Becoming a psychologist despite bad/ineffective experiences with therapy?

[gohogwild]

OK I'll keep this brief because I know this post toes a line.

"My friend" has never gotten much out of my own personal therapy (mainly worked w psychologists & LPCs).

That said, I cannot see myself doing anything else as a career, provided the research/clinical experiences I've had thus far.
I know anecdotal experiences with therapy are not empirical evidence. But has anyone else dealt with their 'faith' in this way? And if so, how have you reconciled it?

Thanks!

---

Members don't see this ad.

 

[foreverbull]

I think of it in the same way as bad supervision, leadership, etc.: we can learn what not to do and steer clear of the mistakes that the therapist made with the person (whoever it is). That’s one way I reconcile it. If you’ve (not you personally, but universal you) worked with more than one therapist in your lifetime, one of them was probably not great due to there being a lot of average to not great therapists out there as part of the bell curve that we’d expect in terms of therapy mastery/skill. And of course there are client factors and bias that affect therapy perceptions, but also just objectively bad practitioners out there.

Also, hearing that there are so many bad therapists out there is disheartening, but on the flip side, with regard to some stories I hear from clients about past therapists, it makes me feel pretty confident that I hold my practice and professionalism to a higher standard than those in the anecdotes I’ve heard.

In my experience, my master’s program was terrible and didn’t prepare me to practice more than basic interviewing skills, and I knew I was going to get better training with my doctorate and grow with more training and coursework. Some folks are happy to stop there and use their interviewing skills alone to provide therapy.

So perhaps hearing about/experiencing the bad inspires some of us make sure we hold ourselves to higher standards so that folks don’t lose faith in our field (and we don’t either).

Edit: And to put it in perspective: mediocrity exists in every career path imaginable. This isn’t unique to our field, so you have to be selective about every professional service you seek, whether it be lawyers, doctors, accountants, etc. to get the best care. Hence why folks in our society with the most money have the most privilege because they can be more choosy and selective with everything they need.

 

[Ollie123]

Agree with the above. It also largely depends on the specifics of what made it bad. Was it a misdiagnosis? I know several people who went into medicine after years of frustration with misdiagnosis and delayed care for themselves and family members. That can be a powerful motivator and certainly has helped drive change. Was it an unethical provider? Bad apples exist in all fields, but fortunately are relatively rare. Was it that treatment didn't work? Well its important to make peace with the fact that we simply aren't very good at treating many things and that many of your patients will either not improve or show only marginal improvement. Was it that your "friend" was presenting with objective life stressors and therapy was just kinda "meh" and didn't really accomplish much? You aren't a miracle worker. Sometimes life sucks and there's no psychotherapy to treat that. The prototypical outpatient psychotherapy case is probably moderate adjustment disorder that would likely resolve on its own just fine over time.

 

[gohogwild]

I think of it in the same way as bad supervision, leadership, etc.: we can learn what not to do and steer clear of the mistakes that the therapist made with the person (whoever it is). That’s one way I reconcile it. If you’ve (not you personally, but universal you) worked with more than one therapist in your lifetime, one of them was probably not great due to there being a lot of average to not great therapists out there as part of the bell curve that we’d expect in terms of therapy mastery/skill. And of course there are client factors and bias that affect therapy perceptions, but also just objectively bad practitioners out there.

Also, hearing that there are so many bad therapists out there is disheartening, but on the flip side, with regard to some stories I hear from clients about past therapists, it makes me feel pretty confident that I hold my practice and professionalism to a higher standard than those in the anecdotes I’ve heard.

In my experience, my master’s program was terrible and didn’t prepare me to practice more than basic interviewing skills, and I knew I was going to get better training with my doctorate and grow with more training and coursework. Some folks are happy to stop there and use their interviewing skills alone to provide therapy.

So perhaps hearing about/experiencing the bad inspires some of us make sure we hold ourselves to higher standards so that folks don’t lose faith in our field (and we don’t either).

Edit: And to put it in perspective: mediocrity exists in every career path imaginable. This isn’t unique to our field, so you have to be selective about every professional service you seek, whether it be lawyers, doctors, accountants, etc. to get the best care. Hence why folks in our society with the most money have the most privilege because they can be more choosy and selective with everything they need.

Your point about masters level training largely providing interviewing skills rings true. My alma mater did not have a clinical psychology professor (or anything close), so much of the exposure to clinicians one may gain in such a situation is through other direct methods. Without good experience or help, it's a little discouraging and from the perspective gained, and may leave questions about the ethics of making others potentially suffer in similar ways. Until then, all directions point to reading these forms and reading books by vested clinicians, until the day one appears, and so, seems a bit less like the end of a rainbow. Thank you for your response.

 

[gohogwild]

Agree with the above. It also largely depends on the specifics of what made it bad. Was it a misdiagnosis? I know several people who went into medicine after years of frustration with misdiagnosis and delayed care for themselves and family members. That can be a powerful motivator and certainly has helped drive change. Was it an unethical provider? Bad apples exist in all fields, but fortunately are relatively rare. Was it that treatment didn't work? Well its important to make peace with the fact that we simply aren't very good at treating many things and that many of your patients will either not improve or show only marginal improvement. Was it that your "friend" was presenting with objective life stressors and therapy was just kinda "meh" and didn't really accomplish much? You aren't a miracle worker. Sometimes life sucks and there's no psychotherapy to treat that. The prototypical outpatient psychotherapy case is probably moderate adjustment disorder that would likely resolve on its own just fine over time.

So many individual, excellent points- your critical perspective is invaluable again. Especially re: objective life stressors and the appropriateness of psychotherapy. I know I am not the first person to observe or be frustrated by the top-downedness, disorganized, potentially narrow, or otherwise inefficient way in which treatment is implemented (compounded by clinician competency/awareness/misaligned common factors or whatever). Quite the beast. Thank you for your response.

 

[PsyDr]

There is a difference between faith in a person, and faith in a profession.

The first contractor who remodeled my bathroom screwed up it. I just hired another guy to fix it.

 

[gohogwild]

There is a difference between faith in a person, and faith in a profession.

The first contractor who remodeled my bathroom screwed up it. I just hired another guy to fix it.

Great differentiation. I think the former is sort of leading to the latter, which I understand is a flawed approach and one I look to improve.

Separately, there are some stray concerns about what it means to be the person which facilitates the uncomfortable process of even good therapy for another person (with it's potentials for transference, obsessiveness, regression, painful vulnerability, etc). And yes these are motivators to be a very good and ethical clinician- but if the cost/benefit doesn't pan out in general- for whatever reason(s)- for many clients, it gives me pause (which I know is very 'duh'). I know there's bad clinicians out there, but psychotherapy (including the experience of it) concerns me in general. This could just be a reflection of my tendency to continuously 'check' to make sure I am acting in alignment with my values as psychotherapy becomes something which I know to be generally accepted and trusted (at least in my ecological niche) to becoming a personal belief and practice of my own as someone who intends to follow this as a career path, etc. I would not be surprised if this is a common process for prospective trainees, etc. And my friends experience of 'meh' therapy certainly plays a part in that.

Sniffing around I've seen some recommendations for Larry Beutler.

Also, I wouldn't give the second guy so much credit- your bathroom also wanted to change by that point.

 

[psychma]

My master’s program gave me the basic interviewing skills and that was about it. It was my two practicums and internship that provided me with skills. Add to that four years of supervised practice with individual and group supervision.

 

[smalltownpsych]

With some of my patients, I am an excellent therapist and earn much praise. With quite a few others I do ok and they benefit and appreciate it. With a few, I totally suck and they never come back. Therapy doesn’t work for everybody and neither does every therapist. I tend to specialize in a few different types of patients and disorders and tend to do well in those areas, but not always. Also, completely agree that therapy isn’t that beneficial for relatively healthy people with situational stressors. I usually just normalize their experience, give them some psychological advice and send them in their way. I find it amusing that some people will try to make a living off those people. My practice is filled with patients with moderate to severe mental illness.

 

[gohogwild]

With some of my patients, I am an excellent therapist and earn much praise. With quite a few others I do ok and they benefit and appreciate it. With a few, I totally suck and they never come back. Therapy doesn’t work for everybody and neither does every therapist. I tend to specialize in a few different types of patients and disorders and tend to do well in those areas, but not always. Also, completely agree that therapy isn’t that beneficial for relatively healthy people with situational stressors. I usually just normalize their experience, give them some psychological advice and send them in their way. I find it amusing that some people will try to make a living off those people. My practice is filled with patients with moderate to severe mental illness.

Thanks for this reply. Therapist fit seems to be one of the ultimate considerations (besides necessity).

 

[sjLando]

Just wanted to ask / share thoughts, therapy for folks who are "going to be ok regardless" is still really valuable. Situational and life stressors therapy helps give the tools they need to handle other situations down the line, and hopefully build some trust in the model so they will be comfortable coming to work with someone later on for something much worse, or will have the tools needed to handle it themselves.

I do worry about the folks who come in though who get nothing out of therapy, build a bad view of it, and are then hopeless later on when something really bad does happen.

This has been a great thread!

 

[sjLando]

Thanks for this reply. Therapist fit seems to be one of the ultimate considerations (besides necessity).

I wonder how this fits in with CAP where you could have potentially much older practitioners trying to help teens. I'm in my 30s now and by the time I'm practicing I will have to relearn all of the pop culture / video games / slang and be even more out of touch.

You go a few minutes these days without watching TikTok / twitch and you are a boomer with how fast the language evolves.

 

[chicandtoughness]

I wonder how this fits in with CAP where you could have potentially much older practitioners trying to help teens. I'm in my 30s now and by the time I'm practicing I will have to relearn all of the pop culture / video games / slang and be even more out of touch.

You go a few minutes these days without watching TikTok / twitch and you are a boomer with how fast the language evolves.

I'm an elder millennial and I personally LOVE that I'm "out of the loop".. the kiddos I worked with loved to educate me. I would frequently "play dumb" (tbf most of the time I was genuinely clueless, not pretending hahaha) as a way to get them to open up. We openly talked about things like TikTok trends. It gives them some sense of ownership and puffs their egos a little to be able to educate me, and then they laugh at me when I try to utilize the slang. Obviously it doesn't work perfectly with every kid, and some will just roll their eyes at you, but using my "out of touch" age as a line of curiosity goes a long way

 

[smalltownpsych]

Just wanted to ask / share thoughts, therapy for folks who are "going to be ok regardless" is still really valuable. Situational and life stressors therapy helps give the tools they need to handle other situations down the line, and hopefully build some trust in the model so they will be comfortable coming to work with someone later on for something much worse, or will have the tools needed to handle it themselves.

I do worry about the folks who come in though who get nothing out of therapy, build a bad view of it, and are then hopeless later on when something really bad does happen.

This has been a great thread!

I agree. Although I tend to work with the more severe and they are the people who tend to need longer term or ongoing therapy, I always want to advocate for the benefits of a positive experience and that although it’s fortunately not really serious right now and I support and reinforce their resilience factors, if it gets worse come on back. Kind of reminds me of when I unknowingly strained a muscle in my chest during yoga and the ongoing pressure led me to think I might be having a heart attack and of course that thought leads to anxiety which also feels like the same. I was happy that no one, other than my spouse and myself, really mocked me for getting checked out, but not needing treatment. Quite the opposite experience actually and if I do end up having problems way way way down the road, I’ll be more comfortable seeking help.

 

[sjLando]

I'm an elder millennial and I personally LOVE that I'm "out of the loop".. the kiddos I worked with loved to educate me. I would frequently "play dumb" (tbf most of the time I was genuinely clueless, not pretending hahaha) as a way to get them to open up. We openly talked about things like TikTok trends. It gives them some sense of ownership and puffs their egos a little to be able to educate me, and then they laugh at me when I try to utilize the slang. Obviously it doesn't work perfectly with every kid, and some will just roll their eyes at you, but using my "out of touch" age as a line of curiosity goes a long way

This is very interesting.

I've been involved in a lot of youth and young adult programs over the last five years and I constantly am thankful when I run into teens being able to fit right in or at least let them know I have some clue what's going on. Especially the older teens being able to build rapport and let them know I see them as equals rather than kids.

 

[Ollie123]

Just wanted to ask / share thoughts, therapy for folks who are "going to be ok regardless" is still really valuable. Situational and life stressors therapy helps give the tools they need to handle other situations down the line, and hopefully build some trust in the model so they will be comfortable coming to work with someone later on for something much worse, or will have the tools needed to handle it themselves.

I do worry about the folks who come in though who get nothing out of therapy, build a bad view of it, and are then hopeless later on when something really bad does happen.

I'd slightly tweak to say it "can" be valuable. Certainly in some instances it is. In other cases it clearly isn't. Whether it is on average is an empirical question I'm not sure I've seen adequately addressed (admittedly it would be pretty darn difficult to do). There are likely a host of moderating factors in place and I'd imagine it varies significantly by type of stressors, which themselves are difficult to categorize. Going through a divorce is not the same as remaining in an ongoing marriage of dubious quality, etc., etc.

 

[gohogwild]

I'd slightly tweak to say it "can" be valuable. Certainly in some instances it is. In other cases it clearly isn't. Whether it is on average is an empirical question I'm not sure I've seen adequately addressed (admittedly it would be pretty darn difficult to do). There are likely a host of moderating factors in place and I'd imagine it varies significantly by type of stressors, which themselves are difficult to categorize. Going through a divorce is not the same as remaining in an ongoing marriage of dubious quality, etc., etc.

Totally agree. Both sides of the discussion do not define a 'relatively emotionally healthy individual with normal life stressors'. I'd be afraid that we are confusing functioning with emotional health.

 

[dazzlingsis7]

Just wanted to ask / share thoughts, therapy for folks who are "going to be ok regardless" is still really valuable. Situational and life stressors therapy helps give the tools they need to handle other situations down the line, and hopefully build some trust in the model so they will be comfortable coming to work with someone later on for something much worse, or will have the tools needed to handle it themselves.

I do worry about the folks who come in though who get nothing out of therapy, build a bad view of it, and are then hopeless later on when something really bad does happen.

This has been a great thread!

Hello, Therapy can be helpful for folks who are already doing pretty well. It's not just for when you're feeling down and out. It's like having a toolbox for life. You learn coping skills and ways to handle stress, which can be super handy down the road.

I do worry about people who try therapy and don't find it helpful. It can leave a bad impression, and they might think it's useless when they really need it later on. But there are ways to make it better.

First, it's important to find a therapist you vibe with. If you feel comfortable with them, it can make a huge difference.

Also, we need to spread the word about therapy and its benefits. Let's break the stigma around mental health, so more folks will be open to trying it.

Different strokes for different folks, as they say. Some people might find talking it out helpful, while others might prefer something like CBT or mindfulness techniques.

And don't wait until things get out of hand. Seeking help early on can prevent bigger problems later. It's all about building trust.