10 Questions to Ask a Trauma Therapist Before You Start

Licensed professional counselors (LPCs), marriage and family therapists, clinical social workers and psychologists in Texas are all licensed through the Texas Behavioral Health Executive Council (BHEC). You can check any of them yourself on the BHEC license lookup.

• Search by name, license number or city. The results show license status, issue date and any disciplinary action.
• BHEC notes that much of a profile is self-reported, but status and discipline come from its own records.

Listen for specific names and ask how they were trained. "I use a trauma-informed approach" is not the same as being trained in a trauma-focused therapy.

• The VA/DoD PTSD guideline (2023) gives its strongest recommendation to cognitive processing therapy (CPT), eye movement desensitization and reprocessing (EMDR) and prolonged exposure (PE).
• It gives a weaker, suggested recommendation to Ehlers' cognitive therapy for PTSD, present-centered therapy (PCT) and written exposure therapy (WET).
• The American Psychological Association's 2025 update to its PTSD guideline lists CPT, PE and trauma-focused cognitive behavioral therapy (TF-CBT) as first-line, and gives EMDR a conditional recommendation.

A good therapist will tell you plainly where their method sits in current guidelines, including when the evidence is still thin.

• Accelerated Resolution Therapy (ART), for example, is newer. The VA/DoD 2023 guideline lists it as having insufficient evidence to recommend for or against. A 2024 systematic review (Storey and colleagues) found five studies, two of them randomized trials, and concluded that ART shows some promise but needs more high-quality research.
• Our article on ART vs EMDR compares the two methods, including where the evidence differs.

Lengths vary by method. In one well-known trial, written exposure therapy was five sessions and CPT was twelve. A Department of Defense evidence brief describes ART as one to five sessions of about an hour.

Ask whether they use a symptom questionnaire, such as the PCL-5, to check how things are going over time.

SAMHSA's guide to trauma-informed care stresses establishing safety and grounding before working through traumatic material. Ask how the therapist will make sure you have ways to steady yourself first.

Also ask what they do if you feel flooded, panicky or numb during a session.

Methods differ a lot here. Prolonged exposure and written exposure therapy involve recounting the memory in detail. CPT focuses more on the beliefs that grew out of what happened. EMDR and ART ask for much less spoken detail.

CPT and PE include practice between sessions. The Department of Defense brief notes that ART does not require homework or repeated exposure to the memory.

The VA/DoD 2023 guideline recommends secure video for trauma-focused therapies that have been tested that way, or when other options are not available.

Therapists generally need to be licensed in the state where you are physically located during the session, so mention it if you will be traveling or living outside Texas.

Counselors do not prescribe medication. If medication, sleep problems or other health issues are part of the picture, ask how the therapist coordinates with your doctor or a psychiatrist, and what they need from you to do that.

Ask about the fee per session, which insurance plans they accept, and what happens if you cancel late.

Under the federal No Surprises Act, if you do not have insurance or are not using it, providers usually must give you a Good Faith Estimate of what your care will cost. According to CMS, you may be able to dispute a bill that is at least $400 more than the estimate.

The relationship with your therapist matters. A good therapist welcomes this question and will help you find another approach or another clinician if that would suit you better.