How do I know I’m seeing the right psychotherapist?
Once you have met with your psychotherapist a few times
you should ask yourself whether the therapist you are meeting with
is the right fit for you. Here are some ways to determine
if the counsellor you are meeting is right for you:
Does your therapist provide a safe environment? Do you
feel comfortable disclosing the intimate details of your life?
Does your therapist understand the risks you have taken and
respond to you in a supportive, caring manner?
Does your counsellor treat you with respect and dignity?
Is your therapist non-judgmental?
Do you feel your counsellor is ethical?
Your therapist should be able to provide you with a “roadmap”
of where you are going. Your therapist should be able to describe
what is happening in the counselling room and his (or her) (for
simplicity for the remainder of the article I will use the pronoun
“he” because I am a male therapist) reasons for approaching
things in a particular way. Your therapist should be able
to describe the theoretical framework being used in language you
can understand.
I work from a perspective that integrates Narrative, Brief Solution
Focused, Feminist, Cognitive, Family Systems and EMDR therapies.
Although I work intuitively, I will be able to describe to you theoretically
why I asked a certain question or took the therapy in a particular
direction. You have the right to know what is happening in
our work. If you are curious or uncertain, you should feel
comfortable asking your therapist these sorts of questions.
Look for someone who shows interest and curiosity in what matters
to you; someone who will ask questions to probe for more information;
someone who shows empathy and understanding about the issues you
are facing.
You should expect your therapist to have lots
of questions.
You should not expect your therapist to have all
the answers.
Your counsellor is someone who has a set of skills that help him
to listen attentively and to help you to explore your situation
by asking thoughtful questions. This is your counsellor's
area of expertise. However, you are theexpert on your life. You are the person who can identify
when you have been successful and when you have run into barriers.
Your counsellor cannot know the best way for you to deal with a
situation — he should not have those types of answers for
you.
One goal of therapy is to provide you with an opportunity to gain
alternative perspectives or new ways of looking at your situation.
Your counsellor should be able to ask you questions that make you
reflect, observe, understand, gain insight and so on.
Once that has happened, your therapist can help you to explore
new possibilities or new ways of dealing with your situation.
Your therapist should help you to identify goals for therapy.
Periodically, you should review those goals together to see if some
have been met, some have changed, some are no longer important and
so on. Ask yourself what your goals are for therapy.
Are they being met? If not, why not?
Feedback is important. You have the right to expect ongoing
feedback:
That might take the form of observations about your strengths
or reminders about times you have been successful.
It might be about contradictions your therapist notices when you
are telling a story.
"You keep mentioning how difficult Connie is to work with, yet
all you have told me are instances where she has been especially
pleasant, kind and helpful. Can you help me to understand
what you mean by difficult?"
Or maybe your therapist notices contradictions in the counselling
room during therapy.
"I notice that although you were smiling when you said that,
your message and tone of voice sounded really angry. What
is really going on?"
These types of feedback can help you to gain insight and make choices
about your behaviour.
You should feel comfortable challenging or questioning your therapist
if he seems:
to be judging
does not seem to take your concerns seriously (or to be giving
them enough weight)
not understanding you
not seeming focused enough.
Ideally, your therapist should respond non-defensively and should
not take what you have said personally. Instead, he should
clarify, answer your questions and help you to gain an understanding.
Your counsellor should recognize the importance of your being able
to challenge other people (including your therapist!), and see the
counselling room as an opportunity to practice that skill.
I say ideally, because it is possible that when you confront your
therapist, in the moment, he may become distracted or frustrated
or irritated by your question. Clearly this is not the preferred
response — but it is certainly a human response and not necessarily
a bad thing. What is important is what happens after
the less appropriate response. Hopefully in the moment, (but
certainly the next time you meet), you therapist should be able
to explain what was happening in that moment of distraction/frustration/irritation,
and to apologize to you for that response. This can demonstrate
that it is alright to have difficulty communicating but that relationships
can heal (inside or out of the counselling room.)
To return to safety, you want to be able to discuss whatever is
troubling you, to know that you will not be judged and to know that
your therapist will help you to find ways to deal with the issue
you have raised. Sometimes your therapist is the first person
to hear a part of your life story. You want to feel comfortable
to take the risk to discuss the issue and to know that your therapist
will help you to feel okay afterwards.
There should be an end to your work together. Your issue
may not feel "resolved" but you should
find that you have gained a new perspective (or a range of ways
of looking at the situation),
have noticed any life experiences that were similar to learn
how you have been successful in the past and how you might be
able to be successful now,
have a range of strategies to try to deal with the situation.
That is the time to end therapy. You do a "piece of work"
which may last 4 to 6 sessions or a few months or a year, then you
stop counselling. You may have issues to address at another
point (with the same therapist or a different therapist), but you
need to stop attending therapy sessions in order to try to implement
change and to evaluate how those changes influence your life.
It is your therapist's job to work himself out of a job, by helping
you to gain perspective and by helping you to look at new approaches
to your situation.
It is important to remember that you are a consumer receiving a
service and you are entitled to the best, most appropriate service
to address your mental and emotional health needs. Make sure
that you have found the therapist who is right for you.
Jeremy Tomlinson, M.Ed., RSW is a therapist in Toronto. He specializes in EMDR therapy, DBR, trauma therapy, life transitions, and sex therapy. Many of his clients are survivors of childhood sexual abuse or have experienced attachment issues in childhood, are survivors of adult sexual assault, or are living with symptoms of depression or anxiety. He currently has a virtual practice in a home office.