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10 Questions to Ask Addiction Therapists

Before you decide on a therapist, it’s important to verify any information you find on the Internet. Call the therapist and ask to speak to them directly. Ask questions to learn more about their approach to alcohol treatment. Use the Navigator Toolkit worksheets to capture the answers.

In this section, you’ll find 10 recommended questions to ask—and the answers to listen for.  Use this information to help find a therapist who has five signs of higher-quality treatment, and who is a good fit for your situation.  

Treat this process just like you would approach any other health care decision—do your research, ask questions, and use your best judgment.

Information to gather before making the call

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A therapist will want to know a little bit about the person needing treatment. You might be asked to share the following kinds of information:

  • Basics: Age, gender, marital and family status, job status?
  • Payment options: Health insurance or other ways to pay for treatment?
  • Alcohol and other drug use: The nature of the drinking problem? Other drug use? Any previous counseling or treatment received?
  • Other health issues: Any other medical or mental health issues?
  • Living and social situation: Stable living situation? Access to transportation? Social support network?
  • Legal system involvement: Any DUIs, probation, other issues?
  • Specialized needs and preferences: Non-English-speaking? Pregnant? Safety-sensitive job?    

Donʹt feel as though you need to have detailed answers to all of these questions—you will do just fine using the information you already know, even if some of your answers are ʺIʹm not sure.ʺ Still, you may want to use the Navigator Toolkit Notes page [PDF-105 KB] to help jog your memory.

Speak to the therapist directly

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When contacting a therapist, you should ask to speak to that person directly if possible. Because therapists spend most of their time seeing patients, be prepared to leave a message so that they can call you back when they are available. (Try this: ʺI am trying to find treatment for a loved one with a drinking problem, and I want to learn more about your clinical practice.ʺ)

If you donʹt hear back within 2 days, call again. If you donʹt hear back at all within a week, cross them off your list.

Tip:  It could take 20 minutes or longer to ask and answer all 10 of the recommended questions. Some therapists will be able to spend this much time with you, but others may ask you to make an appointment to discuss your situation—that’s perfectly reasonable. While it would be preferable to go through all 10 Questions, if the therapist has limited time, you will learn a lot by focusing on their answers to Questions 1, 2, 4, and 9.

 

Q1: Are you accepting new patients?

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Why you should ask: You want them to know that youʹre actively searching for a treatment provider. You also need to know whether they can take on a new patient.

What to listen for: If the therapist says they are not accepting new patients right now, ask them for a referral to someone who might be. Then call and interview that person.

Also note: If the therapist is not accepting new patients, donʹt take it personally—they have only so much time available for appointments. You want someone who can give each patient the attention they need.

Q2: I found your name in a directory of therapists who treat alcohol and drug addiction. Can you tell me briefly your background and your credentials?

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Why you should ask: You should always verify information you find on the Internet. Online directories can be out of date, so you want to make sure that the therapistʹs credentials (license/certification) are current and valid. Youʹre looking for someone with formal training, credentials, and experience in treating alcohol or other substance use disorders.

What to listen for: Therapists—clinical psychologists, licensed clinical counselors, and social workers—should be licensed in your state. But having a license is not enough to ensure quality. So you also want to find a therapist who holds at least a Masterʹs degree and has special training in treating addiction. The specific type of training and credentials will vary, so ask them to tell you more about their experience.

You might also want to ask: How long have you been treating patients with alcohol problems? How much of your practice deals with addiction versus other conditions?

Q3: Will you start with a complete assessment and diagnosis? What does that involve?

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Why you should ask: Itʹs important that a patient be matched to treatment services that address their specific needs. This can only happen if the therapist does a comprehensive assessment that includes more than just questions about their drinking.

What you should listen for: A comprehensive assessment is a lengthy, structured interview. The therapist should describe an assessment process that would give them information about a personʹs drinking, other substance use, mental health, family dynamics, employment, criminal justice involvement, and need for social services or other kinds of support. (Note: Only a medical doctor can appropriately assess a personʹs physical health and any medical conditions.)

You might also ask: How many visits will it take to complete this assessment? How do you involve your patients in developing a treatment plan?

Q4: Can you tell me about your treatment approach for people with alcohol problems? What kinds of services do you offer, and what does treatment ʹlook likeʹ?

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Why you should ask: Ask this question so that you can hear how a therapist approaches the treatment of alcohol use disorder. It will be helpful to hear different perspectives from different therapists.

What to listen for: The therapist should describe a process that has at least some structure to it (indicating that they have a plan), but not so much structure that it sounds inflexible or is the same for every patient. In fact, itʹs perfectly okay if the answer begins with them saying, ʺIt depends on the patient, but generally I will do ____.ʺ

Listen for mention of evidence-based behavioral treatment approaches.    

And listen to the way the therapist describes alcohol use disorder. Remember, addiction is a medical condition—it is not just a sign that someone is ʺweakʺ or needs to ʺstraighten up.ʺ Watch out for anyone who uses language that stigmatizes patients (e.g., calling them ʺdrunksʺ or ʺaddictsʺ or worse). And avoid anyone who suggests that patients need a confrontational (ʺtough loveʺ) approach. Youʹll want to find someone who can provide a caring, supportive environment for your loved one. Language that reflects moral judgment, stigma, or punitive approaches reflects thinking that is inconsistent with the current science of addiction.

Q5: Are you able to arrange for someone to prescribe a medication to treat alcohol use disorder if it is appropriate?

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Why you should ask: Medications can be helpful for some people as part of their treatment plan. Currently, there are three U.S. Food and Drug Administration (FDA)-approved medications for the treatment of alcohol use disorder. Naltrexone comes in two forms: a pill that is taken daily (ReVia® or Depade®), or a long-acting injection (called Vivitrol®) that is given once a month. Other medications are acamprosate (Campral®) and disulfiram (Antabuse®).  

What to listen for: Youʹll want to find a clinician who is at least willing to consider using any of these medications as part of the treatment plan. Most psychologists, licensed counselors, and social workers will not be able to write prescriptions themselves, but they should be willing to coordinate with a medical doctor who can.

While medications are not a good fit for every patient, the option should at least be on the table. Steer clear of clinicians who reject the use of medications out-of-hand (ʺI donʹt believe in medicationsʺ) or who argue that these medications ʺjust substitute one addiction for another.ʺ FDA-approved alcohol medications are not addictive; they can be critically important in giving the brain a chance to heal while counseling and other recovery supports gain traction. If a therapist refuses to even consider the use of a medication, their approach is not in line with current scientific evidence.

Learn more about alcohol use disorder treatment medications.

Q6: If you identify other important issues that need to be addressed—say, mental health or medical issues, or other drug use—what arrangements do you have to help someone receive appropriate care for those issues?

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Why you should ask: Although you may be seeking treatment to address a drinking problem, treatment is not only about drinking. Treatment is an opportunity to address a variety of related issues—some of which may not become apparent until the patient has started making progress in their recovery. Youʹll want to be sure that the treatment option you select is able to help with these other issues if and when they come up.  

What to listen for: Itʹs unlikely that any single treatment provider would be able to address all of the alcohol, drug, mental health, medical, family, social, and other issues that a patient could need help with. But a good therapist will be able to refer a patient to other qualified providers—whether these are counselors, medical doctors, social service agencies, or other resources—and to coordinate a comprehensive treatment plan. You should listen for their ability and willingness to help the patient address all of their needs—even if that means coordinating with other providers.

Q7: What is expected of a patient and his or her family during treatment?

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Why you should ask: This question will help set your expectations about the treatment process and give you a sense of the commitment involved on all sides.

What to listen for: Youʹll want to hear the ʺnuts and boltsʺ of treatment attendance—how many sessions, lasting how long (minutes/hours), how frequently (days per week), for how many weeks or months. Then listen for other expectations—for example, perhaps a therapist expects their patients to get involved in a mutual-help group, or to sign an agreement about taking their alcohol medication (called a ʺmedication adherence contractʺ), or even to use a recovery support app on their smartphone. Different therapists will have different expectations.

Youʹll also want to know what type of family therapy is available, and in what ways family members might be involved in a patientʹs treatment. While the primary focus of treatment will be on the patient, itʹs important that some sort of counseling or program be available for the family too (if they are willing to be involved).  

You should be wary of expectations that sound ʺall or nothingʺ and for rules that are completely inflexible—for example, that a patient would be terminated for having a relapse or forgetting to take their prescribed medication.

Q8: What do you do if someone has a relapse while they are in treatment?

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Why you should ask: This question will give you a sense of how a therapist views addiction and its treatment.  Alcohol use disorder, like other substance use disorders, is a chronic disease that can include periods of recovery and relapse (a return to drinking). Relapse is not a failure; it indicates the need for additional recovery support and behavior change strategies, which can be gained from counseling and, for some patients, medications.  

What to listen for: Youʹll want to hear that the therapist recognizes relapse is part of the recovery process, and that they would respond by making appropriate changes to the patientʹs treatment plan. In some cases, the patient may need more intensive treatment—perhaps a different type of behavioral counseling, or more frequent counseling sessions, or the addition of a prescribed medication, or treatment in a residential setting. Often, it may turn out to be a valuable learning experience for the patient that can help them recognize changes they need to make.

Q9: Can you help me estimate the cost of treatment? Will my insurance cover these costs?

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Why you should ask: The costs of treatment can vary from one provider to the next, sometimes significantly. Insurance may cover some, but not all, of these costs. Before committing to a specific treatment provider, youʹll want to understand what it will cost.

Donʹt be surprised or offended if one of the first questions the therapist (or receptionist) asks you is how you plan to pay for treatment. Just like any other health care service, both providers and patients need to understand the costs involved and how the treatment will be paid for.

Confirm whether the therapist accepts the personʹs insurance. Then ask what other charges you should anticipate—for example, copayments for visits, any specialized tests, or additional counseling such as family therapy. If the therapist does not accept the personʹs insurance, ask them to help you estimate the cost of a typical treatment episode. If affording treatment is a concern, you can ask whether the therapist offers a payment plan or a sliding fee scale to help with these costs.  

Donʹt be discouraged or embarrassed if a certain therapist is more expensive than you can afford. Remember, the most expensive treatment is not always the best one.

Q10: If you turn out to be the best option, how soon could treatment begin?

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Why you should ask: Youʹll probably want to start treatment as soon as possible. Therapists may have limited availability, or they may schedule their intake/assessment appointments on certain days and times. Find out now whether there might be any delays in getting started.

Other questions to ask

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If you have questions, ask them! If you donʹt understand an answer, ask for clarification. Add any additional questions you might have to the Navigator Toolkit "10 Questions" list [PDF-128 KB] before you make your calls. Donʹt worry about feeling ʺdumbʺ—get the answers you need to make an informed decision.

One last suggestion

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Pay attention to the way these therapists interact with you, and how you feel when you are talking to them.

If they provide complete answers to your questions, take time to understand your situation, and demonstrate a concern for you, thatʹs a good sign! On the other hand, if they are rushed, or make you feel like your questions are ʺdumbʺ or not important, thatʹs also useful information. Would you want to be their patient?

After each call, make some notes—not just about their answers to your specific questions, but also the overall impression you got from talking to them. Try to write yourself a note to remind you what made you feel that way. Later on, when you are comparing options, these notes may help you and your loved one make a choice.