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What Makes a Good Therapist?

Below are some suggestions of how to evaluate a therapist. Keep in mind they are suggestions only, because ultimately the best evaluation of a therapist's worth is YOU. If you believe you are getting good service and find your relationship with your therapist helpful overall, then it probably is. One of the first things I teach others about is listening to one's own instincts, "listen to your gut" or your "inner voice." If you have a nagging feeling that something just isn't right between you and your therapist, listen to this. It is important. Talk with your therapist about this. If you and your therapist discuss your feelings and that voice is still nagging you, perhaps you need to find another therapist that suits your needs better. Remember, therapy is ultimately a business relationship. You are in charge. If you don't like the service you are receiving, you can always go to someone else whose service you prefer.

Also beware that different therapists use different methods of therapy. One therapist may primarily use a psychodynamic approach while another therapist might use a narrative one. The styles between these two therapists are going to be very different. Both will favor the type of therapy that he/she uses over other theories, but it doesn't mean that one is better than the other. The reality is, if the type of therapy you are getting is working for you, it is right for you. If it isn't working for you, it isn't working for you. Studies of the different schools of thought in therapy, the different "theoretical orientations," show that it isn't the theory that your therapist believes in and uses in therapy that makes the therapy good, it is the relationship that you and your therapist build. If you have a good relationship with your therapist, you are more likely to get more out of your therapy than if you don't have a good relationship. They style your therapist uses may not make any difference to your experience of therapy at all. Ultimately healing in therapy comes from the relationship of therapy, not the style or technique.

Below are some ideas of what makes a therapist a good therapist. At the end there is also a questionnaire that you can use as a guide. Ultimately, good therapy is an art, not a science. What works for one person won't work for another. The art of therapy is finding what works for each client at a particular time and being flexible enough to change your approach when the client's needs change.

  • Honesty, Sincerity, Genuiness and Frankness: A good therapist is someone who will be honest with you, but not so honest that it is harmful to you. The key is honesty and frankness with tact. Therapy isn't about bringing you down, it is about helping you examine yourself in an open and honest way that is supportive so that you can learn and grow. If your therapist is overprotective of you, your therapist isn't trusting your personal ability to heal. In reality, healing is up to you, not your therapist. Your therapist needs to trust your ability to heal yourself and not protect you from the truth, but on the other hand, it isn't helpful if you walk away from therapy feeling attacked or abused. Truth is only good if it is used to strengthen you. It is not helpful if it is used against you. Often the truth can be very painful, but a good therapist will be honest with you without being harmful towards you. Truth used as a weapon isn't healing truth, it is abuse.

  • Stuck to One's Theoretical Orientation: Most therapists use a particular school of thought more than others. For example, one therapist may be a Jungian Analyst who is trained in examining people's distress through Jungian theory, while another will be more post-modern and use a Solution-Focused approach. In Jungian therapy, it is more likely you will explore the impact of important relationships on your present life and how mythological archetypes may relate to struggles that you encounter regularly. With a Solution-Focused therapist, the past is the past and isn't relevant to today. What matters in this theory is helping you to solve a problem that is specific with a short-term goal. However, if you go to see a Jungian analyst and want help with insomnia or a fear of heights, analyzing your childhood and present relationships may not be the best approach to helping you. Using a short-term method of treatment such as a solution-focused approach, might be more appropriate. On the flip side, if you struggle in relationships and have problems due to past abuse, a solution-focused model will probably not be as valuable to you as a Jungian approach.

  • If It Ain't Broke, Don't Fix It. If something is working in your life, it isn't in need of repair. A good therapist is going to focus on your strengths and help you learn to use your strengths when facing areas of weakness. Your strengths don't need fixing, they are already working. A good rule of thumb is, if it is working do more of it. If it isn't working, try something else, but if it is already working, there is no reason to change what is working for you.

  • Trustworthy: This is something that is critical. Therapy is a very personal and private relationship. It is important that you can trust your therapist, and more importantly, that your therapist is someone who is worthy of the trust you give. A trustworthy therapist is someone who listens to you, is dependable, has good professional boundaries, and doesn't throw surprises your way, but is predictable. If you know that when you go to therapy at 3:00pm, your therapist is going to be there at 3:00pm, see you for the full therapy hour, is going to treat you with respect, set limits if necessary, and can be counted on, then you are working with a trustworthy therapist. However, if your therapist suddenly raises his/her fee without warning, doesn't show up on time to therapy on a regular basis, doesn't listen to you when you talk, and touches your knee or strokes your face - this is a therapist who is not trustworthy. Run don't walk. A trustworthy therapist will set limits in therapy, so that expectations are clear. For example, you should know the "rules of therapy" - what happens if you don't show up to an appointment? What happens if you are late? What if you cannot pay for a session? What will happen when your therapist goes on vacation? What if you get really angry during a session, what will happen? What kind of behaviors will your therapist permit and what won't your therapist permit? What if you have a substance abuse problem and you use? What will happen in therapy? A good therapist will inform you about the "rules of therapy" and enforce the rules. If your session is from 3:00-4:00, most therapists won't see you from 3:30-4:30 if you are late, but will see you from the time you arrive until the end of your therapy hour. An overly flexible therapist isn't any better for you than an overly rigid one. Balance is the key always. A therapist who sets limits and maintains safety is more trustworthy than a therapist who will allow you to abuse him or who lets you "get away with things" all the time.

  • Knows His/Her Personal Limits: No one can be good at everything and there are no therapists who can treat everything. Most therapists specialize to some degree. All therapists are trained in working with "the basics" - issues of depression, anxiety and life adjustment issues, but there are areas that therapists are better at than others. For example, I am a therapist who is really good with teens, adults and women. I have a lot of experience in working with trauma, gender identity, sexuality and issues of oppression. I don't specialize in sex therapy, for example. I may be generally helpful with sexual problems, but in working with me, one may find that they may do better with a sex therapist who specializes in this type of problem. I know about sex therapy and I know about sexual problems, but this isn't an area that I have special training or experience in treating. I know if what I am doing with a couple isn't helping them with their sex life because of my lack of skills, it is my ethical obligation to recommend that they might do better seeing a therapist who does specialize in sex therapy. I will bring this up with the couple and offer them some referrals.