[under_the_iron_sea]

(Sorry for the crazy long post!) I started seeing an LCSW through my county's behavioral health department. I have seen her 4 times over the span of about a month (basically once a week). After our sessions, I need to fill out a little form which has me rate how I felt about our session, how I felt about the way we worked on issues, and how I feel overall about the therapist. I had been rating everything towards the middle, since I wanted to be diplomatic, and honestly I feel like the rating system has some flaws anyway. Today at the start my appointment, the therapist explained that I had somehow been rating her lower than the facility would prefer, and that we needed to talk about my expectations, and why the rating wasn't higher. From the start, I felt like somehow *I* had done something wrong, and was also quite confused as to how a consistent mid-range rating could be considered too low.

When she asked why I hadn't been rating her higher, I explained to her that did feel like sometimes we spend a little bit more time on things that aren't helpful to me during my sessions (an example, at my last appointment, we spent the whole session going online and looking at web-sites of other places I could check out to find more help and support. After 10 minutes of sitting in silence watching a video advertisement for another facility, I said something like, "I could actually probably just watch this at home. Maybe we could move on.") I know I was not rude... I'm intensely aware of other people's feelings (sometimes to a fault) :P

However today she expressed frustration with me, saying that I was being rude and critical during our last session, saying that I had complained that we were "wasting time." I said I didn't know what she meant, and that I really didn't mean to be rude, and I knew I didn't say anything so rude. Then she said something like, "Well, I get the sense that you're being critical of me now. I wonder if maybe you're projecting that attitude onto me like your Father does to you." (My Dad was abusive and hyper critical, and partially why I'm even in therapy).

I just broke down then. That hurt. That felt like something unprofessional. I just couldn't believe that the person who is supposed to be supporting me and helping me was nearly picking a fight with me. All because of this silly rating system. I felt so bad and awkward afterwards, and now I'm not entirely sure I even want to continue with the therapy. I don't know how to get past this. I feel like I can't trust her now, and that anything I say might be construed in a way I don't mean. Has anyone else had something like this happen to them? How did you deal with it? I'm just feeling at a loss right now. It's like we speak two different languages and can't seem to get on the same page :-( Feeling so sad and kind of violated right now...

Briar

Being misunderstood and accused of being rude when you're not just sucks. I am sorry this is happening to you.

Personally, I saw quite a few therapists before I found one with the right style and personality for me. Maybe don't give up on therapy in general, but give on this therapist as not suited for you.

ETA: I did have one guy who snapped at me and was quite abrasive in the first appointment. I had another female T who actually YELLED at me for telling my H how depressed I was when I was desperate for help. A couple just stared at me and didn't talk much, which was intolerable for me. It happens that there are therapists out there who are just not good therapists, or not well suited for all people, and that isn't about you. I hope you can see that this is this therapist's issue and not yours.

[Kated1984]

The rating questionnaire should be confidential otherwise how can they expect people to be honest. If I were you I'd be looking for another therapist sharpish!

[UnderRugSwept]

Wow..."you have been rating her lower than the facility would prefer"? It sounds like she is more concerned about her ratings than about helping you. Do you have the option to switch to another therapist?

ETA: I was once accused of being "hostile" with a T who knew me very well but we were no longer on the same page, and I terminated. I was not being hostile, but I did not agree with her (re: several things) and she didn't like that (at all).

[HazelGirl]

This sounds like a very bad T, or at least one who is more concerned about other things than about you. Time to fire her and find a good one who will care about you more than a numbering system.

[unaluna]

Sounds to me like she deserves an even lower rating!! Who goes to t to effin google?? She can give you a list of websites if she wants, but that is NOT, repeat NOT a session. Ive had LCSWs. Omg. Run away.

[under_the_iron_sea]

Thank you all so much for you responses! I was thinking maybe I was overreacting and that this was just part of therapy... But I really did feel like going online to look at websites wasn't helpful overall to me, and it's so good to hear others say they think it isn't productive as part of a session either. I feel a lot better now. Thank you guys! I don't know what I can do... I might be able to try and transfer to a different person, but I think they all will be LCSW. I haven't really got the money to go to a private practice, so this will have to do for now. Unfortunately it's the county department that enforces the rating system, so I'll have to do it no matter who I see :/ I do think it's a bit ridiculous... and makes me feel extremely pressured to rate everything very high. It's difficult, because I was already rating things higher than I honestly felt at times, because again, I was trying to be diplomatic. But apparently mid-range is still too low... I don't know. I'm still feeling really weirded out by it all. Blah. A day or two from now I'll have some distance from it and be able to think more clearly. Thanks again to all of you. I'm glad to have some other input, and to hear that I'm not being overly dramatic or naive or something. This really helped.

Briar

[StressedMess]

The mental health budget in my state has been sliced and diced so much it barely resembles help any more. Unfortunately the center *has* to worry about their level of satisfaction or they face even higher cuts.

Me and both my girls get treatment at our county MHC center, one T is fantastic one is great and one I absolutely cannot stand. I have asked her and her supervisor to transfer my child's case to someone else, and they are not pleased with me.

Too bad for them, we pay them for help and not judgement or hostility. I would ask to be transferred. Good luck!

Sent from my iPod touch using Tapatalk

[precaryous]

I would find another T.

If you have to stay there -Can you opt out of the rating system?
I wouldn't want to rate anyone anymore...and I agree, it should be an anonymous rating system!

Sounds like that T has an issue with rejection, disapproval...or something.

It is not professional for a T to use your issues *against* you.
T's should be able to handle criticism, anger, whatever...without taking it personally.

[HazelGirl]

Not all LCSWs will be bad. My T is an LCSW and she is amazing.

[vonmoxie]

I totally agree that your ratings should be managed confidentially, because allowing practitioners to see specifically who ratings are coming from, almost ensures that patients are going to be shy about saying what they really think. Maybe it's a new system though, for which they haven't yet worked out logistical kinks.

Originally Posted by under_the_iron_sea

Then she said something like, "Well, I get the sense that you're being critical of me now. I wonder if maybe you're projecting that attitude onto me like your Father does to you." (My Dad was abusive and hyper critical, and partially why I'm even in therapy).

Only you know, but this seems like a pretty cheap shot to me. To use her knowledge of your more sensitive personal relationships to argue her side of an issue that is between her and you, I think is a bit of a conflict of interest. I mean, she's hardly an objective party in this. It's sort of akin to insider trading! Anyway, with an openly managed ratings system like that, she's really going to need to get better at receiving feedback from others...

If you decide to go forward with her as your therapist I hope she will find herself able to discuss the issue more constructively, because to me the only way this should be being raised to you, if at all, is as an opportunity to positively discuss your goals in therapy.

[nottrustin]

I am sorry you had such a horrible session. T is an idiot.

However, providers with all degrees can be idiots not just LCSW...likewise there are great ones with the same degrees. My T is an LCSW...I adore her and she is amazing.

[sailorboy]

Wow, your rating should NEVER be called into question.

Not all LCSW are like that.

I would find a more competent therapist.

[guilloche]

Oh geez... that sounds awful. Your T sounds... awful! I can't believe she lashed out like that at you, totally inappropriate. It sounds like she has her own unresolved crap and isn't going to be much help to you. I get that money is an issue... but really... there HAS to be someone you can see who isn't totally nuts like that?

And, for the record...
- Yes, ratings should be anonymous
- Low ratings should mean that the THERAPIST needs to IMPROVE, not that the CLIENT needs to change their ratings!!!
- After that last meeting, I'd give her the lowest rating possible
- Agree that watching a video online is NOT THERAPY. She can give you the link. It's a waste of your time and money. You're paying to talk to a therapist, not watch videos!

Good luck... I hope you can at least poke around a bit and see if there's anyone else that you can see.

[growlycat]

She sounds way too oversensitive and very unprofessional. You have every right to use your therapy time in a way that you feel is most productive.

The survey thing bothers me a lot. It sounds like she is pressuring you to start scoring her differently!! I've heard of some therapists that have a score that is just between T and patient, to get a gauge of how the working relationship is going.

This is totally different--the clinic is keeping track, which means it SHOULD be anonymous!!! If I were you, continue to score as you wish. If you can, tell her she crossed an ethical boundary.

Wow! This woman's treatment of you belongs on the thread about "Therapist's worse treatment of clients!" This was totally not okay for her to do and she was extremely unprofessional when she tried to turn the session into you being rude or disrespectful of her as a professional. I'm guessing that her supervisor had a "little chat" with her about her low ratings with clients. Her supervisor was totally OUT OF LINE by giving her the specific names of clients who were rating her in a range that wasn't "acceptable to management". I'm guessing that she might be getting lower than acceptable scores from clients other than you. She might even be worrying about being canned. But that is not your problem.

You were honest in your assessment; she was the one who was having problems accepting feedback that wasn't what she wanted or hoped for. Good, solid feedback should be invaluable to a skilled clinician. Believe me, the good one's seek out honest feedback and see it as an opportunity for client growth and their own growth. If she really wanted to learn and grow from this situation (and even more importantly wanted YOU to learn and grow and become empowered), she would have asked you how you viewed her as a therapist--in other words, checking in with you on a regular basis on how you saw the relationship with her. She should have NEVER mentioned the rating scale or asked why you were rating her lower than she though she should be rated. She would have specifically asked you about ways she might be more effective and helpful to you. Instead she unloaded on you. Not okay.

You might think about making an appointment with her supervisor and talking to her about what happened in the session. Believe me, if her supervisor is any good, she would have NEVER wanted or told your therapist to go into her session with you and challenged you why you were rating her the way you were. She would have wanted the therapist to explore your relationship with her and find out were there might be problems or roadblocks. I'd ask for a new therapist!

[Victoria'smom]

I'd ask to switch lcsw. Then on the next rating sheet start writing "choose not to respond".

[iheartjacques]

I thought ratings were confidential. If she's not up to scratch for the faculty, that's on her not you.