How to tell if therapist is doing a good job?

August 11, 2008 12:50 PM

How do I know if my therapist (who's eclectic but I think oriented to psychodynamic technique) is doing a good job?

I've seen him two sessions, and while he does appear to listen and care, his verbal interpretations are mostly very blunt, and tell me obvious things. "You seem tortured by that emotion" (this after I just finished talking for 10 mins how painful the emotion was. Well duh!).

I mean, this guy has a PhD and went to a psychoanalytic institute - he's gotta be reasonably smart, right? But he seems a little shallow right now. Of course, this could be the transference speaking. Or it could be the fact that it's only been two sessions.

Any tips on how I can realistically evaluate whether he's doing a good job or not?

posted by anonymous to human relations (7 comments total)

I was a psych major, and this is just a general thought, but it sounds like your therapist is using a Rogerian or "client-centered" model, which is non-directive, meaning that he's not guiding you, but rather serving as a mirror to help you towards self-discovery/enlightenment/insight/healing. You're definitely describing the mirroring aspect in what he said-- they're basically reiterating it for you to hear it for yourself and then agree/disagree and deal with what that means to you. It can be quite useful, but if he's not using proper techniques of active listening (which is basically the mirroring he's doing), then you might be bored/frustrated because it seems like you're not getting anywhere.

If you want a more proactive approach on the part of your therapist, you might want to seek someone trained in cognitive-behavioral therapy to change a particular behavior/thought process that you want to deal with.

Tips on how to evaluate... well, do you feel better? Do you find it helpful that you've been talking about your issues with someone? Is it enough for you to just let it out and share these thoughts, or are you wanting guidance and suggestions from an authority? Is it insight and self-knowledge that you seek, or do you need to change a behavior, addiction, or thought process? Answering those questions will help you determine what sort of therapy you might need to seek.
posted by potatopeople at 1:05 PM on August 11, 2008 [1 favorite has favorites]

Two sessions is a very short period of time to judge. However, it is important to remember that a therapist is your employee - like a doctor or a dentist. If you are not getting what you want, find another employee. (Did you interview multiple therapists before choosing this one?)

The best judge of the therapeutic process is how you are feeling, acting, and reacting in your life outside of therapy. The initial reactions might not be positive. (For example, you begin to notice negative patterns in your behaviors, but don't see a way to change them yet.) However, if nothing is changing in your life after a reasonable amount of time, then therapy is not working. There is no such thing as a therapist who is right for every person. Even the best therapists have clients who just don't fit their style.
posted by hworth at 1:07 PM on August 11, 2008 [1 favorite has favorites]

Be upfront with the therapist. Indicate your concerns. He should respond and you can come to an agreement on how to evaluate if what he is doing is working for you.
posted by Ironmouth at 1:55 PM on August 11, 2008

Yeah, potatopeople describes active listening well and I agree that that's what your therapist is doing. For me, active listening is really helpful, but it sounds like it might not be working for you. And what works for you is really the only way to evaluate whether or not the therapist is doing a good job.

I also agree with Ironmouth that you should discuss this with your therapist. Talking about the process and figuring out what you need and how to best help you are very much normal things to do in therapy.

I think that conversation with your therapist will probably reveal a lot about his style and approach, and how well the two of you can communicate and work together. For me, listening and caring are two of the most important qualities in a therapist, so if I was in your situation I would definitely go for more seasons before deciding that it wasn't working.
posted by overglow at 3:25 PM on August 11, 2008

I'm the kind of person (perfectionist, etc) who would obsess over whether I picked the right person and let that completely distract me from my ultimate goal, so if you're anything like I am, I'd advise you to avoid letting it distract you.

I'd worry less about whether he's doing a good job and worry more about what you can do to make therapy work better for you. Not to say therapists can't be bad, but therapy also isn't some magic bullet that works exactly the same on everyone no matter what that person does. It's kind of like a camera. Figuring out how to work with one to get the result you want is just as important as which one you select. Instead of getting frustrated at his feedback and silently judging his intelligence or personal depth, you could give him feedback on what works and doesn't work for you and collaborate with him about how to achieve your goals here.
posted by salvia at 5:06 PM on August 11, 2008 [1 favorite has favorites]

Next time you think, "well, duh", say it out loud (or a politer version if that makes you more comfortable.) A good therapist will welcome a challenge as an opening to deepen the therapeutic relationship. The result should be discussion that makes you feel better about working with him. If he is offended or defensive, then I would be more likely to look for a different therapist.
posted by metahawk at 8:12 PM on August 11, 2008 [2 favorites has favorites]

This is old, but yes.
Same thing with me.

Except the first few times, I thought he was actually going to continue with a thought, rather than a restatement of what I'd just said, so I'd say something like "Yes, exactly..."
then there'd be an awkward pause, and I'd realise he wasn't going anywhere.

I've had three sessions, I'll want one more to give it a fair shot.

But apparently, early change predicts long term change, ie if he was going to be effective at all, he'd probably be at least a little effective by now.
(Study - I think they used 6 sessions as the base rate, but, oh well)

I'm trying again, and this time, asking people for recommendations (which people seem reluctant to give - yes, individual variation and all that, but I'd prefer to try the ones that at least one person has thought is awesome).
posted by Elysum at 3:20 AM on October 18, 2008