Questions for Your Prospective Therapist, From Your Own Couch

From anxiety and loneliness to trauma and grief, the coronavirus pandemic is rattling our psychological well-being. According to a poll conducted in April by the Kaiser Family Foundation, 54 percent of women and 37 percent of men say the pandemic is worsening their mental health. Concerns about family members getting sick, economic instability and job loss were the survey respondents’ top worries.

In this tangle of stress, a growing number of people may turn to a therapist for guidance. Your first appointment with a new therapist can be stressful itself, and these days many of these meetings are taking place by phone or video, which may make it harder to connect than in a face-to-face meeting. But as with an in-person session, patients should be prepared to ask therapists questions to help figure out if they are a good fit.

Research has shown that interviewing a prospective therapist can help patients determine whether or not the therapy is right for them. As behavioral researchers have found, queries are the building blocks of connection and conversation. Answers to questions can also reveal how it feels to interact with someone new. And when it comes to therapy, research indicates that therapist and patient compatibility plays a significant role in treatment success.

Here are some questions to get you started.

What’s your professional background?

First, ask about the therapist’s educational background and licensure. Licensed therapists are familiar with ethical guidelines, such as maintaining patient confidentiality, maintaining boundaries and practicing within the scope of their expertise.

It is also useful to ask about the session fee and whether or not the therapist accepts insurance or offers a reduced rate.

Therapy is a broad term, which can imply that all mental health professionals provide similar services. However, they vary in their education, training and ability to prescribe medication. For example, psychiatrists are medical doctors who prescribe medication to treat symptoms of mental illnesses like generalized anxiety, bipolar disorder and major depression. A clinician with a Ph.D. or a Psy.D. is a psychologist, while one with a master’s degree may be a social worker or psychotherapist. They and other types of mental health counselors may offer psychotherapy. Unlike psychiatrists, they do not prescribe medication; instead, they use “talk therapy” to help patients overcome their struggles.

What’s your treatment approach?

Collective traumas and tragedies can affect our mental health in myriad ways. A recent survey conducted in China found that nearly 35 percent of respondents experienced panic disorder, depression or phobias related to the Covid-19 pandemic.

“For any given problem, several treatments can work,” said Joshua K. Swift, a clinical psychology professor and researcher at Idaho State University. Because of this, “all prospective patients should inquire about the therapist’s treatment approach and whether or not there’s evidence it works.” How each therapist answers this question is often guided by their clinical style.

For example, psychodynamic and depth-oriented clinicians often help patients unearth insight about the source of their suffering. For those struggling with concerns like relationship woes, difficult family dynamics or grief, psychodynamic therapy can be particularly useful.

Cognitive-behavioral therapists often see emotional distress as a result of misguided thinking. Focusing on symptom management, these therapists rely on behavioral strategies, such as mood tracking and cognitive exercises, to invoke change. Patients experiencing acute anxiety, insomnia or eating disorders, for example, may find this approach helpful.

Trauma-informed psychotherapists use methods like eye movement desensitization and reprocessing, accelerated experiential dynamic psychotherapy, and somatic experiencing to help a patient process painful emotions using a body-based approach.

In addition to learning about the therapist’s technique, asking how they measure progress and what success they’ve had treating patients with similar concerns are also useful questions to ask, Dr. Swift said.

What types of patients do you enjoy working with?

Open-ended questions, such as “What types of patients do you enjoy working with?” can yield useful information about the therapist’s preference and interpersonal style.

For instance, a therapist may respond by saying, “I’ll answer your question, but before I do, I’m curious what my answer might mean to you?” Others may depict their “ideal” patient by describing who they enjoy working with and why. In some cases, therapists may see the question as an opportunity to ask the patient, “What type of therapist are you looking for?”

Regardless of the therapist’s answer, patients should pay attention to how the response makes them feel. Psychotherapy researchers have found that effective therapists convey understanding, authenticity and expertise. During the first meeting, these qualities can help solidify a collaborative union between the patient and therapist.

How will I know if therapy is working?

When suffering is immense, especially during and following a crisis, people long for relief. However, therapy doesn’t immediately lift one’s pain. Indeed, talking about one’s pain may feel hard at first, at least temporarily. How soon treatment begins to work often depends on the severity of the problem and the amount of past adversity the patient has experienced.

Distress brought on by the pandemic can come in various shapes and sizes. For some, situational difficulties, such as working from home, home schooling or being an essential worker, can bring immense stress. Patients with these challenges may benefit from time-limited or brief psychotherapy, according to the American Psychological Association.

Those struggling with more acute problems, such as the unexpected death of a loved one, unresolved childhood trauma or post-traumatic stress disorder, may need ongoing care until the traumas are worked through.

Research suggests that effective therapists provide an explanation for the patient’s suffering, discuss how therapy works and ask for feedback. Of course, each patient’s situation is unique, and as therapy unfolds, goals can change.

After interviewing your future therapist, ask yourself: “What’s my gut feeling tell me about this person?” said Benjamin Lipton, an A.E.D.P. psychotherapist in New York. If something feels amiss, honor your experience and ask follow-up questions.

A therapist may have pristine qualifications and glowing online reviews, but if the interaction feels off-putting, it’s unlikely that trust and safety will be established. In the end, these two ingredients are essential in any new relationship, including the one with your therapist.

Some resources:

• National Alliance on Mental Illness Covid-19 Resource Guide.

• Covid Coach: a free mobile app developed by the National Center for P.T.S.D. The app offers anxiety management strategies and stress coping tools.

• American Psychological Association Covid-19 Information and Resources.

Juli Fraga is a psychologist in San Francisco. Hilary Jacobs Hendel is a psychoanalyst and emotion educator in New York.