Signs of a good therapist

A good therapist knows how to respectfully redirect me when I start talking about things that don't have therapeutic relevance (e.g. I'm wasting the time I'm paying for).

I really like these two articles, especially the second one:
https://www.psychologytoday.com/blog...t-is-competent
https://www.psychologytoday.com/blog...e-test-therapy

For me:
~caring, compassionate and empathetic
~know when to push a little harder but also knows when to back off
~listens to the client
~is supportive of the client even when the client even when they disagree with their decisions
~handles each client differently based upon their individual needs.

For me, a not completely incompetent one will stay back and stop talking when I tell them to do so.
I have no idea what makes a therapist competent at their job or not. It all seems quite fluid and mostly set up to benefit the therapist. I like that others have lists too and that they find therapists who can do the the things on the list.

I don't really think in terms of "good" or "bad" outside personal relationships (bad friend, good husband, etc.). I would prefer effective or competent.

Obviously this effectiveness or competency is in the eye of the beholder/client. But for me it means the client should be listened to - maybe not always agreed with, but listened to, and that at minimum no harm should be done them. Ideally, a therapist would actually also be helpful in practical ways, traching tools or whatever.

Ha! Great minds think alike!

A good t:
- admits when they have made a mistake
- acknowledges that they don't/can't know everything
- is honest with me; open communication
- sees our relationship as teamwork, as opposed to doctor/patient
- thinks outside of the box and recognizes that no two patients are the same
- compassionate
- doesn't dress up (looks professional but not overly done)
- explains things
- patient
- knows how far to push so that progress continues but not so hard that it is detrimental
- probably a ton of others that I will think of later

I wonder if this thread will become as long as the 'signs of a bad therapist' thread. I figure for some reason it's easier to talk more at length about negative things as opposed to helpful things. In an effort to add to this thread and stay on topic, I found a list online about good therapist qualities. The link is at the bottom of this post.

Fourteen qualities and actions of effective therapists

The 14 qualities and actions of effective therapist, based on theory, policy, and research evidence, can guide therapists toward continual improvement. Various therapists, delivering various treatments, in various contexts, will clearly emphasize some of these more than others.

1. Effective therapists have a sophisticated set of interpersonal skills, including
a. Verbal fluency
b. Interpersonal perception
c. Affective modulation and expressiveness
d. Warmth and acceptance
e. Empathy
f. Focus on other

2. Clients of effective therapists feel understood, trust the therapist, and believe the therapist can help him or her. The therapist creates these conditions in the first moments of the interaction through verbal and
importantly non-verbal behavior. In the initial contacts, clients are very sensitive to cues of acceptance, understanding, and expertise. Although these conditions are necessary throughout therapy, they are most
critical in the initial interaction to ensure engagement in the therapeutic process.

3. Effective therapists are able to form a working alliance with a broad range of clients. The working alliance involves the therapeutic bond, but also importantly agreement about the task of goals of therapy. The working alliance is described as collaborative, purposeful work on the part of the client and the therapist. The effective therapist builds on the client’s initial trust and belief to form this alliance and the alliance becomes solidly established early in therapy.

4. Effective therapists provide an acceptable and adaptive explanation for the client’s distress. Anyone who presents to a socially sanctioned healer, such as a physician or a psychotherapist, wants an explanation for his or her symptoms or problems. There are several considerations involved in providing the explanation.

First, the explanation must be consistent with the healing practice: in medicine, the explanation is biological whereas in psychotherapy the explanation is psychological.

Second, the explanation must be acceptable and accepted by the client, a process that involves compatibility with clients’ attitudes, values, culture, and worldview. That is, treatments are adapted for patients.

Third, the explanation must be adaptive—that is, the explanation provides a means by which the client can overcome his or her difficulties. This induces positive expectations that the client can master what is needed to resolve difficulties. Fourth, the ―scientific truth of the explanation is unimportant relative to its acceptance by the client. The therapist is aware of the context of the patient (e.g., issues of culture, SES, race, ethnicity) in the development and presentation of the explanation. Acceptance of the explanation leads to purposeful collaborative work.

5. The effective therapist provides a treatment plan that is consistent with the explanation provided to the client. Once the client accepts the explanation, the treatment plan will make sense and client compliance
will be increased. The treatment plan must involve healthy actions—
the effective therapist facilitates the client to do something that is in their best interest. Different treatment approaches involve different
actions, but the commonality is that all such actions are psychologically healthy.

6. The effective therapist is influential, persuasive, and convincing. The therapist presents the explanation and the treatment plan in a way that convinces the client that the explanation is correct and that compliance with the treatment will benefit the patient. This process leads to client hopefulness, increased expectancy for mastery, and enactment of healthy actions. These characteristics are essential for forming
a strong working alliance.

7. The effective therapist continually monitors client progress in an authentic way. This monitoring may involve the use of instruments or scales or by checking in with the patient regularly. Authenticity refers to
communication to the client that the therapist truly wants to know how
the client is doing. Administration of scales, for instance, without a discussion with the client, is insufficient; effective therapists will
integrate progress evidence into treatment. Therapists are particularly attentive to evidence that their clients are deteriorating.

8. The effective therapist is flexible and will adjust therapy if resistance to the treatment is apparent or the client is not making adequate progress. Although the effective therapist is persuasive, clients may not
accept the explanation and/or treatment or may not be making adequate progress given the nature of the problem.

The therapist is aware of verbal and nonverbal cues that the client is resistant to the explanation or the treatment, and uses the evidence gleaned from assessing therapeutic progress with outcome instruments. The effective therapist takes in new information, test hypotheses about the client, and is willing to be ―wrong. Adjustments might involve subtle differences in the manner in which the treatment is presented, use of a different theoretical approach, referral to another therapist, or use of adjunctive services (medication, acupuncture, etc.).

9. The effective therapist does not avoid difficult material in therapy and uses such difficulties therapeutically. It is not unusual that the client will avoid material that is difficult. The effective therapist can infer when such avoidance is taking place and does not collude to avoid the material; rather the therapist will facilitate a discussion of the difficult mate
rial and in therapy will address core client problems. Such discussions are typically emotional and thus effective therapists are comfortable with
interactions with strong affect.

When the difficult material involves the relationship between the therapist and the client, the effective therapist addresses the interpersonal process in a therapeutic way (i.e., what is called by some the tear and repair of the alliance).

10. The effective therapist communicates hope and optimism. This communication is relatively easy for motivated clients who are making adequate therapeutic progress. However, those with severe and/or
chronic problems typically experience relapses, lack of consistent progress, or other difficulties. The effective therapists acknowledge these issues but continues to communicate hope that the client will
achieve realistic goals in the long run.

This communication is not Pollyannaish optimism, but rather a firm belief that together the therapist and client will work successfully. This hopefulness is about the client (i.e., the client can achieve the goals) and of the therapist him or herself (i.e., ―I can work successfully with this client.). As a corollary, effective therapists mobilize client strengths and resources to facilitate the client’s ability to solve his or her own problems. Moreover, the effective therapist creates client attributions that it is the client, through his or her work, who is responsible for therapeutic progress, creating a sense of mastery.

11. Effective therapists are aware of the client’s characteristics and context. Characteristics of the client refer to the culture, race, ethnicity, spirituality, sexual orientation, age, physical health, motivation for
change, and so forth. The context involves available resources
(e.g., SES status), family and support networks, vocational status, cultural milieu, and concurrent services (e.g., psychiatric, case management, etc.). The therapist works to coordinate care of the client with other psychological, psychiatric, physical, or social services. Furthermore, the effective therapist is aware of how his or her own background, personality, and status interacts with those of the patient, in terms of the clients reaction to the therapist, the therapist reaction to the client, and to their interaction.

12. The effective therapist is aware of his or her own psychological process and does not inject his or her own material into the therapy process unless such actions are deliberate and therapeutic. The effective therapist reflects on his or her own reaction to the client (i.e., counter transference) to determine if these reactions are reasonable given the patient presentation or are based on therapist issues.

13. The effective therapist is aware of the best research evidence related to the particular client, in terms of treatment, problems, social context, and so forth. Of particular importance is understanding the
biological, social, and psychological bases of the disorder or problem experienced by the patient.

14. The effective therapist seeks to continually improve. Development of skill in an area involves intensive practice with model based feedback. Feedback on the progress of clients is critical to improvement but the feedback is most useful if embedded in a coherent model of therapy so that the therapist can make specific changes and determine the outcomes produced by such changes.

Evidence that a client is not making satisfactory progress is useful but knowledge that the client is not making satisfactory progress and that there is insufficient agreement about the goals of therapy provides information that the therapist can use in this particular case.

Moreover, the therapist can use such information across clients to detect general patterns. The essential point here is that the effective therapist, by definition, is the therapist who achieves expected or more than expected progress with his or her clients, generally, and who is continually improving.

https://www.apa.org/education/ce/eff...therapists.pdf

Since I can only determine what I believe makes a "good" therapist based on my own personal experience, I'd say that I love that the therapists I've actually stuck with over time have three thing in common--Consistency, Self-confidence (not arrogance!)and a willingness to own their own stuff. I really respect those things, and when actually "in" therapy, those qualities give me some sense of stability and comfort. I'm not saying things are all rainbows and ponies, but those two qualities are steadying for me. I also agree with all the other posts and the things they have listed as good qualities.

This is all very subjective. This is what bothers me most about therapy. THere are basically no guidelines and no ways to measure progress or effectiveness.

Effectiveness is often measured in overall functioning. For example, some clients are so depressed they can't sleep, dont eat enough, can't hold a job, isolate themselves, etc.. If after some time in therapy, this client finds themselves taking care of physical needs, is employed, is socializing, etc., then therapy may be working. Whether the improvement is actually due to therapy or a combination of therapy plus other factors is of course subjective, but a correlation would suggest there is at least a relationship.

Isn't looking the apa for this sort of thing rather like asking a butcher about being a vegetarian?

Interesting blog about studies:

https://www.psychologytoday.com/blog...rly-impossible

No, not really....

It's great to have a positive thread about good things in a therapist. It's a balance too, for example with the other thread about signs of a therapist.
For me, personally, I am interested in the positives right now and I hope that this thread can reflect that, as there are other threads to reflect less positive aspects.

There's a lot of emphasis on the idea that the people who have "excellent or wonderful" therapists are going to be hurt eventually. And while I don't necessarily buy into that I can at least maybe understand what they are trying to get at...maybe they think it's a case of "the lady doth protest too much" or that the very depth of emotion or attachment someone has to their therapist is going to be damaging to the client, that the therapist built up a false sense of what the relationship is.

But what about the therapists that are "quietly good". Say, maybe a poster here discusses (or someone doesn't need to discuss) the concrete skills or benefits. That though the relationship was beneficial to their therapy, the relationship wasn't THE THERAPIST itself.

I think that's where I would fit in. I am aware that my psychiatrist is not a permanent figure in my life. I'm not looking for a mother/lover/friend replacement or reenactment. I don't have her personal phone number or email. I don't have any promises outside of session. *shrugs* she is quietly a good therapist.

I'm not sure what others who view therapy as always bad or dangerous would say about her future potential to harm me. And when we choose to reach termination together....is there an automatic assumption that she's going to let someone else down and crush their spirit?

I took this from the same link that you quoted. If you follow the cited articles, you will learn about the guidelines and the ways in which the researchers measured progress and effectiveness.

Not only is psychotherapy widely practiced, it is effective: Those who receive psychotherapy achieve much better outcomes than they would have had they not received psychotherapy (Lambert & Ogles, 2004; Wampold, 2001, 2007)
. In clinical trials, psychotherapy has been shown to be effective in treating depression, anxiety, marital dissatisfaction, substance abuse, health problems (including smoking, pain and eating disorders) and sexual dysfunction, and with various populations, including children,adolescents, adults, and elders
(Chambless et al., 1998)
.
Indeed, psychotherapy is more effective than many accepted, but expensive, medical practices, including interventions in cardiology treatments, geriatric medicine and asthma (Wampold, 2007)

. Psychotherapy is as effective as or more effective than psychotropic medications for various mental disorders, including many depression and anxiety disorders, and results in lower relapse rates than medications (Hollon,Stewart, & Strunk, 2006; Imel, Malterer, McKay, & Wampold, 2008)
. In addition, outcomes in real world clinical practice are comparable those psychotherapy clinical trials (Minami & Wampold, 2008)

Butchers aren't subject to the same ethical and legal standards. So no.

I think it is exactly like looking to a butcher. Butchers may not be subject to the exact same standards as those of a therapist - but they have their own.
Be positive all you like. I agree it seems to help some people either because the therapist has some degree of skill or the client believes hard enough or some magic or luck occurs or whatever. And I even see that in some ways to someone who thought it helped them, the reason might not matter much.

But I would not look to the apa to be honest. Even in my own field I recognize that say looking to the aba for critical information on lawyers is going to be skewed.

Nevermind...

The reason I think my T is very good is that:

- he is attuned to my needs or willing to listen.
-His boundaries haven't changed in the year I've been seeing him
-He can offer me the same time slot each week which meets my needs
-He has never pushed me for details of things I'm not ready to talk about and allows me to go there when I'm ready.
- he is respectful of my choices and decisions.
-He is self aware and willing to challenge his own perceptions.
- he uses supervision ethically and effectively.
- he is smart and experienced.
- he models what a good therapist relationship should look like which has helped me heal from previous T relationship.
- he is thoughtful and attentive.
- and most of all he is consistent.

These are my own very specific qualities of a good T for me. I'm sure there are many people who wouldn't find him a good fit, but he's a great fit for me and I would always look for a T with the above qualities.

I really agreed with your post

I saw what you posted and you must not have read my whole thread. Actually one of the first posts was a negative one about the article i posted. I don't care if people want to debate and bring up their positive experiences on my thread and they have. Fine with me.

Any study can be skewed to make the outcome what the researcher wants it to be.

Agreed....