How To Tell a "Good" Therapist From a Mediocre One

After thirty years of practice, I can confidently say that most therapists are good people. So the likelihood of you finding one who means well, listens carefully, and cares about you is excellent. But these characteristics alone--while critical--do not guarantee good therapy.

Let me give you an example from my own practice, where I often see clients who have seen other therapists. "Martin" called to schedule a couples session with his wife "Carol" because the they were having problems in their marriage. One thing I do before I see clients is have them complete a detailed intake questionnaire, which I read before their first session. This saves time, and it gives me lots of information a person might not think to mention in person.

When I read Martin's Intake, the first thing I noticed was that he'd been seeing a psychologist on and off for ten years. I could also tell that he was profoundly depressed, had never been treated for depression, and probably had a pretty serious drinking problem.

The first thing I did when we met was ask Martin about the work he'd been doing with his therapist--a well-respected psychologist in town. In particular, I asked him how much the two of them had talked about his depression or alcohol use.

I'll never forget his answer: "He never me asked about either... but I've always sort of wondered about both."

I was stunned. How could a psychologist work face-to-face with a man for ten years who was clearly depressed and completely cut off from his wife and kids, without once talking to him about his depression or alcohol use?

This was blatant negligence. And it was especially appalling because the information was so easy to obtain. It was all there in black and white, information I had gotten before ever meeting Martin. What had they been doing in therapy all those years?

The amazing thing was that Martin didn't realize he was getting bad therapy. He liked his therapist and described him as a good guy, someone he trusted and considered to be "kind of a friend."

Obviously, having a good relationship with your therapist is important. In fact, according to a review of the literature on the benefits of therapy going back to the 1980s, almost all studies confirm that the quality of the relationship between the client and therapist is the most important factor in successful therapy, regardless of the techniques or methods used.

But a good relationship with your therapist is not the only criterion for evaluating therapy. Martin's therapist was a good person. But he was not a competent therapist. Without treating Martin's longstanding depression and blatant alcohol abuse, there was no way for couples counseling to succeed.

So if liking your therapist isn't enough, what does distinguish good therapy from bad?

Here are two lists to help you evaluate the quality of the therapy you're receiving. The first describes what I think is Good Therapy. The second, what I think is Bad Therapy.

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