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.”