If you feel you are suffering from bipolar disorder or some other specific disorder, how do you find a therapist or psychiatrist who specializes in working with people like you? How would you know if they use behavior therapy or something else?

B.A.

The best route to finding a therapist or psychiatrist who specializes in what you think you might have is to ask several different sources for referrals, and contact several of those recommended professionals by phone to make sure they have expertise in the condition. You can also ask what kinds of therapy or treatment they use, and/or specifically ask about any therapy or modality in which you're particularly interested. (Or any approach in which you're NOT interested.)

To get such initial recommendations, you can call your state or local affiliate of the Mental Health Association, or your state's psychiatric or psychological association, or the psychology department of your nearest college or university, or even your primary care physician. If there's a national, state or local advocacy organization for the particular disorder (such as the Sidran Foundation for dissociative and traumatic stress disorders), contact them and ask for referrals or recommendations. (You can often find such organizations by conducting a search online.) Your local community mental health center may also be able to suggest people to call. If all else fails, you can go through the phone directory of the nearest city and call the organizations listed under psychology and psychiatry to ask for recommendations.

You have a right to know the training, expertise and therapeutic approaches used by any mental health professional with whom you are considering working. You can even "interview" them to see whether you feel they would be a good fit for you. Even a busy clinician may be able to spend five minutes on the phone letting you know whether or not they have expertise in a certain area or use certain therapies. If you want a more in-depth conversation or interview, or to meet with the clinician face-to-face to get a sense of whether he or she would be a good match for you personality-wise, you may need to schedule an appointment and pay the clinician's fee for the time reserved. But it may be worth YOUR time (and money) to do so, as the nature of the relationship between client and therapist has in some research been found to be more important to the outcome than the type of therapy employed.

If you have insurance and want to use it to cover part of the costs of your treatment, you can also call your insurance company (or, as is most often the case these days, the managed care company that oversees mental health benefits) and ask for a referral to a therapist who has that particular expertise. (Check your insurance ID card or, if necessary, the written policy/benefits description that came with the insurance plan to find the phone number to call.) Keep in mind, though, that managed care companies try to curtail costs by limiting the amount and type of treatment they authorize, and their treatment protocols often recommend psychiatric medication instead of psychotherapy. Without psychotherapy, however, troubled or ill individuals may not be able to learn important coping skills to reduce their distress independent of medication. Insurance and managed care companies also tend to share information about patients' diagnoses, treatment and medications with the Medical Information Bureau, which serves as a clearinghouse on patient information for insurance companies. (I'm not sure to what other uses such information might also be put.) In short, you have far more choice and control over your mental health care if you're willing (and able) to pay for it yourself rather than involving insurance or managed care.