Looking for a good psychotherapist can feel like a big hassle. The impulse to just go with the first person you meet and avoid having to look any further can be strong, but unless you find someone right off the bat who feels like the perfect fit, it’s best to do some shopping. For a healthy and successful therapeutic relationship, you will want to find someone skillful you can trust, who treats you with kindness and respect, and who maintains good, strong boundaries. So it’s important to be selective. There are many different therapists—and types of therapists—out there, so don’t assume that the first one you meet is the right one for you. Plan on talking to at least two to three different practitioners so that you can get an idea of what you want in a therapist and who will be a good fit for you.
While many therapists will want you to come in for a get-to-know-you session that you will most likely have to pay for (although some offer free, short consultations), it will save you time and money if you can have at least a 10-minute phone conversation with a prospective therapist before you set foot in their office. This is especially important if you have experienced therapy-related trauma in the past. Having an initial phone conversation allows you to get an idea of what the practitioner is like, how they manage boundaries, and see whether any red flags pop up to signal you that maybe this is not the right therapist for you. An introductory phone call allows you to determine the likelihood of their being a good fit before you meet them.
I highly recommend you do three things before you start calling your prospects:
- Take some time to consider what you want in a therapist. What kind of therapy do you want to do (e.g., cognitive-behavioral, Jungian, somatic, transpersonal, etc.)? How much do you want to pay? Do you need someone who takes insurance? Do you want to work with someone who specializes in trauma? If you’ve suffered abuse in the past, give some thought to what kind of boundaries feel appropriate for you and what’s negotiable and non-negotiable in terms of the therapist’s behavior.
- If you’re going to be paying out of pocket, decide what your monthly therapy budget is and what you can afford per session. A therapist may have the expertise you’re looking for but charge more than your budget allows. Depending on your needs and your budget, you may want to consider options such as having sessions every other week or doing longer sessions. (Longer sessions can be particularly helpful if you’re doing trauma-oriented work such as EMDR or Somatic Experiencing.)
- Put together a list of questions based on information you want to know. When you get the prospective therapist on the phone, start interviewing. Depending on the length of your list, you may not get to all of your questions, but you can hopefully cover the most important ones.
As you are contacting your prospects, let them know you would like to ask them some questions and would appreciate the chance to speak with them on the phone for 10–15 minutes. This gives them a heads-up so that they can set aside time for the call. Make sure you provide them with your phone number and some good times to reach you.
To assist you with putting together your list of interview questions, here is a sample list that includes questions to ask when you first speak with the therapist (and/or when you have your first session), as well as questions to ask yourself after your initial contact and/or first session, to help you gauge your reaction to the therapist. A number of the questions are from an excellent book called Take Back Your Life—Recovering from Cults and Abusive Relationships by Janja Lalich and Madeleine Tobias, and I’ve also included several of my own. Decide which ones are most important to you and ask those first. The rest you can leave for your first session (if you decide to meet the therapist) or a follow-up call if you decide you want more information. You should have answers to all the practical questions by the end of the first session.
If you think of other questions you’d like to add to the list, please leave a comment below!
Questions to Ask a Prospective Therapist
- What is your counseling experience? How long have you been in practice? How long have you been licensed?
- What types of clients do you work with?
- What are your areas of expertise?
- What type of therapy do you practice (e.g., cognitive-behavioral, Jungian, transpersonal, somatic, etc.)? What does that involve?
- What is your educational background?
- What is the length of a regular session?
- What is your schedule and availability?
- What is your fee? Do you offer a sliding scale?
Note: If you want to consider options such as longer sessions or every-other-week sessions, this is a good time to ask the therapist about these and other possibilities. - What is your cancellation policy?
- What’s your policy regarding phone calls? Are you reachable in a crisis or an emergency? How often do you check your messages? What’s your policy regarding returning phone calls? Do you charge for phone conversations?
- Do you take treatment notes?
- What’s your privacy policy? Do you ever share information and under what circumstances?
- Do you have an advisor or someone you consult with regularly?
- Do you believe in setting treatment goals? How are these established?
- Tell me a little about how you hold boundaries for the relationship. What kind of therapeutic container do you provide?
- What do you do when you run into a client outside the office?
- Do you ever conduct therapy sessions anywhere other than the office?
Note: If the therapist says they sometimes meet clients in coffee shops, make “house calls” or conduct sessions in their home (and do not have a dedicated home office), this may be a warning sign of someone with boundary issues. - What’s your experience working with trauma and abuse? Do you have experience working with PTSD? How do you work with trauma and PTSD? What’s your approach? What modalities do you use? (For example, cognitive-behavioral therapy, EMDR, EFT, Somatic Experiencing and other modalities/techniques may be used in working with trauma.)
Note: If the therapist uses few or no techniques other than talk therapy, ask if they refer out to someone more experienced in working with trauma, should you need that kind of support. - How do you feel about spiritual or New Age concepts? Do you incorporate any New Age or spiritual techniques in your therapy? Do you ever use hypnotherapy or guided visualization techniques? If so, how do you determine if and when these techniques are appropriate?
Note: While these techniques may be beneficial for some clients, they can be very triggering for others. It should be up to you as the client to decide whether or not you want to incorporate them into your therapy. - What is your policy about having physical contact with clients? Do you ever hug or initiate any types of touch or contact? Do you ever use physical touch as part of therapeutic treatment? If so, how do you ensure proper boundaries are maintained?
- Do you believe it is ever appropriate to have sex with clients or former clients?
Note: If the answer is anything other than “Never,” run—don’t walk—away from this practitioner as fast as you can! - Have you ever worked with anyone who was a victim of sexual misconduct by their therapist?
Note: If you have been the victim of abuse by a therapist, it is entirely up to you what you tell a prospective therapist about your situation and when. It’s completely understandable if you do not feel comfortable disclosing information about your abuse until you know this practitioner better and feel you can trust them. If you do feel comfortable disclosing some basic information, then feel free to ask the therapist if they have any experience working with this or similar issues.
Questions to Ask Yourself After Initial Contact with a Prospective Therapist
- How do I feel about this therapist? What’s my initial reaction?
- Do I feel accepted, respected, and comfortable?
- Am I experiencing any negative reactions (emotional or physical)? If so, is there anything I can pinpoint about the interaction that I might be reacting to?
- After a first session in the therapist’s office: Did anything in the environment make me feel uneasy?
Note: It’s not unusual to react to the furniture, paintings, books, or other objects in the office. - Was the therapist direct and open in answering all my questions or did they avoid answering some of them?
- Does the therapist seem sensitive, intelligent, and mature, someone with whom I can feel safe?
- How confident do I feel in this therapist’s ability to work with me?
- Did the therapist give me the impression that they have all the answers or could “heal” me?
- Did the therapist go overboard in assuring me that they were the right therapist for me? Were they trying to come across as the perfect therapist, the only one who could help me?
Note: If the practitioner acts as if they have all the answers to your problems or they’re the only one who can help you, move on to someone else. - How much talking did the therapist do? Did the therapist talk so much that I felt overwhelmed or didn’t have the opportunity to say what I needed to say?
- Did the therapist talk about their personal life? How much did they disclose?
Note: This could be a red flag about boundaries. The therapy should be about you, not about your therapist. - Do I feel that I can easily give feedback, state my needs, and be respectfully heard by the therapist? Do I feel that I can say no to the therapist if I need to?
Regarding red flags, if you feel anxious after seeing the therapist for the first time, that’s not necessarily a sign that something’s wrong. It’s normal to feel anxious or even wary of someone new, especially if you have trust issues. What you want to pay attention to is if you consistently feel triggered by the therapist and it doesn’t lessen after a few sessions, or if you feel in some way unsafe. If this happens, you may want to bring it up in therapy. If the therapist is open to discussing the issue and making changes and adjustments, that’s a good sign. However, if the therapist acts as if it’s your problem or tells you you’re wrong or that you should feel safe, that’s a big red flag. If this happens, move on to someone else!
It’s critically important that you find a therapist you can trust, who makes you feel safe, comfortable, respected and accepted. This is non-negotiable. You may need to speak with several practitioners before you find someone who feels like a good fit. That’s okay! You are worth it! Don’t settle for someone who disrespects you or can’t give you what you need. Just because someone is a practicing therapist doesn’t mean they have done their own personal work! Remember, therapists are just as human as you are. They’re not psychic or endowed with special healing powers or have a direct line to God. They’re simply people who chose to go into a helping profession to support people in need. Some are good at their job and others aren’t. It’s up to you as the consumer to be as discerning as you can. No one else knows you or what you need better than you do yourself. So honor yourself in this process and find a therapist who honors you!
I applause you for the detail oriented questionnaire that you have developed.
Some unfit therapists may answer these questions in a quite satisfactory manner, but then do a bait and switch.
Example: I asked my candidate therapist where he stood on recovered memories. I did not want to run the risk of working with someone who would be too eager to push me. The guy said, carefully, that his job as a therapist was to maintain a safe and boundaried space and not to push.
Great. I proceeded to work with him. After I got emotionally dependent, this person would, every so
often, remind me of that first interview and make it seem I had been rageful and out of control.
I remained with this person for a very long time. Let us say, several Presidential administrations.
So, here are some things to ask about — and also look for.
Are many of the therapists clients friends with each other? Not good. This brings confidentiality issues and is a big red flag that the therapist fails to avoid dual relationships.
1) Ask how long clients work with him or her. It is a very bad sign if a lot of people have been seeing
this person for over a decade. You want to be a client, not become an inmate.
2) My abusive therapist conned me to believe he was special and that he was my only affordable option. Never let someone trick you into this kind of dependency.
3) Keep neutral and ask whether the therapist has benefited from a guru or lama or spiritual master.
You will get an informative answer only if you seem potentially sympathetic.
If it turns out the therapist is a long time disciple of a master (male or female), I urgently advise
getting away and looking for a therapist who is not in such a dependant relationship. I thought it none of my business that my therapist was involved with a guru. Turns out the therapist was so emotionally tied in that many of his clients were disciples, he lived as close as possible to the ashram, decorated
his office according to the guru’s dictates, and the mental health professional he referred me to was also a disciple of this same guru.
In short, this therapist was not fully grown up. He was and is an inmate within his sect. I advise never to get involved with a therapist who believes in gurus or is a disciple of one.
Set a specific goals for yourself in therapy and review it carefully. Beware of mission creep.
Get away if the therapist teases you.
If the therapist tells you to keep something a secret, get the hell out of there. Too many of us need therapy because we are burdened with secrets.
Dare to look the therapist up on the state licensing website. See if he or her license is current. If you ever feel afraid to do this type of fact checking — beware. You should never feel afraid of your therapist.
If you ever feel glad you are ill with a cold because it means you can skip a session, that is a big red flag.
Take a two week break from therapy on your own time. See if you feel refreshed. If the therapist opposes this — beware.
Great suggestions! Thank you for sharing! I particularly agree with leaving a therapist who teases you or asks you to keep secrets.
I do think that there are Buddhist or other spiritual therapists who have benefited by having a spiritual teacher, but I agree that if a therapist is in a dependent relationship with a guru or teacher that can be a red flag. If you have a more “spiritual” therapist, it’s important to be clear which spiritual views, beliefs and practices are YOURS and which are the therapist’s. You should not feel pressured, teased or blackmailed into adopting views, beliefs or practices that do not resonate with you. If you think there’s too much spirituality in your therapy, set a boundary and say so. Also, some therapists have their own “cult” following, so be wary of anything that smacks of cult or group-mind mentality and head for the door.
[…] Also, here is a post I wrote about looking for a new therapist, which may be helpful: http://www.survivingtherapistabuse.com/2014/11/questions-to-ask-a-prospective-therapist/ […]
I experienced abuse with this psychotherapist , he went to my hometown saying he will provide protection for me turns out I was left devastated from his therapy . But unfortunately I went there on my own to get psychiatric evaluation , he put me on psychotic depression, I felt so emotionally drained from him . I couldn’t do anything about it , protection protection from ? EviL people
My abuse was by a therapist… try finding another therapist who’s willing to listen… really listen… not try and change what you know to be true… it’s been very difficult as I cannot trust anyone…. yet I know I can’t sit back and say oh well…. it’s eating my insides !!!!
Rosemary,
I’m sorry to hear you’re having such a difficult time with subsequent therapists. A therapist should absolutely be able to listen to you and respond with respect, without trying to change anything. I have sometimes called a number of different therapists in the search for one person to work with. I do an initial phone call and pay close attention to how they respond to me. If I experience any discomfort with their response, I move on to the next person. It can be hard to find the right fit.
Of course, there are different ways to heal. Writing about what happened can be very helpful. You are welcome to post your story on the Your Stories page and maybe you will get some supportive feedback. I also often recommend that people contact the email responders at TELL — http://www.therapyabuse.org. Many have found that helpful.
All the best!
(Edited to remove the therapist’s and other party’s name)
I want to warn other survivors about being very very selective when choosing a new therapist.
I took me 9 months of healing on my own, and meeting with at least three other therapists before finding one who seemed trustworthy and knowledgeable. I ultimately chose this therapist because she bills herself as one of the few who specialize in narcissistic abuse recovery. The therapist has written an e-book on the topic and is a frequent contributor to the podcast Mental Health News Radio. Irelayed my story to her of having experienced long term emotional and psychological abuse at the hands of my former therapist and was open from the beginning about wanting to take action with a formal complaint to the licensing board.
My new therapist not only encouraged me to file such a complaint, but went so far as to the repeatedly state that she would be “more than happy to act as an advocate on your behalf” by writing a letter of support to be included with my complaint. This was repeated to me many times over the course of several months, not from my asking for such a letter, but came from the therapist directly, of her own volition. This is important to note. Needless to say, I felt that I had finally found a true advocate and someone who would stand with me in my corner, something I sorely wanted and needed to be true. Having the assurance of that letter gave me the confidence to feel like I would finally be heard and believed.
Over the course of the initial first few months of therapy, after hearing more of my story, the therapist then encouraged me to not only file a formal complaint against my former therapist but to go so far as to file a a malpractice lawsuit (while also making it clear she did not wish to be directly involved in that process in any way). After many dead ends, it became clear that no one would represent me in a lawsuit because my abuse had been emotional and psychological rather than sexual. I then began to focus on filing the formal complaint with the licensing board as the only other alternative. When it became clear that I was no longer just talking about the possibility of filing but was in fact going to take steps to follow through with the process, the therapist abruptly and without warning, changed her stance and told me she she was no longer willing to provide a letter of support out of fear for, as she put it “my livelihood”. She seemed to be afraid that my former therapist would sue her (a completely irrational fear and one that would not be legal under the Code of Ethics for the licensing board — no therapist being complained about can retaliate against a former client or other therapist legally). Overall ,she did not seem to know absolutely anything about the process of filing a complaint, nor even the basic code of ethics for her own profession (this is unfortunately not unusual).
It was at this point that I should have terminated therapy with this woman. Making and breaking promises was a common occurrence with my previous abusive therapist (and a huge red flag) and this new therapist’s failure to have integrity with her word was not only highly triggering but ultimately a warning sign that she was not to be trusted and would continue to put her personal comfort level and needs before any real commitment to true advocacy for her clients. Yet, because I was so desperate to simply be heard, supported, and believed, and because she convinced me to stay with her so that I could have a “reparative experience”, I did so for an additional 10 months.
Throughout this time, I came to believe that this therapist was a “good” therapist simply because I was no longer subjected to being regularly demeaned, gaslighted, devalued, convinced of “disorder” and mental illness, or on the other end of inappropriate remarks and physical contact, as I had been with my previous abusive therapist. Instead, the new therapist practiced “unconditional positive regard” for her clients and I had never felt anything less than that with her, though there was little to no real depth to our sessions. I often felt like she simply agreed with whatever I said. There were few real coping skills discussed or learned, and absolutely no component of self inquiry or discussion of previous abuse that would lead me to understand why I had allowed the abuse in the first place. Truly, in the end, this was not “good” therapy and did little to help me heal. In therapy with her, I managed to attract into my life yet another toxic narcissist, this one, nearly as destructive as my previous therapist. The contact was much briefer because I got away much quicker, but the effects were long lasting.
To make a long story short, yet another incident eventually came up between this therapist and I which made it clear that her about face with the advocacy letter was not an anomaly — she would always choose to put her own interests above the interests of her clients, real advocacy, or what was morally right. It also became clear that there were huge discrepancies between the person who regularly sat in judgement and condemnation of her colleagues, while engaging in some of the very same behavior herself, e.g. engaging in personal (friendships not sexual) relationships with former clients.
The first and only time I dared to criticize the new therapist, in a moment of being highly triggered not only by a justifiable sense of betrayal and re-triggered trauma, when she once again showed her true colors, I was immediately terminated; in an email. 14 months of “reparative” therapy washed down the drain in an instant. I had never felt afraid to express anger in my therapy, had never been made to feel that it was shameful or out of place, as long as it was directed at someone other than her. But it was quite clear that justifiable anger or criticism directed at her, was something she could not handle. There was absolutely no room for discussion. Gone was the “unconditional positive regard” or faux empathy she often expressed. She refused to forgive, to understand, or to speak with me about the possibility of returning because she felt *her* trust had been violated. Her outrage was irrationally out of proportion to anything I had written or said (a common trait of covert narcs), I was immediately shamed and blamed, and there was no way to convince her I still deserved her compassion and support. All of my old trauma from the previous therapist came flooding back and I immediately experienced the all too familiar suicidal despair, I regularly felt in my previous “therapeutic” experience . I left voicemails not only apologizing (which is retrospect I had absolutely no reason to do), but also stating that I was having suicidal thoughts. In response, she left me a 3 minute long voicemail in which she spoke of nothing but herself and her sense of hurt and outrage at being criticized. After rattling off the names of nearby practitioners (none of whom are remotely skilled to treat trauma or narcissistic abuse), I never heard from her again.
My experiences with mental health “professionals”, in each and every case have only lead me further into trauma. I have tried to do everything “right” by seeking help when I was going through grief (my first therapy experience), ending up with horrific abuse and further grief/trauma at the hands of someone truly twisted and unqualified to practice, leading me to get help from the after effects of that trauma with someone who was seemed on the surface, the perfect therapist for the job, only to end up betrayed, abandoned, and further traumatized yet again.
I will never again put myself in the position to be harmed by another mental health “professional”. Survivors are far better off and safer reading books, blogs, or watching YouTube videos on the topic, in their recovery than they are reaching out to so-called advocates. There are many who are profiting from this new wave of public awareness about narcissistic abuse, while being covert narcissists themselves. I would wish my experiences in recovery upon no one. Survivors deserve true advocates capable of understanding the complex trust issues we are left with. No survivor should ever be abandoned or re-traumatized by an “advocate” whose fragile ego takes precedence over basic compassion and humanity.
I’m sorry for what you went through with this therapist. Finding a good therapist anytime, but especially after abuse, can be challenging. Since Dr. T I have seen several therapists and I got triggered by quite a few who had lousy boundaries and who weren’t willing to take responsibility for that.
It may be important to note that many people who go into the healing arts are “wounded healers.” And that means they have their own issues that they have worked on — and are perhaps continuing to work on. Like anybody else, some therapists are able to grow beyond their issues; others aren’t. And yes, there are those who are in it for the sense of power it gives them. This is sad, but very true.
There are good therapists out there but you may have to put in a bit of work to find someone who’s genuinely trustworthy — and that may not be worth it. Sometimes the best support is found outside of traditional therapy — in books and blogs, in a community, in a spiritual practice. Whatever works!
All the best,
Kristi
I am not at all sure what to do with this, and it seems like few people understand.
I had a suicidal crisis in November and called and emailed my therapist. A number of things then got very strange: 1) She had “staff” I’d never heard of or seen answering my emails with replies filled with spelling errors and odd turns of phrase, and who gave me an unreasonable demand about going to a hospital immediately when I’d said twice that I was leaving. They made no attempt to call me, and neither did she, but they called the police, who then I suppose came by my home when I wasn’t there.
2) The hospital told me to follow up with her the next day. “Staff’s” email to me stipulated “in two weeks.” Which seemed odd to me when I was finally coherent enough to read through it. Why would a therapist want a suicidal client to wait for two weeks after a crisis before contacting them??
3) I admit, I did something wrong in snapping at her “staff” when I got home and saw that they’d called the police. I shouldn’t have snapped at them, and I apologized twice for my behavior–which my therapist ignored both times. But my therapist immediately insisted I check myself into an inpatient program (despite the hospital saying I wasn’t a threat to myself and could go home), revoked my diagnosis of ADHD and said I was “bipolar with mania,” said that my ADHD meds made me have a manic episode (she doesn’t have a medical degree and is not a psychiatrist) and I shouldn’t take them anymore, then ignored me when I said I’d actually not had them for a few days, then insisted I go on disability.
4) She did not take it kindly when I disputed going into an inpatient clinic.
5) In fact, in a long tirade she sent me when I said I thought “staff’s” instructions were unreasonable and said I was uncomfortable that people I didn’t know were answering my emails, she said I had threatened her and her staff, that I had put them all in danger, that I was blaming her for my problems, that she was a moral person (she said this like five times), that I asked her to break the law, and that I was incapable of self-reflection. In our previous phone call, she also said “Well, what will you do when someone else dies?” knowing that my breakdown was in part over a close family member’s death two weeks ago.
I feel incredibly violated, and like my therapist pushed all my triggers that she knew about, then abandoned me when she knew a previous therapist had also terminated with me the moment I said I was having suicidal thoughts. I looked up her record (only learning today that I could do that), and found out that she was put on probation several years ago for having sex with two clients. And now I’m afraid she’s going to hurt another client like she hurt me.
I regularly feel sick to my stomach when I think about what happened, I’m a mess daily, I keep having emotional flashbacks to the night that this all happened (I have CPTSD and am having other emotional flashbacks because, well, stress tends to trigger them), and I don’t know what to do. I can’t trust therapists anymore, and yet I need help processing this. I know that there are many good therapists out there, but I just feel like even going into a therapist’s office will trigger me into a panic attack.
I don’t know what to do. I’m hurting and frightened and don’t know if I can even file a complaint against her. Even if I could legally, I don’t think I have the spoons for it, especially knowing that she’ll say I’m just a disgruntled ex-client and make me out to be violent. And, you know, she’s a smartly dressed, thin, pretty professional, and I’m a fat, unkempt (because of mental health issues), self-employed crazy person whose every word is therefore suspect.
I feel like I’ve been victimized and put in danger, and it’s slowly eating me alive.
Not long ago, my mom finally said yes to finding a mental health therapist. It’s very helpful to know what questions we’d ask before choosing a therapist for ourselves. I’m positive that my mom will find a professional and experienced therapist with your post’s insight.