Five Ways to Identify a Good Therapist

    I have been in the mental health field for six years. During this time, I have worked with many therapists. Some were very good, genuine human beings whose main goal was to help the people with whom they worked. Some were the opposite. People who were not in the field for the right reasons, crossing boundaries and either causing or participating in unethical situations.

    This topic is so important to me. There are many people who go to therapy, a huge step toward support and guidance. Those people are matched with a therapist. The therapist behaves in an inappropriate way (a word with a lot of meanings, as you will soon read), and the person leaves feeling confused and upset. Often, those people who were so eager to seek help are disillusioned by the experience and are reluctant to reach out again.

    I think people who are considering therapy, clients who are already receiving therapy, new therapists, and therapists who have been in the field for a while can benefit from this post. I hope it can bring awareness to what therapy should be.

    Here are five ways you can identify a good therapist.

 

    What is a Good Therapist?

    I would argue that a good therapist fits the following: has good boundaries, has a good personality, is flexible and able to adapt, has a calm demeanor, is able to deal with stress and crisis effectively, is able to focus on the client without allowing their own personal thoughts and feelings to interfere, and who feels comfortable gently challenging a client for the client's benefit.

     A good therapist is a genuine person who, above all, wants to help the client succeed. Someone who listens to the client's thoughts, feelings, and concerns without expressing judgement. Someone who sets boundaries and sticks to them. Someone who can recognize when something is outside of their realm of knowledge and when to ask for help from a supervisor.

 

  "There are people who are in this field to help, and there are people who are in this field to hurt. You need to figure out who is who so you can do something about it." Something a wise therapist once told me.

 

     What to Watch for

• How much time does the therapist spend talking about the client vs. how much time does the therapist spend talking about themselves? - This is a big indicator of the therapy a client will receive. Therapists are to only disclose information about themselves when they think it could help a client with their journey. For me, this is incredibly infrequent. Outside of small talk questions to get to know a client, I don't share much. Even when I am asked directly by a client, I keep the answer short and simple.

     Why? Therapy with a client should be all about the client. They are paying the therapist to listen to them and to offer guidance where needed. They are not paying the therapist to hear about the therapist's life story. It may sound like I am being dramatic, but you would be surprised to know the number of therapists that I have worked with that have used the clinical space as their own therapy session. Therapists should be aware of what they are sharing with the client and why they are sharing it, at all times. The relationship needs to remain professional, and it cannot remain professional when the client feels like the therapist's problems are invading the clinical space. The client may start to feel like they are not able to share information about their problems because they do not want to burden the therapist. (Some clients may feel this way regardless of if a therapist is sharing inappropriately, so it is very important for the therapist to address those thoughts, should they arise).

A reminder to therapists: as much as we may like our clients, we are not their friends and should not treat them as friends. Treating clients as friends does them a disservice and is unethical. Remember to maintain boundaries.

• How much time does the therapist spend talking vs. how much time does the therapist spend listening? - The therapist should be listening to the client most of the time. Depending on the situation, I would say 50-80% of the session should be spent listening to the client. There are specific therapeutic techniques that require a therapist to listen carefully, such as paraphrasing (collecting the client's thoughts and repeating them back to them in a way that shows a greater understanding) and summarizing (repeating what the client said back to them to show you are listening). If a therapist is spending more time talking than listening, they are not completing those techniques properly.

(A big part of learning to be a good therapist is learning how to sit with silence. Silence can help a client take the time to process an emotion or a thought, or give the client more time to think about something the therapist has said. Humans are used to having complete conversations without long breaks of silence, so this is something that will come with time. Therapists may not be good at doing this right away, and even those of us who have done this a while can struggle at times. This is another thing entirely.)

•  What does the therapist's body language tell the client? - Body language is incredibly important. Even if clients do not pick up on it on a conscious level, they can identify that something did not feel right and may not return. A therapist should be making appropriate eye contact, facing the client, and responding with non-verbal cues when appropriate, like "mmh-hmm" and "okay."

    Sometimes, therapists will take notes while they speak with a client. This is not inappropriate behavior; however, I personally mention why I am doing it. I am a forgetful person. I make sure to point out to the client that I am only taking notes so that I don't forget anything important. I have worked with some clients with paranoid beliefs that are suspicious of what I am writing down, so I feel transparency is best.

    Clients should know that the therapist has to write a note about the session afterward, so sometimes physical notes are very important.

    It is always best to have a timer set on the therapist's watch for 10 minutes before the session ends, or to have the clock placed behind the client so that the therapist is able to watch the time. Either of these options gives a good way to keep time during session without making the client feel like the therapist is not interested in the conversation. (Conversely, there are time where the therapist may want to utilize non-verbal cues to indicate that a conversation is over, something we will talk about in later posts.)

•  What does the first session's "ground-rules" look like? - All initial sessions should have a moment when the therapist goes over the expected flow of the sessions to follow.

    For example, it is important to let the client know that most of what they say does not leave that room. This builds trust and rapport, something a therapist will need to have a good professional relationship with the client. It is very important to tell the client that there are things that the the therapist will be required to notify others of, and what those things are. Being a danger to oneself, being a danger to others, abuse/neglect of children or adults, and current or future crime concerning the safety of others are all things that the therapist will need to report.

    I have a theory that therapists who do not make these ground-rules clear are often therapists who are not good with boundaries. That is based on nothing but my own opinion. Your mileage may vary.

• Boundaries, boundaries, boundaries! - If there are poor or no boundaries in a relationship, it will not go well. Boundaries are important ways to express your personal thoughts and feelings and to let others know what you will accept and what you will not accept. Boundaries are incredibly important in the therapeutic relationship.

    There should be a clear boundary between the client and the therapist. The client is there for help, the therapist is there to help. There should be no contact outside of that relationship. Like I said above, the client is not the therapist's friend. If lines are crossed or rules are broken, the boundary needs to be enforced.

 

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    These points are just a summary of what a client should be looking for in a therapist, and what a therapist should be looking for in themselves. I will go into these things in more detail in future.

    My Personal Thoughts and Feelings 

    I am the type of person who wants what is best for the client. I will point out to the client any discrepancies in what they say with gentle confrontation, but I will remain as non-judgemental and genuine as I can. It's important to me that my clients feel supported and respected as human beings, and I strive to ensure that others do the same for both my clients and their own.

    Clients, use this information to help you make informed decisions about the therapist you are meeting. If you feel uncomfortable, talk to someone else. Not every client and therapist will jive on a therapeutic level, everyone is different and not everyone will get along. Don't let that discourage you from seeking the help you deserve.

    Therapists, take this information to heart. Always keep in mind how you are affecting your client and always make sure that it is in a positive, uplifting, and appropriate way. If you find that you're not meeting these expectations, take a look at yourself and ask why that might be. These are not my expectations, these are expectations based on the ethics and morals of working with others. Be the therapist you want to be. Don't forget to work on yourself as much as you help others work on themselves. If you're interested in learning more, check out my post about how everything you say as a therapist matters.