I’m sitting in yet another therapist’s office, listing off my traumas and waiting for him to say something remotely interesting or new. He nods his head, he fidgets in his chair, he repeats the words I said back to me and comes back with,

“It sounds like you’re feeling a lot of stress. Have you ever thought that you might have anxiety?”

Um…duh, Mark. 

I leave disappointed.

Unfortunately, therapy sometimes devolves into vent sessions with a particularly forgiving friend, who validates the heck out of you and then charges $150 on the way out the door.

If you’ve been failed by therapy, you might recognize the feeling – nerves leading up to the first appointment, feeling unsure if this is going to work for you, and slowly losing interest in your sessions until you finally cancel and ghost this therapist. You might repeat the cycle a few times until ultimately giving up on therapy.

I know for a fact that this therapy can be transformational, empowering, moving, and deep.

I also know that it doesn’t always go that way.

Here are three things that any therapist can do that will improve your experience and your outcomes.

 

1. Request your feedback – is therapy working?

This is called Feedback Informed Treatment and it’s a simple and effective way for your therapist to improve your therapy outcomes. I’d also argue that it’s essential to good therapy.

Some therapists utilize a brief assessment after each session. Others ask questions and request your feedback in a more integrative style. Both can work beautifully.

Your therapist should be curious about how you are experiencing your work together.  They might ask:

• Is this working? If so, what helps the most? If not, what do you feel you need that you aren’t receiving?

• How do you feel after therapy?

• Is there anything you need from me that you aren’t getting?

• Is there anything you would change about therapy?

2. Be okay with being wrong.

“What do you think?”

“Do you agree or disagree?”

“How did that land? How would you fix that to fit better?” 

I ask questions like these in every single therapy session.

Your therapist should check in with you to see if they are on the right track. Rather than getting defensive if you correct them, they should be open to your opinions and point of view. (It is your therapy for your life after all.)

Personally, I try to approach every client’s correction with gratitude and excitement – your opinions are essential! When you correct me, we are getting closer to the truth of what’s happening.

I tell my clients that they are the expert in their lives, not me. If they tell me I interpreted something incorrectly, I’m going to trust them.

If your therapist purports to be the expert on a specific issue, or if they imply that the fact that you aren’t “progressing” means that you aren’t putting in effort, or if they suggest that your “resistance” is making therapy less effective…get a new therapist.

A therapist who needs you to do exactly what they say and how they say it, or to complete homework that is consistently dysregulating or upsetting is unlikely to be helpful. It’s okay (and maybe necessary?) for therapy to be uncomfortable but therapy should never feel unsafe.

 

3. Stay in their lane.

Your therapist should know what they’re good at and what they’re not good at. The most effective therapists know when to refer to trusted colleagues (and they work to create a trusted referral network too). A therapist who doesn’t ask questions about what you’re experiencing before stating that they can help you is unlikely to be truly helpful. 

We all have things we’re good at (for me that’s trauma, eating disorders, and relationship work) and things we are just not equipped to lead people through (for me that’s psychosis, high-acuity substance abuse, and parenting).

If you’re experiencing or managing symptoms that your therapist isn’t familiar with, they should be either paying for excellent consultation or referring you to someone who has already developed a competence with your symptoms.

 

How’s your therapist doing on these three things?