Is Your Therapist Effective?

The more you share with your therapist, the better he/she can understand you and help you reach your goals. Omitting facts or distorting the truth can make your treatment less effective. While being honest may not become easier, the process will grow more familiar. Arriving 5 to 10 minutes before your appointment can allow you to relax and get settled, permitting you to better focus on what you want to talk about that day. To increase your peace of mind, you can request that your therapist review his/her confidentiality policy with you and/or specifically ask what information he/she would have to report to an outsider. Disclosing smaller events or issues first can let you see how it feels and the way that your therapist handles them. You also can write your therapist a letter and give it to him/her during your session. It is likely that he/she has heard something similar from other clients.

An effective therapist should challenge you, allowing you to see things from a different perspective, even if that is difficult, and he/she may assign homework that you do not like in order for you to understand yourself better, communicate more healthily with individuals in your life and/or learn skills (like practicing acceptance and navigating difficult emotions or stressful situations, etc.) Likewise, he/she should regularly ask how you think therapy is going and adjust treatment based on your feedback. When the patient is a minor, parents need to feel comfortable sharing their concerns and observations with the clinician, who should take both seriously. Therapists also should treat patients as their equals and exhibit cultural competence, tailoring sessions to an individual’s specific background.

For children who worry that seeing a therapist means there is something wrong with them or is a form of punishment, parents can emphasize that mental health professionals are like coaches, who will help them build skills that will make them feel better. A diagnosis should precede treatment. As part of an evaluation, the clinician should interview the patient (and his/her parents if he/she is a minor). If medication is prescribed, the dosage should be carefully established by starting with a very low amount that is gradually increased to reach an effective level while also looking for potential side effects. Youth taking psychiatric medications need to be closely monitored as they grow and develop, with checks occurring at least every 6 months.

Problem signs for therapists include: your feeling inferior, judged or that you are not being listened to during a session; he/she does not respond actively, pushes you too hard or talks over you; there is romantic attraction on either side or he/she tries to be your friend; and he/she habitually cancels, is late to or misses appointments. A therapist should guide you toward your goals, not set them or make guarantees about how or when you will reach them. Any improvement should take place at your own pace. Likewise, he/she can demonstrate concern or recommend against certain behaviors, however, a therapist should never make you feel ashamed.

You do not have to remain with the first therapist you find. If you decide to see a new one, be sure to cancel your existing appointments with appropriate notice and consider sending a message that says something like, “I have decided I want to try a different approach with another therapist, however, I appreciate your time and thoughts.” The most effective ones show understanding by approaching clients with compassion, empathy and kindness and making them feel accepted and validated; and children do best when their mental health care providers share information with the other professionals in their lives, including pediatricians and teachers.