When people call me to set up an initial appointment I recommend that they interview me as much as I assess them. There is no charge for our first meeting because I know:
- The decision try therapy is hard.
- Looking for a therapist is hard.
- Investing in therapy is hard.
That’s why I try to ease the stress as much as I can and invite questions to help determine if we are a “good fit”. Developing what psychotherapists call a “working alliance” is essentially team building. If we’re not a good fit, one or the other of us will know pretty quickly, sometimes even in that first phone call.
We may not ‘fit’ for all kinds of reasons. It’s no one’s fault. I may not have the expertise you’re looking
for, my office location or schedule may be prohibitive, you’d rather see a male therapist. What’s more difficult to identify is when the lack of fit has more to do with that hard to identify quality of personality or approach or style.
A good therapist is one who works hard to hone a range of knowledge and skills since not any one is going to fit every person who comes to you for help. A good therapist carries many tools in her tool kit. A professor in graduate school said, “If you only have a hammer all you see is nails.” Some therapists only know how to treat depression so, guess what? Everyone who comes to see them is depressed. Even if I onlytreated one person, as that person progressed through therapy their needs will change and so must my interventions.
So what happens when I don’t have the tool for what my patient needs? A good therapist can put their ego aside for the sake of their patient. If I’m stuck I’ll go to a colleague for peer supervision. Sometimes I will read on the subject or go to a continuing education workshop. Once in a while thebest answer is to suggest a consultation with another professional.
What complicates this decision for the therapist is the concept of counter-transference. Us therapists need to be good and sure we aren’t pushing our patient away simply because we are frustrated, or something about the patient
irritates us or that that ‘something’ has more to do with who we are rather than the problem our patient brings to us.
Being a good therapist requires quite a bit of insight into strengths and blind spots, a lot of patience, compassion and constant assessment, not only of our patient but of ourselves as well. To achieve that, a good therapist’s education and training never stops. That’s what makes us professionals. And that’s a good thing.
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