Signs of a good therapist

Ok...so what you really mean would that you would trust the APA with their therapy standards in the way that you would trust the American Butcher Agency for Butchering standards... because APA involves therapists. and ABA would involve butchers. So presuming for industry bias I am guessing your point is?

I LOVE this place. Love the mature discussions we have here.

One who does not try to be funny is on my list.

One more aspect of a good therapist that I've experienced:

My therapist (and pdoc for that matter) always said that their goal was for me not to have to need to see them forever. They were very good about helping me work towards healing and autonomy. The goal was always to help me move forward to a place of stability and self-governance. It was always pretty clear where I needed to go and what would have to happen for me to get there. It took a long time to get there, but that ultimate goal was always the aim.

Based on my experience of over 20 years of having been in therapy on and off and my extensive readings:

There is no way to guarantee a therapist will be good. Therapy is by nature more complex and inexact than, say, surgery. It's much harder to say when things went wrong. It's much harder to say, "If you getting worse, therapy is not working." There are legitimate reasons why some days or some periods of worsening mood can be experienced. And given the vast range of therapist and patient personalities and therapy modalities and variety of mental illnesses, it's hard to say anything general with complete certainty.

So the best way to approach this is to look at not the signs of a good therapist but the signs of a therapist less likely to cause harm.

And for me it starts with boundaries. In Western countries, boundaries are quite clear and there are ethical rules about patient-doctor relationship and I think it would be helpful for patients to read such rules, such as APA's, before engaging in therapy:

Ethical Principles of Psychologists and Code of Conduct

I am aware of the criticism of APA (both on a personal level in terms of support of unethical psychologists, and politically, as they implicitly approved of torture methods APA takes strong action in response to independent review). In addition, it is possible that some of the boundaries, especially if adhered to strictly, can be inappropriate for some people given their culture or mental illness. For instance, to the extent that touch can be appropriate.

However, these rules are not set in stone and do get changed to reflect latest science and social concerns, trying to provide just enough distance so that patients are less likely to get harmed and at the same time enough closeness exists to provide meaningful care and contact. So I think it's important for patients to be aware of these rules, both in order to empower them to report any mistreatment but also to let them go in there with right expectations of therapy will look like. And most of these rules are there for a reason, and need to be respected, like rules about confidentiality and privacy, harassment or sexual involvement with patients, conflicts of interest, therapist competence, etc.

Beyond boundaries, and in keeping with them, I venture to say empowerment is another part of good/harmless therapy. Lots of people go into therapy feeling powerless, stuck, etc. Whether be it facing relationship difficulties, work problems, or the mental illness itself, they feel powerless. Therapy needs to move in the direction of empowering people to face the problems they have.

In short, I see boundaries and empowerment as key parts of therapy that aims to be at the least harmless.

FYI:

Addendum to Ethics Committee June 2009 Statement

The Ethics Committee considers the prohibition against torture to encompass the specific techniques prohibited by the Council of Representatives Resolution below. The Committee finds this prohibition consistent with President Obama’s January 22, 2009 executive order, “Ensuring Lawful Interrogations.”

Amendment to the Reaffirmation of the American Psychological Association Position Against Torture and Other Cruel, Inhuman, or Degrading Treatment or Punishment and Its Application to Individuals Defined in the United States Code as "Enemy Combatants"

Resolution Adopted by APA on February 22, 2008

BE IT RESOLVED that this unequivocal condemnation includes all techniques considered torture or cruel, inhuman or degrading treatment or punishment under the United Nations Convention Against Torture and Other Cruel, Inhuman, or Degrading Treatment or Punishment; the Geneva Conventions; the Principles of Medical Ethics Relevant to the Role of Health Personnel, Particularly Physicians, in the Protection of Prisoners and Detainees against Torture and Other Cruel, Inhuman, or Degrading Treatment or Punishment; the Basic Principles for the Treatment of Prisoners; or the World Medical Association Declaration of Tokyo. An absolute prohibition against the following techniques therefore arises from, is understood in the context of, and is interpreted according to these texts: mock executions; water-boarding or any other form of simulated drowning or suffocation; sexual humiliation; rape; cultural or religious humiliation; exploitation of fears, phobias or psychopathology; induced hypothermia; the use of psychotropic drugs or mind-altering substances; hooding; forced nakedness; stress positions; the use of dogs to threaten or intimidate; physical assault including slapping or shaking; exposure to extreme heat or cold; threats of harm or death; isolation; sensory deprivation and over-stimulation; sleep deprivation; or the threatened use of any of the above techniques to an individual or to members of an individual's family. Psychologists are absolutely prohibited from knowingly planning, designing, participating in or assisting in the use of all condemned techniques at any time and may not enlist others to employ these techniques in order to circumvent this resolution's prohibition.

APA Ethics Committee Statement ? No Defense to Torture

Yeah but sometimes confrontation is frowned upon here...thats the only reason I deleted it. There are other ways for me to deal with my annoyance that dont involve the possibility of moderators.

I don't want this thread to get derailed, but just want to say there was enough loopholes for them to have allowed active participation of certain APA members and have looked the other way. Which is why they needed to make changes again after the 500 page report came out.

https://www.apa.org/independent-revi...ort-7.2.15.pdf

But to go back to the main point, I think despite what APA did or allowed being done, going against their own ideals, the ethical code itself, as a model of what should be permitted and how therapy relationships should be conducted, is worthy of consideration in our consumer society where consumer needs to know his rights and responsibilities going into therapy in the small chance that the therapist is not going to follow some of these rules.

These are precautions of course and I don't want anybody to assume the worst going in. It is already tough enough to trust strangers. But most licensed therapists got into the profession to help people. At the same time, the kind of trust required means that most of us want to be very sure of what the person is gonna do, whether they will take advantage of us. And I think it's best to go in there prepared and with knowledge of both what therapy should look like and what the ethical rules are. It's empowering.

I did read what you wrote before you deleted it though. What you said about me and my post wasn't accurate. I just wanted to clear that up in case anyone is wondering.

Trying to get back on track . . .

People have mentioned that they love their therapist's ability/skill at listening.
I love it when my therapist is talking and something comes to my head and I open my mouth to speak and then realize that I'm about to interrupt her and I shut my mouth. She immediately sees me pause and she stops dead and encourages me to express what I'm thinking. I LOVE THAT! Where IRL does that happen? Not often in my world of power talkers I love it that she sees her role as secondary to my speaking. . . . as it should be because I'm paying for the time!

I also like that my therapist never seemed ruffled or in a tizzy about anything. The woman is a rock. I might be talking fast, gesturing wildly, spittle coming to the corners of my mouth, my leg jigging up and down in agitation and she is as relaxed and calm as if she was talking to the most easy-going, calm person in the world. She just doesn't get rattled.

Yeah, thats my job. A local mexican restaurant has this sign behind their cash register: "we have an agreement with the bank: we dont cash checks, and they dont make tacos."

Yes, to both of your last two posts.

My T has really fostered strong communication in me. He always has encouraged me to give him feedback. If I don't understand what he is saying, ask him. If I don't agree with what he is saying, tell him. Stand up for what I need and communicate that to him. He has always listened and really heard me out.

And yes, he's a rock. Never gets flustered by what is going on with me (and some of it has been rather fluster-worthy). He always made it very safe to tell him exactly what was going on; I knew he would be able to handle it and help me through it without over-reacting. Always the proportionate, professional, yet somehow quite personal and individual response.

I like the use of the word empowerment in the context of therapy. If I got anything out of therapy it was empowerment, or really, the realization that I was more competent than I thought.

I remember when my mood was low I told my pdoc I just wanted to get better. He said to me "you are doing really well. You might feel lousy, but you're working, taking classes, taking care of three kids and going on dates. Even if you don't feel like it look closer, because you are functioning really well. Better than most." With that I felt empowered, and remembered no one ever feels good all he time, everyone gets depressed and you can't always control that all the time. But I was improving in how I was living and experiencing life. To me that can be a result of good therapy. Focusing on a client's strengths rather than on their perceived weaknesses can be extremely effective.

Consistent, accepting, not changing their mind or ribuild their boundaries too often etc.
Also, caring but admitting their own limits. So, genuine. This last one can be hard I guess, both for clients and especially for the T.

I also like it when my therapist checks in with me after a rough session to see where we are with each other. It isn't a mushy or overly emotional check-in, but it's obvious that she wants to keep a finger on the pulse of the relationship. She'll just pause at the end of the session, make eye contact with me and ask, "Are we okay?" She'll motion with one finger--point at me and point at herself and then move back and forth between the two of us. "Is everything okay?" It's not every session, just after a rough or confusing or frustrating session.

And even if things aren't peachy keen, meaning I might be holding onto a bit of resentment or frustration or anger, the fact that she's checked in, makes things okay until our next session . . . Okay, not always, but a lot of times. I do admit that I'm a hard nut and sometimes I do hold onto a grudge and even a check in doesn't solve everything.

Sorry my mistake. I'm done.

I would be so grateful if this thread could be positive and others could take their criticisms to the other thread. it's kind of triggering to keep having to block/ignore each crop of therapy naysayers who don't really seem to want to discourse but want to take out their legitimate issues with psychotherapy on people who didn't cause them. it makes PC feel unwelcoming and kind of scary. it also seems kind of abusive and needlessly combative.

For me, a lot of what people list as a sign of good therapy for them is exactly what I do not want or need and in fact pisses me off when the woman tries it or at least when the first one tries it as she refuses to explain. The second one at least explains the point of what she is trying to do - I usually reject it as something I don't want, but it is good to know at least that she will tell me.

See, I don't think that's a bad thing! I truly believe that what works for one person, is therapy from H E L L for someone else. I really do like hearing your perception of how therapy works for you because it is different for me than it is for you (have to admit though that it took me a few months of reading your posts in the beginning to see how intriguing and different your approach to therapy was from my own).

The big thing is that you don't insist or assert that how you do therapy is the only way to do therapy. I certainly don't think that anyone here needs or wants to do therapy the way I do it . . . God forbid! It truly is an individual undertaking and the reason I love this forum is that I get to see all the unique and different ways that therapy is used by a wide variety of people. It's nice to know that not everyone does it the same way. Reason I like that? Because therapy is a bumpy, uneven, uncomfortable and frustrating thing for me. It's nice to know that I'm not alone in how difficult it is.

I'm sorry you're not feeling okay about posting, DD. Just post what you want to say when you're feeling okay about things and it'll be fine. One thing I've learned is that not everyone is going to agree with me--just NOT POSSIBLE.

Sometimes the disagreements or rejections on here can be hurtful, but try telling yourself that you can only be true to yourself when posting. Believe me, you'll always have someone or a few someones who agree with you! Take care.

What I think are signs of a good therapist are that a good therapist will spend time in session to help out their clients
a good therapist cares for their clients and not judge their clients
a good therapist shares treatment plans they wrote out for their clients and work on the goals that he or she set up for their clients
a good therapist teach his or her clients coping skills to their clients and give their clients numbers for the suicide prevention lifeline and be there when their clients in a crisis situation.
a good therapist treat his or her clients w respect and never crosses a boundary between their clients .
a good therapist knows when a client is acting inappropriately by setting up a boundary between his or her client who is acting inappropriately during a session .
a good therapist calls his or her clients if he or she will be late for the session .
a good therapist calls ahead of time if they are sick
a good therapist update his or her clients when he or she will be out of the office for any reason
a good therapist never shares any confidential information w/o a written consent from his or her clients family about treatment plans





Diagnosis: Anxiety and depression
meds : Cymbalta 60 mgs at night
Vistrail 2 25 mgs daily for anxiety prn
50 mgs at night for insomnia with an additional 25 mgs=75 mgs when up past 1:00 in the morning

A good therapist refuses to accept or inflict physical, verbal, or emotional abuse.

A good therapist models proper boundaries and behavior toward abusive individuals.

A good therapist does all they can to protect their patients.

A good therapist terminates if a patient physically, sexually, or emotionally abuses the therapist.

Abusive? Really? Wow. Interesting. This seems very controlling and abusive to me. I guess we all have different viewpoints of abuse though.

I didn't mean to sound exclusionary. I think everyone has a right to their opinion and experiences. However, there is already a thread about the negative aspects of therapy and my point was can't we keep the two separate since there's one aready one on the good and one on the bad.

I get that people have run into and had bad experiences with therapists. I too have had a bad experience with a Pdoc. I CHOSE to move onward and upward. Maybe I just learned not to give them so much power. They are merely guides to my goals and a type of accountability person. Mostly the latter. Never would I ever allow a T/Pdoc to say certain things to me or act certain way toward me, but what doesn't work for one may be the perfect thing for another. To each their own.

Again, to those who've had negative experiences, I apologize if I sounded exclusionary that was not the intention. I hope I have explained myself.