Melissa and Tina, a life coach and a therapist, joined together to bring you Sweet Relief from the Everyday Narcissist. This site sweetens the relief, by offering ongoing support and encouragement.

How to Choose a Therapist

If you want to get support from a therapist, it’s a great idea to chose that therapist wisely. You don’t have to use the first therapist on your insurance who has time to see you – you can interview therapists and work with one that seems right for you.  In our culture, we seem to think that therapists are kind of like doctors – if you get the name of one, you go to that one. It might seem odd or unusual to interview and select your therapist, but since the service they provide is not uniform from one therapist to the next, gathering information will serve you. Ideally, you want to find a therapist you are comfortable with, who is versed in your sort of issues, who works with clients like you, who has values that you are comfortable with, and who has methods that sound like they would work for you.

Word of mouth is a great way to find therapists. Hearing what friends have to say about particular therapists can clarify what you are looking for and can help focus your search. If you have insurance, then you probably have to compare what you find against the list of providers who handle your insurance.

Be aware that therapists come from different points of view, and have a wide variety of training. The point of checking them out in advance of starting therapy is to see if you think the fit for you is right. You are unlikely to understand the formal terms for the sort of therapy they offer, but you can understand the basics of their way of doing things if you ask a few questions. Some therapists come from a religious underpinning (which may or may not work for you), and they might not disclose that unless asked. It was at the end of a difficult first session that one non-religious woman found out that her therapist was a Christian who brought certain perspectives and tools to her work.

Think about what you want to get out of therapy. What is your agenda? Is it to get through a difficult patch, get new skills, or look deeply at long term issues? Are you willing to go wherever the process may lead? Consider your possible constraints – insurance, geography, finances, scheduling – and ask questions that let you know if the therapist can work within them. Therapy focuses on you as the client, but interviewing a therapist allows you to focus on the therapist and find out something about them as a person and professional. This sort of information helps you discern who will be a good fit for you.

Try to get at least 3 names of therapists to talk with. Start by calling and asking a few questions over the phone (see a list of potential questions below). If you reach a receptionist or call service, ask for the therapist to call you back because you are interested in possibly becoming a client and would like to be sure you are a fit for their practice. After your initial conversations, if you want to meet with a particular therapist or two (or three) before making a final choice, ask if the therapist would be open to a 15-30 minute conversation in person free of charge.

Here are some things you might consider asking:

How long have you been practicing?
What did you do before you started in private practice?
Why did you chose to stop doing what you did before this?
What sort of clients do you work with the most?
Observe and comment (inquire) about something you find interesting about the therapist’s space.
Have you had experience with people on the receiving side of a narcissistic relationship?
What’s the nature of your approach?
What are the ground rules of therapy?
How do we know when we are complete, how do we end things?
What are your ethical guidelines?
Could my husband/mother/sibling also be your client if you are seeing me?
What is your training?
What sort of clients do best with you?
What do you like to see happen for your clients?
What do you expect of a client?
What makes a client a good client?
What makes a client a not good one?
How long does someone normally stay engaged with this process?
What happens between sessions?
Is our work confidential?

I’m encouraging you to ask questions and compare answers and discern what seems right for you. I’m not encouraging you to over think it or get nit-picky. Be respectful of the therapist’s time and keep your conversation limited. Even a 10 minute conversation can provide with a wealth of information. Establishing a relationship with someone you can trust is of paramount importance to you.

Here’s the experience of one of my clients:

For me, part of the point of the questioning was to have the potential therapist talk a little about themselves.  I interviewed three therapists in person in this last process and two more over the phone.  Of the two phone interviews, one was not accepting new clients and one was so brusque that I felt scolded without even meeting in person.  Feeling scolded is not a good place for me to make progress, and I ruled her out.

In terms of questions, my favorites (and the ones that got me the most information) were:

How long have you been in private practice?
What did you do before you started private practice?
Why did you stop doing (whatever you did before) and start private practice?

Observe something about the therapist or their space.  For instance, “I see that you have a lot of books” or “You have an interesting thing on the wall” – this one is designed to get them to discuss themselves; i.e., “I really like birds, so I have these prints” or, in the alternative, “I have even more books at home. I read them all as part of my training.”  This question lets them talk about themselves apart from their credentials and lets you get a sense of their personality.

Of the three in-person interviews, the first was one of the most interesting. I really liked the woman and thought she might be a fun person to have coffee with occasionally, but I did not feel like she was a great fit.  She was not a bad person, and if she was the only one I talked to I would probably not complain, but at this point I am interested in developing some new coping skills and honing those I already have.  She seemed interested in chatting to see what cropped up.  I did not dislike her in any way, but neither did I think, “Hey, this is a person that can really help me.” 

The second in-person interview was the only man of the bunch.  I really liked him right off the bat. He wanted to schedule a full session for our interview because he thought it would take that much time for him to get to know me well enough to be clear about what we both needed.  He also said that he had not really been interviewed so clearly before.  Admittedly, I did walk in with a notebook and some questions. He was really clear about his process in a way that I responded to and I did think that he seemed like a person who would help me achieve my goals. 

When I asked him about his past work experiences and what led him to private practice, he was really frank.  He was working in a challenging outpatient mental health setting seeing several groups daily.  He loved the work, but when the associated hospital was bought the administrative group changed and that side of his job became so cumbersome, he decided to try private practice. He said that he really liked working with the other staff in the outpatient group and that they collaborated well.

The third interview was with a woman who quickly made me somewhat on-edge.  I was several minutes early, and she walked through her reception area without acknowledging me even though she practically tripped over me on her way to her office.  I was the only person there, so it seemed sort of awkward.  

When I asked about her past experience, she talked at some length about the (same) outpatient mental health setting she apparently ran. She said that she was the clear leader of the therapists on staff and talked for some time about the programs she developed single-handedly. She stated she left that setting because she had outgrown all they had to offer. She then went on to discuss all the treatments that she developed and how great they were. She talked about herself almost the entire visit.

The differences between the second interviews was starkly obvious.  I really responded well to the man I interviewed and he seemed like someone interested in my goals and helping me achieve them. The first woman I interviewed was nice enough, but not really someone I “clicked” with, while the third person was someone that I responded quite negatively toward. I think that the point of interviewing a therapist is to find the right fit for you. Having a clear set of goals is helpful, and having a clear process for interviewing is a must.

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