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What Is A Therapist's Job?

This topic comes from an e-mail letter I received a few months back.
I've only done some minor editing.


THE LETTER I RECEIVED:

What is the job of a therapist? To listen? Anybody can do that, and for free!

I've had two therapists that just stole my money.

What is the job of a therapist? Are they supposed to give advice or just sit there? Are they supposed to help you?

I want you to answer these questions!



MY RESPONSE:

This is a great question, and I do want to answer it clearly and thoroughly for you.

The basic answer is: A therapist's job is to help you to change the things you want to change.

So the first thing a therapist does it to ask you what you want to change, and this can sometimes be a very difficult first step.

For example: Some people come to therapists without wanting to change anything at all. Some clients are ordered into therapy by a court. Other people are also sent against their will (for instance when spouses insist that they get help under threat of a divorce.) These people may not want to change at all. They might even be furious that they have to be sitting there talking to the therapist. When people come to a therapist against their will, the therapist's job is to simply hear that they don't want to change, allow them to quit if they want to, and to also encourage them to consider that they can change and that they can make wise decisions about whether to work at their changes in therapy. So, the first reason you might have had a bad time with therapists is that maybe you didn't really want to be there in the first place, and the therapists were essentially "fishing around" to see if you would change your mind.

Another reason you might have had a bad time with the therapists is that there are many different kinds of therapy.

Some therapists are "non-directive." They believe that the best way to help people is to simply allow them to talk and gather insight about what they want to change and about their own abilities.

Other therapists are very "directive" (me, for instance). They are very free with their opinions and they have ongoing and sometimes quite intense conversations with their clients. They believe that change comes partly from "supportive confrontation" (pointing out things that they think the client should consider changing, while sincerely respecting their right to their own choices).

Maybe you ran into some "non-directive" therapists. If so, they certainly were not a good match for you since you want a therapist who interacts with you more.

That leads to yet another reason you might have had trouble with your therapists. The therapists simply might not have been a good match for you. Clients have to take responsibility for finding a therapist who is a good match, and for moving along to other therapists when they run into someone who doesn't feel right to them. (Some men don't work well with female therapists, or with males. People of different cultures might have widely different values than the therapist. Nobody is a good match for everyone.)

Another big problem that frequently happens has to do with addictions. People who are strongly addicted to alcohol or drugs often have to overcome these addictions first before they are good candidates for therapy. Since the addiction is so strong, they often come to therapy with a chip on their shoulders and are very well prepared to defend their right to continue drinking or using. The therapist knows that they can't get better very fast without first giving up their crutch. But the client believes he needs his crutches. So they tend to go round and round without appearing to get anywhere for a while. (What's actually happening during all this time is that the client's trust in the therapist is building very slowly.)

Yet another problem has to do with managed care. Some therapists work for insurance companies who won't send them clients unless they are very quick at finishing with every client! In these cases the therapist may be more concerned about trying to convince you that you don't need to come back than he is in actually helping you!

Of course, the final reason is simply that there are a lot of lousy therapists (including the ones who follow the insurance company's orders instead of focusing on their clients).

But whether you ran into two lousy therapists, or whether the problem was one of the other things I mentioned, the thing you need to remember is that IT IS YOUR LIFE... and if you want to get professional help you simply must go through as many therapists as necessary until you find the one who is right for you!

I will warn you, however, that even after you find a therapist who is easy for you to trust and who seems competent and ethical, there will still be times when you and the therapist feel "stuck" for a few weeks or even months. Every client has quite a few "plateaus" during which nothing seems to be changing, and they get back to making big changes after that. You will have to tolerate these plateaus along the way. It is just part of the process.

So now I have given you a very thorough answer to your question.... and it's time for you to get on the phone and call another therapist to see if they are a good match for you. (You might want to read: "Are You Considering Therapy?" at my site first.)

Believe it or not, you are the first person to ask me this question in about seven years of answering these letters! I'd be very interested in hearing from you about what I've had to say. I think I'll turn this letter into one of the topics at my site eventually, and hearing back from you about what I've said might help me when I write the new topic....

So thanks again for an excellent question!

Tony S


HIS RESPONSE:

I know I saved a copy of this man's response letter, but I can't find it now.

I'm almost positive he wrote back to apologize for "venting" on me in the first letter, and to say that he was thinking about how the things I said applied to his experiences with his therapists.

I also think he said he would try again to find a therapist who was a good match for him. (I'm not so sure of this part. Maybe it's just wishful thinking…)


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Write To Me, I Want To Hear From You!
Tony Schirtzinger, Therapist (Milwaukee) 

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