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Therapy

How to Tell When Therapy Is Safe and Effective

Here's what you really need to know before seeing a therapist.

Key points

  • Good therapy makes the client feel safe while also providing them with fresh insights about themselves and their behavior.
  • Having a clear checklist of what to expect and red flags that therapy isn't working can help people avoid bad therapy experiences.
  • A good therapy session will leave the client with new skills, new ideas, new desired behaviors to practice, and greater self-confidence.
 Christina Morillo/Pexels
Source: Christina Morillo/Pexels

“If you wanted to see a psychotherapist, what would you be looking for?” I asked a friend. She thought for a moment and then said, “Someone who knows what they are doing, someone safe that I can trust.”

Without realizing it, she had echoed almost exactly what the Professional Standards Authority (PSA) sets out to ensure. The PSA is an independent body overseen by the UK Parliament, which aims to “protect the public by improving the regulation and registration of people who work in health and care” so that clients can “feel confident that the person you see is competent and trustworthy.”

The Human Givens Institute’s register of qualified therapists is accredited by the PSA, which means that we have met their standards in areas such as governance, education and training, information giving, and complaints handling. But what the PSA does not look at is effectiveness. To me, that seems strange. While safety and good complaint procedures are key, surely it is just as important to know whether the therapy you are considering will actually work.

At a PSA seminar that I attended a few years ago, I took the opportunity to ask its then-chair, George Jenkins OBE, why assessing effectiveness was not part and parcel of the accreditation process. He said that agreeing on what constitutes effectiveness would be difficult. I was rather nonplussed.

One woman's bad experience with therapy

The memory of this encounter came back to me recently when I happened to meet a woman who told me her distressing story. Jennifer had been allocated free therapy through a charity that arranged it for people in her profession who had fallen upon difficult times. She had had a bullying boss, suffered a crisis of confidence which had led to low self-esteem and poor work, lost her job, and was struggling to get back on track. Although she had never had therapy before and didn’t know what to expect, she was still rather surprised when the therapist insisted in the first session that she create a timeline of all trauma she had ever experienced in her life.

Reluctantly, she told her that she had been sexually assaulted as a child, that her twin brother had committed suicide 10 years previously at the age of 25, and that she had recently lost her mother.

With just minutes to go before the end of the second session, the therapist led Jennifer through a graphic reconstruction of how she had found her brother hanging, asking for minute details, and then ended the session abruptly because time was up. After a few more uncomfortable and confusing sessions that left her feeling worse, not better, Jennifer contacted the charity, which said she needed to address any complaint to the therapist’s professional body.

The therapist was a member of a major professional counseling association accredited by the PSA—but Jennifer felt her mental health was now too frail to withstand taking out a formal complaint. So she dropped the matter. It took her two years out of work before she dared seek help again. Thus, when therapy is downright harmful like this, even with excellent safety procedures in place, a client still may not be protected.

It is significant, perhaps, that Jennifer didn’t know what to expect from therapy and, therefore, her discomfort didn’t ring immediate alarm bells. It was to help clients in this very situation that the Human Givens Institute published a full and open checklist, which spells out how you can tell if you’ve found an effective therapist or counselor.

Effective psychotherapists or counselors will build rapport speedily with distressed people—and that means treating them respectfully and caring about what they are and aren’t yet ready to disclose. Effective therapists know that conditions such as depression, trauma and anxiety, phobias, and OCD can usually be overcome or managed quickly—and how to do it in as few sessions as possible.

They will be prepared to give advice if needed or asked for, will not use jargon or "psychobabble" or say that counseling or psychotherapy has to be "painful"; they will not dwell unduly on the past and, while being supportive when difficult feelings emerge, will not encourage people to remain in distress but give them skills and new perspectives and understandings that enable them to move on.

Clients should feel better from the very first session.

Effective therapists are ready to assist people in developing any life skills that are lacking, such as social or assertiveness skills or the ability to calm themselves quickly, so that crucial emotional needs for affection, friendship, pleasure, intimacy, connection to the wider community, etc., can be better fulfilled. They will help people draw and build on their own, often unrecognized, qualities and resources, which are almost always greater than they think.

They do all this using a wide range of tried-and-tested techniques, increasing clients’ self-confidence and independence every step of the way and ensuring that they feel better after every consultation—leaving with new skills, new ideas to think about, new desired behaviors to practice, and, most especially, empowered with the belief that things are going to be different.

In a highly positive move, the PSA is at last asking, in a current consultation, whether evidence of effectiveness should be taken into account in their accreditation decisions.

To find a therapist, visit the Psychology Today Therapy Directory.

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