Finding a Good
Therapist
William J.
Doherty, Ph.D. advances the belief
that good therapists are
clinically competent as well as
sensitive to issues of moral
responsibility. The
following is an excerpt from his
writing about positive qualities
to look for in a “morally
sensitive” therapist, along with
some warning signs to watch out
for.
What to look
for in a Good Therapist
-
Caring:
The
therapist seems genuinely
compassionate and values you
as a person. This sense
of being cared for should
start from your first contact
with the therapist, whether on
the phone or in the office,
and should never be in serious
doubt as you move through the
difficult parts of therapy.
I suggest trusting your
intuition in the first
contacts you have with the
therapist. If you don’t
feel warmth and respect, look
elsewhere.
-
Courage:
The
therapist is willing to
challenge you when you are off
base, even if you get angry or
defensive in response.
Therapy should not be
just a feel-good exercise, and
a therapist who does not annoy
you at times is probably not
doing a good job. The
therapist should show you,
over time if not at the outset
of therapy, a willingness to
persevere in facing issues
that you would prefer to
avoid.
-
Prudence:
The
therapist’s feedback and
suggestions about your life
decisions seem realistic and
reasonable, neither too timid
nor too risky. Most good
therapists are cautious about
giving direct advice about a
client’s decisions, but when
they do, the advice makes good
sense, such as the classic
suggestions to “sleep on it”
before sending an angry letter
or to not make major decisions
when seriously depressed.
Prudence should be
visible in the first contacts
with the therapist and should
not flag through the course of
treatment.
-
Willingness
to use moral
language:
The
therapist is willing to engage
in moral discussion about what
is fair, right, honest, or
responsible. The
therapist appears comfortable
talking with you about your
values and your religious
beliefs and about your sense
of right and wrong. This
quality should be visible from
the first time you raise these
kinds of issues.
-
Respect
for your interpersonal
commitments and
responsibilities:
The
therapist honors your
inclinations to act
responsibly toward people you
are committed to in your life,
even when he or she is
sometimes pointing out the
destructive elements in these
relationships. Good
therapists respect their
clients’ pace for making
difficult decisions on morally
loaded decisions such as
whether to divorce a spouse or
whether to institutionalize an
ill or disable family
member.
-
Respect
for your community commitments
and responsibilities:
The
therapist honors your efforts
to contribute to your
community, even though he or
she may challenge you at times
to achieve a better balance in
your life. The therapist
focuses not only on what your
community involvement does for
you but also on what it
contributes to others.
The therapist encourages
you to talk about this part of
your life and about your
values and does not
immediately turn the
discussion back to your inner
life.
What to Be
Wary of in a Therapist
-
The
therapist discourages all use
of moral language:
A
good therapist will
distinguish between “shoulds”
that are moral in nature, such
as “I should not put my
ex-wife down in front of the
children” and those that are
based on non-moral, sometimes
oppressive standards, such as
‘I should finish any job I
start”, or “I should look like
the fashion models I see in
the magazines.” In the
latter examples, a good
therapist is likely to
challenge the meaningfulness
of the “should” and explore
where this injunction came
from in your life. In
the former case, a good
therapist will take the moral
dimension of post-divorce
parenting very seriously.
-
The
therapist is quick to urge or
support cutoffs from other
family members:
Some
therapists are quick to
suggest cutoffs from parents
when clients come to
understand the abuse they
suffered as a child. The
therapist may move too soon to
recommend that the client
write a letter stating, “You
abused me, so goodbye,”
without a full exploration of
this decision and its
consequences for all
concerned, including the
client. Often such
cutoffs include siblings who
were completely innocent but
are swept away in a
premature,
therapist-inspired
“family-ectomy”. These
therapists are like
gynecologists who perform
unnecessary hysterectomies.
I suggest asking a
prospective therapist on the
phone for his or her
philosophy about cutting off
contact with family members in
cases of abuse.
-
The
therapist sees only negatives
in your family or
spouse:
A
good therapist will
demonstrate a realistic but
caring attitude toward people
close to you. A bad
therapist will paint your
family members or partner in
negative colors only and will
interpret your defense of them
as denial. This
therapist sees others in your
life primarily in terms of
their poor treatment of you,
not as people whom you may
care for deeply, despite their
actions.
-
The
therapist always portrays you
as the victim of others, not
as someone who also can harm
others:
Some
therapists work so hard to
help abuse victims not blame
themselves for the abuse that
they lose sight of the
here-and-now ways in which the
client is hurting or taking
advantage of others. A
physically abused wife is not
responsible for her beatings,
but she is responsible for
continually telling her son
that his father is scum.
If your therapist does
not challenge behavior you
sense is harmful to others,
you are not getting good
therapy.
-
The
therapist disparages your
sense of duty towards
others:
When
you talk about how hard it is
to visit your failing mother
in the nursing home,
does the therapist ask you to
do a cost-basis analysis -
what do you get out of going,
and what does it cost you? -
without honoring the moral
obligation involved? Or
when you are struggling to
maintain your disabled child
in your home, does the
therapist continually make the
case for your own needs
without at the same time
supporting your sense of duty
to keep your child at home as
long as you can? Ditto
for community commitment:
does the therapist
suggest that you are trying to
“save the world” to avoid
dealing with your personal
problems, without
acknowledging and supporting
the moral imperative you feel
to give something back to your
community? If so, you
are seeing the wrong
therapist.
Dougherty
encourages clients to raise
“moral” issues with their
therapists with the belief that “a
caring, brave and wise therapist
will listen carefully to your
concerns and work with you to
acheive a better balance in the
therapy. Good therapists are
willing to discuss, and be
challenged about, their stance
toward moral
responsibilities.”
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