What is your perspective on therapy or counseling? Do you admire it, accept it, or feel grateful for it? Or do you disregard it, disapprove of it, or hate it? If so, why? Was it the type of therapist received? The type of other clients you ran into while waiting in the waiting area? Was it the administrative staff or the opportunity for flexible appointments? Was it your therapist or his or her school of thought (i.e., professional perspective)? Sadly, many people misinterpret what therapy is or what it should offer. Because of this, clients drop out of therapy when their overly high expectations are not met. For other people, the therapist or office staff did not deliver in the ways they should have. This article will discuss what therapy is (and should be) and what it is not.
For many people, therapy can be an anxiety-provoking situation for everyone involved. Family members, friends, and spouses often shy away from therapy for many reasons but the main reason, at least in my experience, has been “we don’t fit.”
I have had clients come to my office for therapy and complain about their previous experiences. Their frustration was often justifiable. In many cases, these clients either dropped out of therapy because they were confused or did not feel a connection, refused to call back after the first or 2nd session, or would come to therapy but refused to participate or engage authentically (primarily when geographical options for other services were slim). In other cases, clients will drop out of therapy for personal reasons (i.e., being unable to accept a diagnoses), superior thinking patterns (i.e., “I don’t need therapy because I am not sick”), or a defensive posture (i.e., “how can you tell me anything about me when you’ve only known me for 1 day?”). Thinking patterns, behaviors, defensiveness, an inability or unwillingness to change, or bad therapy are often reasons for why therapy flops.
Because of past negative experiences or word of mouth, most people struggle to understand what therapy is and is not. We, as humans, tend to assign meaning to situations based on our previous experiences. We rarely consider other perspectives if our previous experiences make us too afraid to try again. As a result, clients will give up and never seek therapy again.
Many kids, teens, and adults avoid therapy because their notion of therapy is either incorrect or unrealistic.I have listed a few considerations on what therapy is and what therapy is not. Because this is not an all-inclusive list, feel free to post your ideas in the comments section.
What therapy is (should be):
- A partnership/teamwork: When a client enters therapy, especially for the first time, it is important that the therapist explain what therapy will entail and how the client should perceive therapy. Therapy should include some elements of teamwork in which the client feels comfortable enough to ask questions, respectfully discuss their diagnosis (and challenge it if they do not understand why they have been diagnosed with something), and learn about not only themselves but the people in their lives. A therapist, however, still holds authority in some ways (i.e., authority to make a diagnosis and change it as they see fit, make referrals for other types of treatments, discuss your medical file with other providers with consent from the client, etc). Therapy is not going to be 100% “teamwork” but it should include elements of teamwork.
- Exploratory/open: Clients should always feel as if they are learning something new about themselves and others. When working with adults (in previous settings), I found my most powerful work was done when the client asked questions, bounced ideas with me, and openly discussed their challenges or perspective on something. Clients should not feel the need to withhold information from the therapist.
- Supportive/inquisitive: Therapy should be supportive, open, and exploratory. A therapist should feel comfortable asking the client questions and the client should feel supported in their treatment. Without support and questions, therapy is likely to stand still. No progress can be made.
- Equal but with professional boundaries: As stated above, a therapist has authority over the case of a client, but that does not mean the therapist should abuse his or her power. There should be boundaries around what can or cannot be discussed, email contact, business hours, phone calls, scheduling of sessions, etc. Clients should feel respected by their therapist, even if the therapist has to remind the client of his or her boundaries.
- Healthy/authentic: I’m of the firm belief that healthy therapy includes all of the things above including a therapist who will agree and disagree when necessary. A therapist who sits silently and nods the entire session and avoids giving the client suggestions, may not be a good therapist. Lets face it. Many clients want concrete answers when they come to therapy and many ask for suggestions. A therapist should be able to be honest and foster the development of a healthy relationship.
What therapy is not (should not be):
- A competition: Clients should never feel like they are in competition with their therapist or vice versa. The therapist should be humble and self-confident and not competing with a client because of envy. Believe it or not, I have witnessed such cases and the file should be closed.
- Defensive: It is very likely that a therapist will “push buttons” on a client (for whatever reason) and a client will get angry or defensive. Therapy includes a lot of emotions, thoughts, and behaviors. Some therapists push buttons on clients that need to be pushed and the client often runs away offended, angry, or vengeful. But if a therapist is not respecting you, perhaps you should move on.
- Exploitative: A therapist-client relationship in which you are being used or exploited should never happen. There is no good way to look at being manipulated by your therapist, even if you feel attracted to them or close to them. A therapist who asks a client to do something that would be considered inappropriate or manipulative is not a good therapist. Move on.
- Entrapping/suffocating: It is likely, because of feelings of denial or fear, that a client will end therapy because they were not ready to accept the truth. It is inevitable that a therapist will receive at least a handful of clients like this. Sadly, these clients will say that “therapy felt suffocating.” But there are situations in which a therapist or the office of the therapist can make a client feel guilty for re-scheduling, cancelling, or moving on to another therapist. This should never happen.
- Forceful: If you don’t like your therapy, move on. No one therapist is going to be able to help everyone. That’s impossible. If you don’t like your connection or things just don’t “feel” right, move on. Follow the protocol for ending therapy with that therapist and move on.
What has been your experience with therapy?
There are different kinds of therapy and different schools of thought (i.e., professional perspectives, techniques, and mind-sets about what leads to human problems) and finding the right one can take a few tries. For some people, they never find a good therapist or a “good fit” and often go away and give up.
As always, looking forward to your perspective and experiences.
All the best