I don’t want you to have good therapy. I want you to have great therapy! Good therapy is sometimes enough. A band-aid to get you by. But if you’re tired of good enough, getting by, and settling for less than you know you need or deserve, read on for signs of bad, good, and great psychotherapy.
But first…
You might be wondering, what is therapy, how do I do it, and how do I know if my therapist is going to be able to help me? If you’re like me, you’ve likely been to therapy before and it went something like this; you talked, therapist listened, offered minimal responses (e.g., How do you feel about that? Tell me more), you felt somewhat better that day, but overall, you thought, “is that it?”
After becoming a therapist, I realized that pretty much anyone can get licensed if you put in the time and effort. In other words, just because someone has a license doesn’t mean they are any good at their job and years of experience doesn’t necessarily equate to better either (in fact, new research suggests the opposite). So, to help you out, I’ve outlined some points to consider and things to look for in a therapist and therapeutic relationship.
Defining Bad, Good, and Great Psychotherapy
The Bad
Bad psychotherapy can encompass various elements that hinder progress or, in the worst cases, make existing issues worse. Below are the things to look out for:
- Lack of ethical standards.
This one is a biggie. Bad psychotherapy often lacks professionalism and adherence to ethical guidelines. Therapists engaging in unethical practices are things like breaches of confidentiality, harmful/unclear dual relationships, or failing to maintain professional boundaries that can significantly damage the therapeutic process.
Dual relationship refers to situations where multiple roles exist between a therapist and a client, for example, when a client is a neighbor, friend, or family member. Not all dual relationships are unethical, and some are unavoidable, such as living in the same community and running into each other in public settings. In these instances, the therapist is responsible for setting clear, appropriate, and culturally sensitive boundaries.
Dual relationships that are considered unethical and are signs of bad therapy, are any sexual/romantic relationship between therapist and client or any other relationship where the therapist is exploiting or otherwise misusing the client’s vulnerability. As a general rule of thumb, dual relationships should be avoided.
- Ineffectiveness.
Therapists who lack the necessary expertise or who use outdated or inappropriate therapeutic techniques, such as Freudian approaches, can hinder progress and waste your valuable time. Another sign of ineffective therapists is when your sessions feel directionless, or they fail to address the core issues. If you’re not making any progress after multiple sessions you might want to move on.
- Harmful practices.
Some therapies might even reinforce negative thought patterns or lead to further distress. In extreme cases, a therapist might manipulate or exploit their clients, causing emotional harm. If you find your symptoms or distress worsening over time, it may be a sign of bad therapy.
Other ineffective or even harmful practices of bad therapists are:
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- Giving too much direct advice
- “Preaching” their personal values
- Talking too much about themselves
- Ignoring your direct feedback, repeatedly
- Not asking for feedback
- Inability to appropriately express empathy
It’s important to remember though that most “bad therapists” aren’t bad people, they just may not be very good at their job.
The Good
Good therapy, as stated previously, is sometimes good enough and all that you need at the time. Don’t feel bad if this is your experience. You’re not doing therapy “wrong.” You may even be able to turn your good therapy into great therapy if you provide direct, honest feedback to your therapist and are open to being vulnerable with them. Below are signs of good therapy.
- Solid therapeutic alliance.
A healthy bond between the therapist and client is a hallmark of good therapy. This alliance fosters trust, open communication, and a safe space for exploration and healing. “Therapeutic alliance” is psychospeak for a therapist who actively listens to your concerns and responds empathically. You feel heard and seen and have mutual respect for each other. You shouldn’t feel judged, but if you do, and you tell your therapist about it and you can talk it out and reach a new understanding, this is also a sign of good therapy.
- Evidence-based practices.
Utilizing research-supported therapeutic approaches (meaning, there is scientific evidence it works) helps ensure that the methods used are effective in addressing your concerns. For example, cognitive-behavioral therapy (CBT) has been extensively researched and proven effective for various mental health conditions. Licensed therapists should all be trained in research supported therapeutic approaches and using them. They are also open to adapting their approach to meet the client’s needs, ensuring a personalized and effective treatment plan.
- Some progress and growth.
Effective therapy should lead to visible progress and personal growth. You should feel empowered and equipped with strategies to manage their issues and cope with challenges. Seeing results or changes in yourself from therapy may take some time, but overall, you should feel you are making progress and improving.
The Great!
Great therapy transcends the boundaries of good therapy by incorporating several exceptional elements:
- Personalized approach.
A great therapist customizes the treatment to the individual’s specific needs and circumstances. They adapt techniques and strategies to best suit the client’s personality and challenges. They also ask for feedback, early and often, and adjust accordingly.
- Holistic understanding.
A holistic understanding of your life, your history and the context is essential in great therapy. A great therapist will also recognize the importance of cultural competence, understanding the impact of cultural factors on your mental health. Great therapists also listen deeply. Not just to your direct words but also for when and why you bring something up. They listen to what is not being said as well. They are highly attuned to your body language and the way you say something. Great therapists are deeply inquisitive, asking insightful, deeply probing questions to really get to the core of what you are communicating.
- Strong therapeutic alliance.
In a strong therapeutic alliance, you feel safe and supported even when being challenged. One of the biggest benefits of great therapy is when our blind spots are pointed out to us, or when we are challenged to consider how we may be benefiting from our “problems.” This information may sting a little, as we may not want to address our culpability or weaknesses, but a great therapist knows how to challenge you in sensitive and helpful ways.
- Empowerment and independence.
Great therapy not only guides individuals but also equips them with the tools and skills to navigate life’s challenges independently. The goal is for you to be empowered to thrive beyond therapy sessions. Great therapists educate and inform you on human development, mental health, people skills, psychopharmacology (drugs), therapy techniques, etc. so you can use this information in your daily life.
They also aren’t afraid to say goodbye, meaning, letting you know when they believe it might be appropriate to end the therapeutic relationship, spread your wings, and fly!
Conclusion
Distinguishing between bad, good, and great psychotherapy is crucial for individuals seeking mental health support. Bad psychotherapy lacks professionalism, utilizes ineffective techniques, and fails to establish a strong therapeutic alliance. Good psychotherapy involves a competent therapist who utilizes evidence-based approaches and fosters a supportive therapeutic relationship. Great psychotherapy goes beyond the basics, incorporating innovative techniques, cultural sensitivity, and a deep understanding of the individual’s unique needs. By understanding these distinctions, individuals can make informed decisions when seeking psychotherapy, ensuring they receive the highest quality care to support their mental well-being.
One last note…
Therapists are human too having good days and bad days. When evaluating your therapy, keep this in mind. A good or great therapist will own their missteps or mistakes, apologize, and respond effectively to your feedback.
I hope this information has been helpful to you on your healing journey! If you’d like to learn more, schedule a free 30-minute consultation here.