Questions for a therapist---was I being unreasonable?

[frogjumpsout]

Hi everyone,

I'm looking for therapy to deal with the effects of having PD parents and grandparents, so set up a brief phone interview with a therapist I was thinking of hiring, who'd been recommended by a friend. I had a list of questions to ask her:

1. Do you consider Cluster B personality  disorders to be a valid diagnostic category? (She doesn't because "we're always changing"---not really my experience with PD individuals, so maybe I should have ended the interview there.)   

2. Do you have experience treating patients working on the effects of having been raised by abusive family members, or family members diagnosed with PDs? 

3. What are your approaches in helping those patients? (She got sort of vague here---"It all depends on the patients and their stories.")

4. Do you have any personal or clinical experience with individuals diagnosed with PDs? Could you tell me a little about that? 

At this point, she laughed, sputtered, and said, "I'm baffled by all these questions, no one's ever asked me these questions, and I don't think they're a good approach to our trying to get to know each other."

I thanked her for her time and got off the phone.

Were these questions out of line, or is she just the wrong therapist for me? I won't be using her services, but I had thought a lot about these questions and am planning to use for future interviews...unless, as she suggested, the questions are somehow freaky.

Thank you for reading!!

[Penny Lane]

These all seem like reasonable questions to me! I actually think the questions worked very well for you here - I don't think she would be a good fit for you and you saved yourself the cost of the first several appointments. I think you should definitely keep asking them so you can screen out others like her.

[frogjumpsout]

Thanks very much, Penny!! It may not have come across in the original post but I was sort of freaking out...that unsettled feeling of "maybe I did something really wrong and I don't even know it." I'm glad that it seems like it was just a bad fit.

[Associate of Daniel]

I think you were spot on with those questions and want to congratulate you on being strong enough to ask them.

I hope you find the right therapist for you quickly.

AOD

[frogjumpsout]

Thanks so much, AOD. Your kind words mean a lot.

[Whiteheron]

Ooh - I like those! I may use a few if I decide to go back to T.

[frogjumpsout]

Thank you, Whiteheron! If you do use them, I'd love to hear how things went.

[Scarlet Runner]

I think your questions are perfectly appropriate and that having a set of questions is helpful for both therapist and client. When I was looking for a therapist I had a list of similar questions (not quite as specific, but similar) and talked with two therapists - both of them answered my questions with kindness and clarity. I would encourage you to keep using your questions and I hope you find someone who is a good match for your needs. I think it is very important to find someone who has experience with working with PDs, as that has been a life-saver for me in my journey.

[frogjumpsout]

Thank you, Scarlet! It's good to know that you received a very different response when you used similar questions.

[athene1399]

I think they are good questions. For #3 when she got vague, maybe if that happens in the future ask for an example. Like I do understand what she was saying about therapy isn't one size fits all and you need to change it a bit to fit the individual, but an example of "person x had this going on and treatment style y worked well with them because it helped them with z" gives you a good idea of the T's knowledge.

I agree that she probably wasn't a good fit. To me it sounds like you know what you want out of your T and this is a good way to get there (or to know if they have experience in what you need help with).

[treesgrowslowly]

Those are all perfectly valid questions and she dos not sound like she has any insight into PDs at all. In fact, I am leery if she really does think you are paying her to "get to know each other". That's not exactly accurate to how Therapy should work. 

And also, you were trying to get to know her. You were asking questions and she didn't like it. That's a huge red flag. In a way, she contradicted herself.

Therapists and clients form what they call a therapeutic alliance but it's not a friendship. It's not lets get to know one another. If she meant "we learn if we are a good fit", again this is exactly what you were doing.

There are some crummy Ts out there and the good ones can answer questions about their areas of expertise and experiences with PDs.

You are paying her to provide responsive insights and analysis into your circumstances.

The right T for you would understand your questions and why you are asking them. You dodged a bullet with her. Keep interviewing. You will find someone who responds in a totally different manner from her and I would say, interview at least 1 more person after you find someone who "nails" the interview. To give yourself even more valdiation that you've found someone who is the right fit.

It's your health at stake, if you don't advocate for it to be treated by the best, who will? T's run the gamut. You deserve a good one. Be sure to express appreciation for their time but be clear that you have these 4 questions for them and you are seeking specialized insights that you know not all Ts have.

We wouldn't go to a dentist for foot pain. It's similar with therapy. The generalists (like her perhaps) are not specialized with knowledge about PD abuse.

I totally agree with you, her answer to question 1 rules her out in my mind because, no, PDs are not "always changing" and cluster B PDs definitely exist.

[rubixcube]

In my opinion, and from what I've read on vetting therapists, you nailed it!

I've done a lot of therapist vetting myself as well. I tend to first look online for profiles, make a huge list of facilities in my area, then call the facility and vet the secretary to gauge the therapists working there. Then I speak to the individual therapist that seem to match what I'm looking for(if they're even willing to talk). In all I've vetted over 100 therapists in my area this way. What I've found is that most are not qualified to meet the requirements I'm looking for(very much the same as your requirements).

After finding some potential therapists, I make an appointment to meet, and when I get there I tell them I'm vetting and I hit them with more questions, tell them what my goals are, and gauge their response. This way I give myself an out right away and I won't feel roped in by codependent inability to say "no" and walk away when my needs aren't being met. Some therapists I thought were great, stayed for several months, but in the end found it wasn't quite what I was looking for and had to be assertive(this is difficult for me) and tell them I'm trying something else. Time to move on.

I've found through this process there's a huge distinction between psychiatrists, psychologists, and counselors.

Psychiatrist: Mostly deals with medicine management these days.
Psychologist: A licensed professional with a specialty(this is what we want!). Far more clinical and diagnostic, if you're lucky.
Counselor: Licensed, no particular specialty(usually). Least likely to be what we're looking for, but it's possible. Depends on the person here. Mentally I equate this with general talk therapy and a much less clinical approach.

As soon as I get a vague answer from a therapist, like you did, I close out the conversation, thank them for their time and tell them I need to think about it.

Through pete-walker.com there's a recommendation for therapists that use John Bradshaw's methods. Here's a link to a site with therapists that claim to use those methods: https://creativegrowth.com/finding-therapist-outside-san-francisco-bay-area/

Keep on hunting for a "good enough" therapist!

[Pepin]

I think that all of your questions are great and valid.  If she has no answer for #2 then sheesh....

During my decades of therapy there have been a number of mental health professionals that really missed the mark - and I am beginning to wonder if they are better suited for people who get blue when there is a rainy day!  Personality disorders need to be taken seriously as they are becoming more prevalent -- and especially because we are learning more and more about personality disorders.

It is extremely rare and difficult to find a mental health therapist that is specific in one area. 

[frogjumpsout]

Athene, thank you! I did ask  some follow-up questions and got slightly but only slightly, more specific replies. For instance:
- Me: What techniques or approaches do you tend to use with patients working on these issues?
- Therapist: (huffs) I don't use techniques, I do GESTALT.

Trees, thank you for the validation and advice! I have made notes from your message to use in my next therapist interview. The advice to speak to one more person after the interviewee who "nails" the questions is especially helpful---and never would have occurred to me.

Pepin, I absolutely agree! Yesterday, I got the feeling that the therapist wished that I were asking easier questions, like she was used to giving people advice to, say, take a few deep breaths when they were anxious, or take a nice hot bath if they were down.  It's easy for the therapist to feel like a guru in those cases. And maybe the guru-feeling is the reason why some people become therapists.

Rubix, thank you for making those useful, clear distinctions and for the link! I have some codep. issues, too, and I think that's why I felt so hamstrung yesterday---blaming myself for an interaction that didn't go well. I also have previously fallen into bad habits with therapists, trying to make them feel like they'd been helpful, rather than assessing whether they actually were.  I'm older now. I hope that won't happen again.


Thank you, everyone. I feel much, much better today.

[athene1399]

Frogjump,

So it went from "I do things differently depending on the person" to "I do Gestalt" lol that sound a little contradictory. At any rate, I hope you find a good fit with someone else.

[frogjumpsout]

Thanks, Athene! Exactly.

[1footouttadefog]

Great questions and they worked.

Even of she felt put on the spot or unable to answer them, if she had experience or insight to why you were asking them, she should have addressed them in some less specific way that indicates that she heard you.

For example, I am unable to answer those questions specifically as the nature of my work is not one size fits all.  I am however hearing that you want to work on the effects of relationships and experiences with abusive or personality disordered people.  I have and have had many clients with similar concerns who had success in meeting their therapy goals.  We could discuss your expectations and goals  further in an initial consultation.

An experience professional suited to your needs would not be baffled. 

[frogjumpsout]

Thank you, onefoot!!

[Lauren17]

Thank you for posting this list! I'm impressed with your method off self-advocating.

This week, I followed my gut and decided it was time to try another therapist. I was planning a post asking for advice on how to pick, but now I'm going to use your list of questions.

Well done!

[Scarlet Runner]

I found the therapist listings at psychology today.com very helpful. You can sort by state and town, and then by specialty.