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interviewing therapists


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Everything I've ever read on getting a good therapist says you should interview each therapist before deciding whether to keep them. But every therapist I've ever done a session with (and I've done this with a number of therapists) assumes that I'm there for keeps and that the initial session is for them to ask me questions. My asking them questions doesn't even enter the picture. It isn't just what happens within the session; it's the whole process: recommendation from insurance company for two or three therapists, of which you are expected to pick one; insurance authorization for X number of sessions with that therapist; extensive intake material prior to seeing the therapist.

So the external advice is telling me that I have a free-market-type relationship with therapists, but nothing else about getting set up with therapy suggests that. I have the option to violate social norms by insisting the therapist follow my directions and answer my questions, but I find it difficult to do that because I know that violating social norms tends to damage relationships before they begin, and because it's hard for me to explain to people I barely know why I'm doing something inappropriate and uncharacteristic, and because it's just hard for me to step all over other peoples' expectations, due to my own personal history.

But I am supposed to interview therapists, although I'm not sure I know anyone who ever has. This probably actually would result in my getting a better therapist. I just don't know how people make it happen without being inappropriate in a session. Do you tell people repeatedly ahead of time you want an interview, not an intake? Do you get it in as fast as you can in the actual session before they can ask you any questions? What if they do ask you questions - how do you bring it back around to asking them about their approach or whatever, especially if they're asking you something heavy? What do they say when you say you want to interview them?

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Some questions to ask them:

How long have they been practicing?

Do they have experience treating Bipolar disorder (or whatever your illness is)

What type of therapy do they use? Ask them to explain how it works.

Do they consider themselves to be an effective therapist?

How long do they imagine you will be in therapy? When will you start to feel better?

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I have never "interviewed" any therapists, per se... but the last time I was in therapy, I had first visits with 3 different therapists before I picked one. I actually met with the woman I chose first, but felt like I wanted to see several people before I commited to one. It's funny, because in reading your response I completely see what you mean, how it's not geared towards really shopping around. But I had no conception about what it was "supposed" to be like and I guess I just assumed that what I was doing was normal.

For what it's worth, I didn't have anybody (including BCBS) give me a hard time about it.

But like I said, I didn't interview them. I filled out all their intake paperwork and talked about myself in that first visit kind of way... and then I guess I just kind of picked the one I had the best gut instinct about. But I'm kind of intuitive like that- I'm more comfortable going with my gut than trying to figure out the logic behind things a lot of the time, which I know is maybe the opposite of how you prefer to make decisions.

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I'm with you Resonance. I can't see conducting "interviews" with the professionals. I think MG's questions are perfect, and about as much as I would expect to ask. For the most part, unless there are glaring problems that hit you in the face when you walk in the door, you pretty much have to "jump in" and start talking.

a.m.

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I don't know that I ever interviewed three or so therapists and then picked one. i do know that i went in to see my current therapist very unsure about whether I would want to keep him, but actually, I think that first visit was more of an instinctual rapport thing.

i have to say that the rapport thing is completely subjective. maybe that's obvious, but i think it's perfectly logical, that when you meet someone for the first time and they totally rub you the wrong way, that it might be better to go find someone else. they obviously either aren't making the effort to know you or make you comfortable, and/or the natural vibe is just so off and will only get worse.

i also should point out that i didn't just find my therapist in the yellow pages, I went to a training school in my city, and I knew them on reputation (my good friend's parents were co-founders of the school), and with my intake appointment and some research on their website I came to feel comfortable with the approach they train their students in. I pay out of pocket, and being able to afford psychotherapy was important, and I was comfrotable enough with him being in his last year or so of schooling. It felt like a really good way to forge a relationship with a therapist, and really, both of us grew into feeling comfortable with the process.

I am not really sure what you mean by breaking social rules with a therapist. I think that while there may be bureaucratic conventions that make choosing amongst options difficult, i doubt that most therapists would be offended by a client actually saying they want to make an informed choice before investing a huge number of hours with them.

and as far as i'm concerned, the only social rules in therapy are the ones that the client and therapist work out together. beyond the standard professional codes of conduct, i don't think there is anything set about where the boundaries lie, what you talk about, how sessions are supposed to go, even really who asks the questions -- sometimes in my therapy *no one* asks questions, and a lot of the time, it's me who is asking the questions (not about the personal life of my therapist, but asking things out loud, to the universe, or asking *with* my therapist)..

i don't know if this makes any sense. i think it's perfectly fine to take charge of an initial session if you can manage to do so. and if you end up getting a huge amount of resistance or obstinance or attempts at seizing back control from the potential therapist, go the other way. a good therapist should notice that stuff with the intent to maybe discuss in the future whether this is 'a problem' (i'm not saying it is, but some could regard a take charge 'i'm going to interview you' approach with some kind of pathological character trait) -- in other words, unless they are willing to go with the flow to 'know' you, which initial sessions are designed to do anyway, they are obviously too rigid and prescriptive to be respectful of *your* process, and too caught up in who has the power to actually be able to *see* who you are and your problems and actually be able to help you.

interview appointments should be free. no therapist should charge the insurance company for it, so the insurance company shouldn't care. you take the three options, call them, and say you want to meet for an intitial consultation -- much like one would do with a lawyer. this is pre-intake. or, you could arrange to have some time during intake for them to answer your questions. it's perfectly ok to ask them things like what their politics are or whatever -- i talked to the intake person about my being gay, and how it was important to me that the therapist was sensitive to these issues. My therapist is a queer man, and this was important to me. It could be something like are they aware of autism issues; are they pro-choice or not -- because if you were ever faced with that, and your politics differ, that could present challenges (which could be an excellent opportunity to work through issues)..

man, i could talk forever about therapy.

there are always opportunities with every therapist, even one we get two and a half years into working with before going, 'um, maybe i should switch, this is feeling way too frustrating' or whatever. i've chosen therapists because i thought that working with them would be more challenging than someone else. sometimes that worked for me, sometimes it didn't. ultimately there isn't a wrong choice, really. just how willing you are to work through what you need to work through, with as much flexibility and grace as you can muster.

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Never heard of interviewing therapists, always thought it was more of a gut instinct type of thing, seeing how you feel when you see them a few times initially. I took an instant dislike to one of mine but the one I have now is great.

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The last therapist I went to asked me towards the end of the session if I had any questions for her. That's one way to do it. As the session closes, if he or she doesn't ask that, say something like "actually, can I ask YOU a few questions?" I doubt there will be an issue and if there is, you have an answer; that is the wrong therapist.

I have also read somewhere that a good therapist won't charge you for the initial session (I don't remember where) but I doubt this often occurs in practice.

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i always demanded it. if the therapist got annoyed, i assumed we couldn't work together lol.

i hate the idea that you belong to them after one session. like they don't realize you can shop for doctors and therapists...

anyway, come up with your list of questions and let them know when you set up the appointment that you have a few questions for them before you get started. *grin*

abi

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