Psychotherapy is a unique relationship, a kind of connection that is unlike any other kind of relationship a person has in their life. In some ways, it can be more intimate than our most intimate relationships, but it also paradoxically values a vestige of professional distance between therapist and client.
Therapists, alas, are just as human as the clients they see and come with the same human foibles. They have bad habits, as we all do, but some of those habits have the very real potential of interfering with the psychotherapy process and the unique psychotherapy relationship.
So without further ado, here are twelve things you wish your therapist didn’t do — some of which may actually harm the psychotherapeutic relationship.
1. Showing up late for the appointment.
Therapists will usually charge a client for an appointment if they fail to cancel it with less than 24 hours notice. Yet some therapists seem perfectly oblivious to the clock when it comes to showing up on time for appointments. While the occasional lateness may be excused, some therapists seem to be living in another time zone altogether and consistently show up late for their appointments with their clients — anywhere from 5 minutes to even two hours! Chronic lateness is often symptomatic of poor time management skills.
2. Eating in front of the client.
Unless you have enough for everyone, eating and drinking during a psychotherapy appointment is considered ill-mannered. Some therapists offer clients the same access to coffee or water that they themselves enjoy. (If you’re going to drink something in front of a client, make sure you offer your client the same.) Eating while in session — by client or therapist — is never appropriate (it’s therapy, not mealtime). And asking, “Do you mind if I finish my lunch while we get started?” is inappropriate — clients don’t always feel comfortable enough with expressing their true feelings.
3. Yawning or sleeping during session.
Yes, believe it or not, there are therapists who fall asleep during session. And while an occasional yawn is a normal component of our daily functioning, non-stop yawning is usually only interpreted one way by a client — they are boring the therapist. Therapists need to get a good night’s sleep every night, or else they cannot be effective in their job (which requires constant and consistent attention and concentration).
4. Inappropriate disclosures.
Inappropriate disclosures refer to the therapist sharing a bit too much about their own personal difficulties or life. Most therapists are warned about doing too much disclosure in session with their clients, because it’s the client’s therapy, not the therapist’s. Therapists shouldn’t plan their vacations while in session, go on endlessly about their graduate school training or research topics (especially if they were focused on rats), or share how much they enjoy their summer house on the Cape. Therapists should keep personal disclosures limited (even when the client asks).
5. Being impossible to reach by phone or email.
In our ever-more connected world, a therapist who doesn’t return phone calls or an email about an upcoming appointment or insurance question stands out like a sore thumb. While no client expects 24/7 connectivity to their therapist (although some might like it), they do expect timely return calls (or emails if the therapist allows that modality of contact). Waiting a week for a return phone call is simply unprofessional and unacceptable in virtually any profession, including psychotherapy.
6. Distracted by a phone, cell phone, computer or pet.
Therapists will often ask their clients to silence their cell phone before entering session. The policy has to go both ways, or it shows disrespect to the client and their time in session. Therapists should virtually never accept any phone calls while in session (except for true emergencies), and they should turn away from any other distractions, such as a computer screen. In a world that increasingly values inattention and multi-tasking, clients seek refuge from such distractions in the psychotherapist’s office.
7. Expressing racial, sexual, musical, lifestyle and religious preferences.
Although an extension of the “too much disclosure” bad habit, this one deserves its own special mention. Clients generally don’t want to hear about a therapist’s personal preferences when it comes to their sexuality, race, religion or lifestyle. Unless the psychotherapy is specifically targeting one of these areas, these types of disclosures are usually best left alone. While it might be fine to mention something in passing (as long as it’s not offensive), a therapist who spends an entire session discussing favorite musicians or love of a particular religious passage is not likely helping their client.
8. Bringing your pet to the psychotherapy session.
Unless cleared and okayed ahead of time, therapists should not bring their pets to the office. While sometimes therapists see clients in a home office, pets should stay out of the office while they are in session. To the client, a psychotherapy session is a refuge and a place of peace and healing — pets can disturb that peacefulness and calm. Pets are generally not an appropriate part of psychotherapy.
9. Hugging and physical contact.
Physical contact between client and therapist must always be expressly spelled out and okayed by both parties ahead of time. Yes, that includes hugging. Some clients are disturbed by such touching or hugging, and want no part of it (even if it’s something a therapist might typically do). Both therapists and clients should always check ahead of time with the other before attempting any type of physical contact, and respect the other person’s wishes. At no time is a sexual relationship or sexual touching appropriate in the psychotherapy relationship.
10. Inappropriate displays of wealth or dress.
Psychotherapists are first and foremost professionals, and any displays of wealth and style should be discarded in exchange for dressing in an appropriate and modest style. A therapist slathered in expensive jewelry is a put-off to most clients, as are blouses or dresses that show too much skin or cleavage. Too casual of dress can also be a problem. Jeans may suggest too casual an approach to a professional service that the client is paying for.
11. Clock watching.
Nobody likes to feel they are boring to another person. Unfortunately the therapist who hasn’t learned how to tell the time without checking the clock every five minutes is going to be noticed by the client. Most experienced therapists have a good sense of how long a session has gone without having to look at a clock until late in the session. But some therapists seem obsessively compulsive about making note of the time, and the client notices (and internally, they may tell themselves what they’re saying isn’t really important to the therapist).
12. Excessive note-taking.
Progress notes are a standard part of psychotherapy. Many therapists do not take notes during a session because it can be distracting to the process of psychotherapy. They instead rely on their memory to cover the highlights of the session after the session has ended. Some therapists, however, believe they must capture every detail of every session in their notes, and obsessively note-take during sessions. Such constant note-taking is a distraction for most clients, and some may find that the therapist uses the behavior to keep an emotional distance from the client. If note-taking is done during session, it should be done sparingly and discreetly.
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shared http://psychcentral.com/blog/archives/2010/01/26/10-ways-to-find-a-good-therapist/
When we want to improve our bodies we pretty much know where to find help. This time of year the gyms are full and the meeting rooms at Weight Watchers are packed. But what do we do when we want to improve our inner selves, our relationships, or want to find help with depression or anxiety?
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shared http://vista.engines4ed.org/nutrition/docs/NA_ConfidentialityFAQ.htm
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shared http://psychcentral.com/blog/archives/2010/01/26/10-ways-to-find-a-good-therapist/
10 Ways to Find a Good Therapist
When we want to improve our bodies we pretty much know where to find help. This time of year the gyms are full and the meeting rooms at Weight Watchers are packed. But what do we do when we want to improve our inner selves, our relationships, or want to find help with depression or anxiety?
Making the decision to find help is hard enough. Why should you have to get even more stressed out hunting for the right therapist? It’s like searching for a needle in a haystack unless you have some guidance. So here are a few tips:
1. Forget the yellow pages. A yellow pages listing is expensive so a lot of good people aren’t there. I’m not. Plus there is no oversight or regulation of who can list.
2. Ask a professional you already work with and trust. Your accountant, lawyer, dentist, physician – any professional you have a relationship with who honors your confidentiality is a good resource. These people all run businesses as well as provide services, as do many psychotherapists in private practice. They are well connected in the community and refer to each other all the time.
By the way, when asking anyone for a referral to a mental health therapist you do not have to go into the details of why you’re looking for a someone unless you want to. It’s enough just to say, “I’m having some problems and I’d like to consult a therapist about it. Do you recommend anyone?”
3. Ask friends or family members if they can recommend someone. Usually the first source people reach out to. Just be sure they will be supportive and not intrusive.
4. Use a known therapist as a resource. If you have a friend or a friend’s friend who is a therapist, ask them for a referral. Therapists refer to one another all the time. They will understand that you don’t want to see them (for whatever reason, you don’t have to say) but you want a recommendation from them. In other words, even if it doesn’t feel right going to your sister’s therapist, if your sister really likes her therapist he or she could probably give you a couple of names of good, qualified therapists in the community.
5. Use resources at work. Many places of employment have what’s called anEmployee Assistance Program (EAP). These services might be in-house or out-sourced but the purpose of EAPs is to provide emotional support and counseling for employees in complete privacy and as part of the employee’s benefit package. EAPs are often part of the Human Resource department so ask there if your company has an EAP and how to access it. Usually you would see a counselor at the EAP for a set number of sessions (no charge to you) and if you want to continue they will refer you to a therapist in the community who will take your insurance.
6. Schools and Universities are resources. Your child’s school is likely to have a school counselor or nurse and that person knows therapists in your district to refer you or your child to, if that is what’s needed. Universities and colleges are investing more and more in their campus mental health services. Counseling Centers (often part of Health Services under the Student Affairs department) on campus have qualified psychologists and social workers on stand-by to help with a wide range of situations for current students. Like EAPs, if you need longer term services beyond what they can provide they will see to it that you are linked properly for your continuity of care. As an alum or faculty you should be able to access the counseling center as a resource for a referral.
7. Use your insurance company. You may be lucky and have an insurance company with a truly helpful customer service department. If they do their job right, they should be able to suggest therapists who participate on their panel (which means they have been vetted from here to eternity for all the right professional credentials) and who specialize in what you need.
8. Use the Internet. The difference between the web and the yellow pages is that, for the therapist, listing on reliable websites is not nearly as expensive AND reliable sites require a minimum of professional qualifications to be listed.Psychology Today (PT) probably has one of the more comprehensive listings in the US. They contract with other trustworthy sites like WebMD and this websiteto provide their list to their readers. A therapist cannot be listed on PT unless they can prove they have a legitimate advanced degree in their discipline and an up to date professional license or certification.
A good listing on PT provides you with information regarding the professional’s qualifications, what areas of expertise they may have, how long they’ve been in practice. They should also have practical stuff posted like phone numbers, where their office is located, office hours and whether or not they accept your insurance.
Caveat: Do not look for a therapist on craigslist!
9. Do a Google search. Once you have a few names go ahead and google them. If they have a blog or a website, explore them. Often you can get a sense of who they are by what they write or what is written about them. Just keep in mind that many good, well-qualified therapists are not on the web. Not finding them there is not a reason to rule them out.
10. Don’t limit yourself. Don’t set limits on yourself unnecessarily by title or by logistics. I refer to as many social workers as I do psychologists. Marriage and Family Therapists (MFT’s) are new to New York but in California, and other parts of the US, they’ve been on the scene for some time. Even some psychiatrists provide psychotherapy along with medication management. Studies show that once core requirements are met in education and certification, the effectiveness of a therapist is not dictated by what letters they have after their name.
Skype and telephone. If you live in an area where it is difficult to find a mental health professional locally, you can always turn to tele-sessions using the telephone or Skype. While Skype counseling is a specialized service on the cutting edge, there are therapists world-wide providing on-line counseling. Skype sessions are available to anyone anywhere as long as the technology is available and a common language is spoken. This service has been a particular boon to Americans over-seas who crave counseling from a familiar voice stateside.
One last thought in your search for a therapist: Try to gather at least two or three names from any given source. That way you can cross-reference, and have choices if one doesn’t work out, moved out of town, retired or just doesn’t suit you. You have a right, even a responsibility to yourself, to be picky.
Do you have more ideas that would be helpful to people looking for a therapist? Please let me know!
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Why is client confidentiality important?
How do I assure my client that his/her information will be kept private?
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Client confidentiality is very important when working with clients in a healthcare setting. As a healthcare professional, it is important to assure your client that what they tell you will remain confidential and it is essential that you deliver on that promise. It is not only a question of maintaining professionalism, but it is an important way to gain the client’s trust and confidence in you. If the client feels that they cannot trust you, they may not share important information that can help you care for your client’s health. Trust and confidentiality go hand in hand when it comes to providing your client with excellent care.
One way to look at the issue of confidentiality is to put yourself in the client’s shoes. How would you want to be treated? When sharing personal details about your health, you want to know that the information will be kept private. So, remember to treat your client the way you would like to be treated by a practitioner.
Confidentiality is not just a matter of professionalism. It is so important that the
It is important to bring up the issue of confidentiality directly with your client. Assure them that you understand the information they share is private. The client’s personal information will only be shared with the mentor for educational purposes only.
When you ask the client to sign the confidentiality agreement, you must sign it as well. Your personal assurance and your signature are a reflection of your professionalism and integrity. Do not jeopardize that integrity by sharing information about a client with anyone other than your mentor.
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