How to Tell Good Therapy from Bad Therapy
Many approaches have been taken to therapy over the years. Modern therapy as we know it began with Sigmund Freud who experimented early on with what he believed to be the talking cure. Today’s psychotherapy, however, comes in a number of forms, but the common thread lies in the communication between therapist and patient.
Dr. Noam Shpancer, professor of psychology at Otterbein University in Westerville Ohio, describes the differences in today’s therapeutic methods thusly: “The psychoanalyst will probe your unconscious; the behaviorist will rearrange your reinforcement contingencies; the cognitive therapist will challenge your irrational thoughts; the humanist will provide a safe space within which you may activate your self actualization tendency; the existentialist will encourage your find meaning in the desert of existence; the reality therapist will guide you toward choosing behaviors that facilitate your connection to others; the feminist therapist may show you how your personal problems are manifestations of political patriarchal oppression, and so forth, on and on.” However, it’s worth noting that no single form of treatment negates any other. In other words, there is no “right” or “wrong” form of treatment, objectively speaking; it depends entirely on what works best for the individual patient.
That being said, there is such a distinction as that between good and bad therapy. Just as there are many forms of therapies available there is a chance that some experiences may be successful and others less than successful. Despite this diverse array of options available, many patients will experience the most success if their treatment adheres to the basic principles which pervades all effective therapies. According to Dr. Shpancer, these principles are as follows:
5 Principles of Beneficial Therapy
1. Good Therapy is not Friendship
While it is important to build a foundation of trust between patient and therapist, therapy is not the same as establishing a friendship. The relationship between patient and professional differs from that between friends in a number of ways. Firstly, the relationships between friends can be many and varied, transcending contexts. For example, you may work with friends, see them socially, or even borrow money from them. Conversely, you will not see your therapist outside of the designated setting of your therapy. While the therapist may have a friendly demeanor, they are not friends. If they are friends, then they are not therapists.
Friendships do not normally have goals of any kind, whereas therapy relies on setting goals and meeting them. When we spend time with friends, we can do so because we simply enjoy it, not because we have anything specific that we are trying to accomplish. Therapy, however, has a purpose. It is not an end within itself.
Friendship is forged on equal grounds. Friends typically have equal standing in each encounter. You might consider your friend’s needs just as important as your own. This also goes for interests. In contrast, the relationship between the therapist and their client is one sided. Therapy is about your needs, not the therapist’s. If the therapist uses the patient’s time to discuss their own needs, then it is not good therapy.
2. Good Therapy Affirms One’s Sense of Dignity and Self-Worth
The goal of therapy should ultimately be to affirm the client’s sense of dignity and self-worth. As Dr. Shpancer describes: “Mental health, however, is not a destination, not an end in itself, not a place you arrive at, pearly-gates style, to be ushered into bliss. Rather, mental health is a process you adopt and use in the pursuit of your chosen goals.” Another way to look at this is to think of mental health as driving skill, not the destination to be arrived at. In this perspective, the therapist is the driving instructor.
While therapy can include judgments, it is not about judging the patient. The majority of people who seek therapy have been judged, often harshly, for their thoughts and feelings. Good therapists, however, provide judgment that is constructive, coupled with helpful advice, to help the healing process and offer a corrective experience. After all, patients need more than anything empathy, understanding, attention, acceptance, and encouragement. Good therapy does not patronize,condescend, lie, abuse, or cheat.
3. Good Therapy Encourages Independence and Confidence
Therapy should help the patient improve their resilience, independence, life-confidence, and decision-making. If this is not being accomplished, then good therapy is not taking place. Dr. Shpancer notes that “A good sign of therapy at the brink of failure, or of therapy that’s not legitimate, is when your dependence on the therapist increases over time.” The therapist’s job is not to solve the patient’s problems, it is to equip them with the skills they need to solve their own problems. Otherwise, the therapy isn’t effective.
4. Good Therapy Offers Support and Encourages Action
One of the primary roles of the therapist is to engage the client on multiple levels. This means involving the client’s emotion, cognition, and behavior. Therapists will often focus on understanding their patients empathetically. In doing this, a sort of alliance is established. Through this alliance we can begin to realize the inner workings of our own minds, as well as gain new perspective on our lives. This is how therapy can facilitate learning, providing us with new insights and new ways of thinking about ourselves and our relationships with others. Therapy can also show us new ways of communicating and managing our emotions. Good therapy should also focus on the client’s actions in the world: showing them how to practice new skills, and adopt new habits to improve how they function in the world around them.
5. Good Therapy Lets the Client Do Their Work
A sign that a particular therapy experience might not be working out can be seen if a therapist appears to be taking credit for the client’s work. Therapists are guiding figures, but changes and improvements in their patients are caused the by individual’s own motivation, resources, social support, and determination. Dr. Shpancer also acknowledges that “The client’s experience of the therapy also matters more than the objective measurement of therapy ingredients.” Dr. Shpancer believes that all therapy is fundamentally directed towards the self. He states: “If therapy is to work for the client, the client has to work for the therapy.” Initiation of change is not caused by the therapist, but by the client’s own willingness to change. Good therapy acknowledges this and allows the client to do their own work in addition to providing guidance and encouragement from the therapist.
Knowing the Difference Between Good and Bad Therapy
Knowing the difference between good and bad therapy can mean the difference between having an experience which is effective or ineffective. By recognizing what constitutes good therapy, clients can become more aware of when certain methods of treatment are or aren’t working for them. By acknowledging these feelings and experiences, individuals can make informed decisions and discover what treatments will best help them to become happy, functional, and at peace with their minds and lives.