Patients go into therapy in a very vulnerable state. It is easy to assume that you are the problem when therapy is not going right. Consequently, understanding what makes a good therapist allows patients to determine where the issues lie.
Moreover, the therapist and patient relationship is an important part of therapy. Finding someone who is likely to work well with you is essential for a positive experience and improve the likelihood of treatment success.
Below, I discuss 11 (odd number, I know) important qualities to look for in a good therapist. These qualities are what I consider to be a strong therapist as a current practicing clinician.
1. The therapist is a good listener
Perhaps above all, your therapist needs to be a good listener. If they are not hearing what you are saying, then they cannot understand the emotions and underlying thoughts you are experiencing. For example, they may not notice that you are shying away from certain topics because of guilt and shame. Because of that, they miss an important point of therapeutic contact. Moreover, they won’t be able to incisively determine what might be causing your current problems. A therapist that does not listen is not an effective therapist.
2. A good therapist is empathetic
A good therapist must be in tune with your emotions. To be empathetic is to show that they truly understand and care about your situation. If you sit in front of a therapist and feel as though they are simply there for a paycheck, you’re probably not going to want to share very much or work deeply on your troubles.
3. A good therapist validates your concerns
We are often our own worst enemies. We may shame ourselves for having difficult emotions, or feel guilty for not being to solve a problem by ourselves. A good therapist will validate your experience: that it is tough to be the circumstance you are in and that you want to become more autonomous in resolving your problems. A good therapist will never minimize your emotions or experience; and if they do, it’s only after significant trust is built to remind you that you are much stronger and resilient than you give yourself credit for.
4. A good therapist shows unconditional positive regard
Unconditional positive regard was introduced in humanistic psychology by Dr. Carl Rogers. It is the idea that people are innately good, have the answers to their problems, and just need a little support to get to where they want to be. Although you may not love who you are in that moment, your therapist should show genuine appreciation for who you are as a person. They will find positive qualities when you think you have none. Moreover, they’ll show genuine belief that you can get to where you want to be in your mental health journey.
5. A good therapist is honest and transparent
A good therapist will never try to trick or deceive you. They will be very clear about how the treatment works and walk you through how different strategies work. They will also voice concerns if something about the therapy is troubling them.
For example, they may say “I hear on the one hand that you want to improve your mood, but that does mean we can’t always follow our feelings when it comes to getting out of bed. If we do, then the depression will stay”. Having these frank conversations is important to understanding your feelings but also providing you with some harder grains of truth to support you in your journey.
6. A good therapist explains concepts clearly
A good therapist discusses topics and provides information about the treatment, your psychological symptoms, and the potential causes of your symptoms in a very translational and easy to understand manner. They should not be using technical jargon and clinical concepts that make you more confused and blindly trust them. Within a few treatments, you should be able to answer questions and even teach concepts to other people if you were inclined to do so.
7. A good therapist focuses on your goals and values
A good therapist never pushes you to a certain goal unless it is pertaining to something life-threatening. Otherwise, they should always focus on where you are and where you want to go in your therapeutic journey.
For example, a patient may struggle with anxiety about driving cars and flying planes. Although the therapist, wanting to help, may desire to help get rid of both anxieties about planes and driving, the patient may be only interested in working through their fears of driving cars at this time. They don’t feel ready to talk about their issues with planes. In this case, a good therapist will focus on reducing anxiety about cars, and simply let the patient know that they always check in if they want to tackle their other problems when ready.
8. A good therapist checks in with what you are feeling or thinking
Therapy is not the therapist driving the bus with you blindfolded. A good therapist will check in throughout the session to see how you are feeling with how treatment is progressing. They will incorporate your feedback and re-focus if you are feeling confused about uncertain aspects. In some ways, your opinion will matter more than the therapist when it comes to deciding which components of therapy are most important and what home practices are most helpful.
9. A good therapist collaborates but does not collude
Collaboration and collusion are different concepts. A good example of collaboration is working together to decide which goals are most important. A good example of collusion is when a therapist decides to completely change the treatment because you are anxious about whether you can do a certain home practice. They are feeding your belief that you cannot do something and that something doesn’t work for you despite not even trying it out. Collaboration leads to positive relationships and better outcomes; collusion leads to worst outcomes and maintains fears and lack of self-efficacy.
10. A good therapist engages in evidence-based practices
A good therapist is also a good researcher. Because of this, they will refer to the research for best practices with patients to ensure that everything they are doing are well-supported by evidence. In the beginning of the first session, the therapist will likely discuss the therapeutic modality they will be using and its evidence base.
11. A good therapist is flexible
Finally, a good therapist recognizes when something is working and when it is not. Just because the evidence says it works does not mean that it works for everybody. A therapist will be flexible in deciding alternative options or changing strategies if something doesn’t work or resonate well with the patient.
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