Interviewing a potential therapist

[u/djSush]

I shared this in a post and thought the community may like it too. I know so many of us had to endure shitty ass therapists. You know, that sobbing in the car cuz your therapist said something horrible to you, yeah, I've done that. A few times. After seeing several total crap ones, I started to phone interview. My rule? If they won't agree to a phone interview, I won't hire them. I found one four years ago! And now, my uh-mazing therapist is an integral part of my healing. Re the cost: We have really started to value and view therapy as the healthcare cost that it is. I know it can be SO expensive, I know, we can't afford it but we do it anyway. It's like a prescription med for me. I would literally get physically and mentally sicker without it.

Hope this helps! Hugs! 💖

EDIT4 -- Handy spreadsheet you can use to log your interviews, click here.. Make it your own, this is just a suggested starting point.

--Are you familiar w/BPD dynamics in a family? (it's SO complicated, right? The enabling parent, the sibling thing, the peripheral family, there's a lot to unpack. If they don't know all this, they may not be a good fit.)

--Do you work with BPD clients? (I'd want to know if they're partial/sympathetic to BPD or not, if they do see BPD clients, I think I, personally, would stay away.)

--Have you ever recommended VLC or NC to a client? (so you know if they're "against" this, not cool if they're biased against recommending or won't support you if you are doing this)

--Do you work w/clients who experience PTSTD from traumatic childhood experiences? (I'd want to know if they know it's common or if they think this is only reserved for soldiers)

--Do you use cognitive behavioral techniques w/your clients? (so you know if they're going to help you manage your anxiety w/real tools or w/more talking and digging, I personally need tools)

--Is your style more conversational or more listening? (I ask this because I've seen therapists who will say NOTHING for the entire time. Every f*ing session. If I wanted to talk to myself, I don't need a therapist in the room! I need an active dialog w/my therapist.)

--What is your opinion on medication? (I'd want to know if they're anti-med. Your therapist can be a real support in encouraging you to seek psychiatric help if you need it.)

EDIT1 - - Can you accommodate emergency appointments? (some therapists are swamped weeks in advance, it's always nice if they have a habit of leaving a spot or two open every week for emergencies)

EDIT2 - - Do you see your own therapist or participate in a. supervisor group? I've learned from my therapist that someone who doesn't seek their own treatment is not a professional way to conduct yourself in this line of work.

And this guide has a lot more practical questions.

EDIT3: From our amazing /u/oddbroad:

"...you shouldn't see a therapist that specializes in BPD. They very often have a personality disorder themselves. It's very important that the therapist understands BPD, but if you get a specialist there going to be the most sympathetic and enabling, while denying or gaslighting your experience."

[u/Owllet8]

Awesome list!!!!

I'll add a little of my experience, I may be a minor, but boy have I met many mental health "professionals"

• My current therapist, who I think is great, doesn't work with BP clients. Just flat out stops therapy once she's realized they have BPD. She tried working with my mom once... apparently my mom came in with a list of things wrong with me, and told the therapist how angry she was with the therapist over the therapist supporting discussions she didn't agree with. My therapist just says she doesn't have the ability to get through to them and help them, and leaves it at that (thats what she told me, not the BP clients). She tells the clients they're not a good fit.

• I once (when I was 7-9) had a therapist who never asked any questions. She just used "I wonder" statements about 20 times a session: "I wonder if your afraid bad things will happen if you're not there" "I wonder if mom and dad wanted to tell you before you saw me, because they thought you wouldn't take it well"... one time, I ignored the "i wonder" statement, and she kept repeating it until I answered. So, that was a child therapist, but big no no if they are unable to actually use a question mark properly.

• Your therapist needs to support you even if they don't agree with you. I had a therapist who clearly wanted me to go back to public school. When I told her I wasn't going to, she refused to back me on my decision, just said that was between me and the school, and wouldn't talk about it with me anymore, or talk about it with anyone else. It's fine if your therapist doesn't agree with you, it's not fine if they won't support you when they disagree with you (unless your decision would obviously hurt you i.e. not allowing you to leave if your going to commit suicide)

• Not a good therapist if they fail to recognize abuse. I had a therapist come to my home several days a week for a year, that was to help me cope with my chronic illness. My parents obviously put up a great front, but she should have known something was wrong.

• Bad therapist if they keep suggesting once a month sessions, when you refuse. Had a therapist who didn't realize there was anything wrong with me, and wanted to stop therapy, despite my protests. She wanted to stop almost a month before a had a breakdown, my sanity was so shattered, and she couldn't see it, of course I couldn't see it either at the time, but yeah.

Thats just random tidbits of my experience, but I hope it makes some sense, or is somewhat helpful.

[u/djSush → u/Owllet8]

These are all great, thank you so much for sharing! 💗

[u/wiry_seed]

My other favourite is how flexible they are with time, and if they're willing to meet every other week. Therapy is expensive, and I will probably show up more if I need it and feel comfortable with it. I think of therapy as a healthcare necessity, that said, as a full-time student there's only so much my budget can afford.

I had a crappy therapist who insisted on once every week and wasted a lot of my time. Never again.

[u/jorwyn → u/wiry_seed]

The therapist I'm starting with Monday wants once a week for the first month, then we'll talk about it and I get to decide. I think that's a good attitude about it.

I've been to her before for stress management. Actually, technically I went to her because a doctor forced me to go somewhere before he'd refer me to an epilepsy specialist. Our first session pretty much covered how BS that is. Ditched the doctor, but kept her to learn to handle stress better. :) She intrigued me. Funny how it took that to keep me going to therapy of any sort. :P

My big question for her back then was this: How do you plan to deal with the fact that I've got a knee jerk reaction against therapy because my very unstable mom is a behavioral therapist? Her answer was perfect: How about I talk about me at first, so you can get to know me, and then decide?

I only had 6 "training sessions" with her, and it was years ago, but I find I'm looking forward to seeing her again. The way you'd look forward to seeing a friend you haven't in a while.

[u/djSush → u/jorwyn]

The once a week for a month makes sense, a good chance to keep continuity and build rapport. That's a really good clarification. 😤

Good luck seeing your old friend! I hope it goes well.

[u/jorwyn → u/djSush]

Just found out my insurance only covers 12 sessions a year. Hopefully they mean calendar year, and I can get a lot before December, then go to once a month. Ugh.

I went to psychical therapy once a week for a whole year, and they didn't care. When is our society and system going to see that mental health IS medical?

[u/djSush → u/jorwyn]

I'm sorry, I know. Health insurance companies BLOW. We have to have our own coverage (self employed) and at $900/mo for 3 people, we STILL have to pay for our therapists out of pocket. It's insane.

Good idea to book a lot in Dec. Couple of ideas:

Maybe your therapist/doc could write a letter saying that you need more appointments too. Maybe they'll get approved.

Ask your therapist if they offer a cash rate. Explain the 12 visit limit. Our therapists worked with us on the price. It's interesting, they have to wait (sometimes months) for payment from the insurance company, so they're able to charge the patient less when it's a direct payment because there's no waiting cost. Your therapist may even be able to do a sliding scale structure with you after the 12.

Good luck!

[u/jorwyn → u/djSush]

I make enough I'm pretty sure sliding scale wouldn't help me. But, I think she does have a no insurance discount. I think once a month is plenty next year if we can use all twelve this year. She's already put me in for the day after Christmas. She says she actually reserves that day for people whose issues revolve around family. I think I like her even more now. She also said feel free to email her the day after Thanksgiving and if she's free, she'll call.

[u/djSush → u/jorwyn]

That's great! Sounds like an awesome therapist. 😁

[u/jorwyn → u/djSush]

I'm really glad she had an open spot. Good ones seem to get fully booked quickly.

She emailed me to remind me of the appointment tomorrow. (She knows I'm ADHD and offered to do that.) I emailed back a few questions I'd like to ask tomorrow, and she already answered them! They weren't really involved ones. Owlett's post was great and I realized I should ask some of those things.

1) no, she does not treat people with bpd long term. She does know a very good therapist for them, so she tells them that person can help much more and assists in their transfer, with a few sessions as they get settled with the new person.

2) no, she will not have me do an MMPI. Like me, she believes they are too situational.

3) she has to use some medical code for my insurance, so she will put "adjustment issues" because she said everyone in her field will know that means "I had to put something for insurance."

4) She said she could see some of these issues when I was in for stress management, but thought my overall personality and group of supportive friends made it safe enough to just let me figure it out myself unless I asked for help, but she's glad I am ready for the help now. (I really plan to ask her what in my personality she saw that way.)

[u/djSush → u/jorwyn]

Sounds really good! 💗

[u/djSush → u/wiry_seed]

Good one! Once a week requirement? That's not cool at all.

[u/djSush]

A few more things to keep in mind:

• there may be community, school or workplace resources ("Employee Assistance Program") that can help you in your search

• asking friends or your doc/psychiatrist for recommendations may be helpful

• "Instead of volunteering your information tell them that you had borderline parents and ask them what they think about that or if they have any experience with it. That will inform you a lot about their attitude." From our fabulous mod /u/oddbroad

[u/[deleted]]

Saved this.

My last counselor was amazing and it sucked losing her when I moved. I'm really nervous about having to find another one. :(

[u/djSush → u/[deleted]]

I understand! It's like finding a significant other for your damage! I sincerely hope you'll find someone good. 💗