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Page Contents: Your right to ask questions in psychotherapy.                    

 

I have been seeing my therapist for 10 months now. He has never discussed with me what I’m diagnosed with or what type of treatment course is being taken. I come in, discuss my issues, concerns and leave. Now I have a lot of questions about what I’m being treated for, what’s his theoretical orientation and how long treatment is expected to last, but am uncertain how to ask him. This is my first experience with therapy and did not ask any of the questions—I guess I should have initially—solely out of a lack of knowledge. How now do I ask these after seeing him for 10 months. I would like to know about his educational background, etc. It seems a mute point now to ask after seeing him all this time and I fear he’ll tell me this if I should ask, so I don’t. Any suggestions on how I can bring this up in our discussions?

 

Actually, asking the questions is the easy part. All you have to do is write down the questions, pull them out at the beginning of your next session, and say, “Before we begin with anything else today, I have some questions I’d like to ask.” Then start in. It’s that simple.

The hard part is a completely different issue.

Now, it seems pretty clear that you learned about all these questions by visiting my website. But the question for you is, “Why, after 10 months of psychotherapy, did you decide to visit my website?” What was happening—or, perhaps more appropriately, what was not happening—in your treatment that sent you off looking for answers?

You see, if your treatment had progressed properly, you would have learned the answers to your questions already. Any psychotherapist should discuss his or her license, education, theoretical approach, and expected length of treatment in the first session when you review the treatment consent and office policies form. You should have been given a diagnosis—if you wanted one—within the first two or three sessions. So I can guess that after 10 months of “discussing your issues” you began to think—and feel—that something was not right.

So, first of all, congratulations for recognizing that feeling.

As for what to do about that feeling, it really can be a genuine part of your psychotherapy. If your psychotherapist is competent, then after you have asked your questions, and if they have been answered non-defensively, then the psychotherapist will turn to looking at the underlying feeling that led you to ask those questions after 10 months of treatment. On the other hand, as you can tell by reading some of the other questions in this section, there are a lot of “bad therapists” out there. Given that your psychotherapist failed to discuss some very important issues right from the beginning, and may not have even had a proper treatment consent form, then you may have to face the fact, after 10 months, that you have picked someone who isn’t very competent.

In any event, you will have your real answer when you ask those questions. If asking the questions gets the treatment rolling into a deeper understanding of the therapeutic relationship, then everything is fine. But if your questions provoke a defensive reaction from the psychotherapist, and if the psychotherapist never raises the big Why? as a clinical issue, but instead makes you feel embarrassed or stupid, then you might want to start a search for someone more competent. And, of course, if it comes to that, this time you will know the right questions to ask.

 


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Raymond Lloyd Richmond, Ph.D.
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