Competent Therapists

Here are 4 things that competent therapists do, according to Michael Karson at Psychology Today. I agree.

1. The therapist understands that a therapeutic relationship is very different from a social relationship. My view is that good therapy requires the patient to take off the social mask, and therapist behaviors that are social keep the mask on. Regardless, though, of the rationale for doing so, competent therapists promote a mode of relating that is very different from social relating, and from other forms of (non-therapy) professional relating. One particularly important defining aspect of a therapeutic relationship is the therapist’s acceptance of responsibility for its setbacks, potholes, and failures.

2. The therapist establishes a joint sense of purpose and a mutual understanding with the patient about what they are there to do together. This is captured in a clinical case formulation that is unique to the individual patient (versus a generic, off-the-rack formulation that could apply to nearly anyone). By “unique,” I mean unique.

3. The therapist interprets the patient’s speech as metaphorical or literary, not as merely literal. The therapist can never know what happened in childhood, and can’t even know what happened to the patient yesterday. The therapist understands that this is not a limitation on effectiveness, because the meaning that experiences hold for an individual patient are all important.

4. The therapist interprets the patient’s speech not only as a window into the patient’s narrative, constructed self and world, but also as a metaphorical response to the environment in which it occurs–a commentary on the therapy itself. This is the therapist’s primary source of feedback about what works and what doesn’t.


Read the whole article here.