Blogging on Good Therapy

Hi Folks, 

In an effort to create a document that will help consumers to be informed about how to know the differences between unhealthy and healthy therapy.  I’m asking for your wisdom.  Here are some of my questions that I’d love to have your input on:

What are the warning signs of unhealthy therapy?

How do you recommend choosing a therapist?

What should you expect from a healthy and effective therapist?

In answering these try to be unspecific about the model of therapy, these should be universals that hold trut regardless of which kind of therapy one is doing.

Thanks for your help,

Noah :)

Hi Friends,  I’m writing to clear up some confusion about Good Therapy’s position on the different models of therapy list.  Originally our intention was to limit the list to only models we could endorse as nonpathologizing, empowering, and collaborative.  This is truly a difficult task, one that requires the research funding of a large university, not the salary of a private practice therapist.  And becasue it’s not the theory that makes a model healthy and effective, but rather the therapist, we see little point in focusing our attention on evaluating models.  Sure, it makes sense for models to be evaluated, but we’re not the ones to do that.   It’s clear from my recent post on psychoanalysis that my own bias would get in the way anyhow :)   With all that said, we do reserve the right to exclude a model if it clearly conflicts with the element of good therapy, as we’ve defined them….   So, in an effort to be clear about our policy and position on the models of therapy list, I’m repeating here what we state on models of therapy page:

“The following is a list of therapies which can, if used accordingly, adhere to the spirit, philosophy, and principles of what we at GoodTherapy.org believe to be “good therapy.”  Some have been around for many years, others are relatively new.  Some have been grounded in research, others in theory, and some rely on anecdotal evidence.  Some are popularly accepted, others are cutting edge, and some controversial.  GoodTherapy.org is not in a position to endorse or disapprove any therapy models.  Our intention is to promote the use and awareness of the universal elements of good therapy which can be found across therapies.  However, we do reserve the right to exclude models which clearly conflict with the elements of good therapy.    We encourage you to explore, research, and discover for yourself which therapies may be a fit for you.  We’ve included links to other sites with information on these models so you can have any easy starting point.  We wish you the best on your journey :)

 For those searching for help, please know that even a healthy model of therapy can be used in an unhealthy way.  The therapist you choose is a very important factor in whether a therapy intended to work collaboratively and to empower actually does so.  Also, the following list is a work in progress; there are therapies not yet listed here.  As we become familiar with other approaches we will add them to this list.  Click here to suggest a model of therapy that is not on our list. ”  

Is there is a concern, problem, or issue which you treat in your therapy practice but are not finding in our list of concerns?  If so, please feel free to suggest it to us so we will consider adding it to the list.  We receive many requests to add concerns which are already listed (sometimes worded or phrased differently).  Before making your suggestions please check the list of concerns on the search page by clicking here.  You can make your suggestion by replying to this post in the reply box below. If you don’t see a reply box, Click here to make your suggestions.   Please remember that your suggestions will be viewed publicly.  Thanks for helping!  Noah :)

Is there an Element of Good Therapy that is not described in our document? If so, please feel free to suggest it to us so we will consider adding it.   You can make your suggestion by replying to this post in the reply box below.  If you don’t see a rely box, Click here to make your suggestion.   Please remember that your suggestions will be viewed publicly.  I’ll respond to you in this blog, so check back if you’re interested.  Thanks for helping!  Noah :)

Is there an approach to counseling or psychotherapy which is empowering, collaborative, and nonpathologizing, but is not in our List of Therapies?  If so, please feel free to suggest it to us (please be sure to include a link to more infomation) and we’ll consider adding it to the list.  We receive many suggestions to include therapies which are already on our list, so please confirm that your therapy is not already on our list by clicking here.   You can make your suggestion by replying to this post in the reply box below (scroll to the bottom).  If you don’t see a reply box,  click here to make your suggestion.  When you make your suggestion please include a link to a website where we can find more information.   Be aware that your suggestions will be viewed publicly.    Thanks for helping!  Noah :)

I’ve received two requests to add Psychoanalysis to our list of therapies and I thought this would be a valuable discussion topic and one that would help me to make a decision about whether or not to include Psychoanalysis in our list of therapies.  Here’s my problem:  I know this may be biased an outdated, but the association I have (no pun intended) when I think of Psychoanalysis is of a withdrawn, unresponsive, and impersonal figure providing well timed interpretations about the transference of their “patient,” who lays with the analyst sitting behind and out of view.   I’m aware that this association is based on traditional Psychoanalysis and that the model has evolved beyond its original forms, into numerous approaches such as Object Relations and Self Psychology.  Neither do I underestimate the value of psychodynamic theory and its influence in my work.  I even took part in a year long object relations training about 10 years ago.  But Psychoanalysis presents more than a theory with useful concepts about the intra-psychic world, it’s the way Psychoanalysis encourages the analyst/therapist to “Be” with the client that concerns me.
So, I remain concerned that psychoanalysis does not fit our idea of what “good” therapy is and I’d like your opinion on it.  Here is more precisely what I’m questioning:

1) Do contemporary psychoanalytic approaches hold that that behind the layers of protection, no matter how self-destructive or hurtful to others one has been, there is a loveable and vulnerable Self at the very core?

2) Do contemporary psychoanalytic approaches hold an unwavering belief that people can grow, heal, and transform?

3) Do contemporary psychoanalytic approaches tend to view people as fundamentally and irreparably flawed on some level?

4) Do contemporary psychoanalytic approaches work collaboratively by helping a client to tap into their own intuitive wisdom or do these approaches instead rely more often on the analyst providing interpretation and insight to the client about his or her problems?

5) Do contemporary psychoanalytic approaches encourage the analyst/therapist to be free in their use of Self, open to purposeful self disclosure, and to hold a kind, caring, and compassionate state of being with their clients?  Or is it encouraged that the analyst/therapist be the detached evaluator who relies solely on the working through of transference as the primary method of healing?

Please feel free to post your comments and  thanks in advance for sharing your wisdom, 

Noah :)  P.S.,  thanks to everyone who’s responded.  I just posted a lengthy comment in response to all of yours.  Click on “comments” to read.

We’re writing with some important announcements:

1, GoodTherapy.org is pleased to announce that in our first 2 weeks we have over 100 therapists advertising their practice!  Thanks for helping make GoodTherapy an instant success.  We’re excited about influencing the mental health community in a positive way and for all the people searching for help who will find your listing.   The world can sometimes feel in chaos and it’s a treat to know that many people, like you, are making the world a better place through you’re work.  It’s been nice to read your profiles and see your faces.  What a wonderful collection of people from around the world.  I wish I could meet each of you personally.

2, We’ve updated the Elements of Good Therapy document today with two important elements: “Depth” and “Sometime We Can’t Help.”   We hope that you will take a few minutes to view the elements, they’re also found here on our blog.  If the new elements don’t accord with the spirit and philosophy of your work and you would no longer like to be listed in our directory click here to let us know.  Of course, we hope that’s not the case, but we’d never expect anyone to stick with a group they don’t agree with.  I don’t think we’ll have too many more updates to the Elements of Good Therapy document, at least not for a while.

3, We’ve added about a dozen new concerns to the list of searchable concerns.  Please feel free to log back into your listing and add the concerns you address to your profile.   If and when there are more concerns added we’ll let you know.

4, We’ll be adding a handful of therapy models to our list within the next week.  Thanks to all of you who have introduced us to other ways of helping or reminded us of ways we overlooked.  It provokes awe when I see all the creative and powerful ways of helping that exist.

5,  The Good Therapy Blog is live and ready for your feedback.  Feel free to read our posts and make comments if you wish.  For those of you with your own website, feel free to leave a link to your site on our blog when you comment.  Back-links will help your site rise in the search engine rankings and be found by potential clients.

6, Lastly, we ask that you please help us grow by letting your friends and colleagues know about us.

Thanks so much,

Noah Rubinstein, LMFT and The GoodTherapy.org Team  :)
 
 

We are limited.  We greet our clients with great hope.  We have spent countless hours studying or trade, doing our own inner work, mastering our technique, and learning to “Be” with our clients.  We have parts of ourselves that want to do good work.  We are compelled to help others release burdens and cope with suffering because we know how good it feels to do so.  Yet, there are times when we can’t.  We believe a good therapist never gives up hope that a person can heal in this lifetime, but also recognizes that he or she may not be the one to help, that the time may not be right, the client not ready, and that, for whatever reason, one may never do the work we envision them doing. To do good therapy it helps to let go of expectations and outcomes for ourselves and for the people we work with; though without giving up.

Good therapy often times needs to go deep.  There seems to be a split in the mental health field between approaches that emphasize cognitive solutions and those that emphasize emotional/somatic solutions. Both are important. However, our experience is that healing takes more than insight about a problem, cognitive countering, and surface behavior change.  Rather than turning away from, countering, or compensating for our suffering, healing requires an exploration into the depth of the wounds that fuel extreme beliefs, feelings, and behaviors.  To counter and turn away from is “more of the same” and only leads to more suffering.   Also, healing requires feeling.  As it is often said, “If we can feel it, we can heal it.”  Many of our extreme beliefs, feelings, and behaviors are maintained because we have, in an effort to survive, avoided the wounds, pain, and burdens which lurk beneath.  Good therapy helps one to process and complete whatever hidden and unhidden wounds one has harbored.  Treatment without going deep can be like stitching up a wound without taking the bullet out; it’s more likely to remain sore and require ongoing attention. “Enlightenment consists not merely in the seeing of luminous shapes and visions, but in making the darkness visible. The latter procedure is more difficult and therefore, unpopular.” ~ Carl Jung