potential client by another therapist or another professional like a physician, school counselor, or staff at a treatment center (i.e. hospital or rehab).  I may also get a recommendation by a friend or family member.  If a particular person was recommended to you by someone you know and trust, often this carries a lot of weight.  This person knows you and/or your situation, so he or she is in a position to offer names of people who could help.

3. Do you need an expert?  Most therapists work with common issues like depression or anxiety, often with people of various ages.  But if you’re looking for someone who specializes in working with young children, older adults, LGBT individuals- or with particular issues like trauma, OCD, or substance abuse, it may be important to find someone who specializes in that area.  If you’re searching online, looks for words like “expert”, “expertise”, “specialty”, or “specializes in”.  Although this may not always be accurate, most often it indicates that the person has particular knowledge and experience in a certain area.  If you want to be sure, ask.  Most therapists would not claim to be an expert in something they’re not- and if they’re not the person you’re looking for, most should be able to help you find someone who is.  If you don’t need an expert necessarily, you might be ok to look at other factors in your choice.

4. Face value.  Does this person look like he or she would be a good fit for you?  Nowadays pretty much every therapist has a website or a profile on a Web directory (Psychology Today is one of the most popular).  Websites and directories may include a personal statement by the individual, the populations and areas they work with, and of course information on their location, how to contact them, and what methods of payment they accept.  They even have photos!  So you can use this information to get a general idea of what kind of therapist this person is and whether or not you might be able connect with them.  It would be worth a try to contact them and ask a few questions to see if it might work.

5. The first visit- or the second or third.  Of course sitting in the room with the person, talking with him or her, and seeing if there is a connection is the best indicator of whether it’s going to be a good match or not.  I know this sounds like dating or something, but it is crucial that you feel a good (or at least a good enough) connection with your therapist.  You need to feel heard, to feel like you’re not being judged, and to feel comfortable enough to say just about anything, much less disclose private details of your life.  Of course, this may not happen in the first session- particularly if the therapist is more focused on getting paperwork completed and gathering information during an initial session than usual.  But by the second or third meeting you should know if this is the right person or not.  If not, don’t feel bad about telling the person you want to check into some other therapists.  Even ask for some referrals if you like.  A good therapist should also be a professional, so their feelings should not be hurt by you saying it’s not a good fit.  And whether they are or not, therapy is a service you’re paying for, so you deserve to feel good about it.

2 bonus factors…

6. Location.  The person you see is important, so hopefully you’re not basing your choice solely on the fact that you can walk to the therapist’s office.  However, in reality this may be important.  You might be going close to home or close to your work or school, which of course would be preferable to driving 40 miles out of your way.  If this happens, great, but at times traveling a little farther might be necessary- especially if you live in a rural area, need an expert, or just want to see a certain person.

7. Hours.  Obviously, this is important too.  Most therapists have at least some evening hours, since that’s what most people who work or go to school need.  Some even offer weekend hours.  If you have limited availability it might be harder to find someone, so the more flexible you can be the better.  I see a lot of people at night, but it’s not uncommon to see adults before or after work, or even on their lunch break.  And though I typically see kids after school or in the evening, at times I need to see them before school or at some other point in the day.

If you’ve never looked for a therapist or you have found the process to be frustrating or daunting, I hope this list will give you something to go on.  Sometimes people see one therapist and have a negative experience, so they give up- either because they don’t want to try again, or because they assume all therapists are the same.  I tell people, “If you went to a new hair stylist and got a bad haircut, would you give up haircuts?”  Or, “If you went to one mechanic and felt like he didn’t do a good job, would you stop getting your car worked on?”  I know therapy is different, but the same premise remains.  I encourage you to be thoughtful in your search and not to get discouraged if it takes some time to find the right person.  This is common, but hopefully you will find a good match without much trouble.

All the best,

Dr. Matthews

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