Questions to Ask Your Therapist by Ben Martin, Psy.D. February 17, 2006 Choosing the right therapist is important and often difficult to do simply by looking at ads in the Yellow Pages. Credentials can be important, but are not the whole story. Word of mouth is the best advertisement for the quality of a therapist. While people are still reticent about talking about mental health, experiences of friends or relatives can be valuable. You can also seek information from your primary physician. Although it may feel as though you are the only person with depression, millions of people suffer from the condition. Your physician has likely seen many depressed people in his or her practice and may be comfortable with particular therapists. Finally, you can consult referral hotlines of professional organizations, including your state or local medical society, association or other professional group. They often have a list of members who specialize in situations similar to yours. Questions to ask when choosing a psychiatrist or therapist: Are you licensed by the state? Licensure is important because it means that the provider has passed minimum competency standards for training and expertise. What level of education do you have? Psychotherapy is available from a number of different providers. Psychiatrists are medical doctors who have completed special training in psychiatry. They can prescribe medication in addition to providing psychotherapy. Psychologists usually have a doctoral degree in psychology. They can conduct psychological testing that may aid in the diagnosis of your depression and any associated conditions. Most other therapists have masters degrees in a related discipline including licensed clinical social workers (LCSW), advanced registered nurse practitioners (ARNP) and licensed mental health counselors. What are your areas of expertise? Most therapists are really good at a few things, not everything. What success in treating people have they had? How long have you been in practice? This can be a source of information regarding the therapist’s effectiveness. A therapist who is not effective will have a hard time maintaining an active referral base and staying in business. How much do you charge per session? Costs among therapists can vary widely and are often related to their number of years in training. A psychiatrist or psychologist will probably be more expensive than a social worker of mental health counselor. While this is clearly not a situation of “you get what you pay for,” you should be aware that training differences among these professionals may have an impact on your treatment. Usually, more severe symptoms or complex history and medication regimen, will require a psychiatrist, especially if this person will be primarily responsible for your care. What insurance do you take? Psychotherapy can be expensive and having your treatment covered by insurance will greatly help defray costs. Check that the person you are seeing is able to handle third-party billing (insurance) and that treatment is covered by your insurance plan. You can obtain this information from your benefits person or the therapist. If you are not a medical doctor, do you work with a psychiatrist or other physician who manages the medication? A “yes” answer improves the chances you will be prescribed medication if you need it. Do you have a cancellation policy? Some therapists charge for missed appointments or cancellations within a certain period of time. If you have inconsistent transportation or other issues that may affect your ability to keep appointments this will be important information. Are references available? Ask for recommendations or references from the professional’s other colleagues. In cases of emergency, do you have an ‘on-call’ system? Hopefully, the answer is “yes”. Probably the best method of choosing a therapist is to gauge your reaction to him or her. Research on the effectiveness of psychotherapy has consistently shown that the personal qualities of therapists and how they “fit” with the patient are at least as important as the type of therapy used to produce a positive outcome. If you feel uncomfortable with a therapist after several sessions, make sure you discuss this. If an issue cannot be resolved to your satisfaction, then seek another therapist. If the problem is with you, you will discover it soon enough. Keep in mind, too, that while the therapist may be recognized as being very effective and you can be an ideal patient, you just may not be able to work together. People are different and sometimes relationships do not work out. If that happens, find another therapist.