Therapy Reduces Suffering
Therapy, or psychotherapy, is the process of meeting with a therapist for the purpose of resolving problematic behaviors, beliefs, feelings, and/or somatic responses (sensations in the body). Therapy can address and resolve a large number of specific concerns, issues, and symptoms. You can find a list of issues commonly treated in therapy, here.
Therapy Promotes Self-Actualization
Therapy is also a very effective method of self-growth and self-actualization. In addition to overcoming barriers and helping people to release extreme beliefs and feelings, therapy can help people to increase many positive qualities of Self, such as joy, compassion, peace, self-esteem, spiritual connection, and love. Many people enjoy therapy and relish the journey of becoming more conscious about themselves, their inner world, and their relationships with others.
Going to Therapy Does Not Mean You are “Crazy”
The belief that people who go to therapy are “crazy” or “damaged” is false. The most common demographic of therapy goers include everyday, ordinary people struggling with everyday, human problems, such as depression, anxiety, trauma, andrelationship issues. Only a small percentage of people undergoing psychotherapy qualify as having a serious mental illness; and these folks typically find their way into programs that offer a higher level of care than the average private practice therapist can offer. If a person is afraid of being judged as crazy by others or by their own inner-critic for going to therapy, then therapy would be especially useful in building self-esteem and freeing one from the limitations of what others think.
In all modes of therapy, you will establish goals for your therapy, as well as determining the steps you will take to get there. Whether in individual, group, or family therapy, your relationship with your therapist is a confidential one, and one that focuses on not only the content of what you talk about, but also the process. The therapeutic process, or how you share your feelings and experiences, is considered to be just as important as the specific issues or concerns you share in therapy. On the whole, you can expect that your therapist will be someone who supports you, listens attentively, models a healthy and positive relationship experience, gives you appropriate feedback, and follows ethical guidelines.
Elements of Healthy Therapy
There are some common elements of “good therapy” found universally in healthy forms of therapy. If you are new to therapy or considering therapy for the first time, it might benefit you to review these Elements of Good Therapy.
Warning Signs of Questionable Therapy
How to Find the Right Therapist
And for those of you who are just beginning your search for a therapist, you might consider reading this article about how to find a therapist who is right for you.
As you explore therapy, you may have opportunities to undergo individual, marriage, family, or group therapy as a primary or adjunctive approach to reaching your goals. Here are links to more information about some common modes of therapy:
Types of Therapy
For as many therapists as there are, there are just as many different theories about how people grow and achieve positive changes in therapy. With this in mind, your therapist’s approach to treatment, the “treatment model” that is used, is a very important part of your healing process. It helps to guide you, and your therapist, to reach your goals in therapy. That being said, looking for a therapist can be an overwhelming process, especially when considering the many types of therapy you may hear about. To help, we have created a long list of specific treatment models or types of therapy that you may come across. Each model or type links to a brief overview with more information, resources, and links to more information.
If there is something important you’d like us to consider adding to this page, please feel free to suggest your ideas.
|There are many models, or types of therapy, to choose from. We believe there are a handful of common denominators present in all forms of healthy, ethical therapy. These elements are described here:
Viewing a person as greater than his or her problems is the hallmark of nonpathologizing therapy. It does not mean problems do not exist; rather, it means one does NOT view the problems as the whole person. Working nonpathologically requires a shift in both the understanding and the approach to pathology.
Here is the understanding: Most of the issues people go to therapy for are not organic disorders—they are not hardware problems, they are software problems. These issues are the result of the person’s psyche doing the best it can to deal with life experiences—to adapt, survive, and prevent the person from ever getting hurt again. Certainly, there are some “disorders” that are purely organic in etiology (meaning a hardware problem that is genetic, biochemical, or neurological), such as some forms and instances of psychotic and mood disorders, but these are the minority. However, the nonorganic problems people bring to therapy, which are often labeled as disorders, are actually very organized, orderly, and systemic psychological reactions. Thus, the word disorder is simply inadequate and misleading. Adding insult to injury, being labeled with a disorder can provoke shame and inadequacy and often make people feel worse. Read more about the GoodTherapy.org position on the concept of disorder.
Here is the approach: Treatment of a software problem requires curiosity and compassion in order to undo the orderly and organized response to suffering. Treatment of a software problem does NOT warrant psychological amputation—this is what the medical model does to pathology. When a therapist joins a client in getting rid of a symptom instead of exploring its depths, the therapist is overlooking the client’s opportunity to heal. We do justice to a person’s true nature when we remember that behind the layers of protection, no matter how self-destructive or hurtful to others an individual has been, there is a loveable and vulnerable person at the very core. What about sociopathy?
Therapists who empower their clients maintain the belief that people have the capacity for change and are equipped with the inner resources to do so, even if they never do change. Therapy is based on the belief that people can heal if they want to and if they are able to contribute to their own growth what is sufficient and necessary. Unfortunately, there is a tendency, especially in medical model treatment environments, to view people as fundamentally flawed. When a therapist views a person as flawed or incapable of change, the person is more likely to feel and become flawed. When the therapist is able to see beyond a person’s wounds and defenses, the client is more likely to discover his or her true nature. Some people may not be able to overcome their obstacles and heal in this lifetime, but the therapist should not become an additional barrier.
The spirit of collaborative therapy is summarized in the words of Albert Schweitzer who wrote, “Each patient carries his own doctor inside him…. We are at our best when we give the doctor who resides within each patient a chance to go to work.” Collaborative therapy can be established when a therapist encourages a client to become the co-therapist. Therapists who work collaboratively trust people to know themselves (or have the potential to know themselves) better than anyone else, to access their own wisdom, and to attend to their wounds. This orientation puts the client in the driver’s seat of therapy. Collaboration is not directionless, nor does it put the client at risk of further trauma.
Therapists generally love working with people and tend to be empathic and big-hearted. There is no doubt that providing psychotherapy is gratifying and rewarding for most therapists. Although therapists witness the damage caused by the worst life has to offer – emotional abuse, trauma, violence – they can be rewarded by being present with people during some of their greatest aha-moments, unburdenings, and transformations. Indeed, therapists get some emotional needs met as a part of the therapy process, sometimes even experiencing secondary healing. However, there are some therapists who unintentionally use the therapy process and their clients to soothe their own psychological wounds. These needs vary, but come from the same issues that many of us, therapist or not, have struggled with: to feel powerful, smart, appreciated, good, loved, seen, in control, etc. When a therapist’s psychological needs are met in therapy at the expense of a client, it damages the therapy process and has a high potential to hurt the client. Those therapists who have done their own therapy, have identified their psychological reasons for entering the helping profession, and are aware of, have tended to, and continue to tend to their own wounds and needs outside of their therapy practice, are less likely to depend on their clients to feel good about themselves and are less likely to cause harm. Addressing the client’s needs–not the therapist’s–is the focus of good therapy.
Self is a state of being that a therapist can embody when with his or her clients. It’s defined by Richard Schwartz, PhD, as a state of calm, curiosity, compassion, creativity, confidence, courage, connectedness, and clarity. Self is considered a requisite of good therapy because it is this state that allows a therapist to work collaboratively without pushing, without pathologizing, and without retraumatizing.
Beyond technique and theory is the realm of the relationship: the ongoing human-to-human connection that provides the foundation for change. The relationship is the safe container that allows one to more fully and completely feel the presence of Self while in the presence of another. A therapist who embodies Self and feels unconditional positive regard in the face of whatever the client may be experiencing nurtures the therapeutic relationship. Without a therapeutic relationship, there is no therapy.
Therapy often times needs to go deep. There seems to be a split in the mental health field between types of therapy that emphasize cognitive solutions and those that emphasize emotional or body-oriented healing. Both are important. Healing takes more than just insight about a problem, cognitive countering, and surface behavior change. To heal, we must explore the depth of the wounds that fuel extreme beliefs, feelings, and behaviors rather than turn away from, counter, or compensate for our suffering. When we counter and turn away from our deeper suffering, we experience “more of the same,” which often leads to more suffering. Also, healing requires feeling. As it is said, “If we can feel it, we can heal it.” Many of our extreme beliefs, feelings, and behaviors are maintained because we have, in an effort to survive, avoided the painful wounds and burdens that lurk beneath. Good therapy helps people to process and complete whatever hidden and unhidden wounds they have harbored. Treating a client without going deep can be like stitching up a wound without taking the bullet out; the wound is more likely to remain sore, become infected, and require ongoing attention.
“Enlightenment consists not merely in the seeing of luminous shapes and visions, but in making the darkness visible. The latter procedure is more difficult and therefore, unpopular.” ~ Carl Jung
Good Therapy Is Imperfect
The phrase “good therapy” encourages a misconception: the idea that there is such a thing as pure good therapy, a process exempt of any problems or issues. In the same way that a good marriage is not one without problems, but rather one that works through problems, good therapy will not always be free of difficulties. No therapist is perfect, and no therapy can be provided perfectly, no matter how ideal a therapy may be in theory. Even those therapists who do the best they can to be conscious of their inner world and attuned to the therapeutic process have aspects of themselves that they are unaware of, pieces of themselves that are unhealed, and mistakes they make. Good therapy is the sum of all the experiences, internal and external, occurring as a result of the imperfect psychotherapy process; it leads toward self-awareness, growth, and the release of extreme feelings, energies, and beliefs. And what a blessing it is that even the best therapy can be lined with areas of unawareness, mistakes, and challenges to the therapeutic relationship and yet still turn out good…like a marriage. Think of the beautiful repairs you and your life partner may have made, the important problems you’ve worked out with friends, and the repairs you may have made in therapy with the people you work with. A solid repair improves the connection and deepens the trust. So, cheers to road bumps in therapy, within all relationships, and within ourselves! Read More about “Good Therapy, Bad Therapy, and Everything in Between.”
Sometimes We Can’t Help
As therapists, we are limited. We greet our clients with great hope. We have spent countless hours studying our trade, doing our own inner work, mastering our technique, and learning to “be” with our clients. We have parts of ourselves that want to do good work. We are compelled to help others release burdens and cope with suffering because we know how good it feels to do so. Yet, there are times we can’t help. We believe a good therapist never gives up hope that a person can heal in this lifetime, but we also recognize that he or she may not be the one to help, that the time may not be right, or that this person may not be ready and, for whatever reason, may never do the work we envision them doing. Good therapy means letting go of expectations and outcomes for ourselves and our clients without giving up hope.
If there is a principle of “good” therapy that you’d like to suggest, please feel free to share your ideas with us.
|It’s easy to find a counselor but perhaps more difficult to know if you’ve found one who is right for you. There are a number of questions you can ask that will help you to choose a counselor. This short article outlines 14 of these questions, in no particular order (please note, the words “therapist” and “counselor” are used interchangeably). Thanks to the GoodTherapy.org therapist members who contributed their ideas for this article!
1. What does it feel like for you to sit with the therapist? Do you feel safe and comfortable? Is it easy to make small talk? Is the person down-to-earth and easy to relate to or does he or she feel cold and emotionally removed? Is the counselor “stuck in her head,” or overly emotional and empathic? Is the therapist a “know-it-all” or arrogant? Sure, for many of us, going to a therapist for the first time is a bit anxiety provoking, and it’s important to tease out our own “stuff” from the actual counselor. But, if a counselor doesn’t feel like a good fit for you, that’s okay; there’s absolutely no contract or rule requiring you to continue working with any counselor. However, it’s important to check to see if there’s a part of you avoiding therapy through a dislike or judgment of the therapist. If you find yourself reacting negatively to every counselor you see, then the issue could be yours and may warrant your sticking it out with a counselor in an effort to work through your fears of beginning therapy.
2. What’s the counselor’s general philosophy and approach to helping? Does your counselor approach human beings in a compassionate and optimistic way? Does he or she believe humans are born loving and lovable, or does the counselor believe people are genetically deficient? We at GoodTherapy.org believe that good therapists and counselors adhere to the elements of good therapy.
3. Can the counselor clearly define how he or she can help you to solve whatever issue or concern has brought you to therapy? Experienced counselors explain how they can help, are able to give you a basic “road map,” to their approach, and can even give an indication of how you will know when therapy is finished.
4. Does the counselor seek regular peer consultation? An important professional activity for any wise counselor is regular consultation with peers or consultants. Consultation serves a number of purposes, such as, but not limited to, reviewing cases, receiving advice, getting unstuck, discovering one’s own blind spots, and noticing how one’s own “stuff” may be getting in the way. Consultation provides a counselor with a necessary reality check, a degree of objectivity, and feedback. Even the best therapists benefit from the help of others.
5. Can your counselor accept feedback and admit mistakes? A healthy counselor is open to feedback and to learning that something he or she said hurt or offended you. Good therapists are willing to look at themselves, to check their feelings, and to honestly and openly admit mistakes.
6. Does the counselor encourage dependence or independence? Good therapy doesn’t solve your problems; it helps you to solve your own. Likewise, good therapy doesn’t soothe your overwhelming feelings; it helps you learn to soothe your own feelings. Like the old proverb, therapy is most powerful when it helps people to learn to fish for themselves rather than rely on another to feed them. If your counselor provides wisdom, answers, or emotional support without encouraging you to access your own resources, it is more likely you will become dependent on your therapist to help you feel better, rather than learning to depend on yourself.
7. Has your counselor done his or her own therapy? One of the best ways to learn how to help someone to heal is to do your own therapy and to experience the healing process firsthand. Thus, therapists who have been in their own therapy benefit from this as a learning experience and are probably better equipped to help because of it. Most good healers are wounded healers—those who, in the process of healing their own wounds, have developed the know-how to help others to heal theirs.
8. Does the therapist have experience helping others with the particular issues for which you are seeking therapy? The more experience therapists have addressing a particular issue, concern, or problem area, the more expertise they have developed.
9. Does the counselor make guarantees or promises? It’s important for a therapist to provide hope but not absolute unconditional guarantees. If you have the will to change and put in the necessary time and energy, healing is possible. Most of our wounds anddefenses are the result of what has happened to us and to those around us. Healing can happen quickly in psychotherapy, but only after getting safely through the layers of protective gate keepers, which understandably can take a long time. So, although everyone is capable of healing, changes can take years to happen for some people; unfortunately, because time is limited, some may never achieve the level of healing they desire in this lifetime. In addition, people are not always at a time and place in their growth where they are ready to heal, and a given therapist may not be the right person to help them. Overall, there are numerous factors at play in the therapy process that may contribute to or interfere with healing; we are conscious of some of these factors and unaware of others. And so, there are no guarantees without conditions. More information is available in the section titled “Sometimes We Can’t Help” on the Elements of Good Therapy page.
10. Does your counselor adhere to ethical principles in regard to issues such as boundaries, dual relationships, and confidentiality? There are numerous ethical guidelines designed to keep counselors from harming clients. Most importantly, there is a guideline barring against dual relationships. When a therapist enters into a therapeutic relationship with a client, he or she should not have any other relationship with that person, such as teacher, friend, employer, or family member, although there are some exceptions to this rule in villages or very rural communities. The principle behind this guideline is really about whose needs are being met. A therapist should be there to meet your counseling-related needs for empathy, understanding, support, guidance, unburdening, and healing. When a counselor gets his or her own needs (emotional or otherwise) met by the client, he or she has crossed a boundary, and the therapy process can be damaged or ruined. This is one of many ethical guidelines, and it’s important for a counselor to adhere to these. For more information on ethical standards, you can visit these links:
American Association for Marriage and Family Therapy (AAMFT) Code of Ethics
11. Is the counselor licensed? Licensure implies that a counselor has engaged in extensive postgraduate counseling experience which, depending on the state of licensure, may include up to 3,000 hours of required supervised experience. It also means the counselor has passed a licensing exam. There are many unlicensed therapists who have years of experience and do excellent work, but licensed counselors have (generally but not always) jumped through more hoops and have undergone more extensive supervision than unlicensed counselors. You can contact your state professional licensing board to verify the licensure of a provider.
12. Does the counselor have a graduate degree? There are numerous people who call themselves “counselors” or “therapists” because they have taken a weekend seminar or have learned a certain therapeutic approach. But without a graduate degree in counseling, psychology, social work, marriage and family therapy, or another related field of study, such a person lacks the education, training, and skills to provide safe psychotherapy and counseling. It is highly recommended to only work with counselors and therapists who have graduate training.
|As a companion piece to the 50 Warning Signs of Questionable Therapy article, it’s important to understand there are many signs of good therapy as well. After all, good therapy has been proven to help people from all walks of life, in thousands of different situations, and in countless ways.
Good therapy is all about helping the client to feel better, to make healthy decisions and set healthy boundaries, to move from a place of poor emotional health to good emotional health, to make connections with others, and to replace sadness, anxiety, anger, and frustration with happiness, peace, and hopefulness for the future.
Because the “Warning Signs” article is so focused on the therapist and the behaviors he or she engages in—or doesn’t engage in—we wanted the “50 Signs of Good Therapy” to put the focus on the client, which is exactly where it belongs.
While the “50 Warning Signs of Questionable Therapy” is structured in a list format, these 50 signs of good therapy are structured along thematic lines.
Below is a listing of the 50 signs of good therapy, placed in order by theme:
Training/Credentials, Experience, and Professionalism
Most states and other municipalities require that therapists or counselors meet specific education and training requirements. Though these vary from location to location, all therapists must be educated, trained, and must follow basic professional codes of ethics and guidelines. The foundation for good therapy exists when:
1. Your therapist is trained appropriately and meets all local and/or state guidelines for providing therapy.
2. Your counselor seems competent and experienced enough to help you with your issues and does not appear overwhelmed by them. While it is possible that you may see a counselor that does not have the training or experience to help you with your problems, he or she should always let you know if that is the case.
3. Your therapist explains the therapeutic process and how you can benefit from it, without guaranteeing your success or promising that “everything will be okay.” The bottom line is that no one can make such guarantees—neither the therapist, nor you.
4. Your counselor always maintains professional business practices by keeping the focus on you. She prepares ahead of time for your sessions by reviewing notes or action items from previous sessions, keeps your appointments, is generally on time, demonstrates that she is paying attention, and doesn’t answer the phone, check email, or become distracted during your sessions.
5. Your therapist provides a diagnosis if necessary, but remains steadfastly focused on helping you to manage any such diagnosis and get better. The diagnosis remains the backdrop for therapy, not the focus of it.
6. Your counselor understands and communicates to you that there are many effective approaches to therapy, and no one approach can meet the needs of every client. He or she models open-mindedness about other approaches to therapy.
7. Your counselor explains what psychotherapeutic technique he or she plans to use, welcomes and answers any questions you may have about a specific technique, and requests your comments for any technique that may be new or different for you.
8. Your counselor is active in the therapy community and regularly interacts with other professionals. It is this regular collaboration with other professionals that keeps your therapist current and able to provide the best therapy for you.
9. Your counselor provides insight and knowledge that you otherwise might not have seen. This insight clearly comes from experience and training.
10. Your therapist maintains a good balance between your thoughts and your feelings without neglecting or diminishing either one.
11. Your counselor always demonstrates a balanced and appropriate level of emotion during sessions. Because good counselors are empathic and genuinely care for their clients, sometimes they express emotion when learning about a client’s experience. For example, if the client has experienced the loss of a loved one, the counselor may show sadness. While some emotion is appropriate, an abundance of emotion is generally not okay. Good therapists maintain their focus on you and not their own emotions.
12. Your therapist helps you to work through highly vulnerable feelings or memories in a safe and therapeutic way that does not re-traumatize you. Because of your work together, he or she knows when it is safe to deal with these feelings or memories and when it is not. He or she neither pushes you to “go there,” nor prevents you from “going there.”
13. Your counselor has also experienced being in therapy. Many counselors choose this field because they’ve had positive therapy experiences themselves, and they want to do the same for others. For those who have not experienced therapy prior to entering a counselor education program, most curricula require counseling students to participate in therapy, even if briefly so. This allows therapists to understand therapy from the client’s perspective.
Informed Consent and Other Legal Issues
The term informed consent is common among therapists. It simply means that the client should be made aware of any and all benefits and risks of therapy or a particular treatment or technique so that he or she may make the best decision about proceeding with the therapy. Informed consent is often a legal requirement as well, and these next few signs of good therapy are specifically about informed consent and other legal issues. The foundation for good therapy exists when:
14. You receive a packet, commonly called intake forms or informed consent, to complete before or with your first appointment. This packet should explain how therapy with your counselor works, what your rights are as a client, the fee schedule, insurance information, privacy information, and more. Your therapist should also answer any questions about this packet to your full satisfaction.
15. Your counselor explains to you that therapy is always your choice. He or she should make you feel comfortable with the choice to discontinue therapy or to choose another therapist. Some people decide to leave therapy before the counselor thinks it is healthy to do so, and your therapist is obligated to express any concern if you opt to discontinue therapy before the therapy has been “completed.” However, this concern should not make you feel as if you don’t have the choice to leave.
16. Your counselor maintains your confidentiality at all times. While there are some occasions when it’s necessary for a counselor to break confidentiality, these are typically outlined very carefully in the state’s or other municipality’s legal and ethical guidelines for counselors. Though the guidelines vary depending on where you live, generally speaking, a counselor can divulge the contents of a therapy session or sessions if the client or another person appears to be in imminent danger, or if the court requires information for a legal proceeding. You may want to check your own local and state guidelines.
17. Your counselor maintains the confidentiality of other clients as well. While your counselor may tell you anecdotal stories of other people’s experiences with counseling if there is a therapeutic value to you, he or she should never reveal the identities of other clients or give you any information that would allow you to identify them.
18. Your therapist responds openly and honestly to any questions you may have about complaints filed with the licensing board. We recommend that you always check with the licensing board to make sure your therapist’s license is current and that there are no unresolved issues.
Communication and Client Focus
Effective communication and the relationship between you and your counselor are probably the most important and indicative factors in whether or not your therapy will be successful. While everyone has different communication styles, it is the counselor’s role to be clear throughout the counseling process. A key part of effective communication is the focus of the counselor—which should always be on you. The foundation for good therapy exists when:
19. Your counselor explains right up front how he or she can help you. He or she gives you concrete examples of what he or she will do, what you will need to do, and how you will know the therapy is progressing.
20. Your counselor regularly checks your progress against your goals and helps you to understand where you are and where you may still need to go.
21. You feel a connection with your counselor that shows he or she really believes in you and in the goals you have set for your life.
22. Conversations with your counselor seem natural and balanced. He or she neither talks too much nor too little. He or she uses terms and language you understand and explains any concepts that may be difficult or confusing.
23. Your counselor helps you to see your own role in your level of happiness and recognizes that, while some people in your life may influence you negatively, blame is a destructive force and cannot be part of healthy choices.
24. Your therapist balances the day-to-day needs of managing your symptoms using effective coping skills with the need to work through and resolve the underlying root causes of those symptoms. By focusing on both, he or she is better able to help you progress and move forward than by putting all therapeutic attention on one or the other.
25. Your counselor models the behavior he or she is trying to help you with. He or she is thoughtful with comments and responses, he or she is calm and speaks at a moderate volume, and he or she is not antagonistic or aggressive with you.
26. It is clear that your therapist’s sole purpose is to help you—without focusing on meeting his or her own needs, talking excessively about himself or herself, disclosing personal information that does not hold some therapeutic value for you, or enlisting your assistance with anything that is outside the purpose of helping you.
27. Your counselor recognizes that he or she may not have all of the answers or be able to help you in some circumstances. She freely acknowledges any mistakes, welcomes your honest feedback, and uses these as learning experiences in order to better help you and understand your needs in the future.
Empathy and the Therapeutic Relationship
Empathy, or being able to “put yourself in somebody else’s shoes,” is a hallmark of good therapy. And therapists are often naturally empathic, as this is one of the common reasons they choose to be therapists in the first place. Demonstrating empathy within the therapeutic setting helps the client to feel safe, to feel understood, and ultimately to feel like he or she can make progress.
Empathy is what helps build a relationship with your therapist. And your relationship with the therapist is key to the success of therapy itself. Without a strong relationship, the therapist has little chance of genuinely helping the client work through his or her difficulties, and the client has an equally low chance of progressing.
A number of the warning signs refer to a “dual relationship,” which is quite simply one where the client knows the counselor in another context or setting besides the counseling environment. This secondary relationship can cause confusion for the client, which is why it’s typically an ethical issue. Good therapists maintain a productive and professional relationship with you at all times. While the relationship with your therapist can seem quite close—after all you are sharing your most private thoughts, sometimes over long periods of time—therapists are trained to manage this closeness and not cross the ethical line of becoming friends or romantic partners. The foundation for good therapy exists when:
28. Your counselor maintains a professional relationship with you at all times. His or her demeanor could be friendly, but she never depicts your relationship as a friendship.
29. Your therapist treats you as a “whole person,” an equal who is not defined by your issues, and does not make negative judgments about you. You feel genuine care and concern from your therapist. One of the hallmarks of good therapy is known asunconditional positive regard. This is an idea that is taught in counseling programs across the country; it maintains that the therapist should see clients in a positive light regardless of any behavior, lifestyle, or other issues.
30. Your therapist is respectful of your values and belief systems and does not exhibit an agenda founded on his or her own values or belief systems. He or she is sensitive to your culture and religion and uses aspects of these as part of your therapy, when appropriate. If he or she lacks knowledge about your beliefs, he or she asks questions in a respectful way to gain better insight.
31. Your therapist knows you well enough to understand any physical boundary issues you may have and does not “move into your space” or touch you without asking if it’s okay with you.
32. Your counselor empathizes with you at an appropriate level, such as a natural or fitting response or level of emotion to your life’s experiences, and not one that is either overdone or exaggerated, or flat and almost nonexistent.
Finally, your progress in therapy is the ultimate indicator of whether or not you are receiving good therapy. After all, regardless of how competent or skilled your therapist may be, you getting better is what really counts. Before we get into the final list, it is important to note that just because someone is not making progress doesn’t mean the therapist is bad or incompetent. Therapy by its very nature is highly subjective and influenced by the varying needs, readiness, and styles of both the client and the therapist. Sometimes a client may not be ready for therapy and sometimes the therapist and the client are not a good fit.
With regard to the changes listed below, it should be mentioned that they don’t usually happen all at once; instead, they often happen gradually and in different sequences. The foundation for good therapy exists when:
33. You feel better! You notice that you are happier, calmer, at ease more often, and more hopeful about the future.
34. You are resolving your own issues and not looking to your therapist or anyone else to fix things for you. A good therapist guides you to your own best solutions. They are not “rescuers” who are there to save you from the issues you are facing. Instead they help you achieve insight into your own thoughts, feelings, and experiences so that you can make the right choices for yourself and move toward a healthier emotional state.
35. You handle life’s ups and downs more easily and with more control over your emotions. You see the difficult times as part of life and are less likely to become overwhelmed by them.
36. You are more forgiving and accepting. You are seeing those around you, including those who may have hurt you, as humans who may have simply made mistakes just as you have.
37. You are more connected to yourself and your own emotions, to those around you, and to life in general. You look forward to living your life and not just moving through it.
38. You are beginning to see things differently. Your perspective on life and everything around you is changing, and you see solutions where you may have seen problems in the past.
39. You are making different choices and looking at your own needs more often. You recognize that you have choices you didn’t used to think you had.
40. You smile or laugh more; your whole demeanor is more positive and future-focused.
41. Other people are noticing differences in you, and they are beginning to react to you in different and more positive ways.
42. You are getting along better with the other people in your life—from your friends and family members, to your coworkers, to strangers you come across on a day-to-day basis.
43. You have more hope for a brighter future for yourself and for your loved ones.
44. You have some sort of plan or goal for what you want your life to be, and you’re working towards that goal.
45. You are setting healthy boundaries with the people in your life and actually building stronger relationships because of it.
46. You notice that you’re feeling better outside of the therapeutic setting and not just while you’re talking to your therapist.
47. You feel safe both emotionally and physically.
48. You feel important, competent, and significant in the lives of those around you. You know you have value to them and to yourself.
49. You feel stronger and better able to express your own needs and desires. You don’t feel victimized by the actions of others.
50. You are making your own healthier choices for your behavior, for your thoughts, and for your feelings.
|The items listed below are significant red flags and important information for anyone intherapy or considering therapy. If any of the following red flags appear during the course of your counseling, it may be time to reevaluate your counselor or therapist. Should you recognize one of these red flags, the first step, in most cases, is to discuss your concern with your counselor. Try talking candidly about what’s bothering you. A good therapist should be open and willing to understand your concerns. If your counselor doesn’t take your concerns seriously or is unwilling to accept feedback, then it’s probably in your best interest to consult with another therapist about it. Most therapists mean well and are willing to take accountability for their own “stuff.” So, it’s also important to give your therapist the benefit of the doubt… all people make minor mistakes. And sometimes what people think is their therapist’s issue is actually their own. These “blind spots” can be the most difficult to see and are well worth talking about with your therapist.
It’s also important to note that the following red flags have varying degrees of significance. Some of them are very serious violations of ethical standards, such as a therapist attempting to have a sexual relationship with a client. There is no exception to this rule, and if you find yourself in such a situation, you are advised to report to the state professional licensing board and consult with other professionals. However, a number of the red flags listed below do have “exceptions to the rule” and depend partly on the context. For example, it’s generally unacceptable for therapists to have dual relationships with their clients. So if a counselor is treating the neighborhood barber for his or her depression, the counselor goes to a different barber to avoid confusing the “client-therapist” relationship. However, in small communities it can be impossible to avoid certain dual relationships. Ethical guidelines are flexible enough to take this, and some other exceptions, into account.
In no particular order, it is a red flag if you find that your:
If there are other warning signs or red flags you’d like to add to this list, feel free to make a comment and we’ll consider adding it to the list.
We believe it is important to become familiar with the basic ethical guidelines that therapists should follow before you start therapy with a new therapist, and we encourage you to do so.
Although all the therapists and counselors listed in GoodTherapy.org certify that the therapy they provide accords in orientation and attitude to the Elements of Good Therapy, GoodTherapy.org does not provide a specific code of ethics for therapists to follow. However, ethical codes have been developed by mental health associations for the purpose of setting professional standards for appropriate behavior, defining professional expectations, and preventing harm to people who go to therapy. Mental health professionals have an obligation to be familiar with their professional code of ethics and its application to their professional services.
We provide links to ethical codes below because we feel it is very important for consumers of psychotherapy to know the difference between ethical and unethical behavior. Most therapists intend to “do no harm” and strictly follow ethical guidelines. Overall, mental health professionals are a good bunch. However, not only do good therapists make mistakes, there are some providers who, unfortunately, are careless and unaware of the importance and purpose of some ethical guidelines. We believe it is in everyone’s best interest to become familiar with basic ethical guidelines before beginning psychotherapy. Here are links to the code of ethics for some of the most common mental health professions:
You can discuss questions you may have about the code of ethics your therapist follows with them during your initial consultation or in your therapy sessions. If you believe a mental health professional has acted unethically during your treatment process, there are different ways you can respond. You may choose to discuss the questionable behavior directly with your therapist. You may also choose to seek consult with a different mental health professional and/or a lawyer about your unethical therapy experience. You also can contact the licensing board and/or professional association governing the therapist’s license to ask specific questions regarding ethical guidelines or to report complaints. If you are in crisis or life-threatening danger, call your local law enforcement immediately (911).
While some people utilize just one mode of therapy, such as individual therapy, to address sources of distress or concern, there are a variety of different modes of therapy that may be employed when applicable to help people reach specific goals. Learn more about different therapy modes:
The primary modes of therapy offered include individual, couples, family, or group therapy, and different circumstances may call for different modes. For example, while a person’s main mode of therapy may be individual, family therapy may prove beneficial during a separation or divorce.
In addition, the context in which therapy is provided may vary. Distance therapy and home-based therapy are offered when challenges such as financial hardship or lack of transportation hinder a person’s access to treatment in a professional setting. Residential treatment can provide a more intensive therapeutic route to healing that takes place away from the client’s home. As an alternative to traditional therapy, some people elect instead to form a relationship with a coach who can help them identify and reach personal goals. For youth, school counseling may be available throughout their school years.
People go to counseling and therapy for a variety of reasons. Often, people seek therapy for the first time because someone close to them–a family member, friend, or doctor–has suggested they get help. Others seek counseling because they have identified specific goals or issues that they wish to work on. In some cases, a person may be mandated to attend therapy as part of a court ruling or by a parent or guardian (if the person is a minor).
A common misconception is that people who go to therapy are “crazy.” On the contrary, having a mental health condition is no different than having a physical ailment; there need not be shame in seeking treatment. Also, most therapy clients are people struggling with common, everyday issues. There is virtually no “right” or “wrong” reason to enlist the help of a mental health professional. The help of the right therapist can promote self-actualization, empower self-growth, improve relationships, and reduce emotional suffering. A therapist or counselor is there to work with clients collaboratively on whatever is most distressing or important to them. Often in therapy, a client and the therapist will explore much more than just the client’s initial presenting problem–that is, the main problem that brought the client to therapy. Together, the client and the therapist will decide the goals of therapy, and if the therapy should be short- or long-term.
Want to learn more about why people go to therapy? The following is a list of some issues commonly treated in therapy: