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 inside a bunch of psychotherapist offices, trying to gauge whether all that notebook scribbling is going to translate into 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. Luckily there are therapists like Dr. Ryan Howes that are our tour guides inside the counseling walls. He’s like our match.com concierge, equipping us with the right questions to ask so that we don’t spend years on the couch sitting across the wrong notebook scribbler.
Dr. Howes is a board-certified psychologist in Pasadena, California, where he is in private practice and is Clinical Professor of Psychology at Fuller Graduate School. He writes a blog named In Therapy for Psychology Today and an interview column for the Psychotherapy Networker Magazine. In 2012, Dr. Howes and some of his students formed National Psychotherapy Day (September 25th), a day to demystify therapy and reduce the stigma surrounding therapy and mental health issues. As part of that campaign, last year he held a storytelling event called Moments of Meaning where therapists told true (but de-identified) stories of powerful moments from their own work.
“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,” explains Dr. Howes. “They will tell you where they went to school, where they were trained, what modalities the learned, what they researched, and so forth.” Instead of asking for their resume, he recommends you ask these six questions, and explains why.
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 problem is insomnia, worry, and anger outbursts. How would you treat that?” Hopefully, the therapists 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 part is that they are able to describe their process in a way you can understand. 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. Some therapists are more comfortable addressing the immediate problem, others want to focus on the deeper issue. Which are you?
Many cognitive-behavioral based therapies are focused on treating immediate symptoms, while deeper, psychodynamic based therapies focus on the root causes of the problem. The preferred answer depends on your needs — if you need quick, immediate relief, you’ll gravitate to CBT, but if you’re willing to wait a while to reach a deeper insight, the psychodynamic theories are probably more your style. Again, the therapist’s ability to clearly communicate their approach is key here, even if they say they combine approaches.
3. 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, you are 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, non-directive appeals to others.
4. What role does our relationship play in our work?
Some therapists view therapy as a laboratory – the problems you experience in the outside world will come up between us, and that’s a great opportunity to do important work. For others, therapy is more of a lecture hall, a place where you learn tools and tips to apply outside the session. It’s good for you to know which you’re stepping in to. If you want to learn to confront people and want to practice that with your therapist, you’ll want therapy to be a laboratory. If you want tips for managing your OCD and just want therapy to be a resource for information and exercises, you’ll want the lecture.
5. What are your strengths as a therapist?
Not many clients ask this question, but I 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.
6. Have you been in therapy?
This may be an optional question for to most bold among you, but I think it’s a valid and important question. I think it is essential for a therapist to spend a significant amount of time in their own therapy. In fact, as a therapist myself, I intend to be in therapy as long as I see my own clients. Why? Because it reminds us what it’s like to be in the other couch. Because it helps me discern between my garbage and my clients garbage. Because it models a lifetime process of constant introspection. Because I can learn things from my own therapist that may help my clients. You don’t need to ask specifics, or names and dates, but I think asking if a therapist has been in therapy is a legit question.
But your work is not over there. Dr. Howes thinks it’s even more important to have questions for yourself, such as:
- How soon did you feel relaxed when speaking with the therapist?
- Did you feel rushed to ask your questions, or able to go at your own pace?
- Did the therapist seem to “get” your questions, or did they misinterpret or need to ask for several clarifications?
- Did you feel like the conversation flowed, or was it clunky and awkward?
- Did you understand the response, or was it filled with technical jargon or vague statements?
- Imagine your deepest, darkest secret – could you imagine telling this person about it?
“Study after study shows that successful therapy depends on the quality of the relationship between the therapist and client,” Dr. Howes explains. “You’re much better off seeing a graduate student you connect with than an 40-year veteran and author with whom you don’t feel understood.”
In the end, he advises folks to go with their gut, much like you would with a blind date over coffee.
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Originally published on Sanity Break.