More on good therapy







A good therapist will be honest about their qualifications, and respect your expertise.

For instance:

  • A good therapist will not claim to be an expert in gay issues just because they are a good person and don’t hate same sex couples
  • A good therapist will believe you about religious conflicts, and won’t attempt to dictate to you how to resolve them (eg: If you can’t eat certain things, or need to wear certain clothing around members of the opposite sex, or can’t do certain things on certain days).
  • A good therapist will be honest about which conditions they do and don’t have experience treating

I’m studying to become a therapist, just got an A- (highest grade ever) on my intro to counseling course and I wanted to add to a lot of these therapy posts that many of these things (crossing boundaries, pressuring you to do something, refusing to believe you about conflicts etc.) are also violations of counselor ethics.

Each country/state has different codes of ethics for their counselors, but confidentiality, working at the client’s pace and treating the client as the expert are all pretty constant aspects. If you feel your counselor has violated these ethics you can report them to their governing body. It’s not an easy thing, there’s a lot of bureaucracy, but it is very possible to report a bad counselor and possibly get their license to practice revoked or at least have them reviewed by the board.

It’s not a solution to the actual violation, but it could be a helpful option for some people.

Unfortunately, that’s very unlikely to help most people.

A lot of common boundary violations aren’t considered unethical.

Even many boundary violations that *are* considered unethical aren’t super likely to be punished by an ethics board.

I’ve yet to have a therapist who admitted they couldn’t handle my bipolar or being gay. They’ve worked out as good therapists, even if they weren’t specialists. You have to ask more roundabout questions, like, are many of your patients bipolar? How often do you work with gay people? Or when you research offices, look for offices that cater to gay offices.

Generally, if you have a severe disorder like schizophrenia, bipolar, or autism, you want someone with a PHD and a specialty. A lot of low cost therapists are social workers, who really only learn about depression, peer pressure, and self esteem.

I don’t think someone always needs pre-existing familiarity to be able to work with someone. It’s possible for someone who isn’t familiar with gay issues to learn about them, for instance. (Although it’s ok to decide that for you, personally, you need someone with pre-existing familiarity).

The problem I’m talking about is when therapists aren’t honest about what they do and don’t know. For instance, therapists who insist that they are really deeply familiar with gay issues because they read a couple of books and participated in the Day of Silence every year in school.

Therapists who present themselves as universal experts are dangerous.

(Also, I don’t personally want therapy. But if I did, the last person I’d ever go to is an autism expert.)

My current therapist was initially hesitant about working with me, because I’m Autistic and she’d never worked with an Autistic patient before.

I actually found her EASIER to work with than many therapists with an Autism speciality, especially as what I need therapy for ISN’T AUTISM (I need therapy for depression and complex post-traumatic stress disorder). I found she was much more willing to take me as I am and to ask me questions about how I, specifically, experience things rather than making assumptions based on other Autistic patients she’d had in the past like some of my past therapists did.

When I work with her, I feel like we’re working together to understand my problems and tackle them, rather than her trying to teach me about my life or me having to explain my autism using clinical terms so the therapist takes me seriously. “Having to" explain which parts of my experience are affected by my autism can take up time, but she’s open to listening and that, to me, is the measure of a therapist who is good at working with me - not how many academic accolades they have regarding the condition in question.

Yes. That is absolutely bedrock essential.