Finding the right therapist can involve almost as much energy and time as finding the right spouse. Instead of meeting for coffee, or appetizers and drinks, you’re spilling your guts to people you don't even know, trying to understand whether this process will help or not. If you don’t know what you’re looking for, the important work of therapy can be delayed by months or years.
Therapists are eager to tell you about things that aren’t directly related to your question of whether or not they can help you solve your problem. They will tell you where they went to school, where they were trained, what modalities they learned, what they researched, and so forth. Instead of asking for their resume, we recommend you ask these questions while also explaining why. So that you know that you are in the best of care.
1. My problem is _______. How would you go about treating that?
This is pretty straightforward. Of course, you have to know what your problem is, but even describing symptoms would help. “My problems are insomnia, worry, and anger outbursts. How would you treat that?” Hopefully the therapist's response will either resonate with your game plan or will make sense so you’re willing to adopt a new game plan. The most important thing is that therapists are able to describe their process in a way that you can understand it. If they present a flashy, jargon-filled approach that goes over your head, you can expect to feel similarly confused in therapy with them.
2. Do you tend to lead the session, or follow my lead?
Another key distinction is whether a therapist is “directive” or “non-directive,” which is fancy talk for a leader or follower. Some therapists have an agenda for your session before you sit down: The gameplay is set, and you're a passenger on this ride. Other therapists wait for you to set the agenda, either with a pre-determined topic or whatever comes up for you as soon as you sit down. Again, this is a matter of your personal style — directive appeals to some, while non-directive appeals to others.
3. What are your strengths as a therapist?
Not many clients ask this question, but we think they should. By asking, they’re inviting the therapist to make an honest appraisal of their strongest attributes, and at the same time asking them to point out what they believe are important therapist traits. If they say “my ability to earn fame and fortune,” well, you know what you’re getting into.
4. How do you think I'm doing?
After you've been to about three or four sessions, go ahead and ask your therapist how they think you're doing. This will give you both the chance to reflect on what you've talked about so far and any progress you've gained. It’s also a great way to spotlight any patterns that keep showing up. Knowing the repeat issues helps to initiate a course correction in therapy or a deeper dive into unresolved issues, which is important to get the most out of the sessions.
5. How do you think therapy can help me?
It is very important for all therapists to explain this concept to each individual. By understanding and truly believing in this process, you will have a better experience and likely see better outcomes. Therapists are professionally trained to work through a variety of issues and will use multiple different techniques throughout the course of a session. Although you may not know exactly when the techniques are occurring, it is important for clients to have a general understanding of how therapy will be helpful.
For example, a therapist might say that therapy will help the client by gaining insight and understanding into their interpersonal patterns will help change behaviors, or increasing one’s ability to recognize and alter negative thinking patterns.
Prior to starting therapy, a lot of people are unsure about this process and do not know what to expect. Additionally, many individuals hold misconceptions about therapy – such assuming the therapist will be “giving advice,” or believing that it is similar to speaking with a friend or loved one. This question can help address some of these beliefs.
If your therapist gives you an answer that is somewhat confusing, ask for clarification or for examples of what this might look like.
6. How should I prepare for sessions?
Therapy requires work inside and outside of sessions. For example, in cognitive behavioral therapy, the work outside of the session is fairly structured and often entails completing worksheets. Alternatively, in an insight-oriented approach, a therapist might simply ask you to bring awareness to your more intense emotions throughout the week and recognize the situation, as well as any relevant thoughts that occur at that time.
Asking this question at the beginning of the therapy process can be helpful for multiple reasons. First, it will give you an idea about your therapist’s expectations of you outside of session. If you feel as though these expectations are unreasonable or would add additional stress, you should absolutely communicate that, as there may be a way to modify this. Additionally, this question will help you understand how to get the most out of the therapeutic process and ideally, will help it be more successful.
7. How will I know if therapy is working?
This question is really important to ask, as it helps individuals understand the process of therapy and develop realistic expectations.
This answer will be different depending on one’s presenting concerns, as well as the therapist’s orientation. For example, when working with a cognitive behavioral therapist for anxiety, therapy is “working” when the individual feels more control over their anxiety and can effectively cope with symptoms. Alternatively, when working towards smoking cessation using a motivational interviewing approach, therapy is “working” when the individual feels more intrinsic motivation and confidence about this change. Lastly, if the therapist is coming from a psychodynamic perspective, the success of therapy may be more related to gaining insight and understanding.
Overall, this question helps to identify the potential changes you will see throughout this process.
8. Do you have a license to provide treatment for mental health concerns?
Ensuring that your provider has a license is incredibly important, as this certifies that the individual has the appropriate education, training, and experience to effectively provide clinical services. Additionally, in order to maintain a license, the provider must be in good standing with their governing board’s code of ethics. Requiring mental health professionals to have a license is a way to protect the general public from receiving services that are damaging or unethical; therefore, it is important to ensure your therapist has one.
That being said, navigating licensure within the field of mental health field can be quite confusing, as there are multiple types of licenses that enable a professional to deliver clinical services.
If you come across letters that you don’t recognize, we recommend that you ask your provider about their license and the governing board.
9. Have you worked with individuals that are experiencing similar concerns?
Although a license provides assurance that the professional can provide clinical services, it is important to ensure that this individual has experience that is consistent with your presenting concerns and therapeutic goals.
This question may be less relevant for individuals looking for support related to depression, anxiety, or relationship concerns, as these are fairly commonly seen within clinical practice. However, if you are looking for something more specific such as treatment addressing insomnia, obsessive-compulsive disorder, or substance-use disorders, it is recommended that you ensure your provider has experience with that population.
Fortunately, professionals are mandated by their code of ethics to remain within their realm of competence; therefore, providers should comment on whether they can help you or if you would be better served by a different provider. If your therapist has not mentioned this, we recommend that you ask this question.
We hope these questions help put you at ease as creating a strong client-therapist relationship is extremely important, This will also help you get more out of therapy since you'll be learning and digesting the information as you go. Don't ever be afraid to speak up.
Therapy is, after all, largely what you make of it. Your therapist plays a big part in that, of course. But it can also be helpful to ask questions, and make sure you're getting the most out of the experience.