Who Should You Trust With Your Mental Health?

By Daniel Champer, LCPC – Intermountain Clinical Director

When you have a headache, you can take ibuprofen to feel better regardless of the brand. This is because ibuprofen must follow a chemical manufacturing standard allowing it to be called ibuprofen. Unfortunately, psychotherapy (therapy) is not ibuprofen. While there are standards of care that accompany every psychotherapist (provider) licensed to provide care, the therapy they provided will ultimately be as unique as the provider themselves.
Because of this, it is important to understand the following three things:
  1. What therapy is.
  2. What questions to ask a new-to-you provider before making an appointment.
  3. What the qualities of good therapy and of less-good therapy are.

What is Therapy?

  Psychotherapy (sometimes referred to as “talk therapy” or simply “therapy”), is a practice meant to assist children, youth, families, and adults as they address a broad variety of mental health concerns (such as depression and anxiety), emotional distress, co-occurring substance use, suicidal thoughts or ideation, trauma, and other life-impacting stress. The ultimate intention of therapy is to help someone cope with, alleviate, eliminate, or regain control of troublesome symptoms so they can ultimately experience increased emotional well-being and overall mental health.

Three Questions to Ask a New Provider Before You Make an Appointment:

1. What is their area of expertise?
  Because there are thousands of mental health and relationship issues it is reasonable to expect your provider to specialize in one or more, but not all. It is good to make sure they have the skillset to address your concerns and age (some providers are age-specific – adults OR children).
2. How will they measure progress?
  It is reasonable to learn how a provider will track your progress throughout your sessions. If they have no answer to this question you might need to find someone who can.
3. What kind of license do they hold and are they licensed to practice in your state?
  The process to become a licensed provider takes a serious commitment. Licensed providers must earn a Bachelor’s Degree and Master’s Degree, obtain provisional licensure, complete work experience, pass state or professional examinations, obtain state licensure, and meet continuing education requirements. Providers must be licensed by the states in which they practice.

Three Easily Identifiable Qualities of Good (and Less-Good) Therapy

1. Therapy is Not About Making a Friend

  While there are many opportunities in life to develop friendships and personal relationships, therapy should not provide one of them.
Good Therapy:
  • This provider should ensure your relationship stays professional (example: you will always feel like they are there operating in a professional capacity to address your needs).
  • They should maintain professional language (example: no profanity) and body posture (example: sitting upright and attentively listening).
  • They should work with you and guide you toward the mutually agreed upon outcome you hope to achieve from your sessions.
  • They should focus solely on you, your needs, and your time.
Less-Good Therapy:
  • This provider might be casual around you in language (example:swearing) and gestures (example: lying down) during your session.
  • They might ask you to hangout outside of your sessions.
  • They ask unrelated personal questions that are prying or voyeuristic.
  • They might not help you formulate or work toward the mutually agreed upon outcome you hope to achieve from your sessions.
  • They might multitask (example: look at, or use their phone or computer) during your session.

2. Evidence-based Practice is a Must

  Therapy lives and evolves just like all other medical practice, however, though it responds to new research and current information, any intervention used should be evidence-based (the integration of the best available research with clinical expertise in the context of patient characteristics, culture, and preferences).
Good Therapy:
  • This provider should offer individualized solutions based on tried and tested scientific research with proof of effective application.
  • They should be able to clearly explain the reasoning behind what they are proposing you try or what they are asking you to do.
  • If you are confused, they should work to explain what they are proposing or asking without inserting opinion.
  • They should be able to explain any suggested course of action they suggest through scientific research .
Less-Good Therapy:
  • This provider might use language such as “In my opinion…” or “If I had to guess…”
  • They might offer vague explanations which you may not understand.
  • If pressed for an explanation they may say things like “You will get it after a few more sessions…” or “This is really big stuff to try to understand right away…”

3. Personal Judgment Should Not Exist

  If you have arrived at the need to see a provider, chances are you have worked through a variety of thoughts and opinions to get there. Because of this, therapy should always be judgment-free.
Good Therapy:
  • Sessions with this provider should feel like an experience rather than a lecture.
  • This provider should offer acceptance, and ask questions to help them fully understand you without agreeing or disagreeing with what you tell them.
  • This provider should give understanding, undivided attention, empathy, acceptance, positive encouragement, and support.
Less-Good Therapy:
  • This provider might use judgmental phrases in the vein of “that’s crazy…” or “I wouldn’t have done that…”
  • They might offer advice.
  • They might make assumptions without seeking clarification.
  • They might be condescending, or dismissive.
  Though these tools are just the start of understanding the difference between good therapy and less-good therapy, they should help you begin to make better decisions around who to trust with your mental health.

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