Finding a good therapist is much like finding a good mechanic. You can go to Pep Boys or you can go to the trusted person that friends and family recommend. There is a wide gap in the quality of services you will end up with. My humble advice is to always trust your intuition. If something does not feel right when you see a therapist, remember, they are just people, human beings. If it feels uncomfortable then it is only going to get worse. Then again don't judge a book by it's cover. I have known the supposed "best and brightest" with every configuration of letters after their name imaginable, who are just awful, inexperienced, and socially awkward people. I have also met and worked with people who wear flannel shirts to work and harvest honey for fun who are the most effective and talented therapists going. It is a personal preference, but all in all, you can tell the hacks from the pros if you know what to look for.
This raises a good issue though who are the pros? A wonderful study has been done, on therapists, asking them to rate themselves A - F, just like in school. The results were that 90% considered themselves in the top 25%, 2/3 considered themselves an A or better, 66% considered themselves "above average" and 0 considered themselves "below average." This should tell you something. The moral of the story is that often, very often, what the therapist is thinking of their effectiveness is not accurate. Bell Curve anyone? It is the power of denial. Also, without getting your feedback in some way, shape or form, they have no clue what the truth is about how therapy is going.
Another interesting thing to consider is the results of another mega-study called Project Match. I'll spare the boring details, but one finding (in a nutshell) is that when looking at therapy outcomes, how well it works, the study showed that no single treatment modality (style/approach) CBT, DBT, Psychoanalysis, talk therapies of all sorts, do not influence the outcome any more than the next. So Dr. Whoseewhatsit from Green Budz Healthcare Inc. with all his/her ideas about what to do to you is irrelevant in this regard. What matters is two things. With youngsters, if the parent or family member (support) is involved in the therapy process - better outcomes. Overall, the most important factor is rapport. How well do you click with your therapist? That is the #1 indicator of positive therapy outcomes, better situations, problems managed, goodness.
It doesn't matter how "professional" your therapist is also. A PhD. versus a case manager. No difference in outcomes. People think that a therapist must be like Gabriel Byrne of "In Treatment" to be effective. Not true. The lowliest case manager at the shittiest agency in the worst part of the worst city could have a stronger rapport with the person they are working with and the outcomes vary on that one factor. So don't go see some tightwad who looks and acts like a Wall St. banker just because of the mystique and fantasy that he/she is good because she seems professional. Go to someone who knows their shit! And who can best relate to your life and understand your experience.
Beware of "suggestions" which are sometimes coercions. I have worked amongst some people, therapists, who are all about confrontation. They seem to be angry at human beings in general, especially those who use substances of one sort or another, and they can get real abusive towards people. Avoid that. If it seems bad, it is, get out. You can always, always, always request a therapist change or just leave and get another one. Therapy should never be forced. It never works that way. Medication is another "suggested" thing. Many therapists have ulterior motives for making referrals for medications. They are paid by pharmaceutical companies, some have private practice agreements with Psychiatrists, some just think medication is the wonder candy. They jack so many people up on these medications that all you need to do as a therapist is dust off the person's leaves and water them once a month and you get paid, because you have numbed that person out. How lovely?
Last, this has been quite deficit based of a blog post. I write this just as a warning of things that "they" might not tell you, whoever "they" are. Overall, most, the majority of therapists are very capable people, do get good results, do collaborate with you in your care, do go the extra mile, and are looking out for your best interests. I personally have learned so much from my colleagues about health, life, happiness and how to achieve whatever it is in life that you so desire. Good mental health is arguably one of the most important things in life and these fine people can help achieve that by establishing a good collaboration with you.
Take care,
~ Schneidlomat
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