Your Therapist WON’T TELL YOU THIS… (But I will)

I’m probably going to get in trouble for this, but I’ve got to be honest with you all about 3 SECRETS a lot of therapists won’t tell you about going to therapy!

I’ve been doing a lot of thinking about my field, and what goes on in my field, and I’ve decided I need to tell the world. I need to make it public. There are some things that therapists won’t tell you, but I think the general public needs to know. And if you happen to be a therapist and you’re watching this and you get pissed off at me, just understand that people need to know these things. And it’s really important that we are transparent, because if we’re going to help people improve their mental health, then we have to tell them some very hard truths about our field.

(Number One) For example, most people out in the world do not know that there’s actually something called Brief Therapy, or more specifically there are things called Brief Therapies. There are multiple Brief Therapies which are designed to achieve effective outcomes with clients in the fewest sessions possible.

Most clients do not know that.

They assume that “There’s something wrong with me. So I have to go see a therapist, and I’m going to be in therapy for years because of this issue. I’m going to be in therapy for the rest of my life because of this issue.” But did most people know that there are things called Brief Therapies that are designed to help people achieve the same outcome as long term therapy, but just in fewer sessions?

See, most people don’t know that. So they come to therapy expecting that “I’m a broken person. As a result of my brokenness, I’m going to have to be in therapy for the rest of my life.”

But the truth is: that’s not true, it’s not accurate. You can just come to therapy for a brief period of time in your life and and your life be completely redirected. It’s evidence based, meaning it is supported by research, it is clinically effective, and most of us have been exposed to it in graduate school, if not deeply trained in it. But most therapists are afraid for the general public to know that because they’re afraid you’re going to come into therapy and you’re going to get healed quicker and then you’re going to leave therapy and they don’t make as much money. That’s important.

Number two is most therapists practice therapy in a way that is incongruent to what we were taught in graduate school. So upwards of 70% of all therapists describe themselves as eclectic. And what eclectic means is I take a bunch of ideas from different approaches and I apply them to my clients based upon what I think they need, given whatever problem that they’re experiencing.

But there are two major problems with this. Number one, according to research, we are not good at matching client problem with clinical issue. That is actually not how to make change happen. But most therapists think that that’s their job, to take the client problem and match it with the clinical treatment, and then you produce an outcome. That is not what research says leads to change.

Side note, the thing that research says leads to change is the connection between the therapist and the client. If the therapist and client have a strong connection and the client believes that the therapist genuinely cares about them, then the client is significantly likely to improve regardless of what type of therapy the therapist is doing.

But most therapists take an eclectic approach. And I’m telling you guys, we are not trained to assess problem and then match that with a clinical treatment. And we’re not good at that, even if it were (effective).

What we are really good at is forming connections that are genuine and based on care. And when a person feels cared for, they are significantly more likely to make a positive change in their life.

The other thing that’s really important to understand about the way we were trained is we were trained and studied the work of some of the most brilliant clinicians in the world. Sigmund Freud, Carl Jung, Alfred Adler, Virginia Satir, Steve DeShazer and Insu Kimberg, Jay Haley, Milton Erickson. I mean, the names go on and on and on. Literally not one of them said, “When you’re working with a client with this problem, then switch to this other approach. When you have a client with that problem then switch to this other approach.” They all teach us how to do therapy based upon their theory of therapy. And a theory of therapy is very much something that you have to dedicate time and energy to studying. But most people don’t do that. So what they do is they just get briefly exposed to kind of everything, and then they go and they focus on delivering the therapy based upon your problem and trying to match that to the superficial stuff that they know.

But if you want to be effective, then you have to understand that therapy is based upon the connection. And I have to stick to one approach because that’s how all of the people we studied did it.

So most people, they get their graduate degree and they learn the information from all the approaches because we’re supposed to. We got to pass an exam to get our license. But most people do not do that.

What most people do is they leave therapy, they get their license, and then they start combining all these other approaches, which is not what we’re trained to do. And it actually frightens me that most clinicians are out in the world doing something other than what we were trained to do in graduate school. And I think the general public should know that.

And the third thing that I think the general public should know is as clinicians, we spend a lot of time doing paperwork, treatment plans and case notes and all these things. And I think people should know that, that none of that paperwork is designed to help the client improve their lives. The reason we do all of this paperwork is so that the insurance company or third party payer can justify that they are paying for your services. So roughly every three, maybe six sessions, we have to fill out treatment plans, submit them to the insurance company that is paying for the for the services, and justify what we’re doing. If the insurance company determines that it is no longer justified, they will stop paying.

Now, why this is important is most therapists base their treatment on the treatment plan because they misunderstand that the treatment plan is actually not about treatment. It’s about payment. It’s a way for the insurance company to justify that they’re paying for this thing in a way that is reasonable and their money is not being wasted. Therapists base a lot of clinical decisions based upon these treatment plans when that’s not what they were designed to do.

Again, going back to what I said earlier, the best way to help people grow and experience a positive change from therapy is to form a genuine connection with them based on care. When the client feels like I am connected to my therapist and my therapist genuinely cares about me, they’re significantly more likely to make a positive change in your life.

So those are three super important things that the general public needs to know about therapy so that they can make an informed decision when they go out and select these clinicians. What you need to ask people, ask when you’re interviewing a therapist to work with you, you need to ask them, what modality were you trained in? And have them tell you, I was trained to do this. And I stick to this because I went really, really deep and I learned a lot about this.

Now think about this from a restaurant standpoint. If you go to a restaurant where the chef is like, I cook French food, Chinese food, American food, Latin food, do you think any of that food is authentic and high quality? No. Wouldn’t you want to go to the restaurant with a person’s like, I went to France and I lived in Paris and I stayed there for a decade and I learned to make French cuisine. That restaurant is going to be super high quality. That restaurant is going to be amazing. Well, therapy is the same.

So ask your clinician, “What were you trained to do, and how do you do it?” Their answer is going to tell you whether or not they are just throwing spaghetti at a wall trying to help you, or if they’ve really mastered the approach that they use. And those are the clinicians that generate the highest outcomes.

According to research, the clinicians that generate the highest outcomes are the ones that have fidelity to the approaches they were studied and the ones that go deep into the stuff that they studied. So when you’re interviewing therapists, the number one question what you ask them is, “What were you trained to do and how do you do it?” And if you hear things like, I borrow from different approaches and I apply them to your unique circumstance, RUN. That is not the kind of clinician that generates high consistent outcomes. But if someone says the equivalent of, I went to France and I studied this one thing and went super deep and I wanted it for 10 years and now I’m a great French chef. Like if they say the psychotherapy equivalent of that, if they say, I was interested in Solution Focused Brief Therapy and I found this agency that trained it and I went and studied with them over the next few years and I just got better and stronger, better and stronger, and my clients achieved great outcomes. So now I use Solution Focused Brief Therapy in my work and I will always find a way to make Solution Focused Brief Therapy work for you. Then those are the kind of clinicians you want to see.

They could say the same thing about cognitive behavioral therapy. I went to this agency that taught cognitive behavioral therapy and I went super deep and I really learned it and I understood it and I mastered it and I practiced it and I got supervision from the best people in the world. And now I apply some cognitive behavioral therapy in my work, and I’m going to find a way to make that work for you and your situation.

When you get answers like that, that’s how you know that this is a high quality therapist. You should schedule with them.