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Therapist Do's and Don'ts

Dan Metevier

Curious Shrink
If it's not too self-serving, I would be interested in your experiences where you worked with a therapist that you either really liked or really disliked. No names of therapists please.

What is the best thing a therapist can do?

What is the worst thing a therapist can do?

Thanks!
 
I'm sorry, but the questions seem a bit general. I'm not sure how to respond to them. I think it depends on the individual client though.
 
Best things to do: Trying your best to relate to the client whenever possible. If it not possible to relate to the person, then ask some questions so you can try to picture what it like to be in their shoes.

Worst things to do: Put all blame on the client. Not having faith in them. Making them feel like a liar.
 
One thing I find extremely important as well: Don't let your therapist be an enabler. Validation can be good, but it's very important for a therapist to call out BS when they see it and help change problematic behaviors or thought problems. While the relationship should be friendly, it should never be a friendship; watch out for any therapist who lacks the necessary professionalism that is appropriate for a therapist/client relationship.
 
Do's: Offer support, also when you don't have an appointment with them. Tell people why you are doing things that way or tell them why you advise something.

Don'ts: Talk to me like I'm a little child while im friggin 17 ( this actually happened to me, it irritated me to the point that I went to an other therapist) And pretend you understand something when you really don't, aspies too notice that.
 
I'm sorry, but the questions seem a bit general. I'm not sure how to respond to them. I think it depends on the individual client though.
I take your point. Thank you. Not to put words in your mouth, but is it fair to say that a "good" therapist should treat the client as an individual and not try to generalize about their diagnosis (if any), getting to know the client as a unique person with unique strengths and difficulties?
 
I take your point. Thank you. Not to put words in your mouth, but is it fair to say that a "good" therapist should treat the client as an individual and not try to generalize about their diagnosis (if any), getting to know the client as a unique person with unique strengths and difficulties?
I strongly believe so, yes.
 
Do's: Offer support, also when you don't have an appointment with them. Tell people why you are doing things that way or tell them why you advise something.

Don'ts: Talk to me like I'm a little child while im friggin 17 ( this actually happened to me, it irritated me to the point that I went to an other therapist) And pretend you understand something when you really don't, aspies too notice that.
Thank you! In my experience, Aspies notice almost everything. I love that! Keeps me honest and teaches me a lot. So, being "transparent" seems important, rather than trying to pull any "therapist tricks," so to speak. Does this seem right to you?
 
Thank you! In my experience, Aspies notice almost everything. I love that! Keeps me honest and teaches me a lot. So, being "transparent" seems important, rather than trying to pull any "therapist tricks," so to speak. Does this seem right to you?
Yup. Looking at myself, I hate it when someone pulls a trick on me, that is when I notice. I imagine it not being a very nice conversation afterwards :)

An other key factor for me is that it shouldn't only be business, there needs to be something personal too. If you share something, I do too. Remember! We aren't people that trust someone very quickly.

And honestly I want to believe I trust my therapist, but I don't. I always think: What does she think about me saying this, or doing that. I always get the feeling that People think of me in a bad way (probably experience)

And the last one. There are some things that I don't trust even a therapist with telling. And that is for all of us. You might think that we tell all we know, but what you don't ask, you don't get to know. ;)
 
... being "transparent" seems important, rather than trying to pull any "therapist tricks," so to speak.

This is very important to me. Being honest is paramount to building trust, which is the foundation of a good therapist/client relationship.

And, you're correct ... Aspies do notice lots of things. We don't always let on though. ;)
 
One thing I can say, is quick judgement.

Example:
This may be my own warped perception, but I was meeting with a therapist for first time, and was immediately condemned and felt judged, for self medicating with Cannabis. And pushed towards pills! I almost decided to not go back, but I stayed and gave her the respect she deserved, eventually deciding to stay with her.
I would have preferred a detailed explain of why I need to immediately stop, aside from its side effects. Pills have side effects too. Severe ones for me, that only add to problems.
I don't disagree with the general adversity to this self medicating choice, but get to know me or ask why before dismissing it as something to change, or suggesting some pills.

My reasoning for self medication is over 17 years experience with and without the Herb, on anti depressants, ADD meds and in every imaginable situation. I lived life "sober" in war, school, training, and general life, I lived other periods of life with low levels of herbs consistently and seen better performance academically, socially, and emotionally. Sorry to rant. I appreciate good natured advice and expectations. I am open about my use of herbs when using, with doctors, and the dosages.
 
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Just a general communication pointer, make sure your questions are very specific and direct, and understand that strange answers might be the most honest ones. Don't question them, rephrase yourself without judgment.
 
Flexibility? Medicine and treatment is not black and white, so maybe what would be best for a patient could be anything from pills, to vitamins, to a bit of exercise, to a new puppy, or just simply pacing the room and ranting.

I've never been to a therapist, but I did have a counselor. So my "do not want" advice is to not to threaten to kill the individuals your patient is having trouble with, and don't make up lies about them based on their dislikes. In example, claiming they're refusing to take their son to his check-ups just because the mother has had some very bad experiences with doctors.
Oh, and please don't tell your patients they have no right to complain about financial difficulty if they refuse to submit their bodies to medical experimentation. When the weight of the family is resting on your shoulders, you can't gamble with terrible side effects from being a lab rat for new drugs. You need your health to get what normal jobs you can and provide for them.
 
This might not apply to you, but to your colleagues:

Don't: take on new patients when you are less than a month from retirement. (This has happened to me multiple times.)
 
I can't stand platitudes, cliches, generalities, or mental trickery. I don't want to be babied or coddled, and I don't want to be treated like I can't handle truth, even if it's difficult truth. I choose not to be easily offended by truth, so if there's some negative feedback that needs to be said, just say it.

I don't like fluffy compliments. Honest feedback on something that I've done well is useful, especially if you can tell me specifics about what is good about it and how it affects people. But don't smother me in compliments that are designed to "make me feel good".

Clearly stating what my choices are, and what consequences those choices are likely to entail, is helpful. Then giving me freedom to make my own choices...opportunities to determine what my life looks like. Reminding me of truth when I lose touch with it helps a lot.

It's especially important to me, because of my background, to work with someone who is not easily flustered or overwhelmed, but who also isn't unreachably distant and emotionally unengaged. There are so many people I've not been able to open with because I sensed they weren't "strong enough" to handle what's inside me.
 
A major don't in my experience is that they should not rely heavily on certain stereotypes and don't don't focus on a certain momentary "snapshot".

Granted, perhaps appeance is the first thing one sees and might at times be a result why you have issue X. But if he/she doesn't know anything about me yet, it's nothing more than a "snapshot" of what I'm like. Example; if I dress in black, I might appear a bit glum, I might appear a bit depressed. However, if, like me, you've been dressing like this all your life, the notion of "how are you feeling right now" does become a different matter when you think it is reflected on wardrobe and such.

Besides; I've found that in general, asking me what I like to do (and most likely not just me, but in general), does not always reflect my life that well. This might very well be a momentary snapshot as well. Where I am right now in life, does not mean that I've been there for the past 5 years.
 
If it's not too self-serving, I would be interested in your experiences where you worked with a therapist that you either really liked or really disliked. No names of therapists please.

What is the best thing a therapist can do?

What is the worst thing a therapist can do?

Thanks!

You're very welcome. And thank you.

One "best practise" I haven't seen covered yet: Paraphrase back to the client, without sounding patronising, please, before making notations or forming a response. I can have difficulty finding the right words to express myself. I'm dealing with complex, sometimes confusing thoughts and feelings. I crave understanding. Make sure you help me get it right for the record, for the best chance at productive therapy. From what I've seen here, you're excellent at this, but many therapists aren't.

One bad move: Don't disregard anything I say, just because it doesn't seem important from your clinical perspective. Back to challenges with communication...if I say it, it's important.
 
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Things not to do: Don't become a crutch to your client else when the time comes to end the therapeutic relationship the client will be without support.
Encourage the client to think about their issues in a safe way and to help them develop their own coping skillls.

Things that are helpful: Talk to the client on the level they set. If they talk on an adult level then treat them like an adult. Respect them.
Be a guide to them during the therapeutic relationship but don't get too close.
 
Thanks again for your interest. I don't mean to sound like I am accusing yourself, or all specialists, so forgive me if it does come across that way, but there is one reoccurring issue that I think is quite important for me to bring up.

While I have yet to be diagnosed, I have read many complaints from quite a few of our female members, of some specialists being unable to recognise their AS.

Some of the common complaints have been the following:
  • Specialist informed that the client appeared too "normal" to have AS.
  • Specialist analysed, by comparing the client to the typical male behavioural traits related to AS, but did not seem to recognise the more prominent female behavioural traits.
  • Specialist advised that only men can have AS, or advised that AS in women is extremely rare, and therefore dismissed the case.
  • Men, who are more feminine-minded, or who have adopted a female gender, tend to share in these issues.
Of course, I can not say for certain that all of these complaints were made by those who definitely have AS, as I am no specialist, but it seems to be an issue that is quite common, on a global scale. As a self-diagnosed woman, I can appreciate how this issue can be upsetting; especially to those who have had to struggle in life, or to those who have had to spend large sums of money, only to feel that their disgnoses was not accurate to their own circumstances.
 
Always fully explain any conclusions you come to and the reasons for any "treatment". Also listen if they think you're wrong!

I have never seen a therapist but have had both good and bad experiences with psychologists. When I was 17 the psychologist I saw formed his conclusions and then never explained them. I was too nervous to ask what was going on, eventually it was my parents (whom he had told) who explained it to me. I then tried to tell him that his conclusions were wrong (he was so far off the mark it's almost funny, 2 hours of questioning and he never even asked me "what is making you unhappy?") and he basically told me "I'm a professional and you don't know anything so shut up and do as your told" (yeah I'm paraphrasing a bit :neutral: but that was what I got from it). The result was that the weekly counselling sessions became one more added source of anxiety and misery, and even when I was transferred to a different (good) counsellor at 18 I was so alienated from the profession it took month to even begin to respond to and trust her.

hmm sorry for the rant :sweatsmile:
 

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