I know that everyone's definition of bad therapy and good therapy differs, but I read a lot of posts on this forum that make my skin crawl. I know that bad therapy exists, because I've been through it, so I'm not denying that there are therapists out there who range from incompetent to predatory.

But...there are also good therapists. I just don't see many examples of that on here. I guess because no one goes online to talk about what's working. Even so, I'm curious what others consider to be qualities of bad therapy and good therapy.

Here's my list:

Bad Therapy

• No continuity from week to week (every session feels like an introduction).
• Formulaic/cookie cutter approach to therapy (think good thoughts/good things will happen).
• Little or no response to disclosures (client reveals something painful and therapist awws but says nothing more).
• Overly dramatic facial expressions in response to disclosures.
• Fostering dependency instead of autonomy.
• Reparenting (I know some think this is good, but I do not).
• Too much self-disclosure (I think I know more about my previous therapist than she knows about me).
• Regularly going over time, or starting late/ending early.

Good Therapy

• Strict time limit, and always on time. (I can't believe how much better I feel with 50 minutes.)
• Individualized approach to therapy/flexibility. In other words, is responsive to what the client wants/needs.
• Listens, remembers, responds, and provides a sense of continuity week to week.
• Is not overly dramatic. Shows ease and assurance with the topic, creating calm instead of panic.
• Does not shame with talk of boundaries.
• Client leaves most sessions feeling stronger and connected, but not dependent.

So, those are some of mine. What are yours?

[TheWell]

Good therapy
- appropriate boundries without shaming. I tend to feel queasy when I hear about people who are having text conversations with their T's about non-therapy related stuff. I've texted my T when it was an emergency and recieved help in that moment.
- Allowing the client to ask for what they need without shaming them.
- Not terminating therapy when it get's hard or emotional for the T. I've heard of some T's on here who have terminated for transference feelings. That bothers me so much because the theraputic relationship causes transference. It's the Ts job to deal with them.

[stopdog]

To me, it is good that the one therapist stays back. It is bad when they get all care-y, when they they act like they have a stake in my life, when they try to trample my boundaries and when they do not listen or explain what their attempted machinations are supposed to be for.

[KayDubs]

Top of my list for good therapy would be never shaming the client for what he/she expresses during the session, regardless of content. Holding appropriate boundaries, being reliable (always starts on time and rarely cancels appointments), and recognizing (and correcting for) the therapist's own needs when they come out in session are extremely important for me. And (IMO) a not-so-good therapist would do the opposite.

ETA:

Originally Posted by stopdog

when they do not listen or explain what their attempted machinations are supposed to be for.

This is a great point. I find my therapist is very transparent with her style/approach and doesn't act as if only she is privy to info on her methods and their supposed benefits. If I ask her why she's taking a certain approach or asking me for particular information, she's very open about explaining herself, which helps me trust her.

[ThisWayOut]

I think for me good therapy involves (in no particular order)
-a conversation about boundaries because I am so worried about over-stepping them (I want to know what they are so I don't become annoying/frustrating/overly needy, etc)
-flexibility around frequency
-responsive to my needs (after helping me figure them out)
-some amount of challenging to get me out of my comfort zone
-meeting the client where they are at (emotionally, developmentally)
-listening to and hearing what I have to say, be it verbally, written, or through art
-providing a safe space to bring up what needs addressing
-indulging my need for reality checks and reassurance
-acknowledging if they are uncomfortable in dealing with details of abuse

"bad" therapy woud be
-insisting on a method of treatment that has clearly failed in the past
-pushing their treatment plan ideas without real regard for what I identify as something that bothers me
-too much self-disclosure without therapeutic value
-overly-strict boundaries
-regularly cutting sessions short or letting them go over by a significant amount of time
-minimizing or invalidating my concerns

Bad Therapy:

1.Therapist coddles, pities, and tries to "relate" to my experiences.
2.Therapist is a one-trick pony.
3.Therapist is a blank slate, never willing to show his realness.
4.Therapist lacks professional boundaries and ability to maintain his own self-care.
5.Therapist gets hung up on pushing some particular technique in therapy.

Good Therapy:

1.Therapist is direct and firm, while also supportive and caring.
2.Therapist is "real" with me.
3.Therapist has healthy boundaries and consistent professionalism.
4.Therapist has a set of tools and skills in his repetoire and knows which ones to use at the appropriate time.
5.Therapist is skilled at handling a crisis appropriately.
6.Most importantly, whatever he does, I am making progress and moving forward, perhaps in very small increments, but I'm moving forward.

[ScarletPimpernel]

My T is a good T I don't think I have complained much if at all about her.

But I have had my share of "good" and "bad" Ts too.

Good T:
* Active listener
* Authentic and sincere
* Practices what she preaches
* Has healthy boundaries
* Respects my boundaries
* Actually knows what she is talking about (not reading from a book)
* Is flexible in approach
* Allows me to be at the center of my treatment and treatment team
* Empathetic, encouraging, supportive, caring, safe, nonjudgemental, honest, open, respectful, has a sense of humor, trust worthy
* Can follow my thought process
* Can adapt to the emotional changes in session
* Clearly expresses emotions
* Doesn't over/under react
* Challenges in a constructive way
* Is consistent
* Is on time
* Is continuously studying to stay up-to-date
* Is mentally/emotionally healthy
* Allows hugs (that's a must for me)

Bad T:
* Been practicing for 20 years w/o a license
* Reads straight from a book
* Discloses too much
* Discloses nothing
* Only seems interested in one topic
* Overreacts
* Hospitalizes when not needed
* Judges and/or insults
* Pushes too hard for disclosure
* Doesn't respect my boundaries
* Is coddling
* Is controlling
* Is non-expressive
* Is manipulative
* Terminates you because you have situational problems that keep you distracted so you don't "need" therapy
* Is inconsistent
* Allows their issues into sessions
* Thinks a productive session consists of fighting about boundaries
* Isn't mentally present
* Etc, etc, etc.

Originally Posted by ThisWayOut

-acknowledging if they are uncomfortable in dealing with details of abuse

This is interesting to me. Until I found the one I see now, who's clearly comfortable with all kinds of abuse (well, not comfortable so much as competent and easy to talk to about it) that I realize others I've seen were lacking in this area. I would never again want a therapist that's uncomfortable with these details. In fact, if they are, they should not even be practicing.

Originally Posted by lolagrace

Bad Therapy:

1.Therapist coddles, pities, and tries to "relate" to my experiences.
2.Therapist is a one-trick pony.
3.Therapist is a blank slate, never willing to show his realness.
4.Therapist lack professional boundaries and ability to maintain his own self-care.
5.Therapist gets hung up on pushing some particular technique in therapy.

Good Therapy:

1.Therapist is direct and firm, while also supportive and caring.
2.Therapist is "real" with me.
3.Therapist has healthy boundaries and consistent professionalism.
4.Therapist has a set of tools and skills in his repetoire and knows which ones to use at the appropriate time.
5.Therapist is skilled at handling a crisis appropriately.
6.Most importantly, whatever he does, I am making progress and moving forward, perhaps in very small increments, but I'm moving forward.

I love these lists.

Originally Posted by ScarletPimpernel

Bad T:
* Been practicing for 20 years w/o a license
* Reads straight from a book
* Discloses too much
* Discloses nothing
* Only seems interested in one topic
* Overreacts
* Hospitalizes when not needed
* Judges and/or insults
* Pushes too hard for disclosure
* Doesn't respect my boundaries
* Is coddling
* Is controlling
* Is non-expressive
* Is manipulative
* Terminates you because you have situational problems that keep you distracted so you don't "need" therapy
* Is inconsistent
* Allows their issues into sessions
* Thinks a productive session consists of fighting about boundaries
* Isn't mentally present
* Etc, etc, etc.

20 years without a license??? That takes some rocks.

About the book: I had a therapist that was always switching tactics on me (she was fairly new). Finally, one day I'd had it with yet another new approach she was taking and I asked if she'd been reading a new book. She looked completely caught and admitted that she had. Totally incompetent.

I can relate to the one topic. The last therapist I saw was obsessed with alcoholism (I do not drink and never have) and 12 step programs. It was something that was clearly important to her, so I let her ramble on about it, waiting to see if it would become relevant. It took her moving away for me to get free of that bad therapy.

[NowhereUSA]

I think there's a lot of similarities to lickety's list. The only ones I would move is that I don't like a strict adherence to time and I prefer more self-disclosure from my T... but not right off.

I've seen my T now for six years. I like that he let's me go 10 minutes over at times and that he shares about himself. I don't know if what I know about him is just because of the length of time I've seen him or what, but it makes me feel better knowing about him. I don't trust people I don't know things about. The more closed off someone else is, the more shut down I am. So, for me, his self-disclosure has helped foster a level of trust that helps me open up. It also helps to have him self-disclose because he doesn't do it in a way that is asking me to do anything. It's helped me understand healthy disclosure. I grew up moving very very frequently so my only real experience has been with my mother who turned me into her mini-therapist at 15. So everything she ever told me was with the expectation that I had to give her some emotional support in some fashion and if I didn't give it, I was scolded in some way (silent treatment, yelled at, etc).

I appreciate that my T doesn't think he knows everything and regularly consults with other Ts in his agency. I think a good T gets support and knows when they need support.

Probably a bad T... well my previous T (who wasn't licensed but I was so broke I couldn't afford anything and didn't know about this agency)... she saw too much of herself in me. Sometimes I felt like she was trying to save herself which sounds weird maybe? We had a similar childhood and I know she had depression and I think our similarities of history were too close. I left every session feeling worse and dreading every session. I don't feel like that with my current T. I generally feel better, if nothing else, like some pressure was relieved.

I'm not really sure what good therapy is or what bad therapy is. I think a person shouldn't end up worse off after therapy than they were before therapy. Other than that it's very confusing to me.

Originally Posted by NowhereUSA

I don't like a strict adherence to time and I prefer more self-disclosure from my T... but not right off.

I'm very much the same way. I'm not a stickler for time. I'm a teacher and live and die by those damned bells, so I'm quite willing to forego stict adherence to time schedules outside of work. It doesn't at all phase me if my T gets me a bit late or something. I don't wear a watch; I don't live with my cell-phone in my hand; so, I don't really even notice what time he comes to get me or when we leave. It keeps it natural and relaxed rather than worrying about where the hands are on the clock.

Same with self-disclosure. I've always known quite a bit about my therapists, but the more intimate details came slowly, over time, and completely in context of what we were discussing. I ran quickly from two different female therapists who almost right away disclosed their personal abuse histories I'm assuming as a way to show me they "understood" me. Ick. Freaked me out. One reason I won't go to a female therapist ever again. I've never had a male therapist inappropriately reveal personal information to me. I've actually found men much more sensitive and careful about such things.

[KayDubs]

A certain level of self-disclosure is important for me as well, and I'm glad other people mentioned it. It's another one of those things that helps me trust her.

Personally I like that my appointments almost always begin/end on time. I've read accounts here on PC about therapists who start appointments late and then end on time. I'd be quite annoyed by that because therapy doesn't come cheap and I want the full time that I'm entitled to. We've run over sometimes, but that's if she doesn't have another client in the time slot after me. But I travel quite a distance, sometimes on public transit depending on the day, and find it reassuring that I'll be seen on time. And that I won't have to wait an hour after my appointment for the next train if I miss the last one.

Originally Posted by KayL

A certain level of self-disclosure is important for me as well, and I'm glad other people mentioned it. It's another one of those things that helps me trust her.

Personally I like that my appointments almost always begin/end on time. I've read accounts here on PC about therapists who start appointments late and then end on time. I'd be quite annoyed by that because therapy doesn't come cheap and I want the full time that I'm entitled to. We've run over sometimes, but that's if she doesn't have another client in the time slot after me. But I travel quite a distance, sometimes on public transit depending on the day, and find it reassuring that I'll be seen on time. And that I won't have to wait an hour for the next train if I miss the last one. Moral of my story - it might be time to think about getting a car, lol.

I get that. Fortunately, I don't have those kinds of time constraints to worry about. I'm always his last client of the day, so I don't have to worry about infringing on anyone else's time except my T's, and if he allows us to go overtime, that's his decision. My guess is that he usually gets me 5-10 minutes after the hour and runs to the hour, so it isn't like he's cutting my time short (sessions are designed to be 50 minutes), but again, I don't ever really time it, I kind of figure it out based on when new programs start on the TV in the waiting room. I think that is just the way he works: start after the hour and goes to the hour--because the few times I've seen him during the day he's done pretty much the same thing.

I used to have much longer sessions that ranged from 90 min to 2 hours, and thought I'd never get used to (or like) a strict time limit. But, boy, I am loving this. Things move much more quickly. I don't take forever to warm up or get to the point, and the hour (or 50 min) is much more useful and effective. I never leave feeling worse, or like I needed more time, or that I was being dismissed. I'm always ready to leave, my time feels worthwhile, and I like that feeling.

[NowhereUSA]

Originally Posted by lolagrace

I get that. Fortunately, I don't have those kinds of time constraints to worry about. I'm always his last client of the day, so I don't have to worry about infringing on anyone else's time except my T's, and if he allows us to go overtime, that's his decision. My guess is that he usually gets me 5-10 minutes after the hour and runs to the hour, so it isn't like he's cutting my time short (sessions are designed to be 50 minutes), but again, I don't ever really time it, I kind of figure it out based on when new programs start on the TV in the waiting room. I think that is just the way he works: start after the hour and goes to the hour--because the few times I've seen him during the day he's done pretty much the same thing.

I'm often the last client in his day too and he let's me meander over a bit. We share some similar interests in tv/movies so usually we get caught up in chatting at the end after winding down

Once he didn't have an appt after me during the day (rare day time appt) and he let me go almost an extra hour. I was having a hard time, so it was really nice.

[stopdog]

I keep track of the time and simply leave when the time is up. I do not want a therapist thinking they are doing me a favor or anything by letting time run over a few minutes on a random basis. I have no urge to chat with the woman
For me, bad therapy would also include the therapist trying to be in charge of time keeping. I like watches and clocks and time. I know what I contracted for and if I wanted something else, I would negotiate it or look elsewhere.

Originally Posted by stopdog

I keep track of the time and simply leave when the time is up. I do not want a therapist thinking they are doing me a favor or anything by letting time run over a few minutes on a random basis. I have no urge to chat with the woman
For me, bad therapy would also include the therapist trying to be in charge of time keeping. I like watches and clocks and time. I know what I contracted for and if I wanted something else, I would negotiate it or look elsewhere.

He doesn't think he's "doing me a favor" when we go over. I know that's how you see it though.

We go over for one of two reasons: either we've gotten onto some mesmerizing subject like a new recipe to try or the antics of our dogs , or more likely, the session has gotten extremely intense because I am in crisis of some sort. As a general rule, our sessions are pretty much the normal 50-60 minutes-ish.

For me, bad therapy would include a therapist that adheres too strictly to a clock, not paying attention when a client is not in condition to leave his/her office safely. I'm not sure you've ever been in that condition, but at those times, a therapist has to deal with the emergency in front of him and throw the clock out the window.

[stopdog]

It is not the therapist who is strict about the clock - I am. The bad therapist for me would try to stop me from doing it.
The therapist has tried to talk about the dogs and stuff at the end. But I do not play with therapists.

Originally Posted by stopdog

It is not the therapist who is strict about the clock - I am. The bad therapist for me would try to stop me from doing it.
The therapist has tried to talk about the dogs and stuff at the end. But I do not play with therapists.

It isn't "play" SD. It's called conversation. (Again, I know. Not your thing.)

[NowhereUSA]

SD is the one who throws her money at "the woman" and walks out.

Hehehehehe. Sherlock SD

[RedSun]

I do, I like playing with therapists....

Good therapy....cup of tea, cats, nice venue, easy parking , bit of appropriate self disclosure, letting me talk when I want, but also directing if I'm stuck

Bad therapy (for me) CBT! . Also, would saw a t once who stared at me the whole time like a loon, not good. I'm always wary of people who don't have pets (have they eaten them?) and I don't like waiting rooms with other clients in. And I don't like no tea, but I get no tea.

Good therapy gives clients the space to feel what they feel.
Bad therapy gives the therapist the space to give his/her ego a work out

[KayDubs]

Originally Posted by Red75

Also, would saw a t once who stared at me the whole time like a loon, not good.

Oh man, me too. Saw one t for one appointment who did this. It was like she was shooting lasers out of her eyes right through me. Too intimidating to go back!