lazyweb: Helpful Interview Qs for a New Therapist

[jesse_the_k]

My mental health therapist is retiring. In the next few weeks I'm scheduled for "brief consults" with possible successors.

I've got a couple questions prepared, and I'd love to know what I don't know to ask.

Have you interviewed therapists? Was there a question/comment which proved useful (or harmful)?

Comments

[otter]

I have interviewed several, and passed on some. I'll think and come back to this. Please feel free to nudge me.

[otter]

* Is their conversation style in line with your needs? I do better with someone who goes back and forth with me, rather than hm-mms along with whatever I say.
* Do they have a religious background/inclination that is objectionable to you? Are they able to set it aside in order to work with you?
* Do they work with other people who are (name-that-tune)? In my case, autistic is a significant thing, as is CPTSD.
* Do they have a trauma-informed practice?

I had a medical pracitioner (I think it was integrative medicine) who said it felt like I was putting them through a job interview, and objected to it. I didn't hire them to be part of my care team.

[jesse_the_k]

Very helpful, thanks!

(Good call on the "job interview" person. Later to someone who doesn't want to be taken seriously.)

[otter]

I think the "job interview" person was more of a mind that it was up to her if SHE accepted ME as a patient.

[sheafrotherdon]

I started with a new therapist not long ago. I was quick to tell her a potted history of my greatest hits (so to speak) so that she knew what level to kick in at.

I'm so grateful

[jesse_the_k]

that my retiring therapist was able to spend a session talking me through the handover. I came up with a 600-word things I'm proud to have learned for my initial contact--including "how would you work on dialing back my hypervigilant startle reflex."

Re: I'm so grateful

[otter]

I can say from experience that toning down that startle reflex leaves room for other sensory experiences, thoughts and feelings.

Re: I'm so grateful

[jesse_the_k]

I'm hoping!

Re: I'm so grateful

[sheafrotherdon]

Oh, how wonderful! What a thoughtful transitioning!

Re: I'm so grateful

[jesse_the_k]

Yeah, she's ... tears up a little ... our therapeutic relationship is something I'll treasure.

Re: I'm so grateful

[sheafrotherdon]

I'm so sorry it has to come to a close. That's a big loss.

Re: I'm so grateful

[jesse_the_k]

Yes, yes it is. And I also know I've learned so much from our work together.

[adrian_turtle]

I'm sure you are leading with a question about ableism. You might also want to ask a what-if or recent example of when you wanted to do something but covid precautions (or some food sensitivity that doesn't cause immediate anaphylactic shock) stopped you. See if the therapist regards it as a problem of your anxiety or obsessiveness, or as a problem of perfectly reasonable frustration that needs coping skills. Some therapists see the objective is obviously to stop worrying about covid and stop masking. Others see it as getting more comfortable being the only weirdo at the party wearing a mask, or finding different parties to go to.

I don't recall if this is of immediate concern to you, but you may want to ask what they think of the pervasive pressure to lose weight?

Thanks

[jesse_the_k]

These are excellent points.

My retiring therapist disclosed their ADHD within the first three sessions, which added a lovely aura of access intimacy to our work.

Right now my planned first question is "do you have lived experience with disability?" I'm hoping their reaction will be informative.

Re: Thanks

[adrian_turtle]

Access intimacy is a new concept for me. It's not clear to me that my interaction with another disabled person will have an aura of access intimacy; some people with disabilities have a lot of internalized ableism. As far as I can tell, they used to teach it in medical school. It's the attitude, not just the experience. I may be misunderstanding, as the concept is new to me.

Re: Thanks

[jesse_the_k]

I think you've got it right. Ableism is certainly front and center in the medical school curriculum!

I've been fortunate to know some people where it's easy and safe to be my whole self, including my impairments and my experiences with ableism. Some of them are disabled and others not. I could breathe easier because my therapist made it clear she understood the frustration of being mis-seen, the challenge of creating workarounds and the structural inequalities that makes them necessary.

There are definitely nondisabled people who offer support without strings, without fuss, without needing to score good person points. I've also encountered disabled people deeply invested in performing independence, hyper-competence, and separation from the category of disability.

[pauraque]

A question I've learned to ask is "what schools of therapy do you use/are you trained in?" Even if you're not familiar with all the ones they mention, the key thing is they should mention more than one, and you should be able to establish that they use the techniques that work best for each client rather than trying to crowbar everyone into their one pet theoretical framework.

I hope you find someone great!

[seascribble]

I like this question! When I've asked it, especially for couple's counselling, they gave a brief little explainer of each methodology so that I could look more into it after the call to see how it felt, which is very useful.

Fingers crossed for few interviews and good fits!

Thanks

[jesse_the_k]

These answers are doubling my confidence.

Thanks!

[jesse_the_k]

Crowbar avoidance is crucial.

[soc_puppet]

Here's a thing I reblogged on Tumblr a while back that you might find useful. There's not a lot there, but it might be a good starting point.

[sonia]

What a great article, thanks for the link!

Wow!

[jesse_the_k]

That's a fabulous thread. Thanks so much.

[sonia]

Oof, I'm sorry to hear you're losing a helpful therapist. That's a big loss. Best wishes for finding a new person that's helpful.

If I'm seeing someone in person, I have to go through the whole thing about fragrance-free. For therapists, I like to find out where they keep their notes. Just about everyone keeps them "in the cloud" or "on an app" - i.e. on someone else's computer, vulnerable to security breaches. This is one of the reasons I don't have a therapist. These days you also have to ask if they're using "AI" to take notes - this would be a hard no for me, as it's environmentally gross, highly inaccurate, and *also* a security issue.

I like to find out if they're collaborative or directive. Most of them have a strong agenda, which ends up feeling controlling to me, which is another reason I don't have a therapist.

I go through some version of the "not a starter client" speech. I let them know I've done a whole lot of work on my stuff, and tried all the easy interventions. More for bodywork, but also for therapists, I tell them my system is really sensitive, and less is often better than more.

Oh, thanks so much

[jesse_the_k]

...for your sympathy and your suggestions.

AI to take notes! Yikes. That never even occurred to me, and basically seems incompatible with a therapeutic relationship.

Oh yes, fragrance-freedom has been a big challenge for me as well. I managed to learn some useful things in the 8 months I spent behind an N95 in solo and group sessions, but I couldn't feel completely present. One plus about telemedicine is lowering that barrier, yet the magic of two humans in the same room is not captured in a video call.

tried the easy interventions, my system is really sensitive

Great points to make -- there's a reason we're here together <3.

Re: Oh, thanks so much

[sonia]

Fist bump of solidarity! <3 And good point about access intimacy above - that might put words to some of the discomfort I’ve had.

You’re right, I would hope therapists wouldn’t use AI, but doctors do now, with a minimal one-time request for “consent to use scribe.” Especially with video calls, therapists might not think through the implications of turning on transcription.

[j00j]

I did this recently, for the first time in over a decade, as my first Philly therapist decided to leave the field.
My biggest questions were around grief, addiction loss, and some other recent experiences particular to me- I think a lot of therapists have to handle grief to some extent but I wanted somebody really ready to engage with those topics. Making sure a therapist is up for things happening in my life recently, now, or likely to happen in the future seems important.
Obviously I needed queer friendly and polyamory knowledgeable-- I didn't even look at anybody who didn't list that, because there's enough people who list it now.
I also screened for a range of compatibility on some topics-- I don't need to know my therapist's personal opinion or have them agree with me exactly, but I need to not wind up with someone who hates religion or thinks my Israeli family members are all automatically war criminals or something. This particular one may not be applicable to you, but there may be other themes that apply in these weird times.

Leaving my familiar therapist was definitely a big change, but I do like the fresh perspective somebody new brings. I hope you find someone compatible and are able to settle into that exploration of new perspective as well.

Thanks for these specific examples

[jesse_the_k]

...which sparked a bunch of different ones in my brain.

Like, hey I'm 70 years old and my childhood context is literally history to you--can you assume I'm a reliable narrator

And Israel sigh

A fresh perspective! Great frame.

[dhampyresa]

I would ask what kind of credentials they have (I don't know things work where you are but for example in France "psychologue" and "psychologue clinicien.ne" are not quite the same thing), how the money side of things work (eg can they write you invoices, do they take insurance[1], etc) and how often/for how long they suggest meeting.

[1] I know of a therapist who does hour long sessions but charges them as two 30mn sessions for insurance reasons. Something like this may or may not be an issue.

Good questions

[jesse_the_k]

thanks!

[walgesang]

This is probably going to sound very contrary, but I feel like when I'm feeling out a new therapist less is more? They might be able to tick all the boxes, but really actually sitting there with them for at least a couple of sessions is going to give me a better idea whether it's a good fit than anything else. I suppose my main thing would be to ask if they offer a free intro consult and/or if they can agree that you can stay or go after X number of sessions. There's nothing more awkward than having to break up with a therapist, so sometimes having that known ahead of time can be handy. Hope you find someone who works for you and with you!

[jesse_the_k]

Thanks!

[starshipfox]

This is a big subject, and I think you've received excellent answers in the comments. However, I'd like to add that it's really important to give yourself permission to stop seeing a therapist, even if they initially tick a lot of your boxes. I kept seeing someone who was not a good fit for me because she was trauma-informed and answered a lot of my initial question in a good way -- it's important to vibe with someone, probably even more important than if they answer your questions well. My most recent successful therapist didn't know anything about autism, but was willing to learn and work with me, which turned out to be more important to me than if she'd already known, but didn't fit well with me.

Thanks!

[jesse_the_k]

Learning to listen to that vibing voice is one of my challenges, so I really appreciate this reminder.