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Questions for Your Prospective Therapist, From Your Own Couch Questions for Your Prospective Therapist, From Your Own Couch
(about 13 hours later)
From anxiety and loneliness to trauma and grief, the coronavirus pandemic is rattling our psychological well-being. According to a poll conducted in April by the Kaiser Family Foundation, 54 percent of women and 37 percent of men say the pandemic is worsening their mental health. Concerns about family members getting sick, economic instability and job loss were the survey respondents’ top worries.From anxiety and loneliness to trauma and grief, the coronavirus pandemic is rattling our psychological well-being. According to a poll conducted in April by the Kaiser Family Foundation, 54 percent of women and 37 percent of men say the pandemic is worsening their mental health. Concerns about family members getting sick, economic instability and job loss were the survey respondents’ top worries.
In this tangle of stress, a growing number of people may turn to a therapist for guidance. Your first appointment with a new therapist can be stressful itself, and these days many of these meetings are taking place by phone or video, which may make it harder to connect than in a face-to-face meeting. But as with an in-person session, patients should be prepared to ask therapists questions to help figure out if they are a good fit.In this tangle of stress, a growing number of people may turn to a therapist for guidance. Your first appointment with a new therapist can be stressful itself, and these days many of these meetings are taking place by phone or video, which may make it harder to connect than in a face-to-face meeting. But as with an in-person session, patients should be prepared to ask therapists questions to help figure out if they are a good fit.
Research has shown that interviewing a prospective therapist can help patients determine whether or not the therapy is right for them. As behavioral researchers have found, queries are the building blocks of connection and conversation. Answers to questions can also reveal how it feels to interact with someone new. And when it comes to therapy, research indicates that therapist and patient compatibility plays a significant role in treatment success.Research has shown that interviewing a prospective therapist can help patients determine whether or not the therapy is right for them. As behavioral researchers have found, queries are the building blocks of connection and conversation. Answers to questions can also reveal how it feels to interact with someone new. And when it comes to therapy, research indicates that therapist and patient compatibility plays a significant role in treatment success.
Here are some questions to get you started.Here are some questions to get you started.
First, ask about the therapist’s educational background and licensure. Licensed therapists are familiar with ethical guidelines, such as maintaining patient confidentiality, maintaining boundaries and practicing within the scope of their expertise.First, ask about the therapist’s educational background and licensure. Licensed therapists are familiar with ethical guidelines, such as maintaining patient confidentiality, maintaining boundaries and practicing within the scope of their expertise.
It is also useful to ask about the session fee and whether or not the therapist accepts insurance or offers a reduced rate.It is also useful to ask about the session fee and whether or not the therapist accepts insurance or offers a reduced rate.
Therapy is a broad term, which can imply that all mental health professionals provide similar services. However, they vary in their education, training and ability to prescribe medication. For example, psychiatrists are medical doctors who prescribe medication to treat symptoms of mental illnesses like generalized anxiety, bipolar disorder and major depression. A clinician with a Ph.D. or a Psy.D. is a psychologist, while one with a master’s degree may be a social worker or psychotherapist. They and other types of mental health counselors may offer psychotherapy. Unlike psychiatrists, they do not prescribe medication; instead, they use “talk therapy” to help patients overcome their struggles.Therapy is a broad term, which can imply that all mental health professionals provide similar services. However, they vary in their education, training and ability to prescribe medication. For example, psychiatrists are medical doctors who prescribe medication to treat symptoms of mental illnesses like generalized anxiety, bipolar disorder and major depression. A clinician with a Ph.D. or a Psy.D. is a psychologist, while one with a master’s degree may be a social worker or psychotherapist. They and other types of mental health counselors may offer psychotherapy. Unlike psychiatrists, they do not prescribe medication; instead, they use “talk therapy” to help patients overcome their struggles.
Collective traumas and tragedies can affect our mental health in myriad ways. A recent survey conducted in China found that nearly 35 percent of respondents experienced panic disorder, depression or phobias related to the Covid-19 pandemic.Collective traumas and tragedies can affect our mental health in myriad ways. A recent survey conducted in China found that nearly 35 percent of respondents experienced panic disorder, depression or phobias related to the Covid-19 pandemic.
“For any given problem, several treatments can work,” said Joshua K. Swift, a clinical psychology professor and researcher at Idaho State University. Because of this, “all prospective patients should inquire about the therapist’s treatment approach and whether or not there’s evidence it works.” How each therapist answers this question is often guided by their clinical style.“For any given problem, several treatments can work,” said Joshua K. Swift, a clinical psychology professor and researcher at Idaho State University. Because of this, “all prospective patients should inquire about the therapist’s treatment approach and whether or not there’s evidence it works.” How each therapist answers this question is often guided by their clinical style.
For example, psychodynamic and depth-oriented clinicians often help patients unearth insight about the source of their suffering. For those struggling with concerns like relationship woes, difficult family dynamics or grief, psychodynamic therapy can be particularly useful.For example, psychodynamic and depth-oriented clinicians often help patients unearth insight about the source of their suffering. For those struggling with concerns like relationship woes, difficult family dynamics or grief, psychodynamic therapy can be particularly useful.
Cognitive-behavioral therapists often see emotional distress as a result of misguided thinking. Focusing on symptom management, these therapists rely on behavioral strategies, such as mood tracking and cognitive exercises, to invoke change. Patients experiencing acute anxiety, insomnia or eating disorders, for example, may find this approach helpful.Cognitive-behavioral therapists often see emotional distress as a result of misguided thinking. Focusing on symptom management, these therapists rely on behavioral strategies, such as mood tracking and cognitive exercises, to invoke change. Patients experiencing acute anxiety, insomnia or eating disorders, for example, may find this approach helpful.
Trauma-informed psychotherapists use methods like eye movement desensitization and reprocessing, accelerated experiential dynamic psychotherapy, and somatic experiencing to help a patient process painful emotions using a body-based approach.Trauma-informed psychotherapists use methods like eye movement desensitization and reprocessing, accelerated experiential dynamic psychotherapy, and somatic experiencing to help a patient process painful emotions using a body-based approach.
In addition to learning about the therapist’s technique, asking how they measure progress and what success they’ve had treating patients with similar concerns are also useful questions to ask, Dr. Swift said.In addition to learning about the therapist’s technique, asking how they measure progress and what success they’ve had treating patients with similar concerns are also useful questions to ask, Dr. Swift said.
Open-ended questions, such as “What types of patients do you enjoy working with?” can yield useful information about the therapist’s preference and interpersonal style.Open-ended questions, such as “What types of patients do you enjoy working with?” can yield useful information about the therapist’s preference and interpersonal style.
For instance, a therapist may respond by saying, “I’ll answer your question, but before I do, I’m curious what my answer might mean to you?” Others may depict their “ideal” patient by describing who they enjoy working with and why. In some cases, therapists may see the question as an opportunity to ask the patient, “What type of therapist are you looking for?”For instance, a therapist may respond by saying, “I’ll answer your question, but before I do, I’m curious what my answer might mean to you?” Others may depict their “ideal” patient by describing who they enjoy working with and why. In some cases, therapists may see the question as an opportunity to ask the patient, “What type of therapist are you looking for?”
Regardless of the therapist’s answer, patients should pay attention to how the response makes them feel. Psychotherapy researchers have found that effective therapists convey understanding, authenticity and expertise. During the first meeting, these qualities can help solidify a collaborative union between the patient and therapist.Regardless of the therapist’s answer, patients should pay attention to how the response makes them feel. Psychotherapy researchers have found that effective therapists convey understanding, authenticity and expertise. During the first meeting, these qualities can help solidify a collaborative union between the patient and therapist.
When suffering is immense, especially during and following a crisis, people long for relief. However, therapy doesn’t immediately lift one’s pain. Indeed, talking about one’s pain may feel hard at first, at least temporarily. How soon treatment begins to work often depends on the severity of the problem and the amount of past adversity the patient has experienced.When suffering is immense, especially during and following a crisis, people long for relief. However, therapy doesn’t immediately lift one’s pain. Indeed, talking about one’s pain may feel hard at first, at least temporarily. How soon treatment begins to work often depends on the severity of the problem and the amount of past adversity the patient has experienced.
Distress brought on by the pandemic can come in various shapes and sizes. For some, situational difficulties, such as working from home, home schooling or being an essential worker, can bring immense stress. Patients with these challenges may benefit from time-limited or brief psychotherapy, according to the American Psychological Association.Distress brought on by the pandemic can come in various shapes and sizes. For some, situational difficulties, such as working from home, home schooling or being an essential worker, can bring immense stress. Patients with these challenges may benefit from time-limited or brief psychotherapy, according to the American Psychological Association.
Updated June 5, 2020Updated June 5, 2020
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
Those struggling with more acute problems, such as the unexpected death of a loved one, unresolved childhood trauma or post-traumatic stress disorder, may need ongoing care until the traumas are worked through.Those struggling with more acute problems, such as the unexpected death of a loved one, unresolved childhood trauma or post-traumatic stress disorder, may need ongoing care until the traumas are worked through.
Research suggests that effective therapists provide an explanation for the patient’s suffering, discuss how therapy works and ask for feedback. Of course, each patient’s situation is unique, and as therapy unfolds, goals can change.Research suggests that effective therapists provide an explanation for the patient’s suffering, discuss how therapy works and ask for feedback. Of course, each patient’s situation is unique, and as therapy unfolds, goals can change.
After interviewing your future therapist, ask yourself: “What’s my gut feeling tell me about this person?” said Benjamin Lipton, an A.E.D.P. psychotherapist in New York. If something feels amiss, honor your experience and ask follow-up questions.After interviewing your future therapist, ask yourself: “What’s my gut feeling tell me about this person?” said Benjamin Lipton, an A.E.D.P. psychotherapist in New York. If something feels amiss, honor your experience and ask follow-up questions.
A therapist may have pristine qualifications and glowing online reviews, but if the interaction feels off-putting, it’s unlikely that trust and safety will be established. In the end, these two ingredients are essential in any new relationship, including the one with your therapist.A therapist may have pristine qualifications and glowing online reviews, but if the interaction feels off-putting, it’s unlikely that trust and safety will be established. In the end, these two ingredients are essential in any new relationship, including the one with your therapist.
Some resources:Some resources:
National Alliance on Mental Illness Covid-19 Resource Guide.National Alliance on Mental Illness Covid-19 Resource Guide.
Covid Coach: a free mobile app developed by the National Center for P.T.S.D. The app offers anxiety management strategies and stress coping tools.Covid Coach: a free mobile app developed by the National Center for P.T.S.D. The app offers anxiety management strategies and stress coping tools.
American Psychological Association Covid-19 Information and Resources.American Psychological Association Covid-19 Information and Resources.
Juli Fraga is a psychologist in San Francisco. Hilary Jacobs Hendel is a psychoanalyst and emotion educator in New York.Juli Fraga is a psychologist in San Francisco. Hilary Jacobs Hendel is a psychoanalyst and emotion educator in New York.