mental health: questions to ask psychotherapist

Mental Health

questions to ask your psychotherapist

By Matt Boden, Ph.D. & Howard Berenbaum,Ph.d.

At some point in our lives, many of us will try psychotherapy and then decide whether to continue to engage in a full course of treatment with that provider (which may last for weeks, months or years). This decision is, typically, based on a judgment of whether the benefits of a course of psychotherapy with a given provider are worth the cost in terms of finances, time and effort.

Through conversations we have come to believe that most psychotherapy clients don't know how to judge whether they are receiving quality treatment that will help them to achieve their goals. To facilitate this judgment and decision, we propose 10 questions for any client to ask their provider.

All therapists should be willing and able to provide "good" answers to these questions. Good answers provide information that will help you assess your therapist's competence, whether treatment is evidence-based and timelimited and whether your therapist will systematically monitor your problems/symptoms/challenges.(P/C/S) Good answers will also clarify your therapist's views on your case and make clear whether treatment aligns with your goals and values. "Bad" answers, by contrast, provide no useful information. They are vague, unclear, confusing or indicate you are receiving less than ideal treatment, perhaps from an unqualified therapist.

Ultimately, discussion guided by these 10 questions can build trust and facilitate your therapeutic relationship. Be empowered to ask these questions and find a therapist and treatment who best suits your needs.

Question 1: What P/C/S Will You Help Me With?

A good answer might go something like this: "You have asked for my help to reduce your symptoms of worry. I will address these issues, by helping you to increase your psychological flexibility " A bad answer may look like this: "It will require more sessions for me to know and to be able to tell you."

Question 2: What Is Your Explanation For Why I Have The P/C/S I Have? A good answer could sound like: "Your worries seem to attach themselves to everything you think about. You feel like the worry helps you to avoid bad outcomes, but your life has become small. You spend most of your time at home, where you feel safe, but isolated, numb and depressed."

A bad answer might sound like: "We'll figure this out together."

Question 3: What Do You Think Is The Ultimate Goal Of This Treatment?

Good answer: "Using Acceptance and Commitment Therapy (ACT), I will help you to identify and live according to your values despite your worries. Your life will become bigger, and you will react less to particular states of mind and mood."

Bad answer: "Whatever you want it to be."

Question 4: How Exactly Will Your Treatment Change Whatever It Is You Think Accounts For My Current P/C/S?

Good answer: "You will learn to use a variety of techniques to live in the present moment regardless of the challenges you face. For example, you will learn acceptance mindfulness techniques."

Bad answer: "You have to experience the treatment to understand how it works."

Question 5: How Will We Monitor Whether I Get Better, Get Worse Or Stay The Same? What Specific Assessment Methods And Measures Will You Use?

Good answer: "In the first session, you completed measures of psychological flexibility, mindfulness, depression and worry. You will complete all measures again at the end of treatment, and some measures a few additional times. Improvement will be indicated by higher scores on measures of psychological flexibility and use of mindfulness, with no change or less depression and worry."

Bad answer: "Sometimes I will ask you if you are doing any better than when you began therapy. ."

Question 6: How Many Sessions Will This Take? How Will We Know When To Stop?

Good answer: "This treatment will require approximately 12, 50-minute sessions. In approximately the tenth session, we will examine your scores on the measures completed that week to determine whether we can stop therapy after the twelfth session, or if it would be better to add a few more sessions."

Bad answer: "I don't know how many sessions this will take. We will know when to stop when you feel better."

Question 7: What Are Your Expectations Of Me? What Can I Expect From You?

Good answer: "I expect you to be on time, be sober, be open and honest and to complete homework assignments between sessions. I will regularly ask for updates regarding your well-being and functioning, and for feedback regarding how you think we are doing."

Bad answer: "I expect you to trust that I know what I'm doing, and to follow my lead throughout therapy. I am the expert, I will help you to get better."

Question 8: What Other Treatments Might Help Me With My P/C/S? Good answer: "There are other psychotherapies that might help you, including cognitive therapy. Medications, such as venlafaxine, might also be helpful." Bad answer: "This is the best treatment for your problem. I wouldn't worry about other treatments."

Question 9: To What Extent Does Research Support The Use Of This Treatment For Me? How Strong Overall Is The Research Evidence In Support Of This Treatment? Good answer: "There is modest research support for ACT for anxiety disorders and for depression. I will provide you with a website address where you can review articles about the treatment and supporting evidence." Bad answer: "The type of treatment I practice can be applied to fix just about any problem. I've had a lot of clients who improved from my treatment."

Question 10: What Education And Training Do You Have To Provide This Type Of Treatment For Me? Good answer: "I received training in ACT for anxiety and for depression from an accredited graduate school and internship and have practiced ACT professionally for 10 years." Bad answer: "I have many years of experience."

Ultimately, when we make the choice to begin psychotherapy, we have to keep in mind some practical considerations. Is this process helpful and worth the time, money and effort? As a client, you have the right to clear communication from your therapist as you navigate these questions. We hope that our guiding questions will help start an important conversation.

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.Matt Boden, PhD, a licensed psychologist, is a program evaluator & researcher for the US Dept of Veterans Affairs., Office of Mental Health & Suicide Prevention Howard Berenbaum PhD , is a Professor of Psychology and Psychiatry at University of Illinois & a a fellow of the Association for Psychological Science

To learn more about NAMI programs, visit Website namirapp.com.