Analytic Vision

What Questions to Ask Your Psychologist

Posted by Ştefan Alexandrescu on 17/05/2010

[later edit: welcome to the most read article of this blog. enjoy!]

Last week I have met a former client of mine who asked me how to figure out weather the psychologist he is seeking for counseling is more or less competent. So a good question came into my mind. I would like to share with you my own subjective opinion on that.

The psychological & psychotherapeutical market in Romania has developed during the last years, although themselves the service providers don’t pretty much have any clue on how to promote their services. I know the situation is different around the world, so my suggestions won’t be limited to Romania, but applyable all around the world.

Besides that, there are plenty of specialists, among which you can suraly find a good one. So I will give you some suggestions on what to pay attention to.

First of all, stay away from any service providers who are deeply in love with one specific method or type of psychotherapy. A good psychologist, even if (s)he is specialized in one particular form or method of intervention, must know different and alternative approaches and must be able to provide reasons for why (s)he picked it. That is, (s)he can offer argumented opinions on differences between the approaches (s)he studied and must be able to say why (s)he chose a particular specialization. Also, (s)he must be able to tell you on what kind of problems their specialization works better on. Considering different types of problems, there are different types of suitable approaches.

For example, for troubles in childhood which affect the present life of the client, short-term therapy will not do. It might work: psychoanalysis, transactional analysis, psychodrama, hypnosis, cognitive-behavioral approach. It might provide less effects: neuro-linguistic programming  or jungian psychotherapy.

For anxiety disorders, post-traumatic stress disorder or burnout, you would use neuro-linguistic programming, hypnosis, cognitive-behavioral approach and even psychiatry but rather not psychoanalysis.

So a good services provider must tell you what type of problems does what (s)he’s good at solves. (S)he might even give you examples of types of problems which he solved of a certain kind. The worst kind of answer that you could get is “this works for everything and with anyone” or “I haven’t tried other methods”. If you hear this, just say hello and walk on by.

Another kind of therapists you should stay away from are those who combine spirituality into therapy, or have new-age approaches. If you do not know what “new age means”, please read and watch documentary here [ro&en, php] and here [ro&en, php]. Stay away from these people. Religion is not therapy, although it can offer therapeutic insight. Therapy is not religion, although it might offer spiritual inisght. Keep them separated.

Another thing which you should pay attention to is weather while during talking to him/her,  (s)he interrupts you. A good psychologist must have the ability to listen first, especially while talking to a potential client, and not cutting him/her off while (s)he tries to put questions. A psychologist must, before all, have respect for the client’s inner reality, beliefs and values. That’s why a good psychologist will not approve or disapprove in any manner and in neither case will it emit judgements upon a client’s saying without prior understanding their inner world. A client does not need get the psychologist’s approval, but understanding. The experience of a psychologist does NOT determine their quality as a professional. One can be 30 years of experience and not have basic listening skills and one can have 1 year of experience and have a great deal of interpersonal skills. The quality of the service provided does not depend upon the experience, but upon the personality. Remember that before passing any judgement on psychotherapists or psychologists.

For example, if you believe that UFOs are driven by aliens, I myself would think you’re talking bananas, but that is my own opinion and I am not a psychologist. But a service provider in this field is not allowed to pass any form of judgement, no matter how silly your belief might seem to them. It is your belief and you are entitled to any belief you desire, consciously or uncounsciously. The psychologist must accept it as part of your model of the world, listen to your opinions and respect them, no matter how different they are from their perception.

Ask the psychologist on which criteria does (s)he determine the number of sessions necessary for a certain type of problem and how (s)he structures his/her time during the therapy and during each session. A good service provider must be able to convince you that (s)he has a strategy that has been proven to work.

Ask the psychologist of any potential challenges (s)he has met during his/her career, especially in confrontation to a certain ethical aspect from the psychologist’s deontological code. If (s)he says (s)he has never had challenges it is because:

a) (s)he’s lying

b) doesn’t have enough experience  or

c) doesn’t know the ethical requirements of the job.

Nobody is perfect, and a good psychologist would not deny challenges. (S)he might avoid to answer the question, but (s)he wouldn’t deny such challenges exist. It is better for you to get an answer when putting this question.

Another question to ask is what is the longest period a client has been in therapy. If the service provider answers: “oh, I have clients which go back years, about 3-4”, say hello and walk on by. A therapist who does his job does not make a certain client dependent on him or her, but makes sure that client is getting improvement throughout the process. In some cases, therapy might even take up to 2 years, but any good psychologist, when going after a certain term, must be able to explain WHY (s)he decided to continue therapy with that particular client. Even if it’s a process that takes time, it doesn’t have to take too much time, otherwise you might just be looking at an incompetent or a money-drier.

Ask him or her about the training (s)he’s taken, and about his/her plans for personal development. Such a job requires continuous improvement. If since completing licence or master’s degree, the only training (s)he took was in the main area of expertise (let’s say, psychoanalysis, or hypnosis, or transactional analysis – but only one), it is rather likely that psychologist does not have a broad enough perspective. A good service provider must continuously improve himself/herself.

Ask the service provider what tools of diagnosis does (s)he have. How did (s)he acquired those skills, where did (s)he practice them and for how long? An important part of solving the problem is to call for a right diagnosis. How much time is it alloted to diagnosis? A good psychologist would allot at least 1-2 initial sessions for diagnosis and also must tell you that there is a variate set of diagnosis tools. In some cases, simple questioning might do it, and some might say they have just developed that intuitively. Even if that is the answer, the service provider must explain where did (s)he learn it from, for how long, where did (s)he practiced it, with who, and with which results.

Some psychologists, due to the long process of training, become stiff and tend to think they know it all. The good ones don’t. So they are open to feed-back, as they know feed-back is source for continuous improvement. A good question is “What feed-back did you recently applied and worked”. If they make a pause or look at you blank, just say hello and walk on by.

And, as a final tip, to get a business approach, you can ask the psychologist what’s his/her charge and then put the question: “what are you offering me for this money?” and you will see weather the service provider has a selling pitch or not.

Remember that a psychologist may claim a number of things, but in the same time, (s)he must be able to argument each of those claims with training and/or experience. The simple fact of not complying to some of these request doesn’t mean that the psychologist you’re talking to is incompetent or wants to rip you off. It might not be their fault. In the mean time, the fact that a service provider is well-intentioned or sure of himself/herself doesn’t mean that you should just blindly write a white check and definitely trust them. Some of them might do you more harm than good, even without realizing it.

Another thing to pay attention to is to judge carefully for references. If a friend of yours says a certain psychologist is great, it might mean that service provider is good for them. Not necessarily also for you.

Considering you expect to pay for getting quality questions from a service provider, be sure to get the right answers to earn quality!

I consider that excellent professionals and unfortunate incompetents exist. Both get clients. The problem is that an incompetent ruins someone’s trust to get a good service provider and an excellent professional might not help a customer due to harm done to him/her by an incompetent.

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