The Good Therapist
2023, Steven B. Zwickel
It often seems that when people are having problems, well-meaning friends and relatives will suggest that they go see a therapist. This is good advice, but it is missing one key element—they should go see a GOOD therapist.
A good therapist is someone who can help you examine your situation and then decide if, and how you want to make changes. The good therapist sets realistic expectations so clients know what they are getting. Clear, and if possible, measurable goals and a reasonable timeframe should be discussed at the first therapy session.
A good therapist is not your friend. The therapist’s job is to speak the truth, always, even when it makes you unhappy and uncomfortable. They can be tactful and diplomatic, but they don’t try to sugar-coat things or give false reassurances that “everything’s going to be fine.” When necessary, especially when a client is in denial, the good therapist values fact over tact. The good therapist knows that clients may drop out of therapy when told they were part of the problem, or that their drinking was causing the problem, or that they couldn’t force other people to change.
In fact, the good therapist knows that change often comes from discomfort—you get up and put on a sweater when you feel chilly. Therapy sessions are for overcoming inertia and other obstacles to change, and that means feeling uncomfortable enough to want to make changes. The good therapist helps clients resolve their discomfort either by learning to adapt to it or by making changes in the way they cope with the thoughts, behaviors, and feelings that generate discomfort. Sometimes, the most productive sessions are the ones in which the client feels the most uncomfortable.
The good therapist is there to enable change. The good therapist doesn’t give clients a free pass because bad things have happened to them. Clients are held responsible for whatever their role was, however slight, in creating the problems that bring them into therapy. The therapist is not there to assign blame or to judge who is right and who is wrong. A good therapist listens and responds in ways that help clients get unstuck. He or she does not tell you what to do or put words in your mouth.
Good therapists don’t make optimistic predictions and they don’t, and shouldn’t, give hugs. Hugging and offering a client shoulder to cry on can create a dependency that defeats a major goal of all therapy—helping the client reach independence, so they no longer need a therapist. A good therapist may offer comforting words and encourage clients to identify and appreciate the positive parts of their lives.
The good therapist doesn’t do cookie-cutter, one-size-fits-all therapy. Some therapists follow gurus—people who write books, give lectures, and promote a particular way of looking at, and solving, clients’ problems. The good therapist knows more ways than one to help and is not wedded to one method. The good therapist does not have an agenda. Therapy begins wherever the client is. {The good therapist stays current with trends in mental health, so he or she can discuss other options with clients}.
The good therapist does not have a need to be liked. The good therapist knows that sometimes it will be his or her job to deliver bad news.
Some problems have no solutions. Clients who want or expect other people to change are usually disappointed when the good therapist tells them they are being unrealistic.
The good therapist knows when it is time to terminate therapy.
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I have been a clinical social worker and I’ve been in therapy enough myself to feel confident in saying that anyone considering getting professional help for emotional or relationship problems needs to be a smart shopper.
I know that this can be difficult, especially when you are feeling so overwhelmed by personal problems. You may be tempted to choose the first helping professional you find (or are assigned to), but even though it is hard, I think it is important to find someone who is competent and won’t waste your time and money. A good therapist will be up front about what she or he can do for you.
I have seen people start therapy with the idea of making a new friend who will listen to their tales of woe and sympathize with them. I have known psychotherapists who were needier than their clients and some who did counseling like they were following a recipe in a cookbook.
Talk therapy has its uses and its limitations. If you are considering trying it, give it at least 3-4 sessions before deciding if it is helping you. It may not be apparent that anything is different, but if you don’t feel like changes are taking place, ask your therapist for feedback. Hard as it may seem when you are having emotional problems, don’t be afraid to start over with someone else.
One more note about starting therapy: the therapist should work with you to get as complete a picture as possible, including your medical history, use of drugs and alcohol, family background, availability of your support system, and a sense of your work and home environment. Psychological problems are often accompanied by physical problems and there are direct links between mind and body. A good therapist will talk with a client to explore the possibility that a medical condition is the cause of emotional problems.
Some clients find it useful to be in a group with others who have the same, or similar problems. Clearly this is not for everyone, especially those who are shy or who are not comfortable talking about personal problems in front of other people. Do not let a therapist talk you into joining a group if you don’t feel that it is right for you to do so.
In many cases, talk therapy is combined with medicine, particularly for cases of depression and anxiety. Not all drugs work for every client and, unfortunately, not all therapists are aware of the limitations of these drugs. Talk—a lot—to your therapist before, during, and when you are ready to stop taking medication. You may want to do your own research, too. Talk to your pharmacist and read up on the medication on a reliable web page. It’s important for you to be aware of side effects and signs of other problems.
In addition to medication, other treatments for emotional problems are available, including the use of magnetic stimulation. If you are wary of medication, ask your therapist what other options are available. A good therapist will give you a straight answer and research various choices if they don’t have one. Things that may help include changes to diet, relaxation exercises, and reducing exposure to social media. Find out more from your therapist if he or she recommends other alternatives and ask for information about any scientific trials that validate these techniques. These “feel-good” alternative therapies can help you relax and reduce anxiety, but they won’t really help solve your problems.
