Just had an abrupt & angry therapist termination. What would you do?
April 7, 2023 12:03 PM Subscribe
I just had a therapist get into a verbal argument with me and tell me to go find another therapist. I was in the middle of asking a question when she hung up on me. I would like to do what I can to ensure other people are aware that this is a possible outcome of therapy with this person.
So ... this has been a shit week for me. I came into my online therapy appointment expressing all the ways that I have been feeling alone and abandoned by people I thought I could count on. This therapist has a tendency to respond to what I say with statements that have often felt minimizing, denying, or like she hasn't heard them, and when this happened today ("you need to have compassion for those people"). I tried to be open that I felt she hadn't heard me, and that she was suggesting things that I had just said I was already trying.
From there it got into a bizarre back-and-forth "you're not hearing me - no, you're not hearing me!", which felt ... not like great therapy practice but I acknowledge that every time I tried to respond to what she said she told me I had misunderstood her, so apparently there was mishearing on both sides. She then asked what I wanted from her, and I told her that this was a scary question to me because it's what my last therapist asked right before she decided I was too fucked up to help (and yes, the fact that this is the second therapist to throw me out in about 4 months does mean I've got some reflecting to do; I understand that and will work on it). She said that's not what she said, and I stopped her and asked her to reflect back what she just heard ME say; after more back-and-forth she said she didn't know what I'd said because we were "too far down the rabbit hole" at this point.
She then told me she thought I just wanted to argue with her (I very much did not), and that I needed another therapist. I started asking her something, she said "Oh my god," and repeated that I needed another therapist. I said okay and started to ask what her policies were in terms of helping someone find another therapist - and while I was speaking, she hung up on me.
So ... yeah. I was never wild about her in the first place but it had been such a struggle to find ANYONE that I thought she was at least decent until today. I now feel that this was completely fucked up, and I would like to keep anybody else from experiencing this. What can I do?
- Leave a review (where would be most impactful?)
- Submit a complaint with a licensing board? (is abrupt and hostile termination against their ethics code?)
- Request a request of whatever records she has on me? (okay, I don't know why this would be useful but I'm pissed right now and feel like I ought to get these for ... I don't know why?)
Would any of these make any difference, and/or are there different things I could do? I'm primarily interested in making sure other people don't experience a situation like this from this person. If the best thing is to just let it go I will, but holy shit, you all - this sucks.
FWIW this is in Oregon, and she is practicing as a "Licensed Professional Counselor." Thanks for any help you can provide.
So ... this has been a shit week for me. I came into my online therapy appointment expressing all the ways that I have been feeling alone and abandoned by people I thought I could count on. This therapist has a tendency to respond to what I say with statements that have often felt minimizing, denying, or like she hasn't heard them, and when this happened today ("you need to have compassion for those people"). I tried to be open that I felt she hadn't heard me, and that she was suggesting things that I had just said I was already trying.
From there it got into a bizarre back-and-forth "you're not hearing me - no, you're not hearing me!", which felt ... not like great therapy practice but I acknowledge that every time I tried to respond to what she said she told me I had misunderstood her, so apparently there was mishearing on both sides. She then asked what I wanted from her, and I told her that this was a scary question to me because it's what my last therapist asked right before she decided I was too fucked up to help (and yes, the fact that this is the second therapist to throw me out in about 4 months does mean I've got some reflecting to do; I understand that and will work on it). She said that's not what she said, and I stopped her and asked her to reflect back what she just heard ME say; after more back-and-forth she said she didn't know what I'd said because we were "too far down the rabbit hole" at this point.
She then told me she thought I just wanted to argue with her (I very much did not), and that I needed another therapist. I started asking her something, she said "Oh my god," and repeated that I needed another therapist. I said okay and started to ask what her policies were in terms of helping someone find another therapist - and while I was speaking, she hung up on me.
So ... yeah. I was never wild about her in the first place but it had been such a struggle to find ANYONE that I thought she was at least decent until today. I now feel that this was completely fucked up, and I would like to keep anybody else from experiencing this. What can I do?
- Leave a review (where would be most impactful?)
- Submit a complaint with a licensing board? (is abrupt and hostile termination against their ethics code?)
- Request a request of whatever records she has on me? (okay, I don't know why this would be useful but I'm pissed right now and feel like I ought to get these for ... I don't know why?)
Would any of these make any difference, and/or are there different things I could do? I'm primarily interested in making sure other people don't experience a situation like this from this person. If the best thing is to just let it go I will, but holy shit, you all - this sucks.
FWIW this is in Oregon, and she is practicing as a "Licensed Professional Counselor." Thanks for any help you can provide.
Best answer: I've never filed such a complaint myself but it looks like this could be a place you can do so.
I think you should do it! This is way more extreme and harmful behavior coming from a therapist than I've experienced, and I've already found like 1/3 of therapists I've worked with to be more harmful than helpful. Also, try not to worry too much about the "2 in a row" aspect here. Therapists are supposed to be capable of holding space for you without getting riled up themselves.
posted by internet of pillows at 12:30 PM on April 7, 2023 [10 favorites]
I think you should do it! This is way more extreme and harmful behavior coming from a therapist than I've experienced, and I've already found like 1/3 of therapists I've worked with to be more harmful than helpful. Also, try not to worry too much about the "2 in a row" aspect here. Therapists are supposed to be capable of holding space for you without getting riled up themselves.
posted by internet of pillows at 12:30 PM on April 7, 2023 [10 favorites]
Best answer: I agree that was very badly handled. Therapists should be able to manage a stressful conversation like that better and when they can't should calm down, seek consultation and then try to repair. At the very least, if she needs to terminate, she should offer to help you find someone who is better match. This is actually considered an ethical obligation.
TheOregon Licensing board says "The 2014 American Counseling Association (ACA) Code of Ethics constitutes the required professional conduct of licensed professional counselors, licensed marriage and family therapists, and licensure applicants including registered interns."
And the ACA Code of Ethics says:
A..11.c: Counselors provide predetermination counseling and recommend other service providers when necessary.
A.12: Counselors do not abandon or neglect clients in counseling. Counselors assist in making appropriate arrangements for the continuation of treatment...following termination.
posted by metahawk at 1:21 PM on April 7, 2023 [7 favorites]
The
And the ACA Code of Ethics says:
A..11.c: Counselors provide predetermination counseling and recommend other service providers when necessary.
A.12: Counselors do not abandon or neglect clients in counseling. Counselors assist in making appropriate arrangements for the continuation of treatment...following termination.
posted by metahawk at 1:21 PM on April 7, 2023 [7 favorites]
Firstly, I am so so so sorry this person did this to you. I'm so grateful that you will pursue reviewing or reporting this person. I've been in therapy with 6-7 different therapists over 20+ years and I would be very, um, truly triggered if this kind of abrupt abandonment happened to me, so I would be grateful to know about this unprofessionalism (really, cruelty!) as a prospective client.
From a mental health perspective, having been on the patient side for so long, I would love to throw in a tangential suggestion:
Could you wait to do any reviewing / reporting until *after* you've found a therapist who is a better fit for you? At least for me, the reporting part of the process could bring up additional difficult emotions.
In the meantime, I would: write down everything that happened (which you've done here), but add any details you can think of while it's still fresh in your mind. Seek support from any close, safe friends. Interview 2-3 new therapists and in your intro sessions, mentioned what has happened with your past two therapists. Get a feel for whether they can help you with this recent trauma. Ask if they would handle things differently and if you should be seeking different modalities, etc. And once you've had a few sessions with the therapist you've picked, *then* decide whether you want to review / report. There is no rush.
At that point, if I were up to it, I'd report to the state board (I believe here), and review on yelp and google if you're comfortable doing that.
Sending you so many good vibes! From knowing some therapists, and hearing about friends' therapy experiences, it sounds like people can often be traumatized by therapists, as sad as that is. So please don't feel like this is an only-you thing.
posted by Uncle Glendinning at 1:21 PM on April 7, 2023 [5 favorites]
From a mental health perspective, having been on the patient side for so long, I would love to throw in a tangential suggestion:
Could you wait to do any reviewing / reporting until *after* you've found a therapist who is a better fit for you? At least for me, the reporting part of the process could bring up additional difficult emotions.
In the meantime, I would: write down everything that happened (which you've done here), but add any details you can think of while it's still fresh in your mind. Seek support from any close, safe friends. Interview 2-3 new therapists and in your intro sessions, mentioned what has happened with your past two therapists. Get a feel for whether they can help you with this recent trauma. Ask if they would handle things differently and if you should be seeking different modalities, etc. And once you've had a few sessions with the therapist you've picked, *then* decide whether you want to review / report. There is no rush.
At that point, if I were up to it, I'd report to the state board (I believe here), and review on yelp and google if you're comfortable doing that.
Sending you so many good vibes! From knowing some therapists, and hearing about friends' therapy experiences, it sounds like people can often be traumatized by therapists, as sad as that is. So please don't feel like this is an only-you thing.
posted by Uncle Glendinning at 1:21 PM on April 7, 2023 [5 favorites]
If you are considering filing a complaint with the licensing board, you can get an idea of what kind of cases actually get to the point of official board action by looking at the history of finalized public disciplinary actions. I'm not sure your case would get that far - it is likely to be viewed as a "she said - he said" case. At the same time, if the therapist cares about her license (which she should), it will be shock for her to get a notification from the Licensing Board that she needs to defend herself. So, you will definitely get her attention, even if you don't get any public revenge.
On the other hand, if she seemed like a decent person having a bad day, you might considering giving her a chance to fix things by sending an email asking for an apology and a referral to someone who might be able to work more effectively with clients like you. Note that I don't think you should specify what you mean by "clients like me" - but whatever it is about you that is triggering her - then should she be willing to make an effort to find a different therapist who doesn't mind or even enjoys that kind of client. Email gives her a chance to think it through and choose her words carefully. (She will want to be careful since her reply can be used in the case against her if you file a complaint) If you don't get a reply or get a confrontational one then go ahead with your next steps. But if she is willing to recognize that her behavior not ideal then you will have accomplished your goal of reducing the chance that it happens to the next person.
posted by metahawk at 1:33 PM on April 7, 2023 [3 favorites]
On the other hand, if she seemed like a decent person having a bad day, you might considering giving her a chance to fix things by sending an email asking for an apology and a referral to someone who might be able to work more effectively with clients like you. Note that I don't think you should specify what you mean by "clients like me" - but whatever it is about you that is triggering her - then should she be willing to make an effort to find a different therapist who doesn't mind or even enjoys that kind of client. Email gives her a chance to think it through and choose her words carefully. (She will want to be careful since her reply can be used in the case against her if you file a complaint) If you don't get a reply or get a confrontational one then go ahead with your next steps. But if she is willing to recognize that her behavior not ideal then you will have accomplished your goal of reducing the chance that it happens to the next person.
posted by metahawk at 1:33 PM on April 7, 2023 [3 favorites]
This sounds pretty terrible and I also might be plotting revenge. But what I’d like to think I’d do: write it all down and journal out my feelings and hold off on making any kind of formal report.
posted by bluedaisy at 1:36 PM on April 7, 2023 [3 favorites]
posted by bluedaisy at 1:36 PM on April 7, 2023 [3 favorites]
Best answer: I am so sorry this has happened to you. The entire conversation is inappropriate and bad clinical practice, and the hang up is absolutely an ethical violation. The American Counseling Association’s ethics code prohibits “client abandonment and neglect” and she is required to provide appropriate arrangements for continuing treatment following termination. The link from internet of pillows is the appropriate place to complaint to her licensing board. Whether it actually impacts her license is uncertain, but a call from her licensing board will at least remind her of her ethical obligations and will also potentially give her access to further training if she needs it. However, you also need to take care of your own feelings right now and if that will cause more distress to you, don’t feel you are obligated to do so for other people.
As for records, it might be useful if you ever feel like you’ll need to document any diagnoses she has given you. Typically you can ask for a therapist to write a short summary documenting this but I would not trust her to do so if you needed it in the future. Do keep in mind reading the notes may be distressing to read and it may be better to choose not to unless you need it for later documentation, or at least to wait until you have a new therapist to do so. This conversation could also be hostile, however, so keep that in mind.
I’m going to challenge “I have some reflecting to do.” Frankly, many therapists don’t have nearly as much training as most people think they do, particularly regarding trauma and childhood adverse experiences. This is especially true of master’s level therapist, but even in my PhD program training in trauma was minimal and only focused on acute trauma and did not provide training on how to deal with chronic trauma or other childhood adverse experiences. You mentioned the effects of a mentally ill and alcoholic father in your previous question and described this as run of the mill for therapists—unfortunately it’s run of the mill to have clients like that but not to have the training to appropriately help these clients. It’s a huge problem that results in harm to a lot of clients and I have a big soapbox about it I won’t get on right now, but I will just say I this is not your fault at all.
And finally, even if a therapist does not have this training, they should be able to contain their own emotions in order to prevent harm to you. This is the major cornerstone of therapy. Her failing to do that is not on you. Unless you’re actively harassing a therapist or otherwise doing anything illegal, it’s their responsibility to remain professional—and refer out before they reach their emotional limits. I would not take any of this as a reflection on you, and I’m sorry you’ve been made to feel like it’s your problem when it’s the field to blame.
posted by brook horse at 1:48 PM on April 7, 2023 [32 favorites]
As for records, it might be useful if you ever feel like you’ll need to document any diagnoses she has given you. Typically you can ask for a therapist to write a short summary documenting this but I would not trust her to do so if you needed it in the future. Do keep in mind reading the notes may be distressing to read and it may be better to choose not to unless you need it for later documentation, or at least to wait until you have a new therapist to do so. This conversation could also be hostile, however, so keep that in mind.
I’m going to challenge “I have some reflecting to do.” Frankly, many therapists don’t have nearly as much training as most people think they do, particularly regarding trauma and childhood adverse experiences. This is especially true of master’s level therapist, but even in my PhD program training in trauma was minimal and only focused on acute trauma and did not provide training on how to deal with chronic trauma or other childhood adverse experiences. You mentioned the effects of a mentally ill and alcoholic father in your previous question and described this as run of the mill for therapists—unfortunately it’s run of the mill to have clients like that but not to have the training to appropriately help these clients. It’s a huge problem that results in harm to a lot of clients and I have a big soapbox about it I won’t get on right now, but I will just say I this is not your fault at all.
And finally, even if a therapist does not have this training, they should be able to contain their own emotions in order to prevent harm to you. This is the major cornerstone of therapy. Her failing to do that is not on you. Unless you’re actively harassing a therapist or otherwise doing anything illegal, it’s their responsibility to remain professional—and refer out before they reach their emotional limits. I would not take any of this as a reflection on you, and I’m sorry you’ve been made to feel like it’s your problem when it’s the field to blame.
posted by brook horse at 1:48 PM on April 7, 2023 [32 favorites]
I would also reach out to some of the professional associations to see what they say about reporting. If this person is a member of one of these organizations, they may be able to hold them account (rescind membership until more training/remediation is completed). Here's one.
Oregon Counseling Association
posted by brookeb at 1:52 PM on April 7, 2023
Oregon Counseling Association
posted by brookeb at 1:52 PM on April 7, 2023
I would file a complaint with the licensing board here in Oregon: if this is a habitual pattern and many complaints are received, they can eventually make a difference in how complaints are processed, but this single event alone will not so much as blip on the board's discipline scales.
This will not make a difference for you, but may for others in the future if this is a pattern.
posted by furnace.heart at 2:16 PM on April 7, 2023 [1 favorite]
This will not make a difference for you, but may for others in the future if this is a pattern.
posted by furnace.heart at 2:16 PM on April 7, 2023 [1 favorite]
I now feel that this was completely fucked up
Yeah.
Leave a review (where would be most impactful?)
I think if I were looking for a therapist, the first thing I'd do with a candidate is google them and see if there were any reviews. So maybe try googling their name together with the word "review" - if any review sites come up in the search results, those would probably be the most visible places for other people doing a similar search.
the fact that this is the second therapist to throw me out in about 4 months does mean I've got some reflecting to do
Seconding that therapists are human and a lot of humans are not actually good at their jobs.
I'm sorry this happened.
posted by trig at 2:30 PM on April 7, 2023 [7 favorites]
Yeah.
Leave a review (where would be most impactful?)
I think if I were looking for a therapist, the first thing I'd do with a candidate is google them and see if there were any reviews. So maybe try googling their name together with the word "review" - if any review sites come up in the search results, those would probably be the most visible places for other people doing a similar search.
the fact that this is the second therapist to throw me out in about 4 months does mean I've got some reflecting to do
Seconding that therapists are human and a lot of humans are not actually good at their jobs.
I'm sorry this happened.
posted by trig at 2:30 PM on April 7, 2023 [7 favorites]
I use a rule of thumb when it comes to things that happen: If it happened once it didn’t happen. If it happened twice it happened once. If it happens three times it’s a pattern and should be addressed. (Works for personal stuff and for ‘is the printer really broken’).
I wouldn’t sweat the ‘getting tossed out’ by two therapists as a problem with you. Probably you were unlucky. Therapy should be a place we can rely on the other person to do most of the emotional labor. Sorry this happened to you.
posted by creiszhanson at 4:03 PM on April 7, 2023 [5 favorites]
I wouldn’t sweat the ‘getting tossed out’ by two therapists as a problem with you. Probably you were unlucky. Therapy should be a place we can rely on the other person to do most of the emotional labor. Sorry this happened to you.
posted by creiszhanson at 4:03 PM on April 7, 2023 [5 favorites]
It's not worth complaining. It takes time and effort to find a new therapist. Do that instead of wasting energy on something that won't get you closer to your mental health goals.
posted by Geckwoistmeinauto at 4:09 PM on April 7, 2023 [5 favorites]
posted by Geckwoistmeinauto at 4:09 PM on April 7, 2023 [5 favorites]
Reading your post on the other IFS therapist recommending a DBT therapist made me wonder if this new therapist was a DBT therapist?
posted by ichimunki at 6:01 PM on April 7, 2023
posted by ichimunki at 6:01 PM on April 7, 2023
I'll always regret not pursuing some kind of formal complaint against the psychiatrist who suddenly got religion and started slipping Chick tracts in with my prescriptions.
posted by The Underpants Monster at 6:33 PM on April 7, 2023 [2 favorites]
posted by The Underpants Monster at 6:33 PM on April 7, 2023 [2 favorites]
Best answer: This is really crappy; I'm so sorry your therapist sucked and made things personal and argumentative.
Fist, find someone new, talk to a friend, use your employer's EAP(Employee Assistance Plan), because it's damaging, and you should take care of yourself 1st.
Make the best notes you can about what happened, what time/date, any details. Simple & factual, but include the effect this has had on you, which is likely significant. If you decide to make a complaint, complain to your insurance, if any. I don't know of review sites for therapists that would allow a post. Definitely complain to the Licensing Board, this person needs a new profession.
posted by theora55 at 8:06 AM on April 8, 2023
Fist, find someone new, talk to a friend, use your employer's EAP(Employee Assistance Plan), because it's damaging, and you should take care of yourself 1st.
Make the best notes you can about what happened, what time/date, any details. Simple & factual, but include the effect this has had on you, which is likely significant. If you decide to make a complaint, complain to your insurance, if any. I don't know of review sites for therapists that would allow a post. Definitely complain to the Licensing Board, this person needs a new profession.
posted by theora55 at 8:06 AM on April 8, 2023
Response by poster: Thank you all for your kind and insightful comments. As with the last time a therapist "dumped" me, it has been deeply helpful - and comforting - to read your words. The last time this happened it was at least done in a mature and reasonably professional way, with multiple wrap-up sessions; this time it felt like the therapist had a temper tantrum and ditched me on impulse. The more I replay it (and I am working on letting it go - I'll get there), the more I recognize that a therapist ought to be able to take feedback like "I feel like you're not hearing what I'm saying or maybe I'm not communicating what I mean" without going on the attack. This is a person who has apparently been a counselor for decades; pretty sure a counselor is supposed to support a client's self-advocacy but as many of you said, not everyone is good at their job. brook horse, your comments about therapists not always having the necessary training were especially helpful in reframing this situation; thank you.
In response to a few comments/questions: this was not a DBT-based therapist - I'd emailed every person listed as DBT certified in the state of Oregon, but got no response (and no response from therapists who had DBT listed as a specialty in their Psychology Today profile). HOWEVER, since my last question I am doing a twice-weekly DBT "skills group" through the Portland DBT Institute, and - despite the absolute shit day yesterday was - I do think it has been starting to help. They require participants to also have an outside therapist, so I will need to get another one asap. Honestly, without this requirement I would give the whole damn therapy world a break for a while - between the utter lack of available therapists and the fact that I'm not sure how to establish a trusting relationship again (I started with this last person by describing what had happened with the last one and getting "assurance" from her that she always worked with clients when problems in the therapeutic relationship arose, lol), I'm not quite sure how to expect therapy to benefit me at this point but here we are. I'm getting top surgery in May so I recognize I should have a therapist; if anyone has tips on how to more effectively vet people in the future I'd appreciate it.
I was curious about the couple of comments that suggested I wanted "revenge" on this therapist; honestly, at this point I don't really care much about her one way or the other but what happened to me yesterday feels like something that would be deeply unsafe for some clients. I would like to do what I can to prevent that.
While I recognize nothing is likely to come out of a complaint anyway, I have drafted one up and am going to sit on it for a few days, but unless anything changes I am planning on submitting it. Thank you, metahawk, for pointing out the section of the ACA Code of Ethics that is relevant here, and thank you, internet of pillows, for linking me to the complaint form. theora55, I hadn't even considered complaining to my insurance but am going to look into that, too - and thank you for reminding me about my EAP as I had forgotten that was even an option for getting therapeutic help in the near-term.
I will be okay. I've gotten some really great support from my wife (and dog), am going to attend a trans/gender diverse support group today (and am considering a Monday night ACOA meeting, and am working hard at using my new DBT skills; additionally, the support from all of you has truly meant a lot. Thank you again - you all are wonderful.
posted by DingoMutt at 8:50 AM on April 8, 2023 [7 favorites]
In response to a few comments/questions: this was not a DBT-based therapist - I'd emailed every person listed as DBT certified in the state of Oregon, but got no response (and no response from therapists who had DBT listed as a specialty in their Psychology Today profile). HOWEVER, since my last question I am doing a twice-weekly DBT "skills group" through the Portland DBT Institute, and - despite the absolute shit day yesterday was - I do think it has been starting to help. They require participants to also have an outside therapist, so I will need to get another one asap. Honestly, without this requirement I would give the whole damn therapy world a break for a while - between the utter lack of available therapists and the fact that I'm not sure how to establish a trusting relationship again (I started with this last person by describing what had happened with the last one and getting "assurance" from her that she always worked with clients when problems in the therapeutic relationship arose, lol), I'm not quite sure how to expect therapy to benefit me at this point but here we are. I'm getting top surgery in May so I recognize I should have a therapist; if anyone has tips on how to more effectively vet people in the future I'd appreciate it.
I was curious about the couple of comments that suggested I wanted "revenge" on this therapist; honestly, at this point I don't really care much about her one way or the other but what happened to me yesterday feels like something that would be deeply unsafe for some clients. I would like to do what I can to prevent that.
While I recognize nothing is likely to come out of a complaint anyway, I have drafted one up and am going to sit on it for a few days, but unless anything changes I am planning on submitting it. Thank you, metahawk, for pointing out the section of the ACA Code of Ethics that is relevant here, and thank you, internet of pillows, for linking me to the complaint form. theora55, I hadn't even considered complaining to my insurance but am going to look into that, too - and thank you for reminding me about my EAP as I had forgotten that was even an option for getting therapeutic help in the near-term.
I will be okay. I've gotten some really great support from my wife (and dog), am going to attend a trans/gender diverse support group today (and am considering a Monday night ACOA meeting, and am working hard at using my new DBT skills; additionally, the support from all of you has truly meant a lot. Thank you again - you all are wonderful.
posted by DingoMutt at 8:50 AM on April 8, 2023 [7 favorites]
Best answer: It’s totally understandable to want to bow out of therapy after this, tbh. The outside therapist rule is unfortunately usually a thing with DBT groups. In your case, here are my suggestions regarding finding a new therapist:
1) Particularly if it’s mostly to make sure you have an outside source to process day-to-day struggles, rather than diving into deep trauma work, I actually would really suggest you see a student therapist at a local university if this is an option for you. Yes, they will have less training, but they will be VERY eager to do the right thing and acknowledge the boundaries of their competence, and they will have multiple sets of eyes on them making sure they’ve behaving professionally and ethically. Therapists with a decade of experience can get lax with their interpretation of the ethical guidelines; meanwhile, students tend to be a little excessive about following them. Not a guarantee, but definitely more likely.
2) I have had clients with a background like yours who have good reasons for never trusting a mental health professional again. I think that reassuring clients, “Actually, you should trust me, I won’t do the thing you’re afraid of!” in the first session is unhelpful and reasonably unlikely to be believed. I would consider that rush to reassure and claim they’ll do everything right a red flag, not necessarily in that they’re likely to drop you but that they aren’t experienced in building relationships with traumatized clients. Some green flags would be if the therapist validates your emotions around the situation and encourages you to express whatever the hell you want about the therapy profession, even if it stings them. In fact, if you can bring yourself to—and it’s okay if not because it’s asserting yourself in a place you don’t yet feel safe and that’s scary—I might even consider insulting the field a little and seeing how they handle it. If a therapist can’t take criticism of their field, they sure as hell aren’t going to be able to take criticism of themself as an individual. A good therapist may even model this for you, commenting on how the field is screwed up and apologizing for the abuses you’ve experienced without quickly following it with “but I’m not like that!” Outlining policies is one thing, but it should be clearly about sharing information about a specific process (e.g. that barring extreme circumstances they will not end therapy without offering a final wrap-up session) and not like the therapist is saying, “See? See? You can trust me!”
3) You might look for people trained in interpersonal process therapy. This form of therapy considers the interactions between the client and therapist to be therapeutic and healing itself. This is not just in the “unconditional positive regard makes people feel safe” sense, but also providing a space and relationship where you can be assertive or angry or generally messy and get a healthy and appropriate response from the person across from you. These people are therefore much better at handling conflict in therapy sessions, because part of the training is literally to encourage the client to be angry in front of the therapist so the therapist can model what a healthy response to that anger looks like.
4) A lot of people like to call themselves trauma-informed when they’ve really just taken a webinar or two on the topic and have not integrated this into how they work with clients. I would ask people specifically what their background in trauma is and what training they’ve received. I would not inherently shy away from people who discuss EMDR training, but I would personally weight it less than training in exposure therapy for trauma or cognitive processing therapy (CPT), for complex reasons I can discuss in me-mail if you’d like.
5) Finally, a significant green flag for me is when I am upfront about the various complex issues I face (chronic illness, autism, trans stuff, trauma) and the therapist is willing to say specifically what they have training in and what they don’t. My current therapist asked if it was important to me that my therapist had training in autism, which he didn’t. This has reflected his humility throughout therapy—he does in fact misinterpret a lot or suggest things that aren’t appropriate for me because he doesn’t have that autism background, but he’s extremely willing to listen to me saying, “No that’s not correct, this is what I meant and this is how it works in autism,” and reassess based on that correction. I think asking upfront “do you have training in xyz” about all of the relevant issues could be another good barometer—are they honest about their lack of training and recognize that might be an issue, or do they gloss over what training they’ve received or acknowledge that they don’t have training in x but brush over it as “I’m sure I can make it work”?
Best of luck in your search, and also remember it’s not your fault if your next match isn’t good either. So much of this is outside your control and you’re doing your best with the resources and information you have.
posted by brook horse at 10:01 AM on April 8, 2023 [4 favorites]
1) Particularly if it’s mostly to make sure you have an outside source to process day-to-day struggles, rather than diving into deep trauma work, I actually would really suggest you see a student therapist at a local university if this is an option for you. Yes, they will have less training, but they will be VERY eager to do the right thing and acknowledge the boundaries of their competence, and they will have multiple sets of eyes on them making sure they’ve behaving professionally and ethically. Therapists with a decade of experience can get lax with their interpretation of the ethical guidelines; meanwhile, students tend to be a little excessive about following them. Not a guarantee, but definitely more likely.
2) I have had clients with a background like yours who have good reasons for never trusting a mental health professional again. I think that reassuring clients, “Actually, you should trust me, I won’t do the thing you’re afraid of!” in the first session is unhelpful and reasonably unlikely to be believed. I would consider that rush to reassure and claim they’ll do everything right a red flag, not necessarily in that they’re likely to drop you but that they aren’t experienced in building relationships with traumatized clients. Some green flags would be if the therapist validates your emotions around the situation and encourages you to express whatever the hell you want about the therapy profession, even if it stings them. In fact, if you can bring yourself to—and it’s okay if not because it’s asserting yourself in a place you don’t yet feel safe and that’s scary—I might even consider insulting the field a little and seeing how they handle it. If a therapist can’t take criticism of their field, they sure as hell aren’t going to be able to take criticism of themself as an individual. A good therapist may even model this for you, commenting on how the field is screwed up and apologizing for the abuses you’ve experienced without quickly following it with “but I’m not like that!” Outlining policies is one thing, but it should be clearly about sharing information about a specific process (e.g. that barring extreme circumstances they will not end therapy without offering a final wrap-up session) and not like the therapist is saying, “See? See? You can trust me!”
3) You might look for people trained in interpersonal process therapy. This form of therapy considers the interactions between the client and therapist to be therapeutic and healing itself. This is not just in the “unconditional positive regard makes people feel safe” sense, but also providing a space and relationship where you can be assertive or angry or generally messy and get a healthy and appropriate response from the person across from you. These people are therefore much better at handling conflict in therapy sessions, because part of the training is literally to encourage the client to be angry in front of the therapist so the therapist can model what a healthy response to that anger looks like.
4) A lot of people like to call themselves trauma-informed when they’ve really just taken a webinar or two on the topic and have not integrated this into how they work with clients. I would ask people specifically what their background in trauma is and what training they’ve received. I would not inherently shy away from people who discuss EMDR training, but I would personally weight it less than training in exposure therapy for trauma or cognitive processing therapy (CPT), for complex reasons I can discuss in me-mail if you’d like.
5) Finally, a significant green flag for me is when I am upfront about the various complex issues I face (chronic illness, autism, trans stuff, trauma) and the therapist is willing to say specifically what they have training in and what they don’t. My current therapist asked if it was important to me that my therapist had training in autism, which he didn’t. This has reflected his humility throughout therapy—he does in fact misinterpret a lot or suggest things that aren’t appropriate for me because he doesn’t have that autism background, but he’s extremely willing to listen to me saying, “No that’s not correct, this is what I meant and this is how it works in autism,” and reassess based on that correction. I think asking upfront “do you have training in xyz” about all of the relevant issues could be another good barometer—are they honest about their lack of training and recognize that might be an issue, or do they gloss over what training they’ve received or acknowledge that they don’t have training in x but brush over it as “I’m sure I can make it work”?
Best of luck in your search, and also remember it’s not your fault if your next match isn’t good either. So much of this is outside your control and you’re doing your best with the resources and information you have.
posted by brook horse at 10:01 AM on April 8, 2023 [4 favorites]
I could never work with someone who said things like, "you need to have compassion for those people" to me, so I think you were justified in pushing back on that. I had a great therapist way back in my 20s and we worked together for a long time, but I told her up front: 1) I'm not religious or spiritual so no advice in that arena and 2) never tell me what to do*. She said she could work with that and she was very respectful about adhering.
More recently, I had a therapist ghost me during the pandemic, and I wasn't going to report it because there was so much other stuff going on at that time, but when my EAP (Employee Assistance Plan) called to see if I was satisfied with their service, I let them know what had happened with one of their providers and I felt good about reporting to them. Maybe that is an option for you?
posted by See you tomorrow, saguaro at 5:13 PM on April 8, 2023
More recently, I had a therapist ghost me during the pandemic, and I wasn't going to report it because there was so much other stuff going on at that time, but when my EAP (Employee Assistance Plan) called to see if I was satisfied with their service, I let them know what had happened with one of their providers and I felt good about reporting to them. Maybe that is an option for you?
posted by See you tomorrow, saguaro at 5:13 PM on April 8, 2023
A therapist ought to be able to take feedback like "I feel like you're not hearing what I'm saying or maybe I'm not communicating what I mean" without going on the attack.
That is literally like 80% of the job description.
posted by gottabefunky at 3:23 PM on April 9, 2023 [2 favorites]
That is literally like 80% of the job description.
posted by gottabefunky at 3:23 PM on April 9, 2023 [2 favorites]
Response by poster: Thanks again for all of the support and insight, everyone. Just wanted to update to say that I gave myself the past week to let my emotions settle, and then submitted a complaint to the licensing board today. I realize that it's unlikely anything will come of it - it's my word against hers - but I feel like I can let the whole thing go at this point.
I haven't yet started the whole exhausting process of finding another therapist, but brook horse, I really appreciate your advice on that front. In another day or so I'll start working on that. Thanks again, everyone.
posted by DingoMutt at 9:04 AM on April 18, 2023 [2 favorites]
I haven't yet started the whole exhausting process of finding another therapist, but brook horse, I really appreciate your advice on that front. In another day or so I'll start working on that. Thanks again, everyone.
posted by DingoMutt at 9:04 AM on April 18, 2023 [2 favorites]
This thread is closed to new comments.
posted by The Last Sockpuppet at 12:15 PM on April 7, 2023 [18 favorites]