I’ve learned the most from my therapists and supervisors when I’ve caught them being human, and I think all of us deserve a little more leeway than usual during the current craziness.
But make no mistake–therapists have a duty to maintain a certain level of professionalism for the space to be therapeutic. At times it might feel like you’ve been talking to a friend or a parent, but you should equally feel like you are working with a professional that adds something to your life no one else can.
When you are paying for someone’s therapy services, there’s a certain amount of healthy entitlement I want to encourage you to claim for yourself in the relationship.
Here are the top 5 things I want you to know you are entitled to:
#1. A therapist that shows up on time (give or take 5 minutes) and keeps your appointment more often than they ask to reschedule.
A therapist showing up relatively on time is a non-negotiable for me. I’m more flexible now that we meet over video, but waiting longer than 15 minutes when a session is only 50 minutes long is pretty unfair.
A therapist keeping your appointment is seemingly simple, but it’s a huge deal when we think about our attachment needs to have someone consistently there for you. I’ve known a lot of people that have loved their therapist but ended up needing to find someone else for this reason.
Unfortunately, not every therapist can meet regularly or keep your appointment. A lot of therapists are also moms and caregivers and have to reschedule frequently because their kids or parents get sick or their kids get them sick, etc. Some therapists have chronic health issues that they cannot control. Some therapists got into private practice to be able to travel often or all summer and cannot meet weekly.
Whatever the case–a therapist is (of course) allowed to have a life, but you are also allowed to choose a different therapist if you notice you can’t seem to ever meet with them when you need to. You are also entitled to a conversation about this if needed.
Therapists are human (especially now) and might run late or have unexpected family emergencies (as I have), but it shouldn’t be the norm, and you are entitled to a repair if/when they mess up.
#2. A therapist that cares and seems interested in you.
You are never inconveniencing a therapist by showing up to your appointment. Sure, sometimes (again, especially now) it is hard for all of us to stay present, but overall you should feel like your therapist is actively engaged in your conversations and wants to be there once you get started.
#3 A therapist that is knowledgable and competent in the areas they advertise and say they are.
This is in any licensure’s ethical guidelines. Your therapist should not advertise that they are an expert in something if they’re not. The title “expert” is subjective (especially among therapists), but if you ever get the sense they’ve misrepresented themselves, please bail.
A big area in the therapy world I see this in is couples therapy. It hurts a little to say this because I have been the Associate working at an agency needing to get my licensure hours, but couples therapy really is a specialty. Working with a therapist that treats couples therapy like individual therapy with two people can make the relationship worse. If you do choose to work with a pre-licensed therapist (which many people do to save on costs), they should disclose that they are still in supervision.
Beyond licensure, there is also the consideration of training. How much advanced training a couples therapist should have is again subjective, but I personally would not recommend a friend see a couples therapist that does not have any advanced training. I get asked about my approach and training all the time. I also get how much of my caseload is couples (which is anywhere from 50-75% depending on the week). I’d encourage you to ask any therapist you’re considering these questions too!
Fortunately, most couples seem quick to recognize when they are not getting the support they need.
#4. A therapist that guides the sessions when you need it and adds value to your conversations.
This one is so complicated because all therapists are different and frankly, sometimes clients get in their own way. If your therapist does too much, you might not have to wrestle with the hard stuff or come to your own conclusions. If they do too little, however, you might as well just go talk to a friend.
As a therapist, I’ve certainly noticed that I need to talk more than I used to in order to maintain the same level of support over video that might’ve been felt through my presence alone in the past. Regardless of the platform, therapists should adapt their style to provide adequate support or refer you out if they recognize that you are not a good fit for their approach.
Providing adequate support does require an equal effort on your part and a lot of feedback, but you generally should experience either a) you experienced something helpful or b) they offered something helpful. Over time, you should start to notice that these sessions are building on each other.
Not everyone can create change right away and some change is more internal and harder to measure, but you are always entitled to a conversation about any concerns. If your therapist shames you or labels you “therapy-resistant” I would highly recommend getting a second opinion.
#5. A clearly established therapeutic goal, and a sense that you’re getting somewhere.
How else will you know if you’ve accomplished it? Again, it seems simple, but it’s really easy to lose sight of what you are doing in therapy or how it all ties together. I talk with all of the clients I work with about their goal, and for many of them I write up a treatment plan with short-term, medium, and long-term goals. Not all therapists do this and not all clients want or need this, but I’ve found it to be very useful to refer to it throughout the process and to track progress or lack thereof.
Overall, I am in the practice of preparing for sessions and seeking outside consultation when I need it. I make an attempt to check in with clients and keep a dialogue about how therapy is going for them. Depending on the day, I usually glance back at notes from the previous session and think or meditate on what I think the client needs. Then I’m ready to throw it out the window if the client brings something completely different to the session.
If I recognize I’ve gotten too rigid and need to back off or if for some reason I simply don’t have the time to prep, I will just show up. But what I’m really getting at, is that I put some thought into it. I honestly have no idea how much any of my own therapists have prepared or not prepared for sessions, but what I want to express is that you are entitled to a treatment plan or a conversation about what you are doing in therapy.
Starting therapy can be very confusing, and it can be really hard to know if you are working with someone that is a good fit for you. I hope this post helps you feel more empowered in your therapy and clears up some of that confusion. Please reach out if you need help finding a therapist!
