Selecting A Therapist for Your Foster or Adopted Child
Many parents begin to seek counseling as soon as their child comes home while other families may not see a need arise until a later time, such as adolescence. (I would strongly suggest finding a therapist before there is a critical need for one.) For most families, finding a therapist can be a challenging task especially if there are not trauma informed therapists nearby. This post hopes to give parents some direction on choosing a counselor for their family.
There are many factors to consider from insurance and office location, to the therapist’s degree and training. All of this may seem confusing coupled with the many academic degrees that therapists may hold. Most clinicians will be happy to answer parent’s questions as they go about finding the best fit for their child and family.
Below is a list questions parents can ask the prospective therapist:
1. Do you have a Masters degree (or above) in a counseling related field? Counseling related fields can include but are not limited to: psychology, social work, and marriage and family therapy. It is imperative that your therapist hold at least a masters degree in their field. (By the way, the terms “counselor” and “therapist” are interchangeable and generic ,and do not indicate a particular educational background. The term “social worker” does indicate the person holds a degree in social work but this is not always the case, and therefore, I would encourage you to ask what degree they have received.)
2. Do you have a license to practice independently? Each state and degree has different requirements but a license indicates the therapist passed state boards which indicates experience and competency in their degree.
3. When did you complete your counseling degree? It is preferable for the therapist to have graduated more than five years ago. Of course, counseling is an art and the more years of experience the therapist has, the more likely they are to be adept in their profession.
4. Are you in network with my insurance? If a therapist is IN Network with your insurance, that indicates he or she has a contract to provide services at a particular rate agreed upon with the insurance company. In this case, you would only be responsible for your portion as indicated by your health care policy. To be on the safe side, talk to your insurance company prior to your appointment and find out your benefits, ie: deductible, copays, coinsuance, and out of pocket max. Also, double check with the therapist to ensure they are still in network with the company. I’ve had a difficult time getting my name off panels that I haven’t been on for over 10 years . . . just because the providers name is on the list, doesn’t ensure they’re still on the panel.
If the therapist is OUT of network, you are responsible to pay their fee in full. The payment still can be applied to your out of network deductible and that can be a benefit as the year progresses. Again, call your insurance company to determine your benefits. You also will want to ask the provider if they will file the claim for you or if you will have to file it yourself.
5. How many years have you worked with foster and adoption children? An effective counselor will have at least two to three years expertise in the area of foster care or adoption. And ideally, 30% to 50% of the therapist’s practice should be with foster or adopted children. For some reason, many therapists do not recognize this as an area of specialization, but it most definitely is! You can go to a general child therapist if there are no specialists in your area, but request that they receive supervision from an experienced practitioner in the area of adoption and foster care.
6. What is the location of your practice? This can be an influential factor for some families especially if there are several choices of therapists in your area, and you take your child or children to multiple specialist appointments in a week.
7. As the parent, will I stay in the room during my child’s sessions? Most therapists are not trained to keep a parent in the therapy room, but I strongly believe this is the best practice. There are several reasons this is the most helpful strategy for adopted and foster families as it offers the parent a chance to see the therapist role model behavior and ways to discuss issues with their child. It also provides healthy attachment opportunities for the parent and child . . . if the parent is not in the room as the therapist is discussing emotional issues, then the therapist is in a position to offer comfort to the child (in lieu of the parent) or they have to leave the session to fetch you and the opportune moment is lost by the time you return.
8. How were you trained to work with adopted and foster kids? There are many acceptable treatment models and some options are: Theraplay, Narrative therapy, EMDR (Eye Movement Desensitization and Reprocessing), and Dyadic Developmental Therapy. Research whichever model the therapist uses so that you are familiar with the process and know what to expect in sessions.
9. What additional training do you have that augments your chosen model? It is suggested that therapists have additional training in: individual therapy with children and adults, family therapy, child development, trauma work, Cognitive and Behavioral Therapy (CBT), and Dialectical Behavior Therapy (DBT) just to name a few.
10. Will we meet alone with you in the first session or do we bring our child? A general rule of thumb is parents attend the first session alone unless the child is an adolescent, then the teen may accompany the parents. It is especially important for the child to remain out of the first session so that the parents may inform the therapist of the child’s trauma history. The child does not need to sit and listen to their trauma, as that would be further traumatizing. If the patient is a teen, it’s important that they build a rapport with the therapist from the start and feel the therapist is willing to see “their side” of things and not just their parents “side.”
These last questions are for the family to ask themselves after the first visit or two:
11. Do we feel this therapist is a positive and comfortable fit for our family? In order to discuss emotionally laden subjects, the family must feel comfortable but also be aware of your own difficulties in this area and give the therapist time to get to know you. . . around three to five sessions. If after that time, you’re still not feeling comfortable with the therapist, it’s probably not a good fit.
12. Is the counselor open to our questions about the therapy process? This is hopefully a resounding, “Yes.” A therapist needs to be open to you asking questions about the process as you spend time together.
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Carol Lozier is a therapist, author, and blogger specializing in trauma; and adoptive and foster kids, teens, and adults. Ms. Lozier is in private practice in Louisville, KY.