I am going to a therapist for the first time. Are there any questions I should ask? What should I look for in a therapist?
(Column: Ask the Therapist)
Therapy for the First Time
The first questions to ask are those you ask yourself. Did you feel comfortable? Did you like the way you felt in the office? Did you like the way you were treated? Are you looking forward to coming back? Did you feel helped? Did you feel "lighter" when you left?
If you were able to answer all those questions positively-even if you cried your eyes out, even if you know there is lots of hard work ahead of you-then you are in the right place to start. What questions should you have for the therapist? I suppose that there are the usual questions about credentials though the answers to these questions may not tell you very much. New York State licenses certain professionals to provide psychotherapy. Licensing tells you that the person has a certain amount of education, supervision and practice experience. It also tells you that s/he has a license to protect if anything goes wrong, and probably has malpractice insurance. The license generally allows the practitioner to be a provider for insurance companies. Nonetheless, unlicensed practitioners may be well-regarded, highly experienced psychotherapists. Whether licensed or not, it is entirely acceptable to ask the therapist for references from other clients and for you to call those clients and ask about their experiences.
How do you judge experience? We tend to think that experience improves skill. Certainly length of time in practice increases the number of experiences that a psychotherapist has with a variety of clients, cases and diagnoses. But experience is not everything-often a "young" therapist brings a freshness to the work that is as important as length of service. Generally, psychotherapists working in private practice (as compared to clinic-based practices) tend to work with less severely ill individuals (or should) because they have few resources available in case of crises. If you are interested in trying medication, or have been using medication, ask if your psychotherapist works with a psychiatrist who will collaborate with your psychotherapist. Ask if your psychotherapist "believes" in medication.
Psychotherapists' "beliefs" are an important part of treatment. Psychotherapists come from different backgrounds. Their training shapes the ideas that they bring into the session. Very few of us are classic Freudians anymore. Ask your therapist to describe what s/he sees as the core tenets of practice-what things would never be included and what would always be included. If your therapist is opposed to the use of medication, you are entitled to be aware of this. I have known therapists who will not assist a patient with an SSI application. I know therapists who believe that patients must find the way back to core religious beliefs. Whatever the core beliefs or principles are, your therapist should be able to articulate them for you and explain why they are important-in general, and for you.
At the heart of psychotherapy is the relationship between the patient and the therapist. This is an opportunity to have a corrective experience-to work out something in your life that didn't go well before and get it right this time. If it feels like this corrective experience could happen with this therapist, then all is well.