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This post was co-written with Mitchell M. Handelsman, PhD, whose blog is "The Ethical Professor" and who co-authored the book Ethics for Psychotherapists and Counselors.
On more than one occasion, we have been asked this question. Colleagues and friends know that we teach in the area of psychology or counseling, we have both been psychotherapists at one time or another in our careers, and we have some strong feelings and opinions about professional ethics for the practice. Thus, we get asked the question above in various forms, including:
• "How do I know if I've found a good therapist?"
• "How do I know if I'm working with the right person?"
• "If you were me, what would want to know during the first visit?"
• "My friend told me about their psychotherapist and I think there is some funny business going on but my friend thinks there're good. Should I work with them?"
We love these types of questions for at least two reasons: First, because it says to us that our colleague, friend, or acquaintance wants to make a good consumer choice about selecting a psychotherapist and we think that is really wise. Second, the question gives us an opportunity to share what we believe makes for a good therapeutic experience: an ethical psychotherapist. (By the way, sometimes ethical therapists do unethical things-see "Ethical Therapist: Fact or Fiction?") For us, all these questions boil down to one specific issue..."What should a prospective client look for in hiring a psychotherapist to make a good choice?"
We firmly believe that you should shop for the best therapist-interview several and see how they address your concerns. A therapist who was good for a friend of yours may not be the best one for you.
Based on our experience and reading, we have developed a list of issues or criteria for our colleagues, friends, and acquaintances to consider.
In fact, we have quite the list of "green flags" (professional behaviors and attitudes that prospective or current clients should expect from a psychotherapist) and "red flags" (professional behaviors and attitudes that prospective or current clients should take note of and either not hire the professional or strongly consider ending therapy at the next session). In this blog post we share two in each category.
Green Flags-
Advice About Alternatives. Good therapists will help clients find the best therapist, rather than talk the client or prospective client into buying only their services. This type of behavior and attitude is green all the way because it places a premium on client welfare.
Communicates about Confidentiality. Therapists who talk about issues of privacy confidentiality in the first couple of sessions are laying good groundwork for the relationship. Therapists should tell you how important it is for them not to talk about you to others. They should also mention some exceptions to confidentiality-times when the can or must share information with others (more on this in a future post!) A psychotherapist who is comfortable addressing issues of confidentiality is a good thing. We see this as a big green flag because it shows respect for you and because it may show that the therapist is taking care of business.
Red Flags-
Everybody's Everything. Sometimes therapists will convey, directly or indirectly, that they can handle every conceivable problem, often because they are such incredibly good therapists. The belief that good therapists can do anything shows a naïve and simplistic attitude toward complex phenomena (human emotions and behavior). Thus, this is red flag and we would suggest you don't hire this professional. Keep shopping!
Defensive Declarations. We've known of therapists, even worked with a couple, who feel challenged when clients ask direct questions about what's happening in a session or about what the therapist is doing. Therapists who feel uncomfortable with assertive questions, get defensive, avoid addressing your concerns, and/or communicate that their suggestions or advice cannot be questioned, may not be a good risk. When you are shopping for a psychotherapist, you should feel comfortable asking good, hard questions about the work the two of you will do, and the therapist should be able to answer them to your satisfaction. If you sense some irritation or defensiveness then we suggest you thank the person for their time and go on to the next professional on your list.
