To think therapists are mostly charlatans?

[BlueJuniper94]

I've heard in real life of people who have made radical decisions/changes in their lives because of what a "therapist" has said to them. Things that have surprised me as it seems outside the scope of what I thought therapists are there to do (although it's perhaps not entirely clear what that is now).

Today I was listening to woman's hour where a woman being interviewed about her husband walking out on her and her kids tried to keep it from them for a month as per her therapists advice which she said looking back was the wrong thing to do. I am surely this therapist was handsomely paid nonetheless. Aibu?

As @Noalcohol26 said

Person centred therapists don’t give advice …they provide an empathic space to help facilitate the change their client wishes to make

There's a difference between offering advice as a random/friend/mumsnetter vs holding yourself out as having relevant professional expertise. That's why qualifications and regulatory bodies exist.

YANBU in the sense that a good therapist should refrain from directly advising. Ideally they should reflect client feelings and ask open questions to promote client autonomy and help clients to explore and weight options to ultimately reach their own decisions.

Yes - I mean, it's quite possible that sometimes it is the client, or sometimes it's that the client and therapist just don't mesh, and sometimes it might be the wrong kind of therapy... But all too often the blame is pinned entirely on the client, as though they've 'failed', or not tried hard enough, or had the wrong mindset, when that's not always the case.

And frankly, should a good therapist not be skilled in dealing with and disarming defensive or difficult clients anyway? After all, their entire job is dealing with emotionally dysregulated or traumatised people.

It's this element of 'you need to find the right therapist for you' and, 'you need the right type' of therapy that makes it feel a little 'airy fairy'. Not many people seeking therapy have the financial ability or the mental fortitude to try multiple therapists, or a range of different types of therapy, and there seems to be very little direction for clients as to what type of therapy might best suit them.

So a person could very easily spend months and an inordinate amount of money trying to find the Goldilocks therapy and therapist, and still come up empty.

But in practice, how does this look? It just seems a lot of repeating what the client said.

You obviously meant well but I do think you need to do some training on risk and to rethink your boundaries, as others have pointed out.
Many therapists will be terribly well meaning but ‘the path to hell is paved with good intentions’ etc. It’s always worth keeping this in mind (I say this as a therapist and as a ‘note to self’ as much as anything)

What does that even mean though? What actual things does 'providing an empathic space to help facilitate change' involve? It just sounds like a load of woo-woo buzz words that mean absolutely nothing.

It irritates me, because having been in therapy, it's the kind of thing clinical psychologists would say to me...and they never did anything more helpful than listening and asking an occasional obvious question that had no actual use.

As other have pointed out, this could be used as a training scenario in how not to deal with this situation.

@dampmuddyandcold and @OtterlyAstounding it can be helpful for people, once they’ve vocalised their thoughts, to reach their own realisations

some gentle questioning to discover why they think the way they do can be beneficial because a client can sometimes begin to perceive things differently

once a good relationship is established, some challenging can be done, ie if the client has a strong self belief which might not necessarily be true

some clients just want to be heard

I made a very crude example to show how misunderstanding from what occured in the counselling practice could occur.

We dont know what else could have occurred in that session. Or what sort of client this is. To state its poor practice on so little is actuallly proving my point that people take away what they wish to hear.

A good therapist will work with what their clients needs are, some clients need the label spoken out loud, others will need a different approach.

Doesnt automatically mean we are seeing poor practice in my made up example.

I’m not doubting that is helpful, but I suppose what I’m questioning is that specific training and qualifications are needed for it and that it can only come from someone with that training and qualifications.

It does seem as though therapy probably works most effectively for people who haven't done a lot of self-searching, and need the soundboard of a therapist to work out their thoughts and feelings.

For those already aware of the reasons for their issues/unhealthy thought processes, but who have found it impossible to change them, I've found therapists have worryingly little to offer. Perhaps I've just had bad luck with them, to be fair, but then that ties into the issue it's very cost prohibitive to find the right one.

The cost so often gets brushed off in a way I can’t think of that anything else would.

I def don’t think they’re charlatans! I’ve got a couple of friends who are therapists and they’re amazing people and knowledgeable. The training is rigorous as well.
Obviously some are better than others. I’ve seen a couple and there was a stark difference - you need to click with them too - the relationship is important. And if you’re having CBT you need to put the work in.
id def go back to therapy if needed. I had it for a year but it was fortnightly after a while.

In my experience it means non-judgemental. If have thoughts I have complex feelings about and lack the emotional skills and understanding in which to process what happened then it can get stuck in my head, sometimes for years.

These thoughts can range from existential crisis including suicidal thoughts, to why that person handed me a red cup rather than the blue cup I asked for.

Working with a pyschologist has given me new ways to see these thoughts. In my case all thoughts were problems I had to solve, now they are just thoughts.

This is a skill, that requires practice to complete effortlessly. Other emmotional skills are managing reactive feelings like anger and understanding what lonliness means. I have also been able to actually feel the painful feelings like sadness and lonliness knowing that I will be OK afterwards and that its the only way to make them go away.

It's so expensive!! And it's not as though you can get a refund if they're not a good match for you, or do a poor job - if I paid to get my nails done and the polish all chipped off the next day, I could get a refund.

But if I pay for a therapist and they sit there nodding and smiling and asking 'gentle questions', and I immediately know they're not going to be helpful, then I've likely spent £80 at least and won't get a penny back.

Interesting! Thank you. I think what I've found is that I've never had a psychologist (or therapist) give me new ways to see those thoughts, or taught me those skills - they've all tended to just listen? And occasionally ask a question about how things affect me/how I feel. Pretty much nothing on how to reframe/cope with thoughts and emotions.

Perhaps I've just had poor luck with them, or perhaps you've had good luck! (But I'm quite invested in the topic at the moment, because I'm considering trying therapy again.)

It’s not accurate to say most therapists are charlatans.

‘Therapist’ isn't a protected title in the UK and counsellor/psychotherapist/therapist are often used interchangeably. There’s actually debate within the field about distinctions, but no single legal definition. That makes it confusing from the outside, which is reflected in some of the replies here.

There are also many different modalities and theoretical lens (different ways of understanding the human mind, behaviour and how to work with it) which adds to that complexity.

The majority of practising therapists are members of professional bodies such as BACP or UKCP (these are membership organisations rather than statutory regulators). For BACP membership you need at least three years training, a minimum of 100 supervised placement hours, ongoing clinical supervision, adherence to their ethical framework and their complaints procedures. You should also have had your own personal therapy as part of training. When working with clients you’re expected to have clear contracting, risk management processes and firm boundaries in place.

It’s a demanding profession because it involves working with the complexity and ambiguity of being human. People can’t be sorted into neat boxes and healing isn’t linear and often people can feel a bit worse in therapy before they feel better. They bring trauma, loss, attachment patterns, defences, contradictions. You’re monitoring risk and holding emotional intensity often over long periods. You’re also holding confidentiality - carrying other people’s grief, shame, anger and secrets in a contained, boundaried way. That containment is part of the job.

Ethical practice requires continual self reflection and supervision, untangling what belongs to the client from what belong to you (look up transference and counter transference if you’re interested in learning more - it’s fascinating). Self doubt in this work isn’t evidence of incompetence, often it’s part of responsible practice. Mistakes do occur and good therapists are trained to recognise and repair ruptures rather than deny them.

Therapy also isn’t passive validation. Effective work involves both support and challenge. The client has to be willing to engage in change. It’s also important to recognise, good fit between client and therapist is really important. Research consistently shows that the quality of the therapeutic relationship is one of the strongest predictors of outcome.

There are poor practitioners in every field, particularly where titles aren’t protected. That’s a valid concern. But dismissing an entire profession that requires years of training, supervision, ethical accountability and the disciplined holding of other people’s private material as “charlatans” doesn’t reflect the reality of the work.

A good therapist or Clinical Psychologist should offer lots of different things to try to reframe thoughts/ cope with difficult emotions. Best of luck in your search if you decide to go ahead :)

A good, experienced psychodynamic psychotherapist can be life changing.

unfortunately this kind of therapy is only available privately. It’s slow and expensive.

CBT is (imo) a crock of sh1te. Didn’t help me at all.

I'd like to add career coaches with their Internet qualifications to this

So, while the term charlatan isn't right in this situation, I am concerned that many front line NHS mental health services are provided by people with very basic training. I recently self-referred to my local trust mental health team. I am in peri-menopause and struggling with sleep, which I believe is impacting my mood. I had a clear idea that I want to try CBT-I rather than using sleeping medication. I had an hour long screening interview, where the questions I was asked were based around my scores for depression and anxiety which were high. These questions were from someone who was honest that they were a trainee, delved into my whole life, all traumas I've experienced including childhood. Then, lots of questions about self harm and suicide. Then, questions about what would need to happen that could cause me to be actively suicidal, which meant I had to think hard and say 'well, my DC dying I suppose'. Then they asked for the name of my DC which flagged to me they were recording as a concern, which totally spiked my anxiety of course! At the very end, they asked what pathway I was hoping for, and I told them I had insomnia which I think is effecting my mood and I was hoping for CBT-I. We then had to stay on call for another 30 minutes to discuss that. By this time I was incredibly upset - I'd just had to visualise my DC dying in order to understand a situation in which Id kill myself - and was also 30 minutes late to a work meeting which I had to join with camera off because I'd been crying. It was absolutely overkill, and I decided it wasn't worth it and cancelled my referral.

I should have clarified that it has taken me 10 years of being persistent to get to this point. Often people need a therapist/pyschologist because no-one is actually listening to them. It has been expenisve and I have had to see it as an investment rather than as a treatment.

The therapy you are having sounds like the therapy I have. Non-judgmental but if I do say something completely off the boil - like "this person at work said no to me and now I want to make a complaint about them for bullying" then we talk about how I think I would feel when I have calmed down.

A really good book I read last year that has helped me form an idea of what I am actually aiming for. Its called "Adult Children of Emotionally Immature Parents". It was good because it described what emmotional immaturity looks like in a adult. I recognised myself a lot. Its feels quite personal, but because of the work I had done with the Pysch (you feel attacked because you are embarressed etc.. not because you are a bad person) I was able to get through it.

Erm..sort of.
That's not an appropriate level of support and very blurry professional boundaries. This person should have been directed to crisis services. They should not have had your personal mobile number and you should not be contactable outside your office hours on your work phone.

I would agree with this. I went to an EAP counsellor and I told him something that was really painful at the time and he just laughed at me. I knew it was wrong and he was a berk, but because I was vulnerable at the time it had a less than good affect on me.