Did you or someone you know have a good or bad experience in therapy? As much as I love my field and working with families, I have to admit that there are often few good therapists who wholeheartedly engage in therapy with clients. There are really good therapists, mediocre therapists, and some really bad therapists in this world. It takes time to find the right therapist. Many people would agree that most therapists help fill voids that most of us have such as a void of a parental relationship, sibling relationship, grandparent, or good friend. For most of my child and adolescent clients, I often end up fitting into the role of mother, aunt, or mentor. For many of you, a therapist may fill similar voids or other voids such as a void of loneliness, grief, low self-esteem, or self-identity. But sadly, there are therapists who also play the role of jail wardens (being very strict and unreasonable), police officers (often pointing out the client’s negative behaviors in an authoritarian fashion), or Judges (leading counseling sessions in a confrontational manner). Therapists like this often lack etiquette, professionalism, appropriate boundaries, and compassion. This article will discuss and review some of the things that bad therapists think are appropriate to say to (or think about) their clients.
- You should be forced to talk: I have seen this in many therapy positions over the years. It’s sad to think that many families and even therapists believe that clients should be forced to engage in therapy. I say absolutely not. Therapy is not a time for client’s to feel overwhelmed, burdened, or forced to do anything in therapy. Some people, especially children and adolescents, need to be encouraged or prompted to engage and shown the benefits of engaging in therapy. Forcing people to talk or open up often ends up backfiring on both the therapist and the client’s family. Some client’s become resentful, begin to project negative emotions onto the therapist, or becomes fearful of the therapist in such a way that the therapist becomes an abusive or negative authority figure. When I work with my young clients, I explain to parents that the therapeutic journey does not happen overnight and although there are usually so many questions and concerns that need to be addressed, forcing a person to address the issues typically doesn’t work. A good therapist will alternate between challenging a client to open up by adding some pressure when necessary and allowing a client to take their time.
- You should either take medication or don’t take medication at all: Most therapists are highly uneducated about medications unless they have worked close with a psychiatrist or have received training on medication. Because of this, many therapists hold a black and white view of medication and will encourage clients to either take medication or don’t take medication at all. A good therapist will educate themselves to medication management, provide brief education to clients, and explain the pros and cons of using medications. Therapists should also refer a client to a psychiatrist or nurse who can help explain the pros and cons of medication.
- Confrontations and arguments are 100% healthy: Some people take their own anger and disappointments out on their clients. As sad as this is to say, there are some therapists who use the issues brought up in therapy with a client as an excuse to yell, scream, or challenge the client. It’s almost like a stress releaser. It’s displacement (a term that Sigmund Freud came up with to describe a defense mechanism). The therapist is unable to explore their own issues and will displace negative feelings onto their client. This may occur during phone conversations, during sessions, or over payment of services or insurance.
- I need to answer the phone, respond to email, complete some paperwork while talking: A day in the life of a therapist can truly make you feel out of control. A typical work week for me easily adds up to 60hrs per week and perhaps more! But I certainly recognize that when I speak with my young clients, their families or treatment teams, I must put everything else aside. Phone calls, paperwork, insurance calls, voicemails, meetings, notes, etc. must all take a backseat once the client comes into the office. A therapist who is “multi-tasking” is not tuned into their client. In fact, current research suggests that “multi-tasking” is not effective when trying to complete important tasks. Research suggests that we should tend to one thing at a time. A good therapist will sit calmly, help the client explore feelings/thoughts, and facilitate therapy. A client should never feel ignored.
- I will give my diagnostic impressions but I cannot spend time explaining things or getting agreement: Because I work with so many different families, I must provide psycho-education almost every session on the diagnosis, medication choice, discharge goals, treatment goals, and aftercare. This education includes me speaking with the families about the pros and cons of therapy and helping them develop realistic expectations. Sadly, many therapists fail to provide this education, often feeling they are not adequate or trained enough to do so. Other therapists simply don’t want to take the time to educate clients and their families. It’s easier to report to clients and their families the information received from other therapists or a psychiatrist and move on. A good therapist will know how to guide you. A good therapist will also give the client the opportunity to disagree or agree with certain aspects of treatment.
- You don’t need to read or understand it, just sign: Have you ever been to a doctor’s office for a check-up and asked to sign multiple forms that you just didn’t understand? Were you told “this form is just so I can call your other doctor, sign and date here”? I have. The scary part is that many therapists or agencies ask clients or families to sign forms but never fully explain them or walk you through reading the forms. I am guilty of this myself at times. The day has been long, I am tired, the family or client looks overwhelmed, and I just want the process to be over. I will typically summarize the form and ask for a signature and date. A good therapist will help the client understand important details, encourage them to read the form, and ask questions. And…don’t forget to ask for copies when necessary!
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