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What Makes “Good” Therapy and a “Good” Therapist?

August 15, 2022

If you’re considering therapy, you may be thinking about what type of therapist would be best for you. Most of the time, it’s not about the therapist being either "good" or "bad" but about the therapist being the right fit for you. It’s true that there are better fits than others. We all have different personalities and preferences. Sometimes two people click and sometimes they don’t. Sometimes it may take a few sessions with a therapist to determine if they are a good fit for you.

Considering your reason/s to start therapy may help you determine what type of therapy would be a better fit
. In this post, we will discuss what makes therapy effective and what signs to look out for that may signal it may be time to find a new therapist.


Good Therapy/Good Therapist:

Good therapy includes when the therapist builds therapeutic rapport and alliance with you. They help you feel safe and comfortable. They can accomplish this by cultivating trust and respect in the therapeutic relationship. They provide unconditional positive regard and affirm your human dignity and worth. They have boundaries and are ethical.

  • Good therapy is when a therapist takes into account the whole person, by considering your history, family of origin, your biography, your inner world, and how you subjectively experience the world. They are non-judgemental towards you.
  • Good therapy entails having a treatment focus and clear goals from the beginning. Sessions are focused and structured. The therapist is able to manage their time during the session and address your concerns. They are focused on the treatment objectives but also meet you where you are.
  • Good therapy is when a therapist checks in with you about how you think therapy is going, how they are doing as your therapist, and they welcome feedback.
  • Good therapy encourages and models accurate, honest, and timely feedback and communication (Shpancer, 2016).
  • Good therapists use evidence based practices and continue their professional learning.
  • Good therapists encourage your autonomy, competence and self-determination, but gently help you challenge false beliefs and unhelpful thought patterns.
  • Good therapists help you with finding solutions, building skills, learning and facilitating action, but they don’t tell you what to do. They remind you they are not the expert of your life; you are. Good therapists remind you that you are the one making the positive changes in your life and they give you ownership of the progress you’ve made (Shpancer, 2016).

Other indicators of good therapy include: you feel better and not worse, you feel that you’re getting better and making progress. You feel better about yourself and have more self-efficacy. You continue to gain new insights.


Therapy Red Flags:

On the flip side, you may encounter a therapy relationship that is not going as expected. Sometimes a red flag behavior may be unintentional from an overall good therapist and you feel safe and comfortable addressing it with them. Other times, the therapist may have too many red flag behaviors and perhaps they don’t acknowledge their behavior or won’t accept feedback or take accountability which are situations when you may want to consider moving on. What are some of the red-flags that can clue you into therapy being less helpful than desired? Some indicators of bad therapy include the following:

  • The therapist behaves unprofessionally or unethically
  • The therapist lacks boundaries with you, which may make you feel uncomfortable or question the ethics of their practice
  • The therapist tells you what to do instead of respecting your self-determination, (e.g., telling you to end relationships with loved ones or friends)
  • The therapist makes blaming statements about your family or friends for your problems in a judgemental or devaluing way,
  • The therapist is frequently late or frequently reschedules
  • The therapist cannot seem to remember details of previous sessions and need constant reminders.
  • The therapist checks their personal devices in session or seems distracted for other reasons
  • The therapist is unclear about treatment goals and you are unclear
  • The therapist does not instill a sense of trust, warmth, etc.
  • The therapist takes credit for your progress or assumes they are the expert in your life instead of you.

If you find yourself in a therapy situation that you would like to change, do not give up on therapy. Therapy has been shown to be effective and can help. Sometimes, you may just need to find a better match in the therapist or treatment modality.



Written by:
Makenzie Pacubas, MSW, LCSW. Makenzie is a clinical social worker who has worked in the mental health field for over a decade and now works in clinical quality assurance with CHE Behavioral Health Services. Makenzie lives in Missouri with her husband, Justin, and their two pets. She likes to exercise, read, get outdoors, and try new restaurants with her husband.



References:

“10 Ways to Spot a Good Therapist.” Psychology Today, 2016, www.psychologytoday.com/us/blog/insight-therapy/201603/10-ways-spot-good-therapist.

Shpancer Ph.D., Noam Shpancer. “10 Ways to Spot a Good Therapist.” Psychology Today, 2016, www.psychologytoday.com/us/blog/insight-therapy/201603/10-ways-spot-good-therapist.


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