Episode 12: Is Your Therapist Any Good? How Do You Know?

MichaelTherapyLeave a Comment

What is the frame in psychotherapy and why do we need to keep it from breaking? This week I discuss the importance of boundaries and guidelines set forth by Robert Langs, MD regarding how to know when your relationship with your therapist is healthy – and when it is not. I also talk about the concepts of transference and countertransference in psychotherapy.




Notes From This Episode

Download a Word doc on Lang’s guidelines for psychotherapy.

Go to the webpage for the European Society for Communicative Psychotherapy where you can learn more about Robert Langs’ work.

Here’s a good site, called Good Therapy for locating a psychotherapist

Guidelines for Psychotherapy

From the book: Rating your Psychotherapist
Author: Robert Langs, M.D.

1) Ideal conditions which constitute the "frame"

  • A single, set fee
  • A single, set location
  • A set time and length of the session
  • A soundproof office (or noise machine)
  • Relative anonymity of the therapist (no self-revelations or opinions, focus should be on the patient)
  • Total privacy
  • Total confidentiality

2) Referrals

Good:

  • Local Medical Society, Mental Health Association, or other professional organization
  • Recommendation from a friend who is a psychiatrist, psychologist or social worker or other mental health worker
  • Employer, principal or lawyer recommendation

Bad:

  • A co-worker, social acquaintance, or relative sees or used to see him/her and says he/she is good
  • Therapist is the wife/husband of one of your friends
  • Therapist is a friend or used to be a friend of the family


3) Your first interaction with the therapist

Good:

  • He/she was concerned and listening
  • Said nothing of a personal nature
  • No physical contact except for an initial or concluding handshake
  • At the end of the meeting the therapist set the ground rules for treatment

Bad:

  • He was very physically demonstrative, that is, hugging or holding your hand
  • He/she came on to you sexually
  • Was unprofessional and self revealing
  • Talked more than you did

4) The fee and Schedule:

Good:

  • Set a single, reasonable, fixed fee
  • Won't let you build up debt
  • Won't accept gifts or other forms of compensation beyond the fee
  • Arranged a definite schedule for therapy (day, time, length and frequency) and these have not changed throughout the course of therapy (except when necessitated by work or life circumstances)


Bad:

  • He/she is willing to falsify a fee to an insurance company
  • He/she negotiated a barter arrangement
  • There are repeated changes in time/location/day, length of sessions
  • Sessions start late because other patients stayed late
  • He/she lets you stay longer than the scheduled time

5) Treatment:

Good:

  • Treatment types vary a great deal (cognitive, behavioral, humanistic, etc.): but in all cases: Does it make sense to you?
  • Does it feel okay?
  • It should always remain a professional relationship
  • In general, the therapist should let you do most of the talking

Bad:

  • Therapist keeps directing you to talk about particular issues (your marriage, your sex life, etc.
  • He/she frequently tells you what they think you should be doing with your life ("If I were you I would…)
  • The therapist is hostile, makes you feel guilty, or is seductive

6) Termination:

Good:

  • You felt like a sense of new insight and understanding had been reached and your symptoms had largely (though probably not completely) been resolved
  • It seemed like the right time to end therapy
  • A specific date was set and adhered to (didn't happen in an unplanned way)
  • All the ground rules mentioned previously had been maintained up until the end
  • Once therapy was over you had no further contact with the therapist

Bad:

  • You decide impulsively to stop therapy and your therapist accepts this without encouraging you to consider your decision
  • Therapist badgers you to continue despite your feeling that it is time to stop. He/she insists that you still need help

Resources for this episode

Read Robert Lang’s book on psychotherapy on Amazon.


Related Posts Plugin for WordPress, Blogger...

Leave a Reply

Your email address will not be published. Required fields are marked *