GoodTherapy.org Considers Viability of Advocating for State Licensing Boards to Require Therapists to Undergo Personal Therapy

GoodTherapy.org was born out of the desire to reduce harm to consumers of therapy. The more training, consultation, and personal work therapists do, the less likely clients will suffer an abuse of power or a boundary crossing. Although there are many healthy and conscious therapists providing safe and ethical psychotherapy services, there unfortunately remains a large number of therapists who unknowingly cause harm to their clients, often as a result of the therapist getting their own emotional needs met at the expense of a client.

In the short 2.5 years GoodTherapy.org has been present on the web our association has made great strides in advocating for healthy therapy and reducing harm. By providing a wealth of information to the public about psychotherapy and making the process of psychotherapy less mysterious to non-professionals, we’ve helped millions of people to become better equipped to start therapy and to evaluate the quality of therapy they are already receiving. So, we’ve made a dent and we’re happy about. Yet, there’s more our organization wants to do.

One very large issue we’re considering tackling is the quality of state licensing requirements. Although in recent years we have seen most State Licensing Boards increase and improve the quantity and quality of specific licensing requirements across most professions, one thing that has been entirely absent in licensing requirements, to our knowledge, is the expectation that therapists do their own therapy. The one exception to this is the State of California, which encourages trainees to do their own therapy by allowing every hour of therapy to count toward three units of required supervision. However, it is still possible for a therapist in the United States to be licensed and in practice without ever having been a therapy client. This is something we’d like to see change. We know from experience that many of the best therapists are good at what they do because they have tended their own wounds, overcome their own obstacles, and learned a lot about what it takes to provide healthy therapy from their own experience being a client.

Although this is potentially a controversial issue bound to upset some therapists who don’t want another licensing requirement or expense, a tremendous 87% of members surveyed in our last poll supported such a change. Nonetheless, we recognize that there are some potential pitfalls and concerns, such as confidentiality, documentation processes, and issues related to free-will, autonomy, and the right to refuse services. All of these issues and others need to be addressed before taking such a petition to the State level. This is where we need your help. There are two ways you could help GoodTherapy.org begin to consider taking action toward such a change. First, please consider taking a few minutes to let us know your thoughts by leaving a comment to this blog post. Second, let us know if you’re interested in more information and applying to serve on the board we’ll be forming to research the viability for this potential change.

Thanks again to all of you who have expressed your support for this movement and to those of you who have raised objections. We hope you will join us in improving the quality of services across mental health professions and reducing the potential for harm.

Noah Rubinstein, LMFT
Founder and CEO

https://www.GoodTherapy.org

© Copyright 2009 by By Noah Rubinstein, LMFT, LMHC, therapist in Olympia, Washington. All Rights Reserved. Permission to publish granted to GoodTherapy.org.

  • 37 comments
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  • Jerry Pen

    Jerry Pen

    July 31st, 2009 at 3:05 PM

    Way to go Good Therapy!!! Count me in 100%

  • Allene Kennedy

    Allene Kennedy

    July 31st, 2009 at 3:10 PM

    Brilliant idea. Why no other organization has not already pushed for this change I have no idea.. Keep up the good work guys!

  • Maggie

    Maggie

    August 1st, 2009 at 2:55 AM

    Like every other profession out there it is always going to be a challenge to make sure that all who are a part of that are 100% on board with patient needs, and not necessraily their own, but this is a fantastic first step. Thanks so much for your efforts as we all work to keep therapy credible and reliable for all of our patients.

  • Fletcher

    Fletcher

    August 1st, 2009 at 3:33 PM

    My congratulations on your keenness to step up to the plate on this issue. I agree with the sentiment entirely and hope you gather much support. This has been overlooked for far too long as a state licensing requirement.

  • FrancisW.

    FrancisW.

    August 1st, 2009 at 4:36 PM

    I cannot see any reason a therapist would oppose this unless they were scared of having therapy themselves. How ironic that would be!

  • Laura

    Laura

    August 1st, 2009 at 5:22 PM

    As a consumer of therapy, I generally of course agree with the principle that therapists should not be getting their own needs met (other than, basically, a living and satisfaction in jobs well done, etc) in therapy.

    I would think that confidentiality and documentation processes would be the biggest practical hurdles to this step as a way to achieve that goal, however, and I’m sure you’re aware of the problems. In some cases you’d be asking students to get therapy in small communities where their professional evaluators, teachers, and colleagues are their only reasonable option. I know in small communities dual relationships are (every once in a while) unavoidable, but this requirement seems to double or treble the complexity of an already difficult-to-balance context.

  • LaScala

    LaScala

    August 1st, 2009 at 5:33 PM

    You have nothing to fear but fear itself, therapists. Isn’t that what you would say to your patients? Try it sometime and be men and women of your words.

    This would be a great initiative. Good luck!

  • Julian

    Julian

    August 2nd, 2009 at 10:20 AM

    I too would be a little wary of someone who will not be willing to practice what they preach. Great initiative.

  • Teach

    Teach

    August 2nd, 2009 at 3:03 PM

    Laura I see your point and the same thing could be said for any therapist that practices outwith bustling cities in rural communities. Those therapists that work in such small communities had to be licensed just the same as their city dwelling counterparts. Each will have to take whatever steps are required to comply.

  • Craig H.

    Craig H.

    August 2nd, 2009 at 3:11 PM

    The cons of bureaucratic red tape doesn’t outweigh the benefits. Every intelligent idea that challenges the norm has small beginnings and obstacles to think about. Rome wasn’t built in a day. Go for it, Good Therapy! Get your place in the history books.

  • Kimberly Moffit

    Kimberly Moffit

    August 2nd, 2009 at 3:28 PM

    Hi there!

    I am so happy that somebody has started a website about this. I am a psychotherapist in Toronto – where in Ontario we are having problems with therapists who are unlicensed. I will keep following – great work! Thanks and have a great day!

    Kim

  • soldy

    soldy

    August 2nd, 2009 at 4:11 PM

    Why would a therapist not want to experience therapy from the client side? And I thought empathy was a personality trait good therapists had. Self-exploration just doesn’t cut it in this situation. That’s too easy an escape route.

  • Wanderer

    Wanderer

    August 2nd, 2009 at 4:49 PM

    Never doubt that a small group of concerned citizens can change the world. Indeed it’s the only thing that ever has. – Margaret Mead

    Make that leap from considering to doing Good Therapy.

  • John

    John

    August 2nd, 2009 at 4:50 PM

    I really like your blog and i respect your work on this issue.

  • Sugarlove

    Sugarlove

    August 2nd, 2009 at 5:10 PM

    Congratulations on bringing this up. No therapist has or can claim to have attained perfection. Any that are so arrogant that they think they are beyond learning about themselves should have made an appointment yesterday! I think this is a fantastic idea and will find more support than not.

  • Elizabeth R.

    Elizabeth R.

    August 2nd, 2009 at 5:40 PM

    I second that emotion Wanderer.

    I don’t understand any therapist’s reluctance to work with a fellow professional. Has it to do with being afraid of what the competition would see in them? It makes you wonder. Keep up the good work, Good Therapy!

  • Caroline

    Caroline

    August 3rd, 2009 at 8:54 AM

    Not to be devil’s advocate here but what if a therapist in training really does not need treatment at all? I know that it is a good idea to see how others practice but it seems like it might be a better idea just to have them do more clinical or internship hours. Just a thought.

  • Betsy Davenport, PhD

    Betsy Davenport, PhD

    August 3rd, 2009 at 1:25 PM

    Many years ago I did a local survey about this very thing. I sent a questionnaire by US Mail to every relevant clinician in my area. My return rate was disappointing, but considered high for return rates in general.

    As I recall, there was a large minority of clinicians who had not been in therapy. This disturbed me, and though I never pursued the matter in other areas, to see if there were similarities or not, I do wonder how common it already is for therapists to undergo therapy.

    I think it’s a have-to. The percentage (of respondents, so it might have been drastically skewed — maybe most nonrespondents had not been in therapy — who had not been in therapy was about the same across disciplines.

    I suppose there will be some trouble over what therapists qualify as therapists-to-therapists?

  • Anne Ream

    Anne Ream

    August 3rd, 2009 at 2:29 PM

    I completely support this idea. Denial is present in all people, including therapists. It is vital for therapists to have enough, good therapy to begin to get under their denial of their own issues. Without the recognition and understanding of their own issues there is danger that they will do much more harm than good. A healthy degree of humility is present in a good enough therapist.

  • Mary V. Shull

    Mary V. Shull

    August 3rd, 2009 at 6:19 PM

    It’s about time! I agree with requiring therapists to undergo their own therapy and I think that only improves the quality of therapy we offer our clients.

  • Tina Gilbertson

    Tina Gilbertson

    August 3rd, 2009 at 7:34 PM

    I might have missed an important distinction that’s already been made, and if so, I apologize.
    In case it hasn’t already been made, I would like to do so.
    I am strongly in favor of requiring EXPERIENCE as a client for all therapists seeking licensure. I can’t imagine trying to do this work without it.
    For the reasons cited by others here and many more, I’m not in favor of *requiring* ongoing personal therapy for licensed therapists.
    Encouraging, yes. Requiring, no.
    How about making sure all accredited graduate programs require experience as a client to graduate? That way licensing boards can be sure that master’s degree holders meet the requirement of having experience as a client without having the burden of policing that experience.

  • Marjorie Demshock, MS, LMHC

    Marjorie Demshock, MS, LMHC

    August 3rd, 2009 at 7:53 PM

    While I think it is an excellent idea for all psychotherapists to experience their own therapy and make use of counseling as needed, I don’t think it practical to make it part of the licensing requirements in each state for several reasons.

    First, there is the privacy issue. I don’t think governments have the right to know the personal issues and care people receive for their problems.

    Two, how far back should the mental health practitioner have received counseling and for what issues? And what information would be furnished about the practitioner’s participation in therapy?

    Third, you mentioned that hours in therapy could be counted toward supervision requirements. While complementary, supervision and counseling are two distinct disciplines. Counseling is there to help the client deal with his or her personal issues while supervision typically focuses on the needs/issues of the counselor’s clients and the counseling process that occurs. Merging the two can result in boundary issues.

    As a counselor educator, I encourage my students to seek out their own counseling as needed when issues surface due to the material uncovered in class, through readings and projects, as well as internship experiences working with clients. Therefore, the counseling requirement is best promoted by graduate programs in counseling, psychology, and social work, rather than state licensing boards.

  • Joan

    Joan

    August 3rd, 2009 at 8:09 PM

    I thought this was one area where people understood issues and people clearly. Obviously therapists are still regular people needing guidance every once in a while. I do agree that a healthy degree of humility as Anne said doesnt singe the ego in any way possible.

  • Gina Troisi

    Gina Troisi

    August 3rd, 2009 at 10:50 PM

    I support GT’s plan to begin to tackle this issue. I remember intense debates about his in graduate school – over 20 years ago. I’ve always felt strongly that for power reasons alone (never mind the other very good reasons), no one should be a therapist without having been a client. I’ve also always said that the two most important ways to learn to be a therapist is/was my own therapy experiences and supervision.
    Yes, there’s a lot to be sorted out about how this might ever become a requirement, but it’s a valuable discussion, there’s no time pressure, and we never know where a great idea or novel solution will come from–and it’s less likely to come if there’s no meaningful debate to engage in.
    Thanks for moving the dialogue forward.

  • Crystal

    Crystal

    August 4th, 2009 at 5:45 AM

    As a therapist who has worked with many clients who have been harmed, and in some cases abused, by other
    therapists I firmly believe that this issue needs to be raised on across all therapy and counseling graduate programs and licensing boards. Way to go, Good Therapy!

  • Dennis Friedel, LPC

    Dennis Friedel, LPC

    August 4th, 2009 at 9:13 AM

    I have met several counselors who are actually afraid of entering counseling themselves. They should not have been licensed by the State of Texas, in my opinion.

  • Self Kindness

    Self Kindness

    August 4th, 2009 at 11:52 AM

    Dear GT crew,

    My initial reactions to thought of approaching State Licensing Boards regarding required therapy for therapists for licensure…

    1] Anyone when mandated brings inauthenticity and resistance to sessions
    2] What is considered treatment varies depending on the therapist’s approach.

    As a neophyte therapist an observation I have been making as Supervisee is regarding what is socialized as “norm” in human behavior. Is treatment to bring someone to that “norm” – or is it something entirely different where all or most of what a therapist might have learned as high functioning could be a mask. So, there is much unlearning that goes on for several years in training it seems to me to become increasingly human and present with a client, and self as client.

    I am reading Dr. Herman’s book on trauma and the topic of contagion is right on so far with what I have been noticing about why many therapists are reluctant to show more of themselves in a complex system of regulations, and compliance. It is sometimes confusing where human rights lie, and therapists feel abused by the system. With too much identity as client one risks one’s credibility! So this is a subject of overall overhaul in the field about that is therapy, it seems to me.

    Finally, the line between good therapy and goody goody therapy is fine it seems like, where inherent competition can get setup as to who is the better therapist.

    That said, I am watching, exploring, and learning what I am able in this massive and beautiful profession.

    Thanks for putting out this correct and brave thought.

    Incidentally I do ambitiously try to be in therapy as I train, the balance of how much to process and how much to function is tricky. It has been really helpful for me in working on vicarious trauma… new experiences of trauma I feel by hearing so much suffering from clients. It has been really valuable to me to be client.

  • Joe Mc Donnell

    Joe Mc Donnell

    August 5th, 2009 at 7:12 AM

    It might be a pain to implement, but I wouldn’t mind seeing a two tiered qualifying system distinguishing those who have, from those who have not done their own therapeutic work.

    Thus we all have a choice, but there is a price that some have paid, and the others have an incentive to pay. This could be deliberately delineated on Goodtherapy.org…you know: Goodtherapy and Mabeyoktherapy.

  • Lacey

    Lacey

    August 6th, 2009 at 9:06 AM

    Joe’s idea is excellent. The transparency is there then for the consumer to make an informed choice. Couple that with Tina’s comment about “being in favor of requiring EXPERIENCE as a client for all therapists seeking licensure” as opposed to having to undergo continual therapy and you’re well on your way.

  • Murray S. Kaufman

    Murray S. Kaufman

    August 7th, 2009 at 7:31 AM

    I am very happy to see this issue raised. It has been my long standing belief that personal therapy should be required of all licensees. I
    feel this way for three main reasons: Our own issues must be dealt with first, so that we can
    be much more present with a client, 2) The listing for disciplinary actions by the BBS Disciplinary Board seems to keep getting longer, and 3.My own therapy also served me as some of the best training
    in becoming a “Good” therapist.

  • Betsy Davenport, PhD

    Betsy Davenport, PhD

    August 7th, 2009 at 12:56 PM

    To mandate therapy is an odd thing – though the psychoanalytic schools have always done it – and results could not be guaranteed. I know more than a few therapists who have had lots of therapy yet are still practicing in ways I consider less than fully ethical or even therapeutic.

    Licensure itself is no guarantee of the things we wish to be able to guarantee. There are certified teachers we would not like our children to encounter, and uncertified teachers we would.

    Ongoing efforts to educate people about what they can legitimately expect from a therapist are definitely worthwhile.

  • Tina

    Tina

    August 7th, 2009 at 5:12 PM

    Hear, hear! Betsy makes a very good point. Client education gets to the root of what we’re trying to accomplish, which is the protection of clients from therapists whose need for personal counseling may exceed their talent in providing it.
    Goodtherapy.org already offers well-written advice to potential clients, and I’m sure that even more can be done with the cooperation and efforts of state licensing boards.
    Such education would be easier and less ethically ambiguous than policing mandated personal counseling.
    (I’m still in favor of accredited counseling training programs requiring experience as a client as part of comprehensive training.)

  • Liz Zoob, LICSW

    Liz Zoob, LICSW

    August 7th, 2009 at 6:24 PM

    While I agree that unwillingness on the part of a therapist to sit in the client’s chair raises serious questions, there is no guarantee that being in therapy necessarily addresses longstanding characterological issues. So to me as a requirememnt this is of limited value.

    Also, I fear a requirement could become a slippery slope towards intrusiveness into a clinician’s personal life: whe of therapy was it? And who decides if it was a “successful” therapy?

    On another unrelated note, I want to mention that this is an entirely public blog, and people should be aware that any post they write here can be read by anyone Googling a specific therapist by name, or therapy in general.

  • Dr. Notary

    Dr. Notary

    August 8th, 2009 at 7:53 AM

    I agree client education is very important. Finding those who need the information would be a challenge if they are not already undergoing treatment. The stigma related to discussing mental health issues is unfortunately alive and well.

    How can you educate clients when they want to keep their condition in the dark or haven’t yet been diagnosed officially? Ideally they would have that information to hand before selecting a therapist.

    Keep up the good work, Good Therapy!

  • Lynn Somerstein, PhD, RYT,  LP

    Lynn Somerstein, PhD, RYT, LP

    August 9th, 2009 at 3:44 PM

    All therapists need to be analyzed as part of their training. It’s vital.
    How can you understand someone else without a deep understanding of the self? How else can you have any hope of a shred of objectivity? How can you see your influence on the interaction between yourself and other people without that vital information?

  • Peg Beehan, LCSW

    Peg Beehan, LCSW

    August 18th, 2009 at 7:17 PM

    While I have used therapy and advocate all therapists doing so, I DO NOT support goodtherapy.org taking this to numerous licensing boards in 50 states.

  • VictoriaL

    VictoriaL

    August 18th, 2009 at 8:34 PM

    Hi Peg. Nice to meet you. Would you be open to elaborating on what your objections are please? I have been following this discussion and want to hear all sides before deciding whether to support this or not. Thank you.

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