We live in a world in which pharmaceutical companies have persuaded us that drugs can treat everything from anxiety to depression to post traumatic stress disorder. It is not surprising that many people have come to regard “a pill” as the be-all and end-all to life’s difficulties. In 2010, $11.6 billion U.S. was spent on antidepressants, which incidentally was only 4% of all spending on prescription medications.
As a grief therapist, I am not persuaded that the public is being well served by these pharmacological solutions to life’s problems. I believe that often, especially in mild or moderate situations of depression, anxiety, stress, grief or a host of other mental health challenges, that “talking it out” is a more effective approach. I have concerns that even “talk therapy” (psychotherapy and psychological counselling) is becoming so expensive that only the rich can afford it; but nonetheless, I remain convinced that giving people the opportunity to “put it into words”, whether in a group setting or “one on one” is an appropriate approach to helping them deal with their struggles.
So what should people look for in a good counsellor?
1. Qualifications
It is important that any counsellor has credentials, yet having said that, there is a lot of confusion out there, especially in grief counselling, as to what the standard should be. A good therapist should have a graduate degree, or at the very least, have undertaken specific education and training in the field of counselling. There are numerous people who call themselves “counsellors” or “therapists” because they have taken a weekend seminar or learned a certain therapeutic approach. But without a degree in counseling, psychology, social work, marriage and family therapy, or another related field of study, such well-intentioned people often lack the specific education, training, and skills to provide informed, safe, quality and effective psychotherapy or counseling.
I know one individual who set himself up as a “Marriage and Family Therapist” without ever having had one day of education in the field … by his own admission, he just thought it would be a lucrative job. Personally, I wouldn’t have let him counsel my CAT!! And the scary part was that no-one could do anything to stop him, as long as he didn’t claim to be “a psychologist” (a term which is regulated and licensed by the College of Psychologists.)
People without graduate-level education in a mental health field may lack the necessary skills and know-how to properly diagnose and treat issues, which is dangerous. A licensed therapist will have had many hours of training and supervision, which sets the standards bar much higher. But the problem is that many current therapies are NOT licensed or under the direction of a regulating body, so this becomes a tricky issue.
Even new counsellors fresh out of graduate school may have received excellent theory and “book-learning”, but lack enough actual counseling experience to claim expertise or feel totally confident. I see many people referred to a counsellor by an EAP, and that young counsellor has a general counselling degree but no specific training in grief counselling or in the specific area of concern. In addition, they may not have had much life experience, which clients discern quickly, feeling the person cannot really relate to their situation. Admittedly, we want that young counsellor to get to the next level, where they will have more confidence, experience and know-how, but does that help the grieving person today?
2.Personal Chemistry
I believe there is MUCH more to identifying a good counsellor than credentials. Believe it or not, it is often a matter of personal chemistry. I like to think that I get along well with many people, but there are occasions when I realize that a certain relationship simply isn’t going to work because it just isn’t a good “fit.” It happens in all areas of life.
So, I would ask you to consider, “What does it feel like for you to sit with this therapist?” Do you feel safe and comfortable? Is it easy to talk to them? Is the person down-to-earth and easy to relate to, or does he/she seem cold and emotionally detached? Is the counsellor “stuck in their head,” or “overly emotional and empathic”? Is the therapist a “know-it-all” or arrogant? How do these qualities make you feel?
If a counsellor doesn’t feel like a good fit, that’s OK; there’s absolutely no obligation requiring you to continue working with any specific counsellor, and you can ask for a referral. However, if you find yourself reacting negatively, disliking or being judgmental to EVERY counsellor you see, it’s important to consider whether you are simply avoiding facing the issues that are affecting you.
3. Interpersonal Skills
How good are the counsellor’s interpersonal skills? Effective counsellors are able to express themselves well; are astute at sensing what other people are thinking and feeling; and show warmth and acceptance, empathy, with a focus on YOU, not just talking about themselves.
In practical terms, consider this:when you talk about what you’re experiencing, does your therapist seem interested in learning more about how you feel? Can they communicate with you in language you understand? But a good therapist communicates both verbally and non-verbally Do you have a sense that this is someone you can trust? Did you know that people determine whether or not they can trust someone within 50 milliseconds of first meeting them? So, what do your inner vibes tell you when you first meet this person?
Is this someone who allows you to feel that you can have a good working relationship; that confidences will be kept and that your faith in them won’t be betrayed? It’s true that the ethical code of counsellors as well as priests/ministers includes the proviso that disclosure of illegal or dangerous intention must be reported to authorities such as the police or social service agencies. However, even this requirement should help you feel that you can trust the therapist, because you know that you and others you care about are going to be protected.
4. Sensitivity toward your cultural background
Therapists must be especially sensitive to the culture and practices of different nationalities and faith communities. This includes showing respect for your background and being aware of attitudes within your culture or community toward family relationships, religious practices, and appropriate behavior. It should go without saying that a therapist will not make offensive comments about your gender, race, ethnicity, sexual orientation, religion, or cultural background. However, it’s possible that the counsellor might simply not be aware of specific prohibitions or customs that are an important part of your life. If this happens, explain why and what this is the case. Understanding more about the traditions of your culture or religion might help them modify their views on solutions to certain issues.
5. Therapeutic Alliance
One of the most solid predictors of good therapeutic outcome is the feeling that clients are in a “partnership” with their therapists. This is known as the therapeutic alliance. Ask yourself, do you have the sense that your therapist is interested in getting you on board by establishing goals that both of you agree on and are willing to work towards?
While not every therapist would agree, I firmly believe that I should provide my clients an explanation of their symptoms and be willing to adapt this as circumstances change. People want to know WHY they are experiencing their specific symptoms. So can you understand what the therapist says about the possible contributors to your symptoms and is that explanation grounded in your own sense of who you are and why you’re feeling the way you do.
6. Inspiration, Hope and Optimism
Hope is a tremendous motivator, and confidence that that “this is going to work” is often a large part of the equation in successful treatment. I’m not talking about being artificially or unrealistically hopeful or overly optimistic, but knowing how to strike a balance between realism and hope. They should inspire you to think that you can get better; that you will make it even though it is going to be difficult. Self-confidence, self-esteem and belief in a positive outcome are crucial, because we become what we believe, good and bad.
So, does your counsellor encourage “dependence” or “independence?” Good therapy doesn’t solve your problems; it helps you to resolve your own issues. Likewise, good therapy doesn’t soothe your overwhelming feelings, but rather helps you learn to calm your own fears and emotions.
Therapy is most powerful when, like the old proverb, it helps people to learn to fish for themselves rather than rely on someone else to feed them. If your counsellor provides emotional support without also encouraging you to access your own resources, it is more likely you will become dependent on them to help you feel better, rather than learning to depend on yourself, which is, after all the most effective therapy.