Choosing a Therapist: A Guide With Questions to Ask

How to Choose an Individual or Relationship Therapist And Identify Red Flags Indicating It’s Time to Exit

Let’s begin with a few preliminary points before we get into how to interview and choose a therapist. 

It can be hard to know how to determine the way your therapist will respond if you are experiencing ongoing abuse and are still in that relationship. If you find yourself currently in an abusive relationship, or if you are in a post-separation period and want to heal, most recommendations shared here will help you find the type of therapist best qualified to serve you. 

Have you ever wondered, “Can couples therapy make things worse?” 

If you have, the reality is it can.

Why? 

It’s often challenging for people in destructive, confusing, or abusive relationships to find a qualified expert who thoroughly understands and can identify the underlying root cause of their relationship problems and the proper protocols to intervene. Untrained therapists who do not have the expertise to utilize best practices that are unique to complicated or abusive relationships are more likely to cause further stress, confusion, and harm. Suppose you are separated or divorced from an abusive partner. In that case, you want and deserve to have a therapist who thoroughly understands the dynamics and patterns of behaviors you experienced and may continue to experience post-separation, causing more trauma.

In this article, we will unpack how to interview an individual and relationship therapist and recognize the red flags telling you therapy isn’t working. We will have a deeper look at:

Okay, let’s dive in.

Have you ever felt your therapist was missing the mark or not providing you with the support you needed? 

Not all therapists are the right fit. Listen to your gut. 

Their experience and specific continuing education courses determine their qualifications and specialties, and their personal story and unconscious biases may not be what is best for you. 

Why a Counselor with Experience in Narcissism or Domestic Abuse and Trauma is Important

An essential requirement for your counselor to meet is experience, education, and training in dealing with narcissistic and domestic abuse and trauma.

Some people engage in covert or overt abusive behaviors learned from their family of origin. It doesn’t always mean the relationship is technically “abusive.” But this does not mean those behaviors are less damaging or don’t need to be identified, addressed, and resolved.

In other words, we can all act poorly at times. When a therapist points out the harm our behavior is causing another, healthy individuals immediately implement meaningful change. An abuser who is entrenched in faulty beliefs and thoughts will not. They may stop one specific behavior, but they will replace it with another abusive behavior. Therefore, finding a savvy therapist who can identify confusing, manipulative behaviors and quickly determine whether or not your abusive partner has entrenched characterological faults or simply a few bad habits that can be quickly resolved is essential. 

The therapist also needs to understand the importance of providing unwavering support for the person on the receiving end of the harm due to the trauma abusive behaviors cause. Being willing to name, confront, and understand the depth of the problems will enable the therapist to intervene on your behalf unwaveringly.

Another reason it’s essential to have a therapist who can identify whether abuse is at the root of your relationship problems is that most abuse experts consider couples therapy to be strictly contraindicated for couples where any form of abuse is present. There are numerous reasons for this that we will get into.

A relationship assessment is helpful. This requires an individual session with each person first. Then, if it’s beneficial to have a session with both of you to view the dynamics firsthand, that can follow the individual sessions.

Why is that so? 

Hidden Forms of Emotional Abuse Create Confusion and Chaos

There are forms of hidden emotional abuse that are extremely difficult to understand and almost impossible to detect without the proper education and training. 

Many victims in covert emotionally abusive relationships do not realize they are experiencing a form of abuse, and it can take a very long time for them to gain sufficient clarity on their own to understand they are being victimized.

The hidden or covert forms of emotional abuse are just as damaging as other forms of abuse and among the most destructive to children.

Even one emotionally abusive behavior repeatedly employed is enough to be destructive to a relationship. 

Consider repeated lying, regularly blowing things out of proportion, or continually denying. These are just a few examples of what would seriously undermine emotional safety in the relationship and turn the therapeutic session upside down. 

If you are experiencing covert emotional abuse, it’s essential to get the help of a therapist who is trauma-informed and experienced with abuse. 

They will help you get clarity, which is the first step to healing. 

Abusive behaviors must be labeled using proper language for the victim to gain the essential clarity needed to heal. It’s also essential to name and understand these behaviors so you won’t be blindsided and drawn into another endless circular conflict when they are employed against you the next time. 

A Word of Caution About Couples Therapy

The couples therapy session can quickly become a “He said, she said” situation. Suppose the therapist cannot see the deceptive or covert behaviors as they are playing out during sessions. In that case, the partner on the receiving end of the harm can feel mischaracterized by their partner and abandoned by the therapist. In contrast, the one causing harm becomes emboldened to carry on destructively during therapeutic sessions where the therapist is manipulated. This dynamic, where you feel abandoned by the therapist while the abuser ramps up their harmful behavior, can be very traumatizing. A good abuse therapist can detect abusive attitudes and behaviors from a mile away. They are not likely to be wrongly influenced or miss manipulative tactics. On the other hand, an untrained therapist can be fooled for months or even years, and the secondary harm caused by misguided therapy cannot be overstated.

Narcissists may blameshift, lie, use false accusations, or gaslight you and the therapist. They have many internal reasons for rewriting history in ways that frame the innocent partner as being the destructive one. Suppose the counselor does not recognize these assertions as false. In that case, you will likely sit in the hot seat, forced to defend yourself rather than experience the therapeutic validation you need and deserve. Being falsely accused would create anxiety in just about anyone. If you have been experiencing recurring trauma in your relationship, anxiety in therapy will produce more trauma. Sessions with an untrained therapist will feel chaotic and harmful.

Another reason why caution around couples therapy is recommended is after you communicate your feelings vulnerably within therapy, it’s not uncommon for abusive partners or narcissists to exploit that by shaming or exposing you later - in private or public. It’s key to find a therapist who understands these dynamics and who won’t put you in a position where you’re not being protected emotionally or physically.

The untrained therapist can make things worse for the one experiencing harm by minimizing the problem or problems or asking you harmful questions that place responsibility for the problem at your feet. For example, they may ask, “Why did you get so angry?” Or, they may say, “As long as you are reactive, you’re both harming each other and are equally responsible.” The therapist does not recognize the signs of trauma that have been brought on by recurring maltreatment.

These forms of misdirected therapy can be highly problematic and traumatizing for you.

Most couples therapists treat problems in the relationship as a mutual 50/50 issue. The National Domestic Violence Hotline states, “There is no such thing as mutual abuse.”

Countless couples have spent years in therapy with multiple therapists to no avail because the therapists failed to identify the underlying issue: covert emotional abuse.

How to Shop for a Therapist

Shop Around to Find the Right Therapist.

Dr. Diane Langberg, Christian psychologist expert in trauma and abuse, says we should thoroughly vet a counselor, the same way we would vet a new babysitter before leaving our children with them. It is a very serious decision that can potentially do tremendous harm if the counselor is not equipped. 

You are responsible for shopping for a therapist before deciding on the one that best suits you. It’s essential to recognize that not all therapists are equipped to handle the particulars of your personal or relationship issues. 

You wouldn’t go to a family doctor to treat you for cancer, would you?? 

Of course not. The same is valid for counseling services, where your trauma symptoms or the cancer within the partnership is related to emotional or physical abuse.

Many therapists offer free phone consultations. You won’t hurt a professional’s feelings if you tell them in advance you are shopping for a therapist and ask for a consultation before deciding to use them. Take advantage of this opportunity.

So, where do you begin? 

If your health insurance covers therapy, you may want to start your research with those in your health insurance network. It’s helpful to explore a counselor’s website and google their names to see what others say about them. Explore the list of specialties they boast and their training if they list it. Make sure they are trauma-informed so they can adequately address past trauma and current relationship trauma as essential parts of their comprehensive therapy. 

If you can’t find a qualified therapist locally, consider online counseling services with someone outside your area. 

Online individual therapy may be a good option as you seek a qualified professional. The pool of therapists you can choose from online is broader. If you live in an area with limited resources, this can be a great option for you.

Questions to Ask Before Choosing a Therapist

Below is a list of questions you will want to ask and some reasons why. These questions will help you determine whether or not you should be in couples counseling and how to find the therapist who will be the best fit. Present yourself with confidence and kindness—your disposition matters. 

If a Counselor is defensive or uncomfortable with your questions, they are not the one for you. It’s best to look for a therapist who appreciates your seriousness about getting the right help.

What is the therapeutic environment regarding fair and agreed-upon fees, reliability of scheduled appointments, length of appointments, timeliness, completely safe and confidential environment, and out-of-session availability?

You want a therapist who will take an emergency phone call for a few minutes outside a scheduled session and who won’t charge you. You also want to find a therapist who will give you a full hour or close to a full hour instead of only 45 minutes.

Ask the therapist about trauma education. Are they qualified to diagnose PTSD and complex PTSD?

If they answer yes to your question, ask them what training they have had. Use your discernment to know if they are equipped to provide you with emotional safety rather than trigger you. It’s also critical to determine if they serve all trauma populations or choose to work within a specific category of clientele. Some trauma-informed counselors work with veterans. Others work solely with single-event trauma. You need someone who is trained to diagnose trauma and who works with recurring relationship trauma. You also need to listen for red flags. For example, if you have been married for ten or twenty years and they ask you why you stayed so long, run, don’t walk to the next therapist. They are demonstrating they don’t understand trauma bonds, how complicated it is to unravel hidden forms of emotional abuse, or how trauma compromises cognitive thinking.

What is your education and training in abusive behaviors?

Don’t settle for an answer that says it was part of their educational requirement because a counseling degree only requires 6 hours of abuse training or credits. To decide if they can help you, they need to have numerous hours of abuse training, which the American Psychological Association provides as continuing education. Each licensed professional must complete a minimum number of continuing education hours annually. If you like this therapist, asking them to complete courses on this subject is not unreasonable. You can direct them to The MEND Project’s website, where we offer a comprehensive course for licensed professionals sanctioned by the American Psychological Association in partnership with the Institute on Violence Abuse and Trauma.

What specific training did you have that qualifies you to work with my ethnic population?

If you are part of a specific ethnic culture that accepts hierarchical behaviors against a particular gender, you need someone who is culturally educated. They should be able to tell you about their continuing education courses, how long ago they took them, and whether or not they continue to take classes on this topic.

How would you define abusive behavior in a relationship?

If they answer by naming only physical abuse or overt emotional abuse, then you can see their lack of understanding regarding covert emotional abuse. A skilled therapist will understand the terms gaslighting, blame-shifting, minimization, and so forth, and the therapist will consider these types of behaviors to be traumatizing and abusive. If the therapist says, “Using the word abuse is a bit harsh, so I avoid it,” you’ll know you’re not in the right place.

How many couples have you counseled that were in abusive marriages or relationships?

One or two couples will not be a robust sampling. Suppose the therapist tells you they have been working with couples successfully for many years. In that case, this does not necessarily mean they are qualified. You might respond by asking them, “How did you handle couples where narcissistic abuse was involved?” Their answer will be very telling. If they say they worked equally with each partner, you know they are not following best practices. They are not the right person for you if they tell you they disagree with labels.

Do you feel all marital problems are the responsibility of both parties? In other words, are marriage problems mutual responsibility problems?

When it comes to abuse, the one causing harm is 100% responsible. Abuse is a choice. It’s not an accident, and it’s never the victim’s fault. That said, many untrained therapists aim to align with both partners. They won’t confront the abuser, and they won’t fully align with the victim, even if it is your individual therapist, which is the opposite of best practices and the opposite of what you need and deserve. A therapist treating marriage problems as mutual may ask, “Why did you antagonize or make him so angry?”

Do you see covert abuse - emotional, verbal, psychological - as damaging as overt emotional abuse or physical violence?

The Centers for Disease and Control lists these as equaling damaging behaviors. Covert emotional abuse causes severe trauma and can result in prolonged states of high stress and confusion, what are known as trauma states, for months, years, or even decades.

If you were counseling a couple and it became clear that the husband was being emotionally abusive to his wife, what steps would you take, and what advice would you give?

The response you are looking for is to stop couples counseling immediately, serve you individually, and help the husband find a qualified therapist until he gets dedicated help for his abuse. And if you desire reconciliation, you see longstanding evidence of change.

Ask them if they have confronted abuse. Did they label the behaviors abusive, or did they avoid being straightforward? If one spouse demonstrated entrenched narcissistic beliefs, did they name it so it could be validated and understood by both parties?

If the therapist says something like, “Naming abuse would cause the husband to leave therapy” or “I’m not hired to confront,” you will know you are not with the right person.

How would you help establish emotional and physical safety for the victim? What referral sources would you offer regarding legal, medical, advocacy, or emotional abuse resources?

If the therapist readily states who they refer clients to, you can determine their experience level and advocacy involvement. Good therapists will periodically vet resources and be willing to advocate for you in difficult situations if you would like them to.

What is your strategy for working with abused wives?

Hopefully, they have a plan to understand your need to feel safe, heard, and believed, and help you strengthen and love yourself well, etc. The right therapist will be open by sharing that victims likely will need to reframe their thinking patterns and attitudes about relationships and their personal identity. They will also be excellent listeners and have a broad plan for the healing steps you must address in therapy to process what you’ve been through, support you through your trauma symptoms with understanding and compassion, and help you determine how you can improve connectivity with safe outsiders to help you progress away from isolation. We’ve said how clarity is the first necessary step to healing at MEND. For a nominal fee, the MEND Project offers a comprehensive course for victims and survivors called Finding Clarity and Healing in Difficult, Confusing, or Abusive Relationships. Many who have taken this course report that it saved them a year or more of therapy. Upon completing the four-module course, you will gain a clear understanding of the underlying issues, proper language to describe your unique circumstances, the mindset of the abuser and why it’s so difficult to see the change in them, and finally, critical information regarding the ways you think about yourself that probably need to be reframed to improve and strengthen your view of your self-worth.

If religion applies to you, ask, what do you believe religious texts say about manipulative or emotional abusers and how to deal with them? Is there a case for separation and divorce with covert abusers?

You are looking for an answer that includes, but is not limited to, a path to “yes, there are cases for divorce.” What do they believe from religious texts? These questions are critical when seeking Biblical counseling or religious counseling. You don’t need a therapist who misuses religious texts to guilt you into trying harder or staying if you determine the best choice for you is to leave. Even if you choose to stay, their rigid stance can leave you carrying the lion's share of the responsibility, which is not reasonable or possible.

How would you define spiritual abuse?

If they are vague or protective of a religious organization, they may not understand or respect how damaging this has been in your life. If they aren’t trauma-trained, they will misinterpret your disposition and reactions. They may conclude you are an unstable or angry person. If there isn’t room for you to freely express what you’ve been through and receive their unwavering support, you risk being criticized, wrongly judged and even shunned if you don’t follow their advice. If religion applies to you, you want them to respect your beliefs while at the same time being able to name spousal spiritual abuse, clergy, or lay counselor spiritual abuse. They also need to understand their role to support you confidentially and adequately to avoid the risk of group abuse by a congregation, which can happen when you decide to complain about your spouse, expect to receive the church's support and allegiance to you and support you in the possibility of divorce.

You might ask if the therapist treats couples and individuals or if you plan to participate in a marriage enrichment course with an outside organization. When treating a couple together, what types of assessment do they give the couple in advance to ensure joint therapy or a marriage enrichment course is appropriate for them?

Some therapists might be surprised by this question, which gives you your answer. Experts in the field and MEND, too, feel strongly that all relationship therapists implement a simple relationship abuse assessment tool or questionnaire before beginning with couples therapy. At the very least, a skilled therapist will interview each person separately and then have a joint session to complete their assessment.

As a mandated reporter, what protocols do you follow?

If you have children, you must clearly understand what they will and will not report to police or child protective services and why. Children who live in an abusive home where stress is the norm are more likely to experience their own trauma than not. This is something that requires your serious attention. Children in the developmental stages of life can suffer life-long mental and physical health issues from early trauma. It can also be helpful for a therapist to be part of the process of reporting to Child Protective Services to verify who the abusive parent is.

What therapeutic modalities do you utilize when helping abuse trauma victims heal? What is the usual process leading to healing if in your care?

A good therapist will draw from therapeutic modalities that are proven in research to work well for victims of abuse. Dialectical Behavioral Therapy and IFS are two modalities that have shown much success. The counselor should be able to outline that obtaining clarity about the behaviors employed against you is the first step to healing. Then, deeper work is to be done regarding your lower sense of self-worth or lack of love for yourself, which often originated in your relationship with your primary caregiver(s), even if your parents weren’t abusive.

During an assessment with a couple, if you see abusive behaviors, do you confront them?

You want a therapist who is willing to confront the abuser and name abuse as the problem but who will not do so until the potential fallout has been thoroughly discussed with you. You don’t want your therapist to confront the abuser or say anything you haven’t first discussed and are in agreement with. The therapist must respect and care for your emotional and physical safety.

What is your therapeutic stance in terms of controlled separation, reconciliation, or divorce?

The answer to this question will give you a good idea of their belief system regarding separation or divorce. The right therapist will not impose any pressure to stay or to leave. It’s your choice alone to decide what, how, and when is best for you.

Final Thoughts

Please don’t allow yourself to be intimidated by any therapist. While they have knowledge and expertise in certain areas, they are human beings who aren’t perfect. They are not an authority figure over you. 

You hire them. 

Don’t languish in ineffective therapy. It’s unfortunate, but a good therapist might not be suitable for you, especially if they lack the skill set to identify and respond to the underlying issues causing your specific relationship problems. It’s a priority to partner with a therapist on your healing journey who follows best practices for your situation.

Taking a break is okay if therapy isn’t sitting well with you. You are your best advocate. Make it a point to take good care of yourself. You don’t need to appease your therapist.

If unsure, seek a second or third opinion, and so on. Time apart will give you the clarity you need to decide.