WHAT MAKES A GOOD THERAPIST?
I wish all clients got quality care by all therapists in all types of treatment. Unfortunately, all therapy is not equal.
Let me preface this article by stating that there will never be one type of treatment or one therapist who is a good fit for everyone. We all have different needs, goals, personalities, experiences, and preferences.
However, it’s important to realize for yourself, as an individual, that just because you are meeting with a therapist, does not mean that you are receiving quality care or the type of treatment that will work best for you. It also doesn’t mean that there isn’t someone out there who can absolutely support you in just the way you need.
I also want to acknowledge that taking the leap to start therapy can be daunting and I applaud you for even taking this step. Don’t be discouraged if it takes you a few tries to find the “right” therapist and please know that the right therapist for right now may be different later on and could have been different earlier on. We all evolve all the time and our needs and wants change.
What Makes a Good Therapist?
A lot of people think that a therapist’s job is “just” to listen. However, that’s almost never the case.
A good therapist is constantly evaluating your needs, checking in with you on progress, offering feedback, taking feedback, and considering other options that might suit you better.
When you make the decision to meet with a therapist, presumably, you have specific problems, concerns, or goals in mind. A therapist’s job is to help you address those. It doesn’t mean they do it for you, but they help you find ways to do it yourself. Some therapists might take a more direct path in doing this, others take a more subtle approach.
It’s not all about structure. Yes, some therapists (myself included) love to keep things at least somewhat organized, for example, including agendas, treatment plans, new skills, and homework as part of treatment. But there are other approaches that work for many people too, that might look like “just listening,” but actually are much more nuanced.
It’s important for all therapists to be mindful of their own thoughts and feelings and understand how what they do and say in session might affect the client. That includes initiating uncomfortable conversations, repairing the relationship if a mistake was made, and processing anything else that comes up that’s relevant to the client’s care.
Unfortunately, there is a subset of therapists that is neither direct, structured, nor nuanced, is not very self-aware, does not have adequate skills, and simply does show up and “just” listen, not much differently than a friend or family member might, and that’s where things can get problematic.
What Makes a Bad Therapist?
A bad therapist is one who is primarily interested in cashing a paycheck, like many people in other professions. They are dispassionate, uninterested, unmotivated, and often too burned out to offer personalized quality care to every client.
A bad therapist doesn’t further their education or look at research or new treatment developments, they do not consult with other therapists or seek supervision, and are very rigid in doing things “their” way that may or may not work for their clients.
A bad therapist is not open to feedback and often misses or ignores what a client might say or ask for. They might often be too agreeable with everything their client says and does, even to the detriment of the client. They avoid confrontation or difficult conversations even when it is essential to the client’s growth or they do so in a rude, unproductive, or disrespectful way without adequate explanation and validation.
A bad therapist doesn’t adhere to ethical standards and crosses boundaries on a regular basis. They don’t hold themselves or their clients to any standards, they don’t offer accountability, and in some cases, can do a lot more harm than good.
Bad therapists often show up late, regularly reschedule or cancel appointments, and do so without discussing potential consequences with the client. They also allow clients to “get away” with these types of behaviors on their own without addressing the impact they have on their goals and progress. They are judgemental or biased towards some clients or expect their clients to have the same values they do. They do not recognize when they might be doing harm or no longer helping the client. They do not make necessary referrals to other providers. They think they can and should help anyone and everyone. They do not recognize their own limitations. They fall asleep in session. They don’t recognize the power imbalance. They make rude, malicious, or inappropriate comments.
These are just some of the stories I’ve heard from my clients and colleagues of real experiences they’ve encountered, including some I’ve experienced myself. Note, a bad therapist doesn’t have to engage in all of these behaviors. Just one might be enough for you to seek a different provider. Additionally, being a “bad therapist” does not mean that someone is a “bad person.” We all make mistakes and we all have blind spots. I believe part of what makes someone a bad therapist is not admitting this and refusing to look at their own behavior. I also believe most people (not just therapists) are well-intentioned. However, because of our own experiences, skills, personalities, etc. we often can’t see what others can. This doesn’t make us bad, wrong, or stupid, and it doesn’t even necessarily make us incompetent, it just means we regularly need to self-reflect and evaluate our own needs and actions. That’s how we can make sure we’re taking good care of ourselves and our clients.
We also don’t know what we don’t know. Something might seem obvious to you that isn’t obvious to someone else. A bad therapist is someone who knows there might be something better out there or something they’re doing wrong, and they choose to continue doing it their way anyway to the detriment of themselves or their clients.
There are many additional factors that play into this conversation. This is why all therapists are encouraged to seek consultation, supervision, continuing education, and their own therapy and self-reflection practices on a regular basis.
How To Handle A Bad Therapist
If you feel safe to do so, you can always bring up these “bad behaviors” with your provider and try to repair the relationship. You may be surprised at how easy something is to change or at how productive the conversation feels if the therapist is open to feedback. This conversation in itself can improve your relationships with other people.
If you try to have this conversation and the therapist is not open to it or any feedback, unwilling to make changes, gets defensive or aggressive, then that gives you a lot of information to decide if you want to continue working with them.
If you do not feel safe to have this conversation at all, then that in itself is a sign that you may want to seek a new provider. Regardless of whether you and your therapist agree or disagree on something, therapy is meant to be a safe space for you to raise any concerns, problems, or topics in a healthy, respectful way. If you feel the need to lie, omit information, or cancel or no show your sessions, then it’s time to consider changing providers.
Please note, there is a difference between some of these “bad behaviors” and unethical and/or illegal behavior. If you experienced something that was physically threatening or unsafe or if you were actually physically hurt or inappropriately touched, seek additional support and explore options to report the therapist to their ethics and/or licensing boards. Depending on the nature of the experience, consider taking legal action and/or consulting with law enforcement. You may want to consult with other therapists and/or lawyers to determine what action to take next in addition to terminating treatment.
For your information, having a sexual/romantic relationship with your current therapist/client is unethical and reportable. Most mental health providers have guidelines that prohibit them from having romantic relationships for at least two years after discontinuing treatment. However, they are strongly advised against pursuing these types of relationships even after this time has elapsed. Being a client in therapy is very vulnerable and creates a power dynamic between you and the provider. Bad therapists are those who take advantage of these vulnerabilities and their position of “power” over the client.
That being said, feeling emotionally uncomfortable in session or being challenged by a therapist isn’t necessarily “bad behavior” and may actually be in accordance with your treatment goals. A big part of my work with clients is helping them learn to tolerate discomfort in the short-term so that they can meet their long-term goals. This type of “challenging” typically occurs once safety and rapport have already been established and the client has given informed consent and/or been introduced to the therapeutic interventions. Treatment with me is always voluntary and clients are always free and encouraged to speak up when something makes them uncomfortable or puts them in distress. While I may encourage clients to try a new skill or exercise a few times before they judge its effectiveness (many interventions take time to “work”), a bad therapist is one who continues to push their style, skills, and recommendations even after the client has asked them not to, especially without offering alternatives or explanations.
Please note, this article is not meant to give you any kind of professional or legal advice. It is based on my own experiences, thoughts, and beliefs. Not everyone may agree with me and that’s okay. Take the information that’s helpful and leave the rest. My goal is to help clients become informed consumers and empower themselves in choosing the best providers for them while establishing healthy boundaries and taking care of their needs. I also hope to reduce instances of “bad therapy,” while acknowledging that as humans, we all make mistakes from which we can choose to learn and grow.
Want to see if I may be a good therapist for you? Explore the rest of my website and book a free 15-minute phone consultation today.