Navigating through the word of therapy can be overwhelming. There are so many acronyms and titles to sift through that you may find yourself wishing to had a therapy dictionary to help you make sense of it all! Regardless of whether you get connected with a Ph.D, Psy.D, M.A., or LMHC, there are some characteristics all good therapists likely share. These are some things to look out for that might help you get a better sense of whether or not your therapist is any good!
Do they remember you?
I am not talking about knowing your name, that should be a guarantee! What I mean by “do they remember you” is: does your therapist remember what you have been talking about? Do you find you have to spend the first 15-20 minutes re-hashing the same things you talked about last time? While this may not seem like a big deal, 20 minutes of a 50 minutes session is a pretty significant chunk of time!
Not only that, I would imagine it probably doesn’t feel great or reassuring to feel like your therapist doesn’t seem to remember the salient details of your life, which would likely impact your openness and buy-in with your therapist. No matter how a therapist remembers their clients – whether it is with in-session notes or pure memory – you want to know that they know you, the reasons why you are coming to therapy, and what you want to see change.
Are they available all the time?
Do you have your therapist’s personal cell phone? Can you call or text at any hour and do they respond? Ironically enough, this is likely not a good sign. While in the short-term a high level of availability may seem great, in the long-run it can be a receipt for negative outcomes. You want a therapist that has healthy boundaries for three main reasons:
One: Having boundaries helps reduce the risk of therapist burnout, thus ensuring you are getting the best quality and level of care from your therapist every time (you are likely not going to get the best care from your therapist at 2 in the morning)!
Two: The goal of therapy is for you to develop your own skills so that you can get to a place where you can successfully use them, independent of your counselor. This process will likely be significantly stalled if you constantly have access to your therapist and don’t engage in opportunities to learn how to cope separate from your counselor.
Finally, for some clients a key presenting problem may actually be difficulty with setting appropriate boundaries. Having a therapist with healthy boundaries often helps model what that looks like for clients, helping them learn how to apply that in their own lives.
As a side note, while some therapies like Adherent Dialectical Behavioral Therapy (DBT) do provide “coaching sessions” over the phone, these are meant to be used in case of an emergency or during a crisis urge, in which the client has already attempted to use multiple skills, but is still having a hard time (and even these calls are meant to be limited in time).
Do you feel comfortable?
Research consistently shows us that the therapeutic alliance, or in human terms, the connection and relationship between the client and the counselor tends to be one of the strongest predictors of positive outcomes in therapy! You need to feel safe and comfortable with your therapist. If you feel like you have to hide aspects of yourself, lie, or if you constantly fear their judgement, chances are therapy is not going to get very far. For one thing, your therapist won’t know half of what is really going on, and therefore may only be addressing a small portion of what might be contributing to your symptoms.
For another, you as the client are likely going to be less receptive to anything your therapist has to say, even if it is quality information! It is imperative to have a good alliance with your therapist, as you are likely talking about some of the most sensitive and personal information you have ever discussed with anyone. If you are highly anxious or highly “on-guard,” it is only going to make the therapy process more challenging.
How do they handle feedback?
I feel as though there is this myth or misunderstanding that you are never supposed to disagree with your therapist. This is not true, especially when you feel like your therapist has missed the mark! I often ask my clients for feedback or give them the opportunity to edit my hypotheses as they see fit. It is unlikely therapy will be as effective as it can be if you do not feel you can correct your therapist. Moreover, if you feel your therapist reacts negatively to your feedback, that might create rupture in the therapeutic relationship, which may be very hard to repair if your therapist is not open to feedback about that too!
Are they your friend?
Does your counselor lend you money if you need it? Do you guys chat outside of the the therapy room? Does your therapist tell you a lot about their day and stress, and do you find yourself providing support for them? This is another concept that on the surface may seem like what you are looking for, but can create some real issues. Most people find great solace in the fact that their therapist is one of the few objective people in their lives that can give them honest feedback.
In addition, while friends may be very willing to give advice, a therapist helps you to understand your own thought process and give you strategies to cope better. The other thing to look out for is: how much does your therapist discloses about themselves? Some therapy interventions are very strict when is comes to self-disclosure from the therapist. Others are a little looser, but specify that any self-disclosure should come from a place of therapeutic value (i.e. a therapist sharing their experience with using a specific therapy skill in their own life).
Too much self-disclosure is often a bad thing. It puts the client in the awkward position of having to support the therapist, which can sometimes make clients feel minimized, invalidated, or simply stressed out! It is not appropriate for you to know about your therapist’s marital strive nor their financial stress!
Do they use evidence-based therapy?
Evidenced-based therapy is a term that comes up a lot in the psychology community. It indicates that a specific type of therapy has been scientifically studied and shows positive outcomes for specific diagnoses. Looking for someone who utilizes evidence-based care is significantly increasing the chances that you will find a therapist that has the skills to directly target what you are struggling with.
This can also help with increase a sense of “fit” with your therapist. Finding someone who is specialized in what you are needing – whether it is depression, anxiety, trauma, eating disorders, etc – will get you connected with someone who “speaks the language” of what you are going through and can provide the best tailor-made strategies for getting better!
Have you talked about goals?
Research demonstrates that developing a treatment plan between therapist and client tends to lead to more positive outcomes. This makes a lot of sense: if you both know what you are working towards, you are more likely to get there. In addition, having a treatment plan can help keep you and your therapist “on track,” reducing the chances that you both get lost in the woods in everyday life stress. In addition, I find well-developed, concrete treatment plans to be a great way of tracking or highlighting the amount of change my clients have experienced!
Simply put, it all comes down to goodness of fit.
Sometimes it might take a few sessions to get a sense of fit. If you’ve given your therapist a number of sessions, but you are still feeling disconnected, (if you feel comfortable) give them feedback! Who knows? They might be able to change their approach to make you feel more comfortable! If you do not feel comfortable doing that, or if providing feedback does not go so well, it might mean it is time to find a different therapist. This process can be difficult to maneuver and it can feel overwhelming to decide to start over with a whole new person, but it is likely the immediate discomfort will pay off with the long-term gain you get.
Continuing with a therapist that feels like a bad fit is like trying to push a boulder uphill. You can certainly do it, but it will definitely be a more arduous process! And my thinking is: why make this any harder than it already is? Here at Integrated Care Clinic, we pride ourselves on being able to deliver high-quality, evidence-based care to all our clients in the Tampa Bay Area. If you are looking for a new therapist, give us a call today. We provide free 15-minute phone consultations to help answer your questions, and help you get a sense of “fit” before even scheduling the intake appointment!