I frequently get calls and emails from people who wonder how to find a good therapist or who tell me that they wonder if the therapist they have is any good. If the person is in therapy, I generally tell them to talk with their current therapist about their concerns. However, there are some general guidelines I can give you to tell if your therapist's behavior or technique should raise a red flag.
Let me start with some personal experiences. I had a good friend in New York who married fairly young and had two children within two years. She divorced and was left to raise the two kids by herself, one of whom had ADHD and was a handful. Because of her stress, she would get tense with the kids and one time, grabbed her son which scared her. She immediately called and went to a therapist. During the intake with this social worker, she told her about grabbing her son and that she was seeking treatment to help her deal with the stress of the kids without resorting to anger.
Instead of help, she got a visit from the Department of Human Services who showed up at the door to investigate this young mother's possible child abuse. My friend was devastated. The DHS investigation turned up nothing but my friend worked in social services and feared that she would be labeled as a child abuser. I told her to find another therapist--one who didn't jump the gun without getting all the facts. (I understand that the law is such that mental health professionals must report suspected child abuse but my friend's act of grabbing her son was questionable as an abusive act and one that should have been explored in more detail than the therapist just getting hysterical immediately). My friend refused to go back for treatment after this negative epsiode--and who could blame her?
I have had my own bad experiences with an unethical therapist. In my last years of doing my PHD, I became stressed about grad school and sought out a PHD psychologist to help--she seemed nice enough but I got the feeling she was not crazy about men. If I talked about fear of relationships, she would say something cheerful like, "Well, most men abandon you after a while." I found out she had been recently divorced and obviously was not handling it well. I left after figuring I could make it on my own.
One day, however, I was talking with my post doc supervisor who told me that she had heard I had seen this therapist for treatment. I nearly fainted, I really did not want my supervisor to know I had been in therapy--it was private. I was steaming. I wrote this unethical therapist to tell her she was lucky that I did not report her to the ethics board and told her that she better not dare do this to another patient in the future. Her response--nothing. Note to other doctors and therapists out there--one of the biggest reasons for law suits is dismissing a patient's concerns. Don't do it.
Anyway, enough of my story. Here are some additional tips on how to find a good therapist or determine if you need a new one:
1) The best way to find a good therapist is word of mouth. You might ask others for recommendations or ask your insurance company to match you with someone who specializes in your specific problem.
2) Once you call for an appointment, pay attention to how you are treated on the phone. Does the therapist call you back promptly if you leave a message on the answering machine? Or does his/her staff act courteous over the phone? Arrange a first meeting to see how you get along with the therapist. You are after all, trying to interview and find out if this professional is right for you. If the therapist is good, they will feel the same way. I let clients know that the first few sessions are a trial period to see if we can work together. If not, I give them three names of other psychologists who might be better for them.
3) Remember that the most important ingredient in patient change is a feeling that the therapist likes you. If you sense that there is no real connection with the therapist or the therapist seems to deal in generalities such as "men are this way, women that way etc.," you should bring your concerns up in the first few sessions and discuss them to determine whether or not you should continue which brings me to our fourth point.
4) Do not be intimidated by the therapist's PHD or MD--it does not give them license to hold their degree out as a reason you should listen to them. Listen to the words of your therapist and see if they are beneficial to you or just downright silly or ineffective. Once a therapist says something like, "Listen to me because I have such and such degree," you might want to be heading to the door. This is not to say that degrees and training aren't helpful--they are as hopefully your doctor has a good range of experience with those of similar problems. But it is the knowlege they have to deal with your problem that is important, of course, not just the fact that they made it through school. Sharing with you their degrees and experience in a form or verbally at the beginning of therapy is normal.
5) Finally, if you are in therapy and you feel that no progress is being made, address it with the therapist and listen to the feedback. None of us is past interpreting our problems incorrectly and it may just be a misunderstanding or miscommunication between you and the therapist. Give him or her a chance to help you change these misperceptions but if that nagging feeling continues that you are not getting the help you need or the therapist does not like you/respect you, it may be time to consider a change.
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