Please check out Part One of this two-part series. This post is about your role and rights as a client. As I said in the previous post: therapy should not be something that is done to you. Rather, it should be something you do together with your therapist. For the sake of self-disclosure, I will remind you of my personal theoretical approach. My approach to therapy mainly comes from a postmodern client-centered approach (with some cognitive therapy interventions). If you remember from the first post, my theoretical approach dictates how I see a client, how I see my role as the therapist and what kind of techniques and methods I will use in therapy. My belief that clients should be active co-participants in a therapeutic relationship is influenced by my theoretical orientation. Basically, keep in mind throughout this post that not all therapists will agree with everything I say here. These are my beliefs and these are the things I stand for.
As clients, I believe that you are the consumer and the therapist is providing a service for you. Therefore, it is important to find a therapist that is best suited to be able to provide the best possible service for you. Finding the right therapist is like finding a partner. There should be chemistry. This potential therapist should work to gain your trust and create a safe space for you. And the both of you should be compatible enough that it is possible for the both of you to effectively work together to accomplish your therapeutic goals. As stated previously, this is the time to pay attention to the therapist’s theoretical orientation. Additionally, there is another factor to focus on: the therapist’s personality. Therapists are humans with all the accompanying strengths and flaws. If the therapist’s personality grates on your nerves or simply does not complement yours, you’re going to be distracted from accomplishing your goals in therapy.
Relatedly, think about coming out to the therapist during the intake process, aka that first meeting where the therapist asks you a lot of questions about your past, your personal life and the reasons why you decided to seek therapy. I know the idea of coming out to a therapist as queer, trans*, polyamourous, kinky, etc. may feel nerve-wracking and scary as all hell, but it is actually very helpful in the long-run. A therapist cannot provide care that is designed for you if they do not know enough about you. It is important to ensure that a therapist has the experience and the skills necessary to help someone from your community or communities. Even if, let’s say, your gender does not play a role in the presenting problem (the problem you are coming to therapy to deal with), if a therapist has negative biases or is ignorant about these issues, their ignorance may block them from being able to provide effective therapy. It would be hard to feel comfortable discussing your phobia of talking on the phone if your therapist somehow blames every problem you’ve ever had on the fact that you are genderqueer. Also it is impossible to provide effective therapy to a client without understanding them in their proper context. How can I possibly fully understand a client’s needs and goals if I don’t understand how being Chinese, queer or an immigrant interacts and influences their perspective? How would I be able to tell the difference between reasonable anxiety that comes from being a person of color in a racist society from a maladaptive anxiety that comes from an anxiety disorder without understanding their subjective reality? That said, your potential therapist does not have to be an expert on everything. That would be impossible. A therapist just needs to be open-minded and empathic. Your potential therapist may not know everything there is to know about being polyamourous and that’s fine. However, this therapist should be willing to do some research. You are not obligated to school your therapist on poly-101. It really is not that hard to go look it up on the internet and it would distract from therapy if your therapist kept asking you to explain how you can possibly date more than one person every other session. A therapist should be able to admit when they are not knowledgeable about something and should be willing to put in some work for the sake of the therapeutic relationship.
So congratulations, you bravely walked into their office, filled out the intake forms and then came back a second time for a therapy session. Damn right, good for you. Now that you have chosen a therapist, don’t feel like you are locked in. Do not be afraid to switch therapists and walk away from one if they are not meeting your needs. I have talked to some people who stick with incompatible therapists for much longer than they should because they feel as if they can’t leave. Your therapist is not your parent. You have power. You are the consumer. You can always find someone else if this therapeutic relationship isn’t working out. That’s not to say that you should just leave if there’s a bump in the road. Therapists are not perfect. I’ve bumped heads with my former therapist a couple times. The sign of a good therapist is their willingness to be flexible and their ability to apologize if they have made a mistake. Another thing to keep in mind is that there is a difference between feeling uncomfortable because you are dealing with your issues in therapy and discomfort because a technique or therapist simply is not working for you. If you are feeling uncomfortable or upset, talk it out with your therapist. They should be willing to talk about what is going on between the two of you in session (aka metacommunication). If a technique isn’t working for you, your therapist should be willing to modify it or scrap it altogether. A therapist that is not willing to be flexible and talk to you as if you are a competent adult isn’t a therapist that I would want personally.
Another thing to keep in mind: a therapist is not supposed to give you advice. It is not their place. A therapist is supposed to help you become independent by, for example, providing you with coping skills, teaching you techniques, and/or making you aware of your own inner strengths. Giving a client advice fosters dependence on the therapist by creating a situation in which the client feels like the therapist has all the answers. The client may not think they can come up with answers to their problems on their own and feel as if they would be incompetent without their therapist. This is not the kind of situation a therapist should encourage. If a client has a problem, an effective therapist would help the client brainstorm ways to resolve the situation on their own so that if they ever find themselves in a similar situation, they will be able to handle it without their therapist’s help. I would be incredibly wary of a therapist who dispenses advice or tries to “fix” your life.
Again, please don’t forget that, as the client, you have agency. The therapist is not your lord and master. They are not better than you. They are not smarter than you. You are the expert on your own life experiences and they are the expert on therapeutic approaches/techniques. You deserve respect for your expertise. In my opinion, a therapeutic relationship should be based on mutual respect, collaboration and trust. Don’t be afraid to stand up for yourself and seek out what is best for you. You are important and you deserve the best.
If you have questions or suggestions for future topics, please feel free to send an email to me at firstname.lastname@example.org or tweet to @QueeringPsych on Twitter.