Sign Of A Good Therapist?

[HappyJock]

I have been diagnosed with PTSD, Depression and Anxiety and just went to see my new therapist who was pleased to accept me, as she manually handpicks who she works with because of her unique approach to social work and therapy. She says: "First of all, aren't I lucky that you chose me? I'm so glad. I just want you to know that I do things a little differently. I want you to be able to see me and trust me as a friend, not only your social worker. I think that it makes for a more trusting relationship and allows you to open up more. After working together for a few months or years, depending on the treatment plan and how long it takes to finish that, my care for you doesn't stop. We stay friends."

My response was amazement. I've never seen that before. What are your thoughts?

Update:To clarify, I think some of you misunderstood -- I do not mean "stay friends as in "visit my house and I visit yours." I am saying it was meant to comfort the patient, as she is very professional and has a cheerful personality to ease anxiety. I mean as in she keeps in touch with former patients to see how they are doing and she may exchange phone calls or texts. I don't mean the traditional "Hey, let's hang out all the time!" As with like, let's say... a teacher and a student. If you bump into them in the streets, they won't ignore you. You'll talk, maybe, but it won't be like besties, that's NOT what I mean, haha.

Also, as for the handpicking patients, that's very common. I've called many psychiatrists and they've said "We'll review your case and see if you're worth it. We don't accept all cases, but we can refer you." So that's also extremely common. Not all psychiatrists and therapists want any type of case. But they do have the right to first see you and then decide.

 

[twinkle30]

I don't like that. I like for my therapist to maintain professional boundaries. I don't need a friend I need a therapist. Just my personal opinion.

 

[Crow]

Red lights & sirens are going off. I'd love to hear what the therapists here think.

After update: I have this sort of relationship with my T. We email non-therapeutic info on common interests. We actually have the same vet and acupuncturist so sometimes we see each other out and about and chat. We have session outside sometimes and we're planning to go to a lake for session in Spring. And I'm sure she would keep in touch if one of us moved or our work together ended. So alarm bells are silenced.

 

[Panda Bear]

Uh.....I personally, have a close therapeutic alliance and trust with my T. He has bent some, shares small details of his life, some of his personal struggles and how the relate to my situation. He has taken me out of the office on one occasion...we are working on the second. We text, email...and he has worked hard to repair decades of attachment issues.

But....he is not my friend. And when I leave his office for the last time, we still won't be friends. If I want to see him again? It'll be in another session, because I need his help.

If he approached my fist session with he way your T did? I'd run.....It's like grooming the sexual abused.

Remember, this is my perspective....and I have a very narrow scope of Therapy and therapist. As I'm sure mine is a bit untraditional as well....but he never crosses the friends line.

 

[Queen Boudica]

Yes agree. I don't think it meets with the ethical standards. They can't be your friends. It is like parents you are not friends to your child, that is a recipe for disaster. It does sound like grooming. She hand picks you? You can have a close therapeutic relationship as @Panda Bear describes. My psychologist has done same sort of things. I would tread carefully. Is she a member of a professional body?

 

[HappyJock]

She hand picks you? You can have a close therapeutic relationship as Link Removed describes.

I agree -- that's what I meant. As you can see in my update as I added details, it's a professional relationship, but she makes an effort to make sure former patients are still doing well and they can come visit her as a mutual liking. I think I may have paraphrased a bit as it was a while ago, so her eagerness may have just come off like that, but she is professional. Yes, all psychiatrists and therapists I've EVER had handpick you. I don't mean like they find you, you find them and then they have the right to not take your case if it's not something they think they can treat. And again, most any therapist I've seen sees their former patients, calls them, contacts them. It's never a "Be my BFF. No. You can surely see them if you want to see them on their lunch hour, but it won't go much further than that unless you want to go back to sessions for help. But there's nothing wrong with keeping in touch. It's more of a "I liked working with you, tell me how you're doing, what's new and if you'd like to come back!"

 

[HappyJock]

professional boundaries. I don't need a friend I need a therapist. Just my personal opinion.

I totally agree with that -- but I think I may have come off sounding the wrong way as to what she said. I think it was taken out of context, so referring back to my update which I added should make more sense now for sure. There are therapists for example, once you're done, you're done -- that's it. There are also therapists who wouldn't mind you calling them a few times a year to see how you're doing and if you need to come back. Exchange a few wishes and e-mails, not like becoming a BFF. Friendship as in a bond wherein it won't get lost simply because the sessions have ended. Just as teachers. When you're in high school, it's not allowed that you contact them outside of class. But when you graduate, more than sure you can talk to each other, exchange news, life updates that are brief, but it's not like you'll be his BFF. Haha.

 

[HappyJock]

He has bent some, shares small details of his life, some of his personal struggles and how the relate to my situation. He has taken me out of the office on one occasion...we are working on the second. We text, email...and he has worked hard to repair decades of attachment issues.

That's fantastic; the therapist seems like a good one so I'm glad. Thanks for your feedback! Again, I think it was my mistake as I paraphrased a bit which totally took it out of context... my bad. I meant exactly what you said. She said "friend" so I don't have to think of her as someone to fear. It's like when a therapist tries to ease panic for someone trying to open up. "For a second, forget I'm your social worker. Treat me as your friend, it'll be easier." You know what I mean now? I think it's a two-way relationship. It's professionally intimate because you are the one doing the opening up, but they are the ones creating a safe vibe and helping you see them as more than just some doctor. Yes, they are. But they care for your well-being and if seeing them as someone who has to report everything gets in the way, change the perspective in your mind as if you're talking to a friend and the professional relationship will go easier as the bond between a client-to-patient strengthens.

 

[Crow]

Updated my response above.

 

[Suzetig]

I saw your update but would still have concerns about a T who described their relationship with their client/patient as friendship. It should be a "friendly" relationship but not "friends" because they play a different role in your life. A therapist should be able to both make the distinction for themselves and explain the nature of the therapeutic relationship to clients without blurring. The safety should come from them knowing and explaining their role and you growing to trust that by deciding what you do and don't share. I have a lot of concern about someone who, in order to help you settle in or open up more, suggests that you change your view of the relationship. The defences and barriers we have in therapy are there for a reason and are to be worked with and through, at the clients pace. To try and speed the process up by "pretend I'm your friend" can short cut an important process of the client gaining trust in their T as a professional who has a role in providing a safe, therapeutic relationship. Learning to trust your T as a professional can model trusting relationships elsewhere. Asking you to talk to her "like a friend" when she isn't one can create unreasonable, unconscious expectations in the relationship.

I also have concern about a T who, from the outset, is saying they would want to keep in touch when therapy has ended. When you're done, the work is done. I've had Ts say it's ok to drop them a line from time to time but it's not ok for them to initiate ongoing contact or to "check" that your doing ok. Their responsibility for you ends when the work ends - otherwise they can foster dependence or the relationship becomes about their need for you to be ok and doing well rather than your needs. It's important because it's not your job to meet your Ts needs whether that be for friendship, success in treating clients, growth or whatever.

My current T and I have a very close, caring, intimate relationship that has been very hard won for both of us. She has fairly flexible boundaries but she's a professional who I pay to be in my life for a purpose. When then ends, I don't expect her to keep in touch or check in to make sure I'm ok - I'm not her responsibility any more. Our paths may well cross professionally at times but I don't expect her to have any need to keep contact open with me specifically and would worry if she did.

 

[barefoot]

Now you've edited your original post, I'm not sure why you've posted. I don't mean that rudely! I just mean, I'm not sure what sort of responses you're looking for. You seem not to be looking for people to say they have concerns about her ethics/professionalism because you seem comfortable with her professional boundaries in terms of the keeping in touch after therapy/friendship stuff.

So what kind of input are you looking for from us? Or is she actually setting off some alarm bells for you after all?

Again - I'm really not intending for this to come across as at all rude! I'm just wondering what kind of responses you're looking for because it seems like you're ok with her approach, so I'm not sure what kind of input from us will be helpful to you?

Fwiw, I think it's very odd for her to have framed your relationship as 'friendship' and for her to be talking about you keeping in touch after you complete the work (at all but especially since you've only just started working together and haven't started to build a relationship together yet).

 

[Suzetig]

Thinking about more, and recognising as @barefoot says, you may not want to hear my opinion, I would really worry about a social worker saying "forget I'm your social worker". As a social worker I have very specific duties and powers set out in law about what I can and can't do and in some cases what I must do when working with vulnerable people in any context. I don't ever want my clients to forget I'm their social worker because they may need to rely on me exercising those powers to keep them safe, or may not want to tell me things they know I would need to act on - because they have a right to share or not.

I guess what I'm saying is that there's a power imbalance in any T relationship and pretending she's your friend feels like, at best a denial of that power imbalance on her part or potentially a misuse of her power in offering you something she can't possibly sustain to get you to open up to her. BTW when choosing a T, both sides get to choose, eg she can decide she doesn't have the skill or experience to help you and you may decide she's not the one for you. I would run from any agency or T who said they were going to review my case to "see if I was worth it". I'm always worthy of their time and effort.