What Makes a Therapist Good ?
“She gave me the seeds, and I grew a beautiful plant’”
What makes therapy fit the needs of a young person or you, the reader? How can you know the therapeutic process would be productive and meaningful, helping you grow and flourish? The purpose of this short article is to help you find the right therapist.
The therapeutic relationship is the overarching construct of therapy and encompasses elements such as shared goals, congruence, and collaboration on specific therapeutic tasks. This relationship is thought to be essential in promoting active participation and engagement with emotionally challenging and skill-building tasks. The therapeutic relationship with the therapist shapes the outcome of the therapy; therefore, it is important to find a therapist who is right for you.
Finding the right therapist
A few key words that summarize a positive therapeutic relationship are genuine openness, reliability, acceptance of difficulties, empathic compassion, and the ability to listen and understand. These few words make therapy meaningful and productive.
The therapeutic process is a collaborative relationship wherein a shared understanding of your problems is developed.
The core of the therapeutic process is you, because you are the one who has to lead the change in your life. This is not to say it is easy, simple, or straightforward, but that is where the therapist is there to support you.
In your journey, it is important to find someone with whom you feel safe to share your struggles, feel heard and understood about what you are experiencing, and feel encouraged to make changes. Therefore, it is understandable to say you are not finding the therapist helpful or that you may want to find another therapist.
The quotes on the right are from other young people about their experiences with their therapist and what helped them
Quotes from Young People
The experience of some young people about what fostered a positive threptic relationship with their therapist.
“Felt like I was having a conversation with a friend that cared and I think that was what I needed”
“I think just the situations around me at the time I felt I had no support. It was important that I went somewhere where someone would listen to me and think that I was significant. ”
“I felt like she was taking me seriously, so I was happy’”
“He related things to me and my life, and we often spoke about what was happening to me and my emotions, and how I reacted when things happened. Things like that. So for me, it is very important that the therapy is about me, because I’m the one who’s in treatment, I’m the one who needs to get better. And that’s it. It needs to be about me. That I get the chance to open up and be myself, and that I know that I can trust my therapist. That I am able to talk about whatever I need. That I am allowed to be myself, really. "
Source: DOI: 10.1111/papt.12232
The First Session
“In the beginning you notice that you're standing there with this total stranger, and then you're supposed to just open completely up and, that that was kind of sc- scary to me in the beginning. And you felt that you were perhaps holding back a little in the first sessions”
Source: https://doi.org/10.1002/cpp.2885
It is common to attend the first therapy session without knowing what to expect or what is expected of you. There may be doubt, tension or apprehension especially if therapy was not your own choice and rather initiated by your parent or a teacher.
Therefore here are few things that may help ease that worry.
- It is ok to not know what to talk about in the first session.
- Being forced to show up by parents or teachers does make it harder to find motivation to engage, a therapist can acknowledge that for you and meeting the therapist can also help find the motivation to engage.
- Therapist could be seen as adults who are able to understand and help you navigate the stressors of life.
- Therapy can be an opportunity to finally let everything out and not keep everything bottled up.
- Therapy involves shared decisions, therefore, therapists value your thoughts and opinions including what works well and what does not work for you.
Agency and Autonomy
“The first time she asked me if I should talk or if she should ask questions, and what made it so much easier for me was that I said she should ask questions. It really made a difference. […] I've always found it hard to explain things. I've always had problems getting started talking. It's easier if someone asks, so I can think about what I want to say”
Source: https://doi.org/10.1002/cpp.2885
Fostering autonomy, authenticity, acceptance and a sense of agency are key aspects of therapeutic relationship. Sense of agency refers to the feeling of control over actions and their consequences
The entails
- Therapists offering different options and formats to express yourself (e.g. through conversation, writing, drawing).
- Encouraging shared decisionmaking and choice around session and intervention agenda.
- Collaboration by being able to share your opinions, express your preferences and work together as a team on goal setting and finding solutions.
- Respecting confidentiality, privacy and giving a protected therapeutic space without parental involvement.
References
- Dimic, Tamara, et al. “Young People’s Experience of the Therapeutic Alliance: A Systematic Review. ” Clinical Psychology & Psychotherapy, vol. 30, no. 6, 3 Aug. 2023, pp. 1482–1511, onlinelibrary.wiley.com/doi/full/10.1002/cpp.2885, https://doi.org/10.1002/cpp.2885.
- Lavik, Kristina O., et al. ““Nobody Else Can Lead Your Life”: What Adolescents Need from Psychotherapists in Change Processes. ” Counselling and Psychotherapy Research, vol. 18, no. 3, 25 Mar. 2018, pp. 262–273, www.onlinelibrary.wiley.com/doi/10.1002/capr.12166, https://doi.org/10.1002/capr.12166.
- Moore, James W. “What Is the Sense of Agency and Why Does It Matter?” Frontiers in Psychology, vol. 7, no. 1272, 2016, https://doi.org/10.3389/fpsyg.2016.01272.
- Ryan, Rachael, et al. “Therapeutic Relationships in Child and Adolescent Mental Health Services: A Delphi Study with Young People, Carers and Clinicians. ” International Journal of Mental Health Nursing, vol. 30, no. 4, 25 Mar. 2021, onlinelibrary.wiley.com/doi/full/10.1111/inm.12857, https://doi.org/10.1111/inm.12857.
- Wilmots, Eva, et al. “The Therapeutic Relationship in Cognitive Behaviour Therapy with Depressed Adolescents: A Qualitative Study of Good‐Outcome Cases. ” Psychology and Psychotherapy: Theory, Research and Practice, vol. 93, no. 2, 22 May 2020, pp. 276– 291, pmc.ncbi.nlm.nih.gov/articles/PMC7216827/, https://doi.org/10.1111/papt.12232.
