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Good therapist vs. Bad therapist

ICUP

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Hey Jiggly,

Statistically, they say that the best predictor of therapy is a therapist's empathy, nothing else. I haven't read those studies, but it's a popular statistic they teach you in psych grad school.

I think different styles work for different people depending on their background, how they think, and what they need. That applies for both therapists and patients.

Personally, I've had a bunch of experience counseling friends and I've decided that people benefit most not from getting answers or creating plans, but from creating a genuine connection to another person. I think most dysfunction comes from people not being settled, mentally and emotionally, and I think bonding helps them do this.

Yep. I say that I never would've recovered without my relationship, without trusting and bonding with another. Alot of my dysfunction stemmed from being unable to trust my family from an early age, on. In fact, I was never able to trust anyone in my life until my current S.O. Took me 32 years to find a way out. Also, I needed someone who provided consistency and stability; the environment I never had, and therefore, I was unable to develop. I needed someone who set boundaries for growth and stuck to them. My situation was such that I never had a safe environment to grow within. When I finally got one, I was able to move on and develop.
 

Chloe

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I tried several therapies. Like, practically any. Paid much money etc. They were usually empathic, very..famous and well respected... but we didnt even 'touch' core issues! when i look back at it now. Then one random thing i found by accident made 100x MORE change in 1 hour of audio self-help programme, than 50 hours of therapy. Go figure. :shrug: I have a friend who really had tough past, a lot of sexual abuse etc., and she tried many therapies, without help, I gave her that audio programme, and she said that she experienced freedom, that it was the first thing that works for her, too.

Here it is, The Thing. Mod Note: Torrent link has been removed.
 
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INTP

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She shouldnt be anything else than cognitive behavioristic therapist, even for that, she should look at her attitude a bit..
 

Jaq

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I've had to see more than a few before and I must say. The ones I've seen in my adolescence are better than the ones I've seen when I was younger.
 

INTP

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I had a short session with a woman who seemed like she hated me personally (I've seen two therapists before for my phobias) and this time I just got tested, for a professional-related assessment test. I basically came in to the office and took the test and was given a couple of consultation sessions. There are a number of therapists in that firm, but I was unlucky to get this one.

She was very judgmental as opposed to empathetic or methodologically understanding. Wow. I was quite baffled. She basically asked me how much I earned as a writer (!) and asked me my employer's salary system and implied I was lazy and unmotivated. I came in with a couple of classmates (in graduate school) and they came out fine. Their therapists helped them figure out what kind of work environment they would fit in best and what kind of work they should do upon graduation. My therapist was almost spiteful with me! She kept putting me down. I was really surprised. Wow!

Hopefully you filed some complaint about her to the company and some phychology association shes involved
 
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It is best for the therapists to understand their patients and not just rely on tactics they've learned. To conceive their own methods supports their own understanding. I have witnessed some family counselors and as comforting as they are, they can be kind of dull. It is important not to share just optimistic bullcrap or even pessimistic nonsense. But maybe that's only important in psychiatry. However, it is important to acknowledge all the potential emotional variables. I have noticed that some counselors remain blind to some important factors of the patient's mind and fail to see the whole picture. You have to know when to apply particular methods and when to get creative.

Oh, and also it is very important to be unbias and remain open-minded.
 
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ESFP

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Well, I didn't the like the therapist who told what kind of person I should be. However, I think it's not good not to rate the behaviour of a client either. A good therapist should help a person become a better person, like a teacher. Those who are not like that are not very good therapists in my view. In my opinion, a therapist should have strong moral values. Otherwise the clients will abuse the help to go on doing bad things.
 

Mole

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The Problem and the Solution

The difference between a good therapist and most of us here is that the good therapist has been trained in empathy, while most of us here are still limited to sympathy.

Sympathy is natural and intuitive, while empathy needs to be learnt and practised.

And empathy is uniquely helpful, while sympathy amplifies the problem.

So sympathy is part of the problem, while empathy is part of the solution.
 

Siúil a Rúin

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What makes someone a good therapist and what makes someone a bad therapist?

I imagine there's such a thing as them having different styles and some being good and some bad.

This came to mind because a friend of mine wants to be a therapist. She has a "tough love" approach to everything and is very blunt. It's like Dr. Phil but without any finesse (do they teach finesse in school?) She says that she's all about making people accountable and that she's not interested in providing long-term therapy for anyone. She said that short-term therapy is what she wants to do because in her words "people will drain you if you let them". I thought this was odd.

When I think of a therapist, I think of patient, enduring, understanding and helpful. Maybe that's what I think I need if I went to a therapist, but I can see how some people need tough love.
The Dr. Phil persona is pop psychology. It is drive-through therapy. There are some contexts mostly within the behaviorist school of psychology in which the therapy is short, to the point, and focuses modifying the external behavior of the client. For short-term therapy this approach can be the more effective than trying to dig deeper. It sounds like that most closely matches what your friend is describing although it does have a system of underlying theory that is applied and is not just personal opinion. It is used when there isn't funding for deeper analysis. It is worth mentioning that it is considered unethical in counseling to deliberately impose your own values onto a client because as a vulnerable individual it is wrong to coerce their thinking. This is why various schools of counseling focus on helping the client sort out their own issues. Even back as far as Freudian psychology the therapist was to be a blank slate not communicating any individuality or opinions. This allowed the patient to project their issues onto the therapist as a way of drawing them out. Humanistic psychology focuses on the individual as the expert of their own life needing the therapist as a helper who listens deeply enough, and provides enough unconditional positive regard to create a safe enough environment for the client to exam self on a deeper level to work out their issues.

Counseling programs may not admit an individual determined to tell others what to do and then move on to the next without any deeper investigation. There is a great deal of risk of harm and that approach is best left to call in radio shows with "Dr. Helper" or whomever.
 

Lark

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I think the purpose and style of the therapy will be all important.

I cant see anyone who believes that others are going to bleed them dry being able to muster the empathy and master the active listening skills involved in therapeutic relationships, even in brief therapy and solutions focused brief therapy that's pretty much requisite, requisite to forming any kind of therapeutic alliance or the kind of attachment necessary even an initial assessment.

At the initial assessment stage there needs to be opportunities for the sort of openness and honesty which will determine what sort of therapeutic intervention or style is to be employed, or determine if the therapist even uses that style or form of intervention, if you take the example of the Sopranos, which was mentioned already, the therapist in that is advised by another therapist to stop seeing Tony Soprano, she's either a depth psychologist or person centred therapist from what I've seen of the show up to that point and the therapist advising her rightly points out that Tony isnt lacking insight, which is what both of those approachs are about, and therefore should be referred to a cognitive behavioural therapist.

CBT therapists are more about motivation and targetting clearly defined patterns of thinking, or more likely acting, habits, and the therapeutic alliance is more precisely about tracking together progress, set-backs, relapse cycles and the like. I am not convinced that being a domineering or directive personality is necessarily going to work.

Whatever the approach, from the brief therapy/solutions focused brief therapy, which is the most short term in theory, to depth psychology practitioners, which is much more long term, there's going to be terminable and interminable cases, from the days of Freud therapists have speculated as to what causes that or why it is, there's no hard and fast answer even yet but the findings from neuro-psychology about attachment being patterned on the brain I find pretty persuasive.

Attachment style dictates a lot and will influence what Freud first describes as "transference", which can be a good or a bad thing, its most simply the application to every relationship the affects and emotions associated with the first attachment relationship. It could well determine whether any therapeutic alliance is possible from the outset, whether the therapy is going to be terminal or interminal etc. etc.

Sometimes the people who seek therapy to change a specific problematic behaviour, like alcoholism or paranoia, will go into what's called spontaneous remission or appear to recover rapidly because they the therapeutic alliance itself has permitted the satisfaction of a developmental need which has remained unsatisfied, or more likely it compensates for a developmental deficit while it lasts. At least that's one of the conclusions reached from the "good marriage" or "good friends" explanation of why so many people who could have disordered, deficient or improvable attachment styles manage to cope or function without ever having a breakdown, ever requiring a break through or ever coming to the attention of a therapist.
 

Lark

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It is worth mentioning that it is considered unethical in counseling to deliberately impose your own values onto a client because as a vulnerable individual it is wrong to coerce their thinking.

Its of course unethical or wrongful but its also likely to be totally ineffectual, a lot of the training which is being deployed in my workplace (residential social work) is catching up with this now but its something I've always thought, people can be quite studies in determining what's necessary to bluff or feign compliance, if that's what started in a therapeutic session its all for nothing and pointless. Its likely to be the case with clients who're vulnerable and want to please their therapists. Its also likely to be the case with reluctant or involuntary clients too.

There's also the tragic, although not really that common, reality of individuals becoming rudderless, aimless and dependent upon their therapists. Once the therapy is finished and the therapist gone they'll revert to whatever troubles brought them into therapy in the first place.
 

Giggly

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Will the fact that she's doing biblical counseling change anything?
 

ChocolateMoose123

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That's what I think too but she thinks EVERYONE needs tough and blunt.

I have a pet theory that if a person grew up in and lives in an environment that's "tough" then they probably need the tender kind of therapy, but if a person grew up in and lives in a tender or mushy environment than they probably need the tough and blunt variety of therapy.


I was a psych major in college and seriously considered mental health counseling. I understand your friends' remarks....with some exceptions.

I remember thinking that Woody Allen having been in therapy for 20 years was a failure. No one should need therapy for 20 years. Progress should be made.

I found that counselors were less likely to know how to bridge their patient into a "How are you going to take this info (progress from therapy) and utilize it to change your life in a positive way?" That's where a tough-love approach can come in handy.

Basically a good therapist is both soft and tough. Soft at the start and as the patient strengthens the therapist should become firmer in challenging them. (they cannot suggest/tell a patient what to do but they can ask questions of that patient that get different thought processes going). A good therapist should have empathy and should read and adjust their level of firmness or softness to the patient but ultimately have a goal of recovery and independence for that patient. Do you see a sense of empathy in your friend?
 

ChocolateMoose123

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Will the fact that she's doing biblical counseling change anything?

Oh. I just saw this....I bow out here as I'm biased.

I have a lot of issues with biblical counseling as right and wrong are filtered through biblical interpretations. The people and situations involved take a back seat to whatever the Church believes in. :dry:

To give a real world example, my mother and father went to counseling. She wanted to divorce my father. My father was physically abusive to my mother. Broken bones, etc. This was known by the counselor and because 1) divorce is a sin. 2) it says in the bible to "forgive seventy times seven" 3) it says in the bible to "obey your husband" = she was the sinner. She stayed in the marriage another 4 years because of that. Yeah. I'm not a fan and I don't consider it professional counseling.

Please anyone don't take my post as an attack on Christianity or God. It was neither.
 

Giggly

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Oh. I just saw this....I bow out here as I'm biased. I have a lot of issues with biblical counseling as right and wrong are filtered through biblical interpretations. The people and situations involved take a back seat to whatever ideas the Church believes in. :dry:

To give a real world example, my mother and father (a Pentecostal preacher) went to counseling. She wanted to divorce my father. My father was physically abusive to my mother. Broken bones, etc. This was known by the counselor and because 1) divorce is a sin. 2) it says in the bible to "forgive seventy times seven" 3) it says in the bible to "obey your husband" = she was the sinner. She stayed in the marriage another 4 years because of that. Yeah. I'm not a fan and I don't consider it professional counseling.

I was wondering why you'd even need a degree for biblical counseling but I'm thinking the degree makes them seem more credible to someone religious who is seeking counseling.
 

ChocolateMoose123

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I was wondering why you'd even need a degree for biblical counseling but I'm thinking the degree makes them seem more credible to someone religious who is seeking counseling.

you can be a "counselor" in a church without any degree at all. If you get a degree, like your friend, it's probably from a Bible college. They do not follow the same guidelines for DSMV.
 

Mole

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Its the other way around.

Both sympathy and empathy come from the Ancient Greek. And sympathy means to feel the same as, whlie empathy means knowing what the other feels but without feeling it yourself.

So you can see empathy is a high level skill that requires education, training and practice.
 

Santosha

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A think that a good therapist has the ability take a deep understanding of the patient and bridge it into optimal function. By optimal function I do not mean what society might dictate as "functional" I mean the optimal mental, emotional and spiritual states of the individual. THe focus of insight and implementation would always take precedence over being soft or friendly (though depending on the individual these tactics will likely build rapport, aiding insight.)

The act of being a therapist (not just getting a psych degree) usually draws those with tremendous patience, empathy and a deep concern for fellow human beings because therapy is definately not where the big bucks are (for a majority) and its far too draining to chalk up to idealistic and self righteous notions. There may be a few igits that make it through the initial nets but lack staying power. So I don't really believe in "bad therapists," moreso bad combinations. And I think that some people hear the word 'therapist' or 'psychiatrist' and think they are somehow superhumans, with an ability to see right into ones soul extracting it with some fantastical device, make a few adjustments, and send one on their way. It's just not realistic. Humans like anyone else, with their own quarks, fixations and trials.. but they have studied, they've seen some things, and the better ones have probably been around for a while.

It is just as important for the patient to be committed and open-minded as it is the therapist. More-so infact. We each hold the key to ourselves.. but a good therapist will know which locks they go in and how to open them when the key breaks off.
 

INTP

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Both sympathy and empathy come from the Ancient Greek. And sympathy means to feel the same as, whlie empathy means knowing what the other feels but without feeling it yourself.

So you can see empathy is a high level skill that requires education, training and practice.

Its the other way around :D

Empathy is feeling what other person is feeling, sympathy is feeling bad because other is feeling bad/understanding what the other is feeling and having compassion because of those
 
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