Considering Therapy?
Suggestions for Choosing a Therapist After Pregnancy Loss
by Denise Jess

September 2000


Grieving the loss of my pregnancies has been the most challenging journey I have endured in my life thus far. I feel very blessed to have a supportive and loving partner and close circle of friends and chosen family. Nonetheless, I found that I wanted an objective, yet compassionate outsider to help me walk this journey of grief. After my third loss, I decided to work with a therapist. My process of choosing a therapist is the focus of this article. I offer it in hope that it might be useful to others walking a journey of grief who are considering seeing a therapist or counselor.

Where To Begin?
Once I made my decision to see a therapist, I had to start the process of choosing. I began my search by asking friends for recommendations. While few of my friends had dealt with pregnancy losses, I knew their life journeys had been hard in other ways and trusted their experiences. I also considered which therapists and counselors my HMO could cover to help reduce our family’s expenses. I put together quite a long list, based on these referrals, which proved to be both a blessing and a curse. How would I further scale down the list?

I chose to clarify what I wanted in a therapist. I visualized and meditated on the question of what do I need from a therapist and from a therapy relationship? These are the points I considered in my thinking:
  • Relationship between the therapist and myself. I knew I wanted to work with someone who partnered with me in my grief work, who believed that I was the expert on my own experience and who would support me in using this expertise to learn and grow.
  • Spiritual and philosophical beliefs of the therapist in alignment with my beliefs. This means that I wanted to work with someone with whom I shared common ground. I needed to know that we were working from a similar understanding. Since I have found pregnancy loss to be a profoundly spiritual experience, I wanted to work with someone who had a strong sense of her own spirituality. I also need to work with someone whose spirituality would not be in conflict with mine. While I want to be challenged in my thinking and feelings, I knew I needed to have enough common understanding with my therapist so that I could move forward with her; not get derailed by a mismatch in belief systems.
  • Therapist's gender and beliefs about women. While I was not closed to the idea of working with a male therapist, I felt strongly that I’d prefer to do this work with a woman. I felt that there would be some shared understanding about our bodies, about the emotions that go along with our bodies and about how the medical community often views women between myself and a female therapist. While it was less important to me that she has a pregnancy loss history, it was critical that she understand the emotional and physical connections between body, spirit and mind.
  • A willingness on the part of the therapist to help me integrate my loss experiences into my life. My view is that the losses I’ve experienced will stay with me for a lifetime and they help shape who I am. I was not interested in working with a therapist who wanted me to “get over” my grief and “move on.” I wanted to work with someone who could help me integrate my grief into my life: to help me learn more about myself and to even help me find the gifts that are buried within deep sadness.
  • Type of therapy that appealed to me. Not all therapy has to come in the form of “talk” or psychotherapy. I assessed my own learning style and decided that I wanted to be open to a variety of techniques; including visualization and self-hypnosis, movement, art or music therapy and body work.
The Interviews
After clarifying what I needed in a therapy relationship, next I needed to talk with the folks on my list and assess which of them might be a good match for me. So, I set up phone interviews with the therapists and counselors. Oftentimes, when I describe this process to friends and others I meet, they seem amazed that I would interview the therapists. I believe that in our society we are often led to believe that we should not be active participants in choosing our physical and mental healthcare providers. But how many of us would rent the first apartment or buy the first house we saw? Or gather only one estimate to replace a broken furnace or leaky roof? If one so carefully thinks through decisions when they involve material possessions, it only stands to reason that decisions about one’s physical and emotional health should also be weighed with considerable care.

Most of the women I interviewed were open to talking with me and answering my questions without booking a formal appointment and charging me for a session. I began my conversation with each woman by stating my need in a short manner and asking if she had time to answer some brief questions that would help me determine a good match between therapist and myself. If the therapist didn’t have time during my initial contact, we set up a time to talk. When I encountered a therapist who was hesitant or resistant to talking with me, I removed her from my list of considerations. Most phone interviews lasted approximately 10 to 15 minutes.

Following are the questions I used when interviewing therapists. I didn’t feel a need to ask every therapist every question, but I listened to my gut. Sometimes I felt that a particular question wasn’t relevant and skipped it or realized that the woman had already answered my question in another way.

  • What is your experience with grief and loss? I intentionally framed this question in this way, so that the therapist could answer it from both a personal perspective, if she chose, or from a professional one. I learned a lot about how each therapist views the grief process through this question and could assess how much alignment there was between my experience of grief and hers.
  • How do you support someone in dealing with her/his grief? I used this as a follow-up question, if I needed further clarification.
  • How do you work with clients? This question helped me learn not only about their methodology, but how they view clients. I learned which women saw their clients as partners in the healing/learning process vs. which women saw themselves as the leader or head of their clients’ processes.
  • What sort of working relationship do you try to create with your clients? This is a follow-up question to the first and I would ask it if I still felt unclear about the therapist’s willingness to see me as the expert on my own experience.
  • How do you address therapy relationships that aren’t working or that have reached a natural end? I asked this question, because I wanted to know how comfortable the therapist would be with openly discussing the end of a therapy relationship.
  • What is your experience and attitude in working with lesbians? I asked this question because I am a lesbian. I needed to make sure that the person I worked with was going to be a safe person: that her attitudes would not subtly or overtly have a negative impact on our working relationship. I’d suggest asking a form of this question if you have any concerns \ that you might be judged based on any aspect of yourself. Judgment of this kind is inappropriate, especially in a therapy situation.
After asking these questions, I checked in with my gut for a reaction:
  • Did the person seem genuine? Did they seem to be what they said they were?
  • How would I feel about doing deep personal work with this person?
  • Would this be a person I could build a trusting relationship with?
After careful consideration, I made my choice and have been very pleased. I feel like we’ve established a working relationship that is healthy and full of growth for me. Periodically, I reassess my choice: I check-in to make sure I’m still on target with my therapy goals. I ask myself:
  • Is this a respectful relationship where I feel like a partner in my care?
  • Do I feel like my experience and expertise are honored and utilized in the process?
  • Do I feel like I am growing?
  • Am I learning to integrate the experience of loss into my life in ways that are healthy and nurturing?
  • Am I able to carry the experiences and revelations I have during a session into my daily life?
I realize in writing this article that I have some financial resources and this allows me to choose from a wider pool of possible therapists than others might have access to. Even if one is limited by a managed care system or insurance restrictions, I’d still highly recommend making an informed choice for yourself. Each of us deserves to have a working relationship with mental health professionals that meets our needs and honors our journeys.


Denise Jess and her partner, Jani, are proud mothers to one living child, Rowan, conceived after six years of infertility and four spirit babies, Cassidy, Mandy, Keegan and Molly.

You may reach Denise at newmoon@terracom.net for comments.




© 2000 by Denise Jess. This work is protected by copyright and may be distributed or published only with the express written permission from its author. You may, without permission, publish or otherwise provide the URL (web address) of this page.




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