Questions to ask a therapist, counselor, or psychologist in Tacoma, WA

What questions should you ask a therapist, counselor, or psychologist before you get started in therapy?

If you read my first blog Finding a therapist, counselor, or psychologist in Tacoma, WA you know that finding a counselor in Tacoma is totally doable. Maybe you made a short list, and saw that all of them offer a free consultation, but what does that look like? What should you ask? And what do you need to know to make the most of it?

Questions to ask a Therapist in Tacoma

I feel you! I get this question a lot from friends and family, and TBH, even though I’m a therapist, it can be just as hard for me when I’ve been looking for a counselor I trust and like to help me through an unexpected event, hard feelings, or a difficult break up. So I came up with a short list of questions, and some pro-tips so that you can go in prepared, because -let’s be honest- I get butterflies in my stomach when I have to call someone new, and when I’m feeling sad, anxious, lonely, or otherwise vulnerable it’s a hundred times harder. So let’s get rid of a couple of those butterflies. Set them free, and make the call!

Before we even get started, my first pro-tip is to think of this call kind of like a job interview, but you are the interviewer. This can help to rebalance the power, and that can be an important part of therapy. (Look at you already starting to do the work!) If that feels too foreign, you can also think of it like a blind date. While it’s not romantic (big no-no!) it is the beginning of a new -possibly intense- relationship, so it’s normal to have some sweaty palms, awkward moments, and hope they like you too.

Question #1: Do you have experience working with the issues I am looking for help with?

Why this question is important: Sometimes when someone calls a counselor they just want to get this part over as quickly as possible. But even though therapists are well trained in a wide variety of problems and concerns, we also each have our areas of expertise, or even concerns and problems or types of people we prefer to work with because that’s when we do our best work!

Think of it like a job interview: You want the best person for the job. You want them to have experience doing the job you are hiring for, so if they don’t, that’s ok, but you’re looking for the best candidate.

Think of it like a blind date: You want the prospective partner to be a good match for you. People connect through similar and complementary traits and experiences. While your date may be a good person, if they don’t want kids (or do), don’t like to travel (or do), or don’t like long term relationships (or do) and that doesn’t match with you, that’s ok, but you’re gonna keep looking for someone who’s a better fit, right?

What to look for: You want to find someone who hears what you’re asking and empathizes with the pain you are experiencing. You may not know all of the jargon they use, so it’s totally ok to ask them to explain what things mean. This is a first opportunity for you to see how your therapist will attend to your concerns. A good response may help you feel more relaxed, feel like your concerns have been heard, and that your therapist is capable and attentive to addressing your needs and concerns.

How I might answer this question as the therapist: “I’ve dedicated my career to mental health and wellbeing, and I’ve worked with people in all stages of their mental health journey and in many different settings. I’ve got a lot of experience with a lot of different issues, but the people I do my best work with are women who are kind and are trying so hard to be good people. They come to me because they are feeling overwhelming anxiety or pressure to perform, they are struggling in their relationships and aren’t sure why, and they are holding on to beliefs that are limiting them from being their authentic self. They are having panic attacks, crying spells, feel like an elephant is on their chest, or are numbing through drinking, cannabis, retail therapy, or lots of vacations to exotic destinations. They are conflicted with bending to others, or standing up for themselves and doing what they want to feel happy and fulfilled. They often have religious or childhood trauma that is exacerbated by being a woman. They often have past or current relationships that are emotionally controlling or manipulative. They typically excel in their career, and have a few very solid friendships, but struggle with trusting many people around them. How does that sound compared to what you’re experiencing at this time?”

Question #2: What does therapy look like with you?

Why this question is important: There are a million-and-one (or probably more!) ways to do therapy. Many people get their idea of what therapy looks like from TV, social media, or horror stories of when someone (maybe them) saw a therapist and it didn’t go well. I always ask my potential clients this very question, because I want to know what you’re coming in with. And, the answers I hear most often are “I don’t really know” or “talk about my problems, maybe learn some skills to help me cope with anxiety, depression, my relationship, etc.”. And while the first is totally valid, and the second is totally true in many instances, I like to say “therapists are like dogs. We are all the same species but not necessarily the same breed. If you want a Chihuahua and get a Great Dane, you are not going to be happy and it’s going to be a difficult experience.” And, if you are not a dog person, it’s good to know before you get too far into it, therapy is not the only way to address mental health, it’s just one way that works especially well if you are open to it.

Think of it like a job interview: You want the candidate to know what to expect in the job and vice versa. Negotiating the job description and asking and answering any clarifying questions is important to do so that you can both be satisfied with the job duties, description, and expected outcomes.

Think of it like a blind date: You want to know what to expect from this first date. Is this a one night stand or first interview for marriage, or are the two of you going to have some fun, meet new people, maybe make a love-connection at some point. All of the outcomes are totally ok, but you definitely want to know if you are on the same page, right?

What to look for: Someone who uses more than just jargon and technical language. If a person is saying “person-centered”, “CBT”, or “EMDR” or other language you may or may not have heard, but don’t understand what that looks like in actual appointments, it’s ok to ask them what that means and how that looks in the work you will do together. A good start is a therapist that gives you a basic idea of what a session looks like, or what a course of treatment might look like, generally. Obviously your personal situation will affect how long you will be in counseling, and you can decide what that looks like for you.

How I might answer this question as the therapist: “Therapy with me can be pretty intense, but in a good way! It is often very conversational, educational, and structured. It’s also fun. Sometimes there are tears and big feelings, always there is empathy and my hope for you seeing you as you truly are, and learning to love yourself first, most, and always.

I educate about neuroscience and the latest discoveries in the mind-body connection and mental health. We discuss your values, beliefs, thoughts, feelings, goals, actions, relationships, communication, boundaries, intuition, and so much more. My clients say that they like that I explain what is happening in their brain and body when they experience anxiety, depression, panic attacks, or other symptoms. And that I explain why these feelings are important evolutionary protections, and how to use them as strengths and recalibrate them.

My clients also say that they love my values and boundaries activities, and we use these discussions regularly through our work together as you reconnect to your internal wisdom. I also use Lifespan Integration as a very targeted approach for trauma, ptsd, relationships, self-discovery, and building emotional resilience.”

We do talk about your current problems, and learn coping skills along the way, but we do so much more so that you can not only learn to “manage” your symptoms, but actually find relief, heal from past or current traumas, and reconnect to your internal wisdom. My hope is that through our work you will learn how to soothe yourself and seek supportive relationships and experiences so that you can live mentally healthy without being in therapy for years or feeling like you need a safe place to talk to someone forever because you will learn how to have authentic conversations with trustworthy people, and trust yourself. You will achieve optimal mental health and know what to do when circumstances show up that challenge your mental wellbeing. Doesn’t that sound nice?

Question #3: Do you take my insurance or have a sliding scale?

Questions to ask a therapist, counselor, or psychotherapist in Tacoma, WA Therapy 101 series: your need-to know-guide. Connect at www.counselinginwashington.com

Why this question is important: Eek! The money stuff! It is best to try to get this question answered even before you call (check out their website or online directory profiles, or call you insurance benefits representative to find out), but currently in the world of mental health, the truth is, it’s getting harder and harder to get into a counselor who actually takes insurance and doesn’t have a long waitlist! That’s a blog for another day, but if you want to know a bit more about why it’s so hard to find a therapist who accepts your insurance who you can actually see, check out John Oliver’s recent piece on mental health in America today.

But this question is important because therapy costs money, and it’s good to know who’s paying the bill, how much it’s going to be, and what it means if you or your insurance pays, or if your therapist subsidizes the fee with a sliding scale. And a lot of feelings can come up when money and emotions are showing up in the same space. Paying for therapy can be hard because it can bring up complex thoughts and feelings.

Additionally, human nature shows us that we like to spend money on things that trigger the pleasure signals in our brains, and we avoid things that trigger pain signals in our brains. Put these two well-studied facts together and you see that paying a big therapy bill where you are likely to experience some discomfort and unpleasant feelings as part of the process, may be part of the reason why people avoid therapy for years and prefer to spend money on vacations, expensive clothes, cars, and toys, and still feel like something is missing.

Think of it like a job interview: An employer wants to know what it’s going to cost to hire an employee, and what part of the budget that is coming from. And an employee wants to know if the wage is going to be worth the work, and provide them with the money they need to pay their bills, save for retirement, and have some spending money. They may also want to know if it’s worth all the hard work they will have to do at the job.

Think of it like a blind date: Somebody’s going to have to pay the dinner bill or you may both be washing dishes at the end of the night. While traumatic experiences can create intense emotions between mutual survivors...it’s ok not to seek those experiences out. They show up too much in today’s world anyway. Just decide how the bill will be paid before you even start the date.

What to look for: A therapist who clearly explains your financial obligation and what payment options are available to you. Ask further questions if you are unclear about what private payment, insurance reimbursement, or sliding scale options look like.

How I might answer this question as the therapist: “I' am a private pay therapist. This means I do not work with insurance providers. I also do not provide special receipts for OON (out of network) insurance reimbursement. I realize that this can impact accessibility, but I find that I do better work when I am not having to deal with the rollercoaster that is currently required for therapists to work with insurance providers. I hope that this environment changes so that mental healthcare is more accessible, but I do not anticipate working with insurance providers in the foreseeable future because I also value the privacy of my client’s records, and want to limit third-party access to your personal mental health records. You may be ok with providing this information to insurance, but I am not. I have seen how mental health records can negatively impact a person’s employability, insurance coverage, and other areas of life.

I also believe that there is a lot of empowerment that can come from paying for your own therapy out of pocket. This is how I have personally paid for any counseling I have received in my life. I realize that not all budgets are the same, but I believe that the transformational impact of therapy warrants the financial investment. It may take shifting some things around in your budget, or going without some other discretionary items, but having worked in a variety of mental health settings and primarily with clients who were unemployed or underemployed, I know that there are resources available, and that the service I provide is not right for everybody.

I also do not provide a sliding scale. As a solo private practice owner, my business model does not support subsidizing anyone’s fees. I give back in other ways including providing free professional peer consultation groups, volunteerism to communities in need, charitable giving, and 20+ years working with underserved communities.”

I hope that however you decide to pay for therapy, you are thoughtful about the investment you are putting into your mental health and the powerful ripple effect it can have in every other area in your life.

Question #4: How frequently and how long do I need to come to counseling?

Why this question is important: It can be hard enough to show up for therapy, so having some idea of what to expect and for how long, can help you feel a bit more control as you start counseling. Also, it is not uncommon at some point due to schedules or big feelings, to have some ambivalence about why you are even coming to therapy, and how long it will last. So knowing at the start creates an understanding between you and your therapist about your commitment to the work and any expectations about when to be done.

Think of it like a job interview: Knowing the work schedule helps employees and employers know what to expect from each other when it comes to actually getting the work done. Some jobs are contract jobs and some are indefinite. Some therapists (and many insurance providers) have set treatment structures or limits to treatment. Some therapists have a more open-ended or long term therapy structure and therapy could foreseeably never end.

Think of it like a blind date: This one may not be asked so directly, but there is usually an undertone of “am I going to see you again? When?” if things go well. And even if it’s unspoken, both parties usually know if they want to see the other person again and maybe even how often. And sometimes endings are clear, and other times they are not. But it saves a lot of heartache to find out up front.

What to look for: A therapist who can give you a basic idea of what to expect. Your own reasons for counseling, and what comes up throughout the work, may impact this, but therapists have a general idea of how long and how often they typically see their clients to deliver best results. Regular and consistent therapy has shown to provide the best outcomes for change, so plan to make it a priority in your weekly schedule for at least three to twelve months, as a general recommendation.

How I might answer this question as the therapist: “My clients who come weekly show and report the most impactful change and progress toward their goals. I find that if clients are wanting to come less than weekly, it may be that they are feeling some ambivalence about therapy, something else is showing up in life that is a priority for them, or it may just not be the right time for them. Because of this, I only see clients committed to weekly therapy.

How long my clients stay in therapy depends on why they came in and what shows up through our work together, but generally clients come for 6 to 12 months or 20 to 40 weekly sessions. I have also had clients come in with specific, acute concerns and receive targeted Lifespan Integration therapy in 2 to 3 months or 5 to 10 weekly sessions. If clients need more than 12 months of therapy I may refer them to another provider who offers longer term therapy. My hope is that my clients finish therapy with the insight, awareness, tools, and supports in place to achieve optimal mental health and that our relationship becomes naturally unnecessary because they know what to do without me guiding them.”

Question #5: What are the next steps to get started with therapy?

Why this question is important: If you’ve had a good consultation, you probably want to know how you can schedule an appointment, or if there is anything you need to do before you actually get in to see your therapist. It is a common fear that the first therapy appointment is where you have to “get into it”. While some therapists work this way, silently looking at you until you say the first word or start word-vomiting all of your long held confessions, fears, and insecurities…many don’t. (I don’t. I’m not a fan, though I get it and that some people like it, I think there are other ways to find out all those things…like asking you.) The truth is, you may not actually “get into it” until the third contact. (Consultation call -> intake & assessment appointment -> first therapy “get into it” appointment).

Think of it like a job interview: You want to know when the start date is…so things can get started. But there is usually onboarding that happens before. Probably filling out some forms, financial logistics, and even an orientation. This all happens in therapy too.

Think of it like a blind date: You may already have each other’s contact information, but at the end of the night there is often a moment where you both are communicating -in body language and words- when the night ends, how it ends, and if/when another date will happen. Nobody likes going in for a kiss only to get an ear, and fake numbers are for solicitors, not people who genuinely liked you and want to get to know you.

What to look for: Look for someone with a clear process. You may set up your next appointment at the end of the call, so have some ideas in mind -or your calendar close- so that you can schedule something. Find out if your therapist does a regular weekly spot, schedules week by week, or has self-scheduling. Be flexible with when you can meet. So many people want weekday appointments after 5 pm or weekends, believing that you have to have that time because therapy in the middle of the day will be too much, but really, it’s not. You go to doctors, dentists, lunches, and movies (you’ve never played hooky during work to go to a movie??? Do it!!) during work, you can take an hour a week during work to attend to your mental health. Let’s normalize employers supporting time off for mental health treatment because it increases productivity, wellbeing, and general rapport.

How I might answer this question as the therapist: “If you are ready to start, let’s get you on my schedule. Once we set a date to meet, I’ll email you some documents from my secure online portal. You complete them at least 24 to 48 hours before your first appointment. This confirms your appointment. Your credit card will also be charged at that time to reserve your spot. If you are unable to complete your paperwork by then, your appointment will be canceled and you can call to reschedule once it is complete. I cannot hold your spot if your paperwork is not complete or your payment method does not work. Do you have any other questions for me today?”

Now that you know what questions to ask a therapist in Tacoma it’s time to call those counselors you found

I hope this helps you find the right therapist in Tacoma. If you are still feeling stuck, give me a call at (435) 776-5959 for a free 15-minute phone consultation. I’d be happy to see if I can help or direct you to the right person. If you are looking for help with trauma or relationship counseling for women, you can read more about how I can help here.