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  1. #1
    No moss growing on me Giggly's Avatar
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    Default Good therapist vs. Bad therapist

    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.

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    Administrator highlander's Avatar
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    I read somewhere once that the relationship with the therapist is of greater importance than their actual competence. Giggly, I think the characteristics you mention are probably those that you possess yourself and so that would work for you if you were to work with a therapist. Maybe a tough and blunt therapist would be good for a tough and blunt person. I really don't know though.

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    Senior Member prplchknz's Avatar
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    depends on the issues/person, but I don't want a therapist that's like your friend that's stressful.
    In no likes experiment.

    that is all

    i dunno what else to say so

  4. #4
    No moss growing on me Giggly's Avatar
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    Quote Originally Posted by highlander View Post
    I read somewhere once that the relationship with the therapist is of greater importance than their actual competence. Giggly, I think the characteristics you mention are probably those that you possess yourself and so that would work for you if you were to work with a therapist. Maybe a tough and blunt therapist would be good for a tough and blunt person. I really don't know though.
    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.

  5. #5
    RETIRED CzeCze's Avatar
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    Oh! Oh! Oh! Me! Me! Me!

    I wanna answer!

    First, I think your friend might do better with cognitive therapy or another modality that is about the nitty gritty and usually has a short term course.

    Second, I think a good therapist is kind of what your friend is pin pointing - someone who actually believes in empowering and helping their patient. Your friend sounds like she might be a bit of bully though for some patients. You also need to be understanding of where the patient is coming from and be able to gauge how best to approach them. It's a balance.

    I think a bad therapist is someone who makes the mistake of trying to be their patient's friend or gets caught up in being liked or admired. It's not something explicit (like sleeping with a patient) so it's not something you can get your license revoked over but I think it's egregious enough that you should.

    I dated a woman (I won't say the type lest I offend those who share her type BUT YOU CAN HAZARD A GUESS!?! haha) who saw the same therapist for like 8 years. I think the therapist was one of those misguided bleeding hearts who really wanted to "help people". But her version of helping people was basically coddling them and being a mother figure and nodding sympathetically no matter what their patients told them and basically stroking the patient's ego. The girl I was dating never said what a great or effective therapist that woman was, just that she ENJOYED spending time with her pretty much and felt good that the therapist seemed to like her. DEAR GOD.

    Seriously 8 years - no improvement, that girl actually nosedived while I was dating her and became suicidal (now THAT is a good time) and needed to see a psychiatrist on top of her crappy therapist and was put on suicide watch etc.

    Bah, okay now I'm just in a bad mood.

    But yeah, therapists do need a commitment to actually improving the lives of their patients and identifying and addressing the patient's main issues. They can do it in a nice soft way or maybe a more brusque confrontational way but they must do that in order to be effective and therefore a 'good' therapist. People who become therapists because they want to be "nice" to people disgust me now. Ugh. So much ego involved.

    I've noticed from watching reality shows (whee) about OCD etc. that legit therapists (at least cognitive therapists) are true professionals in that they show absolutely no emotional reaction to the poking and prodding of their patients. Patients can manipulate you (I think my ex and her therapist were in some gnarly co-dependent relationship ) They remained calm and focused on the patient and addressing the patient's issues and removed their own egos from the equation as much as possible. You can see some of the patients have an extinction burst but the calm, unyielding face of the therapist wins out.



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  6. #6
    & Badger, Ratty and Toad Mole's Avatar
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    Rapport

    Rapport is sign therapy will be successful.

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    Senior Member ICUP's Avatar
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    Quote Originally Posted by highlander View Post
    I read somewhere once that the relationship with the therapist is of greater importance than their actual competence.
    I think so. It just depends on what the person needs as to what makes a good therapist. Some people need kind and patient. Some people need tough love.
    I tend to need a combination of the two. Support, understanding, and patience intermingled with setting goals, boundaries, and motivating and pushing me to new heights.
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    Administrator highlander's Avatar
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    Quote Originally Posted by Giggly View Post
    That's what I think too but she thinks EVERYONE needs tough and blunt.
    If I were to guess, I would think this approach would work particularly poorly with an INFP for example

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    Senior Member Lily flower's Avatar
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    I'm sure that some people respond to some types of therapists and some respond to others.

    That said, I think that to be a successful therapist, you really need to be able to empathize with other people and understand things from their point of view, and it sounds like she doesn't have the ability to do that.

    It sounds like she would do better in a "fixing" profession like being a doctor. No one wants to go see their bossy aunt for therapy.

  10. #10
    (blankpages) Xenon's Avatar
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    Quote Originally Posted by CzeCze View Post
    First, I think your friend might do better with cognitive therapy or another modality that is about the nitty gritty and usually has a short term course.
    I was just about to mention Albert Ellis: the creator of one of the first types of cognitive therapies. He was known for being blunt and even pushy at times, and his therapy was much shorter term than was typical when he originated it. Here's a bit about him (from the book 'Learned Optimism' by Martin Seligman)

    ....Gaunt and anglular, always in motion, he sounded like a (very effective) vacuum-cleaner salesman. With patients, he pushed and pushed until he had persuaded them to give up their beliefs that sustained their depression. "What do you mean you can't live without love?" he would cry. "Utter nonsense. Love comes rarely in life, and if you waste your life mooning over its all too ordinary absence, you are bringing on your own depression.You are living under a tyranny of should's. Stop 'should-ing' on yourself!"
    I do think that there are certain qualities all therapists should have. Even in an blunt approach like the above, the client should feel respected and listened to. You can respect someone as a person even while showing them that their beliefs or actions are absurd. And you'd need to continually listen to people and be open to new information about them, rather than quickly deciding what someone's deal is and what's best for them and stubbornly pushing that no matter what (last counsellor I saw did this...really pissed me off). Just to mention a few necessary abilities/traits, I'm sure there's more.

    Quote Originally Posted by CzeCze View Post
    I dated a woman (I won't say the type lest I offend those who share her type BUT YOU CAN HAZARD A GUESS!?! haha) who saw the same therapist for like 8 years. I think the therapist was one of those misguided bleeding hearts who really wanted to "help people". But her version of helping people was basically coddling them and being a mother figure and nodding sympathetically no matter what their patients told them and basically stroking the patient's ego. The girl I was dating never said what a great or effective therapist that woman was, just that she ENJOYED spending time with her pretty much and felt good that the therapist seemed to like her. DEAR GOD.
    Heh. Well, at the risk of being suspected to be the same type as your ex (and I'm "hazarding a guess" that it isn't the one I've listed), I'll confess to having been in that position myself. Not for eight years, but too long. It wasn't that I thought feeling good around my therapist was enough...but I liked being around him so much I kept rationalizing it to myself, telling myself it could start working at some point. It was like people can get in bad relationships: telling themselves 'we can make this work, we can make this work' because they're attached to the person and don't want it to be over, and it isn't until it has been over for a while that you look back on it and go 'What the hell was I thinking?'

    To his credit, he did question me about what I wanted out of therapy, tell me things needed to change if I wasn't getting it, asked me if I wanted to see someone else. He didn't aim to just be my friend. But it wasn't happening for me, and I just wouldn't admit it to myself for a long time. I don't know if it was his style (he was very non-directive, and I often just felt lost and aimless), or my own ambivalence, or what. I've never actually had a successful experience, so I can't say. You hear so much, "It's the relationship that matters" and it's not bad advice, but it would be helpful to hear exactly what to look for in the relationship. It's not just rapport, or trust, or empathy or kindness. You can have all those things and still have ineffective therapy.

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