How to select a good therapist?

[No_Go]

I hear over and over again that if you want the therapy to be effective, there should be a good connection therapist-patient. How to determine that early on?

 

I want to discuss issues from my past, basically not so great childhood to put it mildly, which potentially affect my relationships and social skills. However, the therapist so far (2) basically pushed me towards discussing current issues, not super helpful for me. The most recent one stated something in lines of "you're highly functioning, so I'd not focus too much on the past". Is that unprofessional? Any tips where to find good ones (my location is MA)?

[Tayla]

The goal at the beginning is to gain perspective on the here and now.

 

I recall my early sessions and all I wanted to do was ruminate about my past. That was shot down quickly! My therapist was forthright and said, we can look at the past when you remain in the present. Sometimes we think the past has the answers to our problems. When actually being objectively able to discuss things in a healthy here and now stance moves things along.

 

My first therapist was 180 degrees different from my personality. Where I was manipulative, she was straight up direct. Where I wanted to yak yak, she sat and doled out tasks for the week. Turns out she was a master at her craft of guiding sessions and creating a stable environment to work on issues.

 

Blind trust was initially required.

 

Sometimes the very thing we don't want, is the very thing we need to improve our lives. Pick a therapist that openly has a plan for the sessions and goals. Then entrust. Its ultimately up to the client to do the work.

[No_Go]

Thanks, it is useful to hear your experience.

 

May I ask did you go to them with a specific problem in mind? Or they defined your issues over the course of the therapy?

 

Also, I understand trust is crucial, but let say with a once a week schedule, when shall I expect to know if the therapist is a good one and stick or i should look for a different one?

 

The goal at the beginning is to gain perspective on the here and now.

 

I recall my early sessions and all I wanted to do was ruminate about my past. That was shot down quickly! My therapist was forthright and said, we can look at the past when you remain in the present. Sometimes we think the past has the answers to our problems. When actually being objectively able to discuss things in a healthy here and now stance moves things along.

 

My first therapist was 180 degrees different from my personality. Where I was manipulative, she was straight up direct. Where I wanted to yak yak, she sat and doled out tasks for the week. Turns out she was a master at her craft of guiding sessions and creating a stable environment to work on issues.

 

Blind trust was initially required.

 

Sometimes the very thing we don't want, is the very thing we need to improve our lives. Pick a therapist that openly has a plan for the sessions and goals. Then entrust. Its ultimately up to the client to do the work.

[sportygirl89]

My first therapist was awesome. He had many different resolutions per problem I had. He had me do tasks as well. He was a saint.

 

This younger therapist. While nice, I felt like all I did was talk about myself. Never got anything out of the actual sessions.

 

I'm in process of searching for a new therapist.

[No_Go]

While nice, I felt like all I did was talk about myself.

 

I had the same experience...

[d0nnivain]

Any medical treatment has to be a partnership. If you go to a "regular" / body doctor & say my left leg hurts you are going to leave when that person tries to treat your right shoulder.

 

 

 

 

When the therapist said that s/he didn't want to focus on the past that was your cue to say, no I'd rather talk about that because I think it's where my problems started. You are the best diagnostician for you. Never forget that.

[whichwayisup]

I hear over and over again that if you want the therapy to be effective, there should be a good connection therapist-patient. How to determine that early on?

 

I want to discuss issues from my past, basically not so great childhood to put it mildly, which potentially affect my relationships and social skills. However, the therapist so far (2) basically pushed me towards discussing current issues, not super helpful for me. The most recent one stated something in lines of "you're highly functioning, so I'd not focus too much on the past". Is that unprofessional? Any tips where to find good ones (my location is MA)?

 

You will just know. You'll feel at ease and get a good vibe from the therapist within a few sessions. If one doesn't feel like the right match for you, keep looking until you find the right person to talk to.

 

Cognitive behavior therapy might be helpful for you.

[deckard11]

Good therapy costs a lot of money.

[Tayla]

Any medical treatment has to be a partnership. If you go to a "regular" / body doctor & say my left leg hurts you are going to leave when that person tries to treat your right shoulder.

 

 

 

 

When the therapist said that s/he didn't want to focus on the past that was your cue to say, no I'd rather talk about that because I think it's where my problems started. You are the best diagnostician for you. Never forget that.

 

I politely disagree.

Medically -yes.

Mentally- rarely.

 

A good therapist when starting sessions works with the client to define goals.

 

I will leave it at that as what worked for my treatment plan may or may not work for others. I had to gain clarity, and that wasn't going to happen if All i did was yap about the past. I had to regroup and gain strength to confront any past concerns. to each their own.

[preraph]

First, go online and read up about the different styles of therapy so you'll know which one sounds best for you to start with. Like, I hate the ones that sit and listen and don't give feedback. So go read up about that and decide the type therapy and then go looking for that type therapist in your area. Listen, it is a crap shoot. Some are really nice but seem to totally not get you. I know they say there is no reason for a therapist to need to have anything but the training, but the only one I ever went to seemed to have zero life experience except straight and narrow stuff, whereas I had a ton of nonconventional life experience. I felt she simply wasn't tooled to get ahead of me.

 

So you do end up having to try different ones sometime. Listen, there are even online therapists now. It's no cheaper, I don't think, but you can Skype them and at least maybe check out a few.

[carhill]

OP, check out and interview some psychologists in your area who specialize in early life trauma/abuse.

 

Some psychs will interview for free, some at a cost. Lay out some questions for the psych relevant to your issues and listen. If things match up, move forward; if not, state that and any relevant reasons and ask if they have a colleague they could refer who may be a better fit. That kind of stuff goes on all the time. Good psychs want the patient to feel the therapy environment is a positive place, even if there are challenges within it.

 

If at all possible, try to get a referral as a start point from someone you know and trust, like your doctor, lawyer, other mental health professional, family member or close friend, etc.

 

Most importantly, go into the process knowing what you want to achieve and being able to communicate that and being willing to do the work. Psychological work and change, generally, is a slow and tedious process. There's no 'quick fix'.

[Timshel]

I would suggest at least three consultative appointments. Let there be no mistake....therapists/psychologists/psychiatrists have personalities. I can't tell you how many therapists I have seen cry/vent over their own life issues. They also have their specialties and approaches which may not 'fit' every potential client.

Shop a therapist as you would any medical professional who is tailored to your specific need and goal.

 

Note: If meds are suggested, be aware that often there will be a period of adjustment...more/less dose, a particular script isn't beneficial...try another. Typically two months at minimum to find an effective/beneficial psychotropic.

[carhill]

OP, relevant to your question about an unprofessional response, I can share with you how our MC handled such questions, as a clinical psychologist who specialized in abuse.

 

When you shared your comment:

 

I want to discuss issues from my past, basically not so great childhood to put it mildly, which potentially affect my relationships and social skills.

 

'Which social skills do you feel are impacted, and how?'

 

'Tell me about someone you consider your best friend and your relationship with them'

 

 

--------------

 

In another area, if you feel you've suffered marked periods of depression or anxiety in the last year, to the point you feel they've impacted your health and maintaining relationships, share that with the psych. They can assess and, if a therapist or psychologist, can refer you as appropriate to a medical doctor for medication assessment. Another option is, especially if feeling depressed or anxious now, interviewing a psychiatrist at the front end, since they can work the medical and psychological, referring out for talk therapy. It all depends on your situation and focus and, as appropriate, insurance or ability to pay.

[dichotomy]

I have used three therapist in my life (one was actually a M.D. Psychiatrist a rare thing now or days).

 

Each had VERY different viewpoints and approaches, and I ended up getting something from each, but never got it all.

 

 

One I felt you could tell anything too - and he would never think it was bad or strange. Thats good in one way of course However because of this he felt - what ever floats you boat and no actions are bad if they help you feel good or get over something. He at one point discussed the benefits of married men seeing escorts with me.

 

Another was very moral (don't tell me bad stuff or I will scowl and be shocked), but because of this she helped my wife get some clarity. Also this therapist was highly sensitive to loss and offered me alot of deep caring sympathies over some major losses that I could not get elsewhere.

 

The last therapist was amazing with sexual and marriage issues- real common sense call it as she sees it. I owe her a debt of gratitude. However I would not really see her outside of those two issues.

 

 

Sorry to say but you may just need to try a few sessions and decided to try another. Or (as I did) you may find a particular therapist is good with one thing - and use them for that.

 

and yes as someone mentioned they are very expensive, but hopefully you have insurance to cover it.

Edited January 14, 2016 by dichotomy

[salparadise]

Get a recommendation from someone who is familiar with the therapists in the area. You could waste years going from one to another randomly looking for a feel-good situation, and there's a high probability of rejecting someone who would be excellent if they're not telling you what you want to hear. Don't go with predefined notions of what the solution/method should be, and don't think you can assess a therapist in one or two sessions. Those in the community will know who the heavy-hitters are and are not. If you don't know anyone connected then start with your physician.

 

 

-------

PS: Oh, yea... ignore bad advice about you being you own best diagnostician, or any advice from people who set themselves up as authority on everything.

[mtnbiker3000]

IME - you only need spend so much time in the past. Because you can only make changes moving forward. So at a certain point, the why's, who's and where's of the past are no longer really that important...

 

If I wanted to, I could spend hours, days or even weeks on end rehashing my past and all of it's associated trauma. Just not helpful for getting me where I want to go any more...

[spiderowl]

While the current trend in therapy appears to be to focus on the 'here and now', a good therapist will not push you in that direction as they would be able to learn and work with you from whatever you present to them. Many therapists now focus on changing 'behaviour' without wanting to go too much into why behaviour is as it is. This always seems superficial to me.

 

Asking how you are feeling now is a good thing as they need to get soundings from you, but a therapist should be willing to explore what you feel is relevant. If they don't, they are denying your formative life experiences and, ultimately, their lack of interest in those could be demoralising. I would think that is important that the therapist has the mental flexibility to work through things with you, not try to steer you elsewhere, unless it is something you both agree you need to find a different focus on.

 

I think you will know when you've met a good therapist because you will relax and feel understood. I would definitely look for one who has got the right qualifications and background though. You can't be too careful. You might find a person-centred counsellor to be of more help than a behaviourist approach.

Edited January 22, 2016 by spiderowl

[truthtripper]

While the current trend in therapy appears to be to focus on the 'here and now', a good therapist will not push you in that direction as they would be able to learn and work with you from whatever you present to them. Many therapists now focus on changing 'behaviour' without wanting to go too much into why behaviour is as it is. This always seems superficial to me.

 

Asking how you are feeling now is a good thing as they need to get soundings from you, but a therapist should be willing to explore what you feel is relevant. If they don't, they are denying your formative life experiences and, ultimately, their lack of interest in those could be demoralising. I would think that is important that the therapist has the mental flexibility to work through things with you, not try to steer you elsewhere, unless it is something you both agree you need to find a different focus on.

 

I think you will know when you've met a good therapist because you will relax and feel understood. I would definitely look for one who has got the right qualifications and background though. You can't be too careful. You might find a person-centred counsellor to be of more help than a behaviourist approach.

I agree here. We can't really move forward without looking back. The present is defined by the past. I wasted a whole decade chasing my tail, trying to figure myself out in the process of avoiding my painful past. Only when I began to make connections between my past and my present, did I begin to understand and develop compassion for myself, which enabled me to start healing.

[truthtripper]

Many therapists now focus on changing 'behaviour' without wanting to go too much into why behaviour is as it is. This always seems superficial to me.

It's easier for therapists to focus on the 'here and now'. It requires less emotional energy and they are less likely to experience vicarious traumatisation(second-hand trauma). I've seen at least fifteen therapists over the last twenty years. I think they are not adequately trained to deal with and thus 'sit' with their clients' traumas. After many years of failed therapy, I had a completely different and refreshing experience with a therapist who had social work training. She was not afraid of my pain. Since seeing her I have seen two other social workers who are also very good. So my advice is to find a therapist with this training. Social worker training encourages the therapist students themselves to self-reflect and self-improve, which is lacking in a standard psychology degree.

[Greene0Kelly]

Speaking about a therapist, you might want to read this blog.

 

https://recoveryexperts.com/rebuzz/journals/how-do-therapists-love

[No_Go]

How long did it take to him/her to define goals while working with you?

 

I politely disagree.

Medically -yes.

Mentally- rarely.

 

A good therapist when starting sessions works with the client to define goals.

 

I will leave it at that as what worked for my treatment plan may or may not work for others. I had to gain clarity, and that wasn't going to happen if All i did was yap about the past. I had to regroup and gain strength to confront any past concerns. to each their own.

[No_Go]

Similarly to yours, mine just couldn't reflect on my life experience. Not to blame him, I'm also a foreigner and some things are not universal. Maybe an older therapist would have a better chance to have more diverse life experience...

 

 

First, go online and read up about the different styles of therapy so you'll know which one sounds best for you to start with. Like, I hate the ones that sit and listen and don't give feedback. So go read up about that and decide the type therapy and then go looking for that type therapist in your area. Listen, it is a crap shoot. Some are really nice but seem to totally not get you. I know they say there is no reason for a therapist to need to have anything but the training, but the only one I ever went to seemed to have zero life experience except straight and narrow stuff, whereas I had a ton of nonconventional life experience. I felt she simply wasn't tooled to get ahead of me.

 

So you do end up having to try different ones sometime. Listen, there are even online therapists now. It's no cheaper, I don't think, but you can Skype them and at least maybe check out a few.

[No_Go]

These are good examples.

 

In my case I don't think anything specific changed last year, according to the therapist that I was seeing I'm 'high-functional'. But I had more time than usual to evaluate things, started a new relationship, switched careers, immigrated, and had to communicate with much more people than I have done before - so I start paying attention to my own behaviors, which are sometimes unusual

 

I wonder shall I dig in past traumas if I learned to manage my life with it, at least for now...

 

OP, relevant to your question about an unprofessional response, I can share with you how our MC handled such questions, as a clinical psychologist who specialized in abuse.

 

When you shared your comment:

 

I want to discuss issues from my past, basically not so great childhood to put it mildly, which potentially affect my relationships and social skills.

 

'Which social skills do you feel are impacted, and how?'

 

'Tell me about someone you consider your best friend and your relationship with them'

 

 

--------------

 

In another area, if you feel you've suffered marked periods of depression or anxiety in the last year, to the point you feel they've impacted your health and maintaining relationships, share that with the psych. They can assess and, if a therapist or psychologist, can refer you as appropriate to a medical doctor for medication assessment. Another option is, especially if feeling depressed or anxious now, interviewing a psychiatrist at the front end, since they can work the medical and psychological, referring out for talk therapy. It all depends on your situation and focus and, as appropriate, insurance or ability to pay.

Edited January 30, 2016 by No_Go
Forgot something

[losangelena]

I think a good one can help you understand how your past experiences effect your current circumstances. Mine and I go back and forth. I've been with him for almost 1.5 years, and we spent a lot of time in the beginning talking about past trauma and making connections between my early family life and the life I have now. But, we also focus a lot on what kind of life I want to have, and what I need to do to reach those goals, so it's a good balance. In my experience, awareness is key, but action is just as good.

 

Also, it's like any other relationship, your personalities have got to mesh. That doesn't mean finding someone who will just make you feel good or who tells you what you want to hear, but I mean someone with whom you can be open and candid.