Blogging on Good Therapy

by Noah Rubinstein, LMFT
Executive Director GoodTherapy.org

The GoodTherapy.org Team received a question today from Brit, a visitor to GT, in response to the featured article, “50 Warning Signs of Questionable Therapy & Counseling.”

Brit writes, “Should a good therapist in the beginning stages of the therapy request a historical summary of the client in order to provide good counseling? I have a friend in counseling and the therapist did not ask for historical family information. This friend comes from alcoholic family…..Should we be concerned?”

My guess is that there are many answers to this question. With so many different philosophical orientations, different approaches, and models of therapy, not to mention different generations of therapists all trained differently to some degree, the range of responses might be quite varied indeed. Some therapists spend hours gathering historical data and completing initial evaluations, others work in the here-and-now, preferring to dive in to the work on the first meeting, and others are somewhere in the middle. And of course a lot of what a therapist begins with depends on the presenting problems and the client’s needs. (more…)

by Lisa Dale Miller, LMFT

Click here to contact Lisa and/or see her GoodTherapy.org Profile

As a long term yogic and vipassana meditator, and a mindfulness-based psychotherapist who regularly teaches meditation practices to my patients, I find the growth of mindfulness as a clinical intervention very timely. Last year, I attended two conferences focused on the use of mindfulness as a clinical intervention: “Meditation and Psychotherapy” at Harvard Medical School and “Mindfulness and Psychotherapy” at UCLA.

Interestingly, the conference at Harvard featured a greater percentage of presenters who do not use meditation as an intervention in their clinical work. For them, mindfulness is a teachable skill set, extrapolated from a way of viewing life gained from sustained Buddhist meditation practices. These presenters included: Steven Hayes, founder of ACT, Lizbeth Roemer, U Mass GAD researcher and clinician, Tal Ben-Shahar, Harvard Lecturer on Positive Psychology, and Jayme Shorin, LICSW, sensorimotor trainer. The fact that the organizers of the Harvard conference felt it necessary to devote over half of the presentation time to methodologies that do not include meditation was, for me, significant.

Though this might be expected at a “Mindfulness and Psychotherapy” conference, in fact the UCLA conference featured more presenters discussing the use of meditation and compassion practices as a clinical intervention. These presenters included: Thich Nhat Hahn, Vietnamese Buddhist monk and meditation teacher, Jack Kornfield, Tara Brach, Harriett Kimble Wrye, and Trudy Goodman, all psychologists and meditation teachers, and Dr. Daniel Siegel & Harvard neuroscientist Sara Lazar presenting the neurobiology of meditation. (more…)

by Elisha Goldstein, PhD

More and more it seems like life can be so hectic. It’s as if we purposely overload ourselves with more things than we could possibly ever accomplish. Sometimes as I’m going to sleep I think about all the things I need to get done and when I’m awake during the day I think about all the things that need to get done. Take a shower, make coffee, eat breakfast, brush my teeth, go to work, etc… It’s almost as if at the end of the day I can truly ask myself, “where did the day go?” Enough of these and I can ask myself the same questions in weeks, months, or even years!

So when I feel like these questions are coming up, I do some brief exercises that help bring me to the present moment and remind myself that I’m living. (more…)

Written by Nancy Poitou, M.A., M.F.T., C.T.S 

Most of the research done on meditation has been done on Transcendental Meditation referred to as TM. I am not promoting TM over any other type of meditation, any technique is used has pretty much the same effects on health.

Research in the new field of psychoneuroimmunology show that emotional states, behavioral patterns, and mental attitudes are central issues in health and disease. A well documented relationship between the brain and body function is the neuroendocrine pathway. Stressful circumstances reduce the body’s immunologic response by suppressing disease fighting blood cells, lymphocytes with the production of cortisone-like compounds. A ten CPS (cycles per second) Alpha state induces a strong immunological system, more control over pain, blood pressure, heart rate, body temperature and even bleeding. (more…)

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.

Have you ever felt upset about something and just wanted somebody to listen to you?  I know my dear wife has asked me on a number of occasions to “just listen.”  Even I, as a therapist who helps and guides others to listen to each other day in and day out, can find it hard to relax the impulse to do something about it.  Yes, part of it is because I care.  But more of it is because it can be hard to sit with how I feel to see another suffer….  And trust me,  I intimately know the misunderstood feeling I have when someone’s anxiety gets triggered by me expressing some minor suffering I’m experiencing.  I know the feeling of wishing my uncle could just listen to me or give me a hug when he, instead, tells me what I should do, or worse, tells me some universal truth like, “It’ll get better.”  I know he’s only trying to help me and trying to shield himself from his own discomfort at seeing his nephew not perfectly ok, and I love him for it regardless.   I know this doesn’t sound like it has much to do with therapy, but I believe it does; and on a deeper level than just a therapist not solving their clients problems.   The realm of the intra-client relationship, the way one relates to his or her /inner world/ego states/parts, is where I believe the truth that solving one’s problems with a little “s” actually interferes with Solving one’s problems with a big “S,” shows itself quite profoundly.   Let me explain by telling a story:

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