Yet another therapy question... How many sessions should one plan to give a new therapist before deciding if the the therapist will work out? (I know, of course, there are ones that are so terrible you probably immediately know. But I'm wondering more about the ones that don't ring any loud alarm bells, but, in the long run, won't be a good choice.) Should I plan on say two sessions? A month? I want to be fair, and give a therapist a reasonable chance. But I also don't want to waste months, which seems to have happened with my most recent therapist. This is particularly concerning, since it sounds like I'll have to transfer to a new therapist without really knowing much about her (except the vaguest glowing praise of how good she is!).
You should have a sense of how you are relating, the therapist's style, and a basic idea of whether this is someone you can trust and attune with after 2 or 3 sessions. But equally important are red flags: -- A therapist that gives direction or advice -- A therapist who pushes any particular outcome -- A therapist who regularly shares personal details, unless there is a specific therapeutic value to you (for example, relating your experience to something s/he has been through) is a therapist with bad boundaries. -- A therapist who criticizes or judges you (though, for someone overly sensitive, they may see this where it is not actually happening.) -- A therapist who is rigid in his or her technique (say, aggressively pushes EMDR or CBT techniques or Brainspotting or something else to the exclusion of other approaches. All are fine when appropriate.) -- Sessions that are mostly chit-chat, with no deep work, no questions that make you think or reframe or contemplate -- Sessions where the therapist tells stories (unless exceptionally rare, specifically for your therapeutic benefit.) -- If you don't ever leave feeling "stirred up", then you probably aren't doing effective therapy. Not every session but many. -- If you aren't coming out with new perspectives and insights about yourself pretty regularly, you aren't growing. -- It's reasonable to ask a therapist if s/he sees a therapist for supervision, or for his/her own work. I know many therapists who would never see a therapist that doesn't have a therapist. On the positive side: -- Depending on why you are there, the therapist's approach, and your needs, you may have homework or assignments. This is a good thing. -- Someone you can tell absolutely anything to, without worrying about being judged. -- Someone that absolutely feels safe, trustworthy, and reliable. There are probably other warning signs and positives, but those are ones I see a lot. With the red flags, if I saw any of them, basically, I'd run the other way. Keep in mind that good, effective therapy is hard work. You'll feel like you don't want to go some weeks. You'll feel wrecked when you come out some weeks. You'll also see yourself improving pretty significantly over a relatively short period if you have a good therapist. So, if you go 2 or 3 sessions, and you don't feel any obvious red flags, the next question is, how are you connecting to this person? How easy will it be to trust and be vulnerable with him or her? If you feel like that is developing or will develop, then it's worth continuing. I know some folks who, if they can afford it, see two or three different therapists for one session, and then decide. But, for myself, I've managed to luck into three different therapists, over the years, each of whom was good, and each of whom had different skill sets.
I, too, would say 3 to 4, which would be about a month. The only thing is that, as you work on things, some aspects of the therapy and the therapist may come up later. I am having this happen with the therapist I see now. I have brought them up. I think we have made some progress or he understands what my position is and why I am concerned. In therapy in the 2000s, I had a therapist that I didn't see the red flags with and it was partly my fault. I had already looked at the available ones in this one area very thoroughly, knew that I had already crossed off most of them, and then got overwhelmed with what was going on in my work life - which this therapist knew about - and I kept going. He was a snake. Therapy for him was not about helping people. It was a power trip. Your gut can be reliable. Ask yourself what your gut is telling you between 2 to 4 sessions.
I think sometimes these things can be therapeutic interventions or trying to form a transference. Not always adeptly. That being said, I'm probably biased because that's what I wanted from my most recent therapist. Just somebody to bounce ideas off of. The therapy, I did myself, and just checked in to see what he thought of me and my changes. Also, what would they do with somebody who had little insight and was intractable? Maybe sometimes advice is OK. My therapist didn't push anything on me I didn't already know, but sometimes it's nice to hear it from somebody else, or hear about something to try. Like an expensive "friend". However, in one case I think he was off base and should have dug deeper, which I now see in retrospect, so I suppose it can be a red flag.
Advice is pretty much never appropriate from a therapist. There are a whole bunch of reasons for that, but suffice it to say, the purpose of therapy is helping people to discover within themselves what stands in the way of success (as they define it) and, if they choose to, either change or learn to accept and appreciate the way they are. Direction, in the form of encouragement, can be OK, but again, it gets into the issue of interfering with the client's self-direction. Neither of these are absolutely hard and fast, but they should be rare to the point of almost never. The problem with simply giving advice to the 'intractible' client is akin to giving a fish to a hungry man, rather than teaching him to fish. The therapist's role is to encourge the client to find his or her autonomy. I've never worked with someone with extreme dependent personality disorder, which is someone with difficulty making decisions, so I'm not sure what one would do in a therapeutic setting with someone like that, but I'm pretty sure that giving them advice would not help them improve and cultivate more autonomy. There are few absolutes with therapy, but there are a lot of really terrible therapists out there, and while there can be exceptions to any of the red flags above, generally speaking, if you're seeing that, especially early on in the therapeutic relationship, it's likely to indicate a problem with the therapist's professional ability.
