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Questions to Consider when Interviewing a Psychotherapist
The following is meant as a guide to help facilitate discussion between you and a potential psychotherapist. There are no right or wrong answers to these questions but, rather, by the way in which the therapist answers you will get a feel for his/her style of practice and how he/she may approach the issue of birth trauma. Keep in mind that many therapists may not have any previous experience treating birth trauma. Experience treating trauma in general, including clinical work supporting women who are recovering from rape or abuse, would be a good starting point.
Essential Questions to Ask:
What are your credentials and how long have you been a therapist?Most states require therapists to be licensed after they have completed educational requirements. Therapists will have different credentials based on the education they have completed. Skill and expertise come with practice and experience. Credentials and experience should be weighed with other factors before choosing a therapist.
Do you use a specific approach to therapy in your practice?There are many different forms of therapy; psychoanalysis, cognitive behavioral, psychodynamic, humanistic, etc. Many therapists use a variety of approaches to work with clients in order to tailor the therapy to the client’s specific needs. It is important to be aware of what approach the therapist uses, and weigh whether or not this philosophy is compatible with your concerns.
How long is a session? How often would we meet?Sessions are generally 50 minutes long but, sometimes, therapists will do longer sessions in certain circumstances, such as when using a specific therapeutic technique. Depending on your severity of symptoms and needs, sessions may be scheduled more or less often. On average, sessions are generally scheduled weekly.
Do you charge by the hour or by the session? What is your standard fee? Are you covered by my insurance plan?Therapists can charge a wide range of rates. Some provide financial assistance under certain conditions through sliding fee scales, and others are covered by insurance plans. Asking these questions will help you determine how you can pay for the therapist’s services. Beware of making care decisions based only upon price. A therapist experienced in treating your specific care needs may be worth the extra cost and take much less time to help you heal.
Have you had experience working with women who have had postpartum mood disorders?Postpartum mood disorders occur in mothers after the birth of a new baby and include depression, anxiety disorders such as panic, obsessive-compulsive disorder, traumatic stress, and more severe mental illnesses such as schizophrenia, bipolar disorder, and psychosis. The concerns faced by women experiencing postpartum mood disorders should be properly understood by mental health professionals through their training and work experience.
Have you had experience working with clients with post traumatic stress disorder, or other trauma based issues?After the birth of a baby, some women experience symptoms of trauma. These symptoms may include flashbacks of the traumatic event, intrusive and obsessive thoughts, avoidance of situations reminding you of the traumatic event, and/or difficulty sleeping. Over time, all of these symptoms can interfere with daily functioning. If a therapist has had training and experience working with sufferers of PTSD and other trauma-related issues, he or she will be able to recognize your symptoms as traumatic in nature and will not simply diagnose and treat a separate “postpartum depression.”
Can you share your thoughts with me about traumatic responses following childbirth?Consider that if a therapist does not think that the experience of childbirth can be traumatic, it may be difficult to work with them when you feel traumatized by your birth experience.
Do you use any therapeutic techniques in dealing with trauma? What is your training and experience with these techniques?Often therapists are trained and skilled in a variety of techniques. These techniques may include expressive therapy, dialectical behavior therapy, hypnosis, the Emotional Freedom Technique (EFT), and Eye Movement Desensitization and Reprocessing (EMDR). Asking this question will give you the opportunity to find out which techniques the therapist you are considering uses, and what their training with these techniques may be. Remember that one size rarely fits all, and a therapist should have a variety of options available for you.
Have you had experience working with women who felt traumatized by their birth experience?It may be difficult to find a therapist who has had prior experience with traumatic birth issues. If a therapist has experience working with trauma-based concerns and seems understanding that birth can lead to trauma, you may have a good match for your needs.
Do you feel that trauma from birth is different from postpartum depression? In what ways do you feel the symptoms differ?Though unrelenting trauma symptoms can lead to concurrent depression, birth trauma is not postpartum depression. A competent therapist is responsible for understanding and assessing the differences between the two. Asking a potential therapist this question should give you a good idea whether the therapist is a good fit.
Supplemental Questions to Ask
Do you feel that a woman could perceive her birth as traumatic, even when others may say it was a fairly typical experience?Researcher Cheryl Beck says that “trauma is in the eye of the beholder.” That which appears to be a typical experience may be traumatic to the person giving birth or to others who were present. A therapist ought to be able to recognize the symptoms of trauma and be willing to work with you to explore the causes and alleviate the symptoms.
Would you be open to working with me through expressive therapies, such as art or writing?Using creative expression can be very therapeutic for patients processing traumatic experiences. Many women who have experienced a traumatic birth find themselves working through that experience using art, writing, or some other creative process. A therapist may not have experience or training in these types of therapies, but may be willing to learn or work with you if you are interested in using expressive therapy.
Do you recommend any specific complementary treatments such as chiropractic or massage?It is often very helpful for clients who have experienced trauma to get some type of body work. Depending on a therapist’s style of practice and knowledge, he or she may encourage clients to employ various forms of bodywork. A holistically-minded therapist may be able to give you recommendations for practitioners of complementary treatments.
Would you be open to reading materials that I bring in about birth trauma that I feel would be beneficial to our work?A growing body of research exists on the topic of birth trauma and a therapist may be willing to stay up to date by reading sources that you share. Some therapists may not be willing to do so because of time constraints. Asking this question will give you a sense of a therapist’s style, openness and willingness to working with you on this issue.
Do you have any opinions about medications for treating trauma?Some therapists may be qualified to suggest medications for treating various issues, but are not qualified to prescribe it. If they feel a medication could be helpful, they will refer you to a doctor or psychiatrist. Some therapists prefer that their clients with depressive symptoms be on medication, others prefer to work with clients who are not on medication, and others make this determination based upon the needs of the individual client.
What is your policy on calls or emails between sessions? Are you available in an emergent situation?When recovering from a traumatic event, you may experience some times of acute need to discuss a particular concern. Some therapists allow some contact between sessions and are willing to have a short phone conversation or schedule an appointment on short notice. This question can help you gauge your need and the therapist’s ability to assist you.
Do you work with clients who practice self destructive behaviors, such as abusing alcohol or self injury?Self-destructive behaviors are a common side effect of trauma. Some therapists will refer you to other services if you engage in self-destructive behavior, but others will be willing to work with you on these issues. A therapist who does work with substance abuse and self injury may make referrals to other services if he or she feels it would be helpful. Some therapists will not work with clients who self injure, or may terminate therapy when it is discovered that the client self injures. This question will gauge the therapist’s willingness to work on tougher issues.
Do you feel that we could work together and that you could help me with my issues?A therapy/client relationship ought to be founded on mutual respect and a willingness to work together. The relationship you establish with the therapist is important, and you should feel a connection with them and a desire to work with them on your issues. After asking the questions on this list and hearing a potential therapist’s responses, you will want to know if the therapist feels comfortable accepting you as a client.
Remember that therapists are obligated to legal regulations of informed consent. The American Association for Marriage and Family Therapy define informed consent in therapy as such:
Excerpt: "1.2 Marriage and family therapists obtain appropriate informed consent to therapy or related procedures as early as feasible in the therapeutic relationship, and use language that is reasonably understandable to clients. The content of informed consent may vary depending upon the client and treatment plan; however, informed consent generally necessitates that the client: (a) has the capacity to consent; (b) has been adequately informed of significant information concerning treatment processes and procedures; (c) has been adequately informed of potential risks and benefits of treatments for which generally recognized standards do not yet exist; (d) has freely and without undue influence expressed consent; and (e) has provided consent that is appropriately documented. When persons, due to age or mental status, are legally incapable of giving informed consent, marriage and family therapists obtain informed permission from a legally authorized person, if such substitute consent is legally permissible."
Source: http://www.aamft.org/resources/LRM_Plan/Ethics/ethicscode2001.aspYou are free to be fully involved in all decisions regarding your care. If you do not understand an assessment, diagnosis or treatment-related concern, it is the therapist’s job to explain his or her thinking to you in such a way that you can understand. You should always be a full participant in your care, and never undertake treatment or a therapeutic technique which does not feel appropriate to you.
Healing from postpartum mood disorders and trauma following childbirth is very possible. With the right care team at your side, you can recover and thrive.
Click here for a PDF version that you can print and bring with you to interview your potential therapist. This PDF version has just the questions without the extended notes.
Click here for a PDF version of the questions and the extended notes.
©2009 Solace for Mothers, Inc. Permission granted to copy for personal use provided content remains unchanged and copyright and contact information is included