So far in this mini series looking at therapy we have taken a look at why therapy can work, what happens when medication is relied on incorrectly, and how therapy can still be effective even when our mental illness comes as a result of genetics or neurology.
In this part of the series I thought we would look at what we should expect in a good mental health therapist.
I should explain that I have either prepared or planned this piece and that as usual I am simply typing the thoughts that occur to me (well the logical ones at least) and will edit it a little before hitting publish.
I am of course no expert in this field and offer only my own opinions and understandings and so I will be relying on he input of others reading and providing feedback on this piece and therefore recommend your reading both this piece and any comments that have been made.
But before I look at the qualities I would look for in the therapist we should I think be mindful that the therapy itself is just as important as the therapist.
The therapy may be the best therapy there is but if it isn’t accessible to you it is useless and when considering that accessibility we need to be mindful of the accessibility not just there and then but for the duration of the therapy.
Accreditation is there for our protection and we need to be mindful that some therapy and therapists exist, depending on where you live or the type of therapy being offered, that do not have either accreditation or a legal requirement to be certified or accredited. Personally I would avoid these like the plague.
Likewise we need to check out just what any accreditation displayed means.
The truth is that Accreditation does NOT always guarantee that the therapy will be good but it is at least an indication.
Adequate and Realistic Time Frame.
Having an indication up front how long the therapy is going to last in respect of number of sessions and length of each session can be invaluable. It affords you the ability to commit based on an informed decision and can also help with any rejection or abandonment issues you could have when the therapy ends. (But see flexibility below)
Affordability and accessibility (see above) go hand in glove. Again it could be the best possible therapy there is but if it isn’t affordable (and affordable for the duration of the therapy) then it is useless. On this same note we should always bear in mind that if we have to cut down on essentials in order to get that therapy then we run the risk of adding stress and difficulties to our lives which we really don’t need and which can make the situation self-defeating.
The appropriateness of the therapy is essential and what is vital is that the therapy should be appropriate to who you are (Gender, Age, comprehension levels etc) and what you have been through and go through and not just to what that therapist has trained in or specialized in.
Challenging and Purposeful.
Therapy which affords you to feel good about a situation which is unhealthy and which can be fixed is not therapy it is excusing. Therapy that affords you to cope with situations that can’t be fixed is understandable but all therapy need to challenge and inspire in purpose.
Identifiable Exit Strategy.
This very much ties in with the ‘Adequate and Realistic Time Frame’ above and ‘Flexibility’ below. The truth is that very often, until the therapist gets to know more about you he or she can’t really tell how many sessions you are going to need. But having a clear exit strategy will at least allow you an understanding of the process and the time frame and again can help with any abandonment and rejection issues.
Flexibility is in my opinion important in respect of three main areas – Scheduling, Program, and Duration.
Scheduling – Mental Illness and poor mental health can bring such disorder into our lives and whilst it is right and fitting that we do all we can to bring order into that any therapy that does not accommodate occasional cancelling and rescheduling of appointments demonstrates a lack of understanding of what I go through and the difficulties I face and I personally would avoid it.
Program – It is your therapy as they are your hurts and issues that you are dealing with. No-one can fully predict what will come up during therapy and this the program must be flexible enough to be able to accommodate proper and adequate responses to those things or at very least referral to others who can.
A therapist can be the best OCD therapist in the world but if you are attending therapy for an unrelated reason, the potential benefits from that therapy may well be greatly reduced. It should deal with the issues that you want or need to deal with or refer you to folk who can deal with those issues.
So having looked at the therapy it self let’s look at what would I look for in a mental health therapist?
Here is my by no means exclusive list…
I need to be able to feel that I can actual talk to the therapist and that they are both interested and care.
I need to know that they can hold their own and encourage me (assertively if needs be) to think a different way, approach things in a new way. Remember sometimes and in fact very often we are our own worse enemy.
I need a therapist who is not just ‘going through the motions’ or earning a wage packet. We all have challenges and difficulties in life and we all burn out at some time or another but your burn out is my fall out and your lack of caring is my lack of inspiration.
Communication skills are not just about what you say. They about what you don’t say, what you do say, when you say it and how you say it. They are about your eyes, your heart, your body language. I ned to know you care so I too might be inspired to care.
Therapy is about making me feel good and being able to be good, not you looking or sounding good. I don’t need someone who feel so self-important that they will just stand at the top of a pit shouting climb up to where I am, I want one who will run the risk of getting their hands dirty and reach down and give me their hand.
I need a therapist who can demonstrate that they have enough intelligence to be able to understand and keep up with my thought processes. But also one who can explain but doesn’t feel the need to rub it in when those thought processes are on a go slow or have stopped or gone off the rails.
Very much linked to ‘Communication Skills’ above, I need a therapist who can hear as loudly what I don’t say as what I do say. Who will listen with both of their ears and their heart. If you don’t have a direct link between your ears and your heart you are little use to me as a therapist and that link isn’t also connected to your brain filtering both what get’s through to your heart and comes out of it you are no use to me whatsoever as a therapist.
IN short I need therapist who will use their training and experiences as a foundation but one from which they are willing to reach out, but not so far that they fall over or knock me down.
I need a therapist who I can relate to. Who I feel has some form of common bond with me. One who I can see not so much coming along on the journey that I am taking but at least willing to be there at the various stops along the way and to do so with some interest and a connection at least in part with what I experienced between those stops.
I need a therapist who is real and tangible. I am not looking for theories or dispassionate text book responses. If I wanted an audio book I would by one.
I need a therapist that I can relate to but also have confidence in. Trust is huge issue in therapy. If you don’t present that you care about yourself, your conduct and your appearance how can you hope to inspire me to care about mine?
Regardless of your opinion of what has happened to be or been done by me I need the therapist to respect that I am me. Broken, damaged, hurt as I maybe I am me and that me deserves respect even if the fallout doesn’t.
Sensitivity and Patience.
This is another huge one for me. If I open myself up to you don’t make me feel dirty or shameful or worthless and know that my hurts are deep for a reason and so my being able to bring them to the surface may take time. Work at the pace that is best for me and in a manner which is best for me, not just what is best for your schedule. Remember you are my therapist not the rapist.
This I accept is a personal preference. And here again it is for me a huge one. As a Christian my faith is core to who I am. Likewise I am convinced that we are not physical beings seeking a spiritual experience but spiritual beings living a physical experience. Any therapy must therefore acknowledge understand and incorporate my spirituality.
Another huge one, I need to know I can trust you as my therapist. Trust your judgement, your reasoning, your motivations and your advice. And a huge part of that trust for me is your understanding that you do not automatically have the right to my total trust from the outset. I have been hurt before and will need to build my trust in you. If you can’t understand that then can I respectfully suggest a career change might be in order?
Here’s a strange thought! Your understanding as my therapist that these are my issues, my hurts, my pains, my fears, is just as important to me as your understanding them and how they can affect people. I need you as my therapist to understand how unhealthy they are for me even damaging they may be to me yes, but also how integral to who I have become they are and how much difficult it is for me to let go of them. Understanding therefore how hard it is for me to share them, let go of them is important, but understanding what an enormous gift it is for me to accept you as part of that process is essential.
So there you have it or them. My ‘by no means exclusive’ but hopefully fairly comprehensive lists about what I look for in the therapy and the therapist.