Dear Therapist:

My spouse and I went for marriage counseling for a while for some issues with someone who seemed to be a very competent therapist. The therapist seemed to understand how to breakdown the issues and attempt to work on resolutions. However, some things didn't seem to be adding up right. For example, the therapist left off a few sessions at some very crucial points, leaving us feeling very vulnerable and with a lot of raw emotions exposed, but with no tools to deal with them until the next session. There were other things as well...  I am wondering if this is something normal for marriage counseling? In which case, do we look for another counselor more experienced or just drop the whole marriage counseling idea? More importantly, how does a client determine if a therapist is doing their job correctly even if it's a difficult process, or the therapist is perhaps not competent enough.

Thanks

Response:

It sounds like your experience with this therapist may have been both positive and negative. You mention that the therapist appeared capable, and was seemingly able to help in certain areas. However, there were some areas in which you feel that the therapist fell short.

You mentioned only one specific problem, but alluded to others. The issue that you mentioned relates to the therapist having helped the two of you to identify a problem—but then letting it stew until the next session. There are a few reasons that this can occur. The most obvious possibility that comes to mind is that the therapist simply didn’t recognize the level of emotion that the session evoked. Sometimes, we feel that a good therapist should understand the impact of our interactions. It may seem that therapists can—and should—pick up on our emotions, and identify the necessary intervention.

Of course, therapists are not infallible. We are trained to collect information, assess the situation, and to use various therapeutic techniques to help make positive changes. Perhaps most importantly, we are trained to maintain a collaborative relationship with our clients. The reciprocal exchange of information is paramount. This means that therapists should always be alert to any possible breakdown in communication. This includes non-verbal communication, like recognizing when a client’s needs are not being met.

Although it is technically the therapist’s job to foster the proper communication within the therapeutic relationship, communication goes both ways. There are times when something is obvious to us, making us feel that the other person certainly sees it as well. However, we are all human, with our own emotions, needs, insecurities, defenses, and perspectives (yes; even therapists are human!). As in any relationship, if the other person appears not to understand your feelings or needs, it is your prerogative to discuss this with them. Remember that therapy is meant to be a collaborative experience. You are not there to be “cured;” rather, you are there to work jointly on the issues that you identify.

It is possible that your therapist believes that opening a can of worms without resolution is a good idea for you. Perhaps the belief is that your spouse and you have—or will develop—the capability of working it through on your own. Even if this is true, however, it should be something that is discussed. If the therapist does not discuss it, this can mean that they are not truly open to communication in the way that they should be. Or it can mean that they simply did not recognize the consternation that these sessions evoked. Perhaps the therapist “should” pick up on issues like these. This is their job after all. However, in every relationship it is the responsibility of all parties to make their needs knows, and to discuss issues as they arise.

You asked how a client can determine whether a therapist is doing their job properly. In order for us to know whether anyone is doing their job, we need to have a clear sense as to the nature of the job and the goals to be achieved. Without clearly defined goals and ways of assessing their attainment, we wind up all too reliant on the “expertise” of the person that we hired. Therapists and clients should identify clear goals and the means with which to measure the degree to which they are achieved.

You may believe that your therapist is not open to communication or not properly listening to your concerns. Or you may have the clear sense that their time is more important to them than helping you. If this is the case, it may be necessary to switch to another therapist who is able to properly collaborate with your spouse and you. You seem to have gained something from the therapy process. It would be a shame not to capitalize on these gains with the appropriate therapist.

-Yehuda Lieberman, LCSW

  psychotherapist in private practice

  Woodmere, NY

  adjunct professor at Touro College

  Graduate School of Social Work

  author of Self-Esteem: A Primer

  www.ylcsw.com / 516-218-4200

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