Quick Overview: The sources reviewed do not establish whether trust, transparency, and collaboration should determine a person’s choice of therapy setting. NIMH says rapport and trust are essential in psychotherapy and that people should feel comfortable with a therapist and confident in their expertise. SAMHSA identifies trustworthiness and transparency, collaboration and mutuality, and empowerment, voice, and choice as principles of trauma-informed programs, organizations, and systems. These sources have different scopes and do not identify one setting as right for a particular person.
Trust and the Therapist Relationship
NIMH defines psychotherapy, also called talk therapy, as a variety of treatments that aim to help a person identify and change troubling emotions, thoughts, and behaviors. It describes psychotherapy as involving different approaches. A therapist may use one primary approach or incorporate elements from multiple approaches depending on training and experience, the condition being treated, and the needs of the person receiving therapy.
When discussing what to look for in a therapist, NIMH says rapport and trust are essential in psychotherapy. It also says that therapy discussions are deeply personal and that it is important to feel comfortable with the therapist and confident in their expertise.
This guidance concerns psychotherapy and the therapist relationship. It does not establish that any particular therapy setting will create trust, nor does it predict what therapy will be like for a particular person.
A Preliminary Conversation Can Provide Information
NIMH says that, after identifying possible therapists, a preliminary conversation can help a person understand how therapy will proceed and whether they feel comfortable with the therapist. According to NIMH, such conversations may occur in person, by phone, or virtually.
NIMH identifies several topics a person may ask about: a therapist’s specialty, the approach the therapist may use, whether the therapist practices a particular type of therapy, and the rationale and evidence base for that approach. NIMH also includes therapy goals, a recommended time frame or number of sessions, how progress may be assessed, and what may happen if improvement is not occurring.
These topics can support information gathering. They do not provide a formula for selecting a therapist or setting.
Transparency Within Trauma-Informed Approaches
SAMHSA describes a trauma-informed program, organization, or system as one that recognizes the widespread impact of trauma, understands potential paths for recovery, recognizes signs and symptoms of trauma, and responds by integrating knowledge about trauma into policies, procedures, and practices while seeking to actively resist retraumatization.
Within that organizational description, SAMHSA identifies trustworthiness and transparency as a principle. It says organizational decisions are conducted with the goal of building and maintaining trust with participants and staff.
SAMHSA’s description applies to trauma-informed programs, organizations, and systems. It does not state that every therapy setting uses a trauma-informed approach, and it does not present transparency as a comparison tool for choosing among therapy settings.
Questions About Process Stay Within the Evidence
NIMH’s preliminary-conversation topics offer a direct basis for asking about process. For example, a person may ask what approach may be used, what its rationale and evidence base are, what goals may be discussed, and how progress may be assessed.
A person may also ask whether a therapist recommends a time frame or number of sessions and what may happen if improvement is not occurring. Asking these questions does not assume that therapists, organizations, or settings operate in the same way. It is a way to request information that NIMH specifically identifies for a preliminary conversation.
Collaboration, Mutuality, Voice, and Choice
SAMHSA identifies collaboration and mutuality as a principle of trauma-informed approaches. It describes this principle as placing importance on partnering and leveling power differences between staff and service participants.
SAMHSA also identifies empowerment, voice, and choice as a principle. It states that organizations foster a belief in the primacy of the people they serve to heal and promote recovery from trauma.
These principles describe features of trauma-informed approaches at an organizational level. They do not establish how collaboration will be experienced with a particular therapist, within a particular service, or in a particular setting. They also do not answer whether one therapy setting is preferable to another.
Reflection Questions for Learning More
| Question for reflection | Your notes |
|---|---|
| What would I like to understand about how therapy would proceed? | |
| What approach would I like to ask about, including its rationale and evidence base? | |
| What goals would I want to discuss? | |
| What would I want to know about how progress may be assessed? | |
| What questions relate to feeling comfortable with a therapist and confident in their expertise? | |
| What would I like to understand about partnering, voice, choice, or power differences? |
Practice Note: This reflection table is a general-education tool. Its process questions are based on topics NIMH identifies for preliminary conversations, while its partnership questions reflect principles SAMHSA describes for trauma-informed approaches. It does not evaluate a therapist, organization, or therapy setting.
Questions to Bring to a Consultation
Rooted Integrative Therapy describes scheduling a consultation call as a first step, with an opportunity to ask questions and consider fit. Possible questions include:
- What is the purpose of the consultation call?
- Which services does Rooted Integrative Therapy offer?
- What therapeutic approach may be used, and what is its rationale and evidence base?
- What goals of therapy might be discussed?
- How may progress be assessed?
Frequently Asked Questions
Does NIMH say trust matters in psychotherapy?
Yes. NIMH says rapport and trust are essential in psychotherapy. It also says it is important to feel comfortable with the therapist and confident in their expertise.
What does SAMHSA say about transparency?
SAMHSA identifies trustworthiness and transparency as principles of trauma-informed approaches. It says organizational decisions are conducted with the goal of building and maintaining trust with participants and staff.
What does SAMHSA say about collaboration?
SAMHSA identifies collaboration and mutuality as a trauma-informed principle. It describes this as placing importance on partnering and leveling power differences between staff and service participants.
Can a preliminary conversation address questions about therapy?
NIMH says a preliminary conversation can help a person understand how therapy will proceed and whether they feel comfortable with the therapist. NIMH identifies questions about approach, rationale, evidence base, goals, time frame, progress assessment, and what may happen if improvement is not occurring.
Can I contact Rooted Integrative Therapy?
Rooted Integrative Therapy’s Connect page invites inquiries and appointment requests. Its FAQs describe a consultation call as a first step with an opportunity to ask questions and consider fit.
Sources and Further Reading
Sources used for this article:
- National Institute of Mental Health: Psychotherapies
- Substance Abuse and Mental Health Services Administration: Trauma-Informed Approaches and Programs
A Grounded Next Step
Rooted Integrative Therapy offers individual therapy, couples therapy, group therapy, and therapy intensives. Alina Hovsoyan, LCSW, is associated with Rooted Integrative Therapy. The practice offers in-person therapy near Orem and Provo, with virtual therapy across Utah.
To ask questions or request an appointment, visit Rooted Integrative Therapy’s Connect page. Please do not include urgent or highly sensitive clinical information in a general inquiry.
This article is for general education only. It is not a diagnosis, treatment plan, or substitute for individualized mental-health care. A qualified mental-health professional can help you consider what fits your circumstances.