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As an intern -level therapist, I wish I could be mad about y'all's spicy take on therapy (looking at you, @erythrura :) but unfortunately, much of your criticism hits the nail on the head. I absolutely believe that if we had more social support available and more of an "it takes a village" mentality that my job would be significantly less necessary. Although it is not always the presenting problem, almost all of my clients struggle with loneliness and friendships. However, I do want to make a distinction. When it's done well, therapy is supposed to be much more than just friendly support.
Therapy can help people with social anxiety face their fears enough to make friends in the first place. Therapy can help people with extreme depression feel okay enough to stop laying in their bed all day and go spend time with friends. Therapy can help people with trauma and attachment issues learn to trust people again enough to let their friends in. Therapy CAN do these things if it is done by a competent professional, but unfortunately, there are a lot of terrible therapists out there. If you think you could benefit from seeing a therapist, here are some vetting tips:
Different levels of qualifications do not matter. You just need someone qualified ( Ph.D., Psy.D, LCMHC, LCSW, LCAS, LMFT, etc.) You might think that you want the therapist who has the highest level training (doctorate), the most years in practice, the most specialties etc., but none of these things are the end all be all when it comes to your therapist. I went to a psychologist with many years of clinical expertise, and she spent half the session talking about herself. I couldn't believe that I actually had to keep directing the conversation back to my issues and away from hers. In contrast, I am currently seeing an intern-level therapist and she is the BEST therapist I have ever had. I was her very first client. She had no clinical experience and did not need any to be amazing.
2. With that being said, just because someone has their therapy degree does not make them a good therapist. Although it is difficult to be accepted into graduate school, once you are there it is completely possible to pass your classes and graduate even if you are incompetent at basic counseling skills. I think it SHOULD be harder to pass and get your degree because you guys suffer when the institutions accredit people who may be good at academics but just are not good therapists. I think there is an "it" factor when it comes to therapy that cannot be taught and some students do not have the "it" factor but get their degree anyway.
3. More expensive therapy does not mean better therapy. If your copay is high or you do not have insurance, look for a therapy intern. Some private practices will have interns who offer free to low-cost services on a sliding scale. I work at a private practice and my services range from pro bono to 40 dollars a session. Major universities with Ph.D. programs also usually have an intern clinic with a low-cost sliding scale.
4. If you do not have any kind of mental health issues and are only looking for advice, see a life coach instead of a therapist. Therapists are not actually supposed to tell you what to do. We are supposed to help you figure out what YOU want to do. "Therapists do not give advice!" is drilled into our heads over and over again in training. If you feel that your therapist is telling you what you should do rather than helping you get curious about yourself and your life, that is a great sign that you are seeing a terrible therapist. This is the one time I will give you advice:
If you have a terrible therapist, leave!
5. There is a difference between advice, homework, and psychoeducation. Advice would be like this:
Imagine that my client comes to me and says: "My boyfriend hit me, but I want to stay with him."
"You should try communicating how you feel," is advice (and terrrible advice at that) and as a therapist I am not supposed to give advice.
However, believe it or not, "You should leave your boyfriend," would also be advice, and I'm not supposed to do that either, despite how much I might want to.
Instead, I would explore with her things like, what is it that is making you want to stay? What do you want from your relationships? What are your values/what is important to you? If you stay, what do you think will happen? If you leave, what do you think will happen? I don't give her advice. Instead, I get curious and help her understand what SHE wants to do and why.
Homework with this client might look like having her write a story about what her dream relationship would look like. Then in session, we might look at how her dreams compare to her current reality.
Psychoeducation with this client might look like providing her with credible readings or Youtube videos on the effects of abuse, trauma bonds, or other relevant psychological phenomena. This is still not me telling the client what to do, but rather providing her with information that is relevant to her situation so that when she makes a decision, she can make an informed decision.
6. Be wary of male therapists. I am definitely biased, but I just find it really hard to believe that men can be good therapists for women. We have one guy in our training program. I've observed his sessions with clients and also done mock sessions with him, and in my humble opinion, he is the worst at therapy of all the interns.
7. Ask your therapist what she thinks of feminist therapy. Although it has feminist in the title, feminist therapy is actually just the idea that being the therapist is inherently a position of power, and therapists have to do extra work to make sure that the scale of power are more balanced by centering the client perspective. Feminist therapy builds on this idea as well by saying that therapists must also be conscious of how other elements of power and oppression work both in the therapy room and outside and make this a point of conversation by "broaching" power differentials with the client (such as being different races).
8. Educate yourself on the different therapeutic orientations, and ask your therapist in the intake assessment what kind of therapeutic orientation she uses. I saw the complaint pretty frequently that your therapists only listen, nod, and say "mhm." No wonder you guys are frustrated! That is very annoying. If you are going to therapy and want homework and specific techniques to do, I would look for a CBT therapist or an ACT therapist. If you are artsy and creative, I might suggest narrative therapy, which is all about the stories we tell ourselves. A Rogerian, humanistic, or person-centered therapist is going to be much more of the nodding and mhmming, which (believe it or not) can be effective for some people but it is definitely not appropriate for all people. Finally, if she says "eclectic" for her therapeutic orientation, to me that is a bad sign because it shows that she hasn't picked one or two therapeutic knowledge bases to master and get really good at.
9. Just like with scrotes, always vet your therapist and be ready to leave. I think you will know if your therapist is a good fit within the first 2 sessions. The first session is an assessment session where we are just asking you a bunch og rapid-fire questions so I would wait until you are able to see at least one session where they have attempted to do therapeutic work with you. If you don't like your therapist after 2 sessions, trust your gut and move on. I know that the search for a good therapist is frustrating. For some who don't urgently need therapy the search is so frustrating that it may not even be worth it. For me, it was worth it. My final experience in therapy has been life changing. I learned to set boundaries. I learned my worth and secured better friendships. I trust myself more. I learned to sit with my emotions. I stopped blaming myself for my parent's neglect. Merely having more or better friends couldn't have gotten me to this point because it would be unreasonable to expect the same things I've gotten from my therapist to come from my friends (unconditional positive regard, therapeutic techniques, one-sided emotional labor etc.) I am more confident, loving, and brave as a result of therapy and it has been worth every penny.
10. Communicate with your therapist. I know we hate that word at FDS, but it is true. Therapsts are not mind-readers. If you are frustrated and do not feel like you are getting what you need from therapy, tell your therapist. Tell her you want more techniques. Tell her you want homework. Tell her that you didn't like it when she said X and why. Tell her that you don't feel like she understands you. If she gets defensive, that is a great sign that she is a terrible therapist, and you should leave. Instead of getting defensive, she should get curious about what is not working for you and how she can be of better assistance to you.
11. Go into therapy with an understanding of the purpose of therapy as well as the limitations of therapy. As others have pointed out, therapy cannot do anything about your external environment, nor should it be expected to. Therapy attempts to influence your external environment by changing YOU, but therapists are powerless to change your environment directly. Therapy can't save you from experiencing microaggressions, catcalling, or being preyed on by a capitalistic society. Therapy can't send a HVM to your doorstep to cure your loneliness. Therapy can't mail you a circle of HVW to spend your time with and help you level up. Therapy can't change your abusive boyfriend, your abusive parents, or your abusive boss.
However, therapy can help you find your self-worth so that you leave your abusive boyfriend. Therapy can help you not to internalize the microaggressions and catcalling as much and understand that it isn't your fault. Therapy can help you value your time and learn to set boundaries so that you leave pickmes in the dust and make room for the HVW you will eventually stumble into.
I like the analogy that views therapy as calling a mechanic when your vehicle is broken down on the side of the highway. We don't drive to your car and fix it for you, but we walk you through how you can fix it yourself. We can't turn back time and prevent your car from breaking down. We can't protect you from experiencing another tire blowout on the road. We can't help that some people are born driving BMW's and others are strapped with motorized scooters. All we can do is help you make the best of what you have and give you tools and techniques so that you can fix it by yourself the next time your car breaks down.
12. You should not be able to tell much of anything about your therapist's worldview. By this, I don't mean that your therapist should be a "yes" woman. My good friend is a social worker and she told me she is working with a man with autism whose presenting problem is loneliness and isolation. He says that he wants friends but in every story that he tells about himself it is clear that he is rude and insensitive to others. She has started taking the tactic of pointing out this discrepancy to him when he starts talking about his loneliness and explaining that his behavior is likely connected to why he is lonely. So, I am not sayig that your therapist should always take your side and never tell you her opinions on anything. I am saying that her views on things like religion and political issues should not be immediately apparent unless you ask her, and even then, she ought to exercise discernment about self-disclosure. For example, my political views align most closely with conservativism, and a client was ranting to me the other day about how terrible conservatives are. I just said, "It's really clear that this is very important to you. Let's explore some of the values that your political party represent to you."
I hope this was helpful! I look forward to hearing your thoughts in the comments.
Side note: Both individual counseling and couples counseling are not appropriate for sex-offender or batterers BUT group counseling can be effective if the counselor takes an authoritative and confrontational approach as outlined by Lundy Bancroft in "Why does he do that?" However, group counseling with batterers can also be poorly facilitated. We watched an unfortunate documentary about this in my training and the therapist took the approach of trying to help the batterers connect with their "feelings" rather than challenging or confronting them. Lundy Bancroft explains that a therapist should not have unconditional positive regard when it comes to batterers and in fact positive regard should be VERY conditional on good behavior. A good couples counselor will not agree to see a couple if they are aware that their is current abuse. They will insist that the perpetrator receives treatment first. As far as individual counseling, I'm unfortunately not sure that it is always apparent if you are working with an abuser. Lundy Bancroft goes into this in his book as well; narcissistic men are often very charming and have the people around them fooled. As individual therapists, we do not have any information to go off of except what the client provides us with. While we can do some reading in between the lines, scrotes stay lying about themselves.
Oh neat, I'll make time to read this, thank you.
Thank you so much for this! You are a lifesaver. I saved the link for my own appointment. Thank you. 💕
This is great, thank you!!
My former therapist was an expert on trauma recovery and EMDR. She helped me so much to recover from childhood trauma, and to reframe nearly everything I thought I knew. I'm grateful to her, and she changed my life. ❤️
The thing I didn't like about her is that she thinks I'm too negative about men. She thinks there are lots of good men out there, but I've only experienced bad men because of my childhood abuse. Part of me wonders if she is correct: I had terrible boundaries, and really bad men could "get in," to my life easily, which colors my perception of all men. On the other hand, this may be an example of pushing her values onto me? I'm just not sure. I got really annoyed when she'd tell me "not all men," and frankly this is one reason I stopped seeing her. She was great at encouraging me to protect myself with men. But I felt like she just wouldn't acknowledge how much risk there is out there.
FDS is the first community I've found that actually assesses men's behavior without denial, and encourages women not to trust until it's been earned. This validation has been VERY healing for me. I know my therapist would agree with the "vet vet vet" and B&D approach, but she wouldn't appreciate the "most men suck" attitude around here. Lol
I've pretty much graduated therapy, but would love to talk to someone IRL from time to time. You've made me curious about "feminist therapists," I didn't know they exist! I may look for one. Thank you!
This should be bolded, underlined, emphasized, repeated, and shouted at the top of your lungs forever. This is probably the single most important piece of information that you wrote. "Eclectic" is a huge red flag for therapists. It most likely means you're going to get some kind of half-assed, kind-of-CBT, kind-of-person-centered, not-really-anything therapy. That's only worth your time if you just need somebody to talk to. In which case, what you need is a friend, not a therapist.