<p>A neighbor is looking for a therapist for her daughter who recently graduated from college. (Mom thinks that daughter is depressed–she doesn’t like her job, and she lives with her parents and can’t afford to move out, is what I know about the situation.) During our conversation, she said, “I am not sure a psychologist will help, but it probably won’t hurt either.” </p>
<p>I am curious whether you all wise and maybe psychotherapy-experienced parents think this is true–should a parent be worried about possible harmful effects from a psychologist? (And I mean a mainstream, cognitive-behavioral-therapy practicing therapist, not a psychoanalyst or someone who wants to recover repressed memories.)</p>
<p>We think about physical treatments having risks and side-effects but I have never thought about the possibility of mental health treatment having the same concerns, until my neighbor made that remark.</p>
<p>Yes, it can be harmful if the client and the therapist are not a good match. I always tell people to give the new therapist a couple of sessions and if they are not comfortable to move on. No therapist can be a match for every client and most of us do not take it personally. The important thing is that the client feels understood and comfortable.
Again, not speaking to unusual therapies–just regular stuff.</p>
<p>Many parents come along for first session, just to see the therapist, the office set-up. They may inquire if they can communicate with the therapist and ask about confidentiality. One dad asked about co-fees and automatic payments. </p>
<p>Its not unusual for someone to feel uncomfortable with a therapist. In my office, the person can ask to shift to another T in practice. Reasons? gender, too talkative, too quiet, too old, too young, too perky, too strict with rules. </p>
<p>And sometimes a therapist will suggest another T who they feel will be a better fit. </p>
<p>Young adults can benefit SO much, looking at relationships with friends and family, dating, personal and professional goals, how they think/feel about situations, and so on. </p>
<p>I think that therapy, deep introspection with a professional guiding the way is a gift. But the therapist is only as good as the patient’s listening skills and the desire to fix what is wounded or broken.</p>
<p>Therapists being helpful or not aside, teaching a depressed young person that therapy is a valid option, as well as seeking treatment in general, rather than suffering in silence, is useful as a life skill. </p>
<p>After a lot of resistance, I got one D into therapy years ago for a specific issue. She states it may have helped a bit. What I saw, was a girl looking glowingly happy after the sessions, and the issue was approached with less angst.</p>
<p>Speaking as a therapist and a parent, the wrong therapist could actually create further difficulties in the following ways:</p>
<p>-most likely poor outcome, especially with a young, vulnerable person could be that they see one counselor who is not a fit and decide that no one can help them and stop looking. This could be a case of a competent therapist, but a poor match or discouragement caused by no immediate result. Depressed people by definition frequently lack hope, and may give up easily without encouragement from home. </p>
<p>Incompetent therapists could create problems in a variety of ways:
-not being knowledgeable enough or willing to refer for additional medical/medication evaluation if indicated (if not medically trained themselves).
-becoming inappropriately involved with a patient or not having their own act together in ways that preclude assisting others
-not being pro-active/effective in managing severe symptoms, perhaps because they lack connections to other professionals or a hospital setting if needed. </p>
<p>Therefore, I would suggest the following for parents seeking help for their kids:
-Research who to start with carefully, seeking recommendations from those in the know locally (primary care docs, therapist acquaintances, school counselors, etc.)
-Talk with your “kid” directly before they go: See if they have strong gender preferences, don’t think they could “talk to an old lady”, etc. Acknowledge that it is hard to know in advance how it will work out, but that you are there for them while they begin, want to hear feedback, will go with them initially if indicated, and be willing to look for alternatives if it is not a match. A good therapist will help a young adult articulate this, but you have the long term relationship to normalize a getting to know you process.</p>
<p>I list the possible problems in the context of the question posed. I do believe that learning how to seek help when indicated is a huge life skill and can make all the difference when one is struggling due to circumstances, biology/genetics, temperament or a combination of all. Most therapists are not inappropriate, respect boundaries and want the best for their clients. That said, there is no field without some subpar participants. </p>
<p>From the OP’s brief description of the young woman’s situation, it just sounds like she is having a tough time getting traction in adult life, and her reality isn’t matching her expectations. Discontent in this case may possibly be an entirely rational and healthy response to circumstances, not a disease that needs to be treated. Disappointment or situational unhappiness is not the same as clinical depression.</p>
<p>I spent a long time with an ineffective therapist (for me), and after I stopped (for financial reasons), I realized that it just hadn’t helped. Years later, when I realized I really needed to see someone, I delayed for a long time, thinking that it would be difficult to find someone who was a good fit. Once I did find someone, she was wonderful.</p>
<p>So, OP, my advice for your neighbor (worth what it costs you!) is to make sure her daughter understands that sometimes there are issues of fit but just because it doesn’t work out with one therapist, she can and should try, try again.</p>
<p>Plus, as others have noted, it may be a situational thing. There are therapists that are very good with this kind of specific issue.</p>
<p>I think therapy will rarely “hurt”…as some above said to maximize the benefit the fit of the therapist is important (and frankly fit can be hard to judge in the first several sessions–much of (non-CBT) talk therapy is sort of oblique in the beginning ie getting to know the patient without a lot of feedback and patient not being self-aware enough to understand why the therapist keeps coming back to certain things the patient thinks are unrelated). </p>
<p>An example of bad fit that a friend of mine had was a therapist who kept assigning her reading homework every session. The therapist may be a smart person who liked certain readings and found them insightful but was frustrated and unable to work with someone who didn’t think that way.</p>
<p>As others have said, finding the right match is key. Don’t be afraid to shop around.</p>
<p>Also, a good therapist will want to make sure your daughter has been medically tested for physical problems (like thyroid imbalance) that can create the same symptoms as mood disorders. You’ll do that through your family doctor. You might save some time if you see your doctor now.</p>
<p>I am not offering a medical opinion. This is pretty standard stuff.</p>
<p>I agree with all of the above. I have a friend who has been to several different therapists. The one that would have actually helped her with her issues was rejected by my friend. IMO because the therapist saw through the bull. Now she sees a therapist who seems to play into her delusional thinking. This is not helpful. It may even be harmful because it is not going to help my friend confront her issues.</p>
<p>I think it is important to find someone who will be supportive but not blow hot air up your “you know what”.</p>
<p>Sadly, there are some poorly trained folks out there or folks who practice outside the scope of their expertise. Get a good referral. There are plenty of excellent therapists as well.</p>
<p>We’ve needed lots of therapy in this family! The key is finding the right one. A very wise therapist told us that if the therapist is a poor match, therapy “fails” between the 3rd and 5th sessions. This means that if, after 3 or 4 sessions, you don’t think the therapist is a good fit, find another one. There will be no harm if you do this, and you will eventually find one that you can work with.</p>
<p>The degree doesn’t seem to matter as much as the skill and natural ability of the therapist. An MSW may be as good as a PhD, and either one will work with an MD if you need meds prescribed.</p>
<p>^^ Agree with Massmomm’s last point. D had a couple of sessions with an experienced therapist (I forget what his credential was) and didn’t like him. She felt he was “judging” her – her POV, I’m sure not true, but that was her takeaway and I didn’t want to waste time trying to convince her otherwise. I then found a young man who was an MFT intern, and they hit it off immediately. She did good work with him.</p>