PSYCHOTHERAPY
You’ve probably walked into a therapist’s office at some point in your life. Multiple reasons exist, ranging from dedicated substance treatment to marriage and family therapy. Markers of good therapy are somewhat abstract and quality seems linked to a few components. Maximizing therapy may require answers to some key questions.
How naturally-gifted is the therapist?
Psychotherapy is essentially a series of personal encounters. It is exceedingly valuable to have a friendly, compassionate therapist whom you genuinely like. If your agenda is to build insight and greater coping in your life, find a therapist who understands your specific goals.
How well-trained is the therapist?
There is a wide discrepancy in the quality and volume of training in the world of talk therapy. Programs can run as briefly as multiple months or continue for many years. Probably the most extensively trained therapists available are through the old-school method of psychoanalysis. These clinicians often have 6-8 years of training BEYOND their primary degree and specialty. A psychiatrist or post-doctoral completion for a Ph.D. psychologist requires years of post-residency work.
What modality does the therapist emphasize with clients?
This is a complex question. Many therapists train in multiple modalities. These range from CBT to couple’s therapy. Good therapists have the skillset to tailor treatments to individual clients. There are also therapists who really emphasize only a single modality such as Trauma Therapy. The advantage of the latter seems to be greater understanding and access to cutting-edge methods. A disadvantage seems to be the dilemma of the “plight of the hammer”. Everything seen can be a “nail!” This is especially true in the world of Trauma-Focused therapy. Some clinicians will frame all of life distress and hardship as “trauma”. However, this term should probably be for use with PTSD and subthreshold PTSD conditions.
Problem-Based or Insight-Based
Breaking therapy modalities into ‘Problem-based’ or ‘Insight-based’ can be useful. An example of a problem-based therapy would be a specific course of care to treat depression. This may include homework, guidance, and specific skills practice in the office. Problem-based therapies have time limits and seek to restore your previous functioning.
Insight-based therapy emphasizes things like personality, family system, and development. It is a slower form of therapy than the problem-based approach. Both modalities can be successful for addiction recovery. The most important thing to keep in mind is that you are agreeing to the form of therapy that the clinician is providing. If you are seeking more of a brief problem-based approach and your therapist only sees you weekly for 2 years, things seem likely to fail.
How much time does the therapist have to work with you?
Finding the right therapist is only half the battle. You somewhat need to be the “right patient” for that therapist. To match your needs, you’ll want them to have appropriate availability, caseload size, and willingness to schedule appointments. Interestingly, there are some situations in which the therapist may over-schedule appointments with you to achieve faster results. This may be more service than you actually need. These practices do call into question the fiduciary role of psychotherapy which involves the therapist making a living and having a vested interest in your meeting with them.
Can you strike a balance between desire and best interest?
Quality psychotherapy needs to walk a middle line of providing you support and kindness while simultaneously challenging your blind spots. Some of the most wretched therapy involves a complete lack of therapeutic confrontation. One of the dilemmas in this is that honest feedback and exploratory sessions in therapy may make you feel more uncomfortable and less welcoming of the process. Clinicians often avoid this subtle conflict in the room.
Is the therapist well-trained in addiction treatment?
Another complex topic and not as easy as “I need the best addiction expert for maximizing therapy for my recovery”. Open-minded clinicians can be the best therapists for people in recovery. They are able to emotionally explore the change process in recovery while having limited experience with addiction. Some of the worst therapy can be from the recovery gurus. Instead of embracing an open-minded approach, these people spend the session instructing you on what you need to be doing to be in actual recovery. There are multiple factors at play here and we may not have a great answer until you start the therapy process.
Do you believe that the treatment feasible?
The treatment needs to live! That basically means that if too many things get in the way of your course of talk therapy, it won’t make much of a difference in your life. Such barriers include cost, travel time, distractions, relocation, etc. Explore these factors from the beginning as they will definitely present themselves through the process one way or another.
These are some of the sensible questions to ask yourself (or to outright ask your therapist) for maximizing therapy, your time, money and effort in talk therapy. It is important to acknowledge numerous intangibles when experiencing psychotherapy and the emotional context of these ‘intangibles’ often is useful material itself. If a relationship works out in your life and you feel connected with that person, what were the variables that made it that way? Being able to answer that question with your therapist can be transferable to your personal life so that you feel connected on the homefront.