You've decided to seek help from a therapist and you've found a few in your area that you're considering. Before setting up your first appointment, any good therapist will take time to answer your questions on the phone to make sure that you and him/her are likely to be a good fit. Research shows that the "fit" between you and your therapist is as important as the type of treatment they provide. Since we're dedicated to people living with chronic illness, our list is specific to this.
Here are 8 questions that everyone should ask:
- What is your approach to treatment?
As we'll talk about in a future blog post, there are MANY approaches to psychological treatment out there. Your experience will be different depending on this, so it's important to know what theory the therapist works under. Common answers include Cognitive Behavioral Therapy (CBT), Interpersonal Therapy, Psychodynamic or Psychoanalytic, Humanistic/Existential, Family Systems, Acceptance and Commitment Therapy (ACT), Mindfulness Therapy, and Client-Centered Therapy. Some therapists might say they're "eclectic" or they use multiple approaches. While this is relatively common, you want to know what their primary approach is. For example, my approach is CBT and I understand the client's experience and develop my treatment based on this theory. I may borrow from ACT or Family Systems depending on the person, but my overall approach is from the CBT model.
- How many clients have you seen with (insert your condition here)?
The therapist should be able to give you a ballpark estimate, not just "several." Ask for some specific examples about how they worked with someone with your condition. If they don't have experience with your illness, that may not be a deal breaker if the person has extensive experience with other illnesses (see next question).
- Do you have any specialty training in chronic illnesses?
If a therapist is advertising that they work with people with chronic illness, they should have some specialty training in this area. This may have happened in graduate school in during their post-graduate work. For example, I have a degree in clinical psychology and my graduate school offered a specialization in "health psychology." This means I took extra classes on physical illnesses, working in medical settings, and specific treatments for chronic conditions. The therapist may have experience working in medical settings, such as hospitals or outpatient clinics, or have attended professional conferences. Ask about all of this.
- How long does your typical client work with you?
There is no way we can predict how long treatment will take for each person, but we can give a range of how long most clients work with us. This will also depend on the treatment approach of the therapist. For example, CBT is generally designed to last up to 6 months where Psychoanalysis is designed to last several years. Any experienced therapist should be able to give a general statement about how long they work with most of their clients.
- Do you accept insurance?
There's a bit of a debate in the mental health world about accepting insurance. Some do, some don't. This has a lot to do with the red tape often associated with working with managed care companies as a mental health provider, as well as sometimes-severely discounted fees that we're paid by the insurance companies. If the therapist does not accept insurance, ask how they work as an out-of-network provider and will work with you to obtain reimbursement for fees you'll be paying out of pocket.
- How will you work with my physician?
A good therapist working with people with chronic physical illnesses will want to be part of the treatment team and not work in a bubble. If it is important to you that they work with your regular physician, ask how they typically do this. Most will, with your permission, contact your doctor and discuss your treatment without going into great detail about your problems. Rather, will discuss what brings you in (anxiety about having a relapse in cancer symptoms, for example) and what the treatment plan is. They will send an update if anything major changes and then send a treatment summary when you are finished.
- What are your fees? Fees that therapists charge vary, and will differ depending on what part of the country you live in. Ask if they charge for the first visit/consultation or if this is provided free of charge. This will also vary by therapist. If you have limited finances, ask the therapist if they offer a sliding fee scale or reduced fees based on your income and family size.
- Do you have any references?
Ask to speak to some of their other professional colleagues. They can't give patient references because of confidentiality rules.