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David Rye. Ruchira Agrawal. Sarah White. Ivanka Menken. Joe Currier. Not in every session, but a lot. Once I wanted to say how I became angry at some man who stepped into the garden no fence against my will…. The therapist pushed to talk about another issue which he prepared, so I gave up. It was not that bad… I hoped I could raise it some other time. Many other sessions the therapist started to distract me from the topics I wanted to talk about -all those who were not related to my childhood, usually it ended up by a completely different issue that the therapist talked about his favorite -sexual experiences, even though I was not in relationship , it was as he wanted to push me into these topics despite my current energy and feelings were somewhere else.

At the end of those session I was confused. I could have not talked about what was happening to me. I tried to bring up my current issue again and again a fight with the therapist. The therapist said couple of phrases to my share and started another issue…often very mind-related and I gave up. I tried to follow the therapist- topics in my mind. I guess it means that I needed to process my emotional and body experience from the trauma and I was distracted from them into my mind, by also choosing another topic the one the therapist considered important.

I never asked directly :are you a PTSD specialist, do you have any experience? My life from birth through my mids was a mess of chronic horrifying stuff mixed in with jolts of new awful events. All anyone needs to do is to live in the present-day reality as best they can, without being distracted by flashbacks. I practiced Staying in the Present many thousands of times over several years, and got more and more and more relief as my reactions got quicker. As I said, just a thought. I also have had a few unfortunate experiences with professionals who are supposed to help, and never hurt.

My psychiatrist of 9 years terminated by sending me a form letter — she actually just put my name after the Dear… part. That was it. The damage she did — it was one of the hardest things for me to handle. I just can not understand why anyone, but especially a professional, would treat someone like that. Needless to say, I now have more trust issues than ever. Does anyone know if this is something that could be reported? Dear Mara, In thinking about the termination through the letter, I have a couple of questions. One, had you been seeing this psychiatrist regularly?

Two, has there been a long time since your last appt. Sometimes a clinician cannot have a patient on their caseload who is not keeping appts. It actually becomes a liability for them. They have no choice but to terminate after several attempts to schedule or contact you. If she is leaving her practice entirely, a letter may the way she notifies a large case load.

If you have been seeing this psychiatrist regularly, I would indeed imagine that you would feel hurt by this kind of notification. This is worth discussing with her. She would need to know the impact of this letter on you. It is clear though that you do feel hurt by this, so I encourage you to contact the psychiatrist to express yourself. I have had a couple of practitioners who have eaten during a session. One ate a Whopper there was a Burger King next door , the other, an apple. I never said anything, but I was mildly irritated. I also had a therapist that would sit and wait for me to say something and get mad that I was not working at it.

As i worked with her futher she changed a lot she was not warm and fuzzy any longer but hard and mean. When she did dump me she said she no longer looked forward for me coming to see her, and i became harder to work with….. When I did discuss this with her she told me I have a personality disorder were did that come from?

I am sorry that you had such a terrible experience in therapy. I am a LMHC who has been working with survivors of sexual abuse for years. Not once have I made a client feel so uncomfortable. Most of my clients have told me several times how grateful they are and how much therapy has helped them. Please do not give up on treatment. It really does work once you find someone you can connect with. Best wishes!

These have been excellent issues and a very good discussion. As moderator of this blog thread, I decided to post the above comment by Trace because her second paragraph is quite supportive and valid. I removed it. Also, be aware there are some Social Workers who have Drs in other fields. LCSWs can have just as much or more post graduate training in psychotherapy as any psychologist. Also, the idea that social workers do not adhere as strictly to their ethical guidelines as psychologists do to theirs is false and terribly misleading. In fact, the ethical guidelines for Social Workers are highly respected in the field of mental health as an enormous effort to prevent harm.

I am surprised the comment was removed; it does not sound slanderous at all. What you said about social workers adhering to their ethical standards as much as psychologists do is of course absolutely true. Ethics standards for Psychologists are simply much stricter in many areas; they are known to have the tightest ethical standards in the U. I am also surprised to hear you say that some social workers can have as much psychotherapy training as any psychologist.

All psychologists have a minimum of years of graduate training after college, and most get additional training and practice beyond that before getting licensed. You are welcome to correct me, however, if I am wrong…. A therapist should be considerate and able to adapt or find a kind way to explain why it is important they do what they do. If it still does not feel right for you, report them to their licensing board!

All licensed therapists must make this information available to you upon request. In any event, the administrator is correct. If one goes to the website for the National Association of Social Workers and reads the code of ethics it is every bit a stringent, specific, and highly ethical as that of those who belong to the medical professional and psychology profession. Those with a MSW must do an internship that accounts for about half of the required 60 credits.

A MA in psychology, for example, only requires 30 or so credits and no internship. To be licensed LCSW, for example usually requires passing a National test, presenting verification of a certain number of years experience varies by state and letters from supervisors. Good Psy. Sure admin, chiming in here about the LCSW vs. The research is very clear neither discipline is better than the other in terms of therapeutic effectiveness and this finding is across disorders.

Years of experience is also not at all correlated with effectiveness. Thank you for the site and the interesting topic. First let me clarify. In the State of California there is a written and an oral exam. The oral exam is now a written series of Vignettes. This is by choice as I work for the federal government and could just take the national exam and leave it at that.

It has taken me 6 years counting 4yrs undergrad to complete the degree alone. And two years minimum to complete the post degree hours of supervision.


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As a case manager and addictions counselor. Now as for the degree it self. It was required that I complete a minimum of 80 units. It is counted as Hrs. In social work this is a true internship and it is part of the curriculum to qualify for the MSW degree. Very much like the medical degrees.


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You must complete during your degree! This is usually completed within two years but in some cases with approval from the academic standards board at the University, you can extend the degree to three years. That requires the student to attend a major university. The standards for the MSW degree are huge. For good reason, the MSW degree is also the oldest mental health degree and profession in mental health, except psychiatry.

I have therapist I rely on that is an awesome guy. He is a PsyD and a wonderful therapist and person. The ability for two people to relate and communicate on even ground with trust and honesty. This process takes time, patience and requires focus on the relationship. Credentials are very important as well as licensing.

What is a LCSW? Clinical Social Work Defined Clinical social work is a practice specialty of the social work profession. It builds upon generic values, ethics, principles, practice methods, and the person-in-environment perspective of the profession. Its purposes are to: Diagnose and treat bio-psycho-social disability and impairment, including mental and emotional disorders and developmental disabilities. Achieve optimal prevention of bio-psycho-social dysfunction. Support and enhance bio-psycho-social strengths and functioning.

Clinical social work practice applies specific knowledge, theories, and methods to assessment and diagnosis, treatment planning, intervention, and outcome evaluation. Practice knowledge incorporates theories of biological, psychological, and social development. It includes, but is not limited to, an understanding of human behavior and psychopathology, human diversity, interpersonal relationships and family dynamics; mental disorders, stress, chemical dependency, interpersonal violence, and consequences of illness or injury; impact of physical, social, and cultural environment; and cognitive, affective, and behavioral manifestations of conscious and unconscious processes.

Clinical social work interventions include, but are not limited to, assessment and diagnosis, crisis intervention, psychosocial and psycho-educational interventions, and brief and long-term psychotherapies. These interventions are applied within the context of professional relationships with individuals, couples, families, and groups. Clinical social work practice includes client-centered clinical supervision and consultation with professional colleagues. Adopted 12 Feb. Very nicely stated. Thank you for taking the time here. As you mention, the internship standards are pretty intensive and the requirements for licensure are also very stringent.

Yes the MSW degree is just that, a professional degree. Which is a little different than an academic degree you mentioned. Mainly, for the obvious purpose of referral and using our strengths in the mental health field as professionals to better help our clients. We all know people who may be of a different degree or background that excels in a certain type of help they can provide a client. No one wants to think that they have nothing to offer a client.

But, all to often that is the case. I think it is imperative that we as profession begin to operate similar to the medical profession. They form medical groups and they have their specialists in certain areas who like what they do and do it well. There should also be some front line general practitioners in our field. Mental health groups of all backgrounds would help facilitate this, much like medical groups.

But we all must be able to recognize our own limitations. Whether it is personality, skills, education or personal background. My Old Therapist would make me wait for 20 minutes cause she was starving as I read an old magizine she chomped on her to go lunch.. What a rip. I personally would walk out of the session or prior to the 20min being up if my therapist treated me that way. No excuse. On Dual Relationships. Dual relationships can be unethical and illegal, they can also be unavoidable or even mandatory, yet some dual relationships are clinically beneficial. We need to be flexible and learn that the meaning of dual relationships can only be understood within the context of therapy.

Ofer Zur. I think you make a good point, which is that the relationship between you and your therapist is what is essential to getting help and benefits from therapy. Always assuming your therapist is licensed and appropriately trained for your issues. I note, however, that it is not so much the training that has been important as it has been the connection we were able to establish ….

I have been seeing a counselor for 16 years for many family events. I cannot afford to see her now. I am not sure what to do. I feel guilty but I am more comfortable with her. Also the second counselor keeps her uneaten lunch supplied by the drug reps in her top drawer to munch on between appts:. I appreciate the opportunity to share my experiences.

During my 4th brain injury recovery I too was hugged after each session without being asked. I have a hard time with boundaries and confrontation so I discontinued therapy without explanation even though I really needed further help. I am online seeking that help now after 7 years and noticed this blog. What I needed was to overcome fear and devise compensating learning tactics. Since then I have earned a 3.

I doubt those counselors could match that. I regret skipping college due to my fears, lack of understanding my brain injuries and listening to really bad advice from ignorant school guidance counselors. Think about adding the following item to your list. They should not discourage you from honorable goals. I have gratitude for many clients that show dedication and trust in their treatment with me. Some work harder than others, some more internally motivated than others.

I strongly believe that I have an ethical responsibility to continue to see internally motivated clients although their ability to pay has changed. Do I owe that same loyalty to those who are only externally motivated? No, because it would be a disloyalty to keep someone in therapy that is not clinically progressing regardless of their ability to pay. If a client is committed and loyal to their treatment, then yes, I would and have reduced their fees to what is reasonable for that client at that time.

In the event that a potentially new client cannot afford the services, there are many community counseling services that receive funding for those who are financially limited and in need of therapy. As these economic times have become fragile in the past year, I have had a couple of very motivated clients who have been laid off from their places of employment and they have lost their health insurance by no fault of their own. Many clients have issues of past abandonment with authority figures or persons they had entrusted.

I believe that refusing to see them in their time of financial crisis would be ethically irresponsible and clinically would be considered to be an issue of abandonment. So, Denise, it looks like you have a great topic for your next session…how has this issue revealed clinical significance on your issues you are addressing in therapy? PS-I love this forum! Very thought provoking as a therpaist and excellent real life continuing education.

To add another to the list: A therapist telling you not to talk about certain issues, i. Supposely the woman gave her one diagnosis to then change it. They are obssesed with each other and that leads nowhere. It is plain bullshit that you can file a complain and hold them accountable.

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Noone should have that much power. This is a sign of poor organization in my opinion, distracts from the work at hand, and is terribly disruptive. If there is not one, then the likelihood of it occurring and your being able to do anything about it during the 50min we are together is unlikely. Please answer the calls between appointments, at night or in the morning.

Being always available is not helpful, and a lot less productive. Dual Relationship? I was seeing a therapist for depression, anxiety, and numerous emotional issues. During one of my sessions she asked if I wanted some tea she was seeing me at her home as she was going to make some, I said no thank you. When she returned with her cup of tea she sat down and brought up a completely different topic, with no correlation to the prior subject.

This will be my last session. I appreciate this website very much, and am glad you posted warning signs to help educate us as patients. God Bless you, and may your hearts be healed so you can enjoy the beautiful things life has to offer each and every one of us. They are also not taking any new medicare or disability patients. I do see another therapists off and on now and they keep asking me if i am seeing her.

I think they will drop me if i am. I too was seeing a therapist for a number of years. I had a good relationship with this person, and started to heal. As I developed other supports, that the average person would have, such as friends, a faith community and a chosen family, the therapist naturally stepped into the background. Then the friends died, the faith community kicked me out and the chosen family left and moved out of the country. I was still seeing the therapist, at the time, but the therapist has not given me an appointment in over 15 weeks, prefering instead to have me check in by phone leave a message and would call me back and leave a message.

Granted I was not being charged for this, but found it highly annoying. I had an outstanding balance due, which was scheduled to be paid from the next paycheck and I went out on disability, and the payment was delayed only until the disability payments started coming in. The therapist has now been paid. However things have deteriorated to the point where I no longer feel comfortable talking to this person…. I am all done.

I think it is a great way for both professionals and consumers to keep up to date and really see the concerns people are having. What I find so distressing is that many professionals are not helping their clients understand the therapy process, and what its all about. I am saddened to have read so many accounts of unprofessional behavior. I always encourage people to be informed consumers, and to know the different ways that you can file a complaint if you feel that you have been a victim.

I also encourage people to keep the dialogue open if you feel that something is off about your therapist, or your therapy. Sometimes, it can be very beneficial to openly discuss your concerns about certain behaviors, such as the eating during sessions, taking phone calls, excessive wait time etc. As an MSed and LPC I had to complete a masters degree of 60 credit hours from an accredited university, plus over clock hours of true internship experience. After this was completed, in order to be licensed by the board in the state of Ohio, I was required to pass the National Counselors Exam,and background check.

From my experience I have learned that while there are many different helping professions such as psychologists, clinical social workers, clinical counselors, and psychiatrists, their degree and experience is not always going to tell you how they will be in sessions. How you connect with that person is going to tell you. I think every therapist brings something different to the table, just as every client does. You have every right to find a therapist that you feel comfortable with. With that in mind though, make sure that you give someone a chance, sometimes it just takes a little time for the therapeutic relationship to grow.

I want to file a claim on my therapist, she makes me sick she took advantage of me and raped my soul. How can these so called professionals get away with this behavior…??? I just feel sorry for her clients she has now…. One recommendation I would not completely agree with is the suggestion of getting a therapist referral from your medical doctor. A regular doctor, in my opinion, has more or less no special ability to make a therapist recommendation. And — of course there are exceptions. Or see if anyone you know knows a psychologist or social worker, as these professionals know therapists and their work.

While most of these seem excellent warnings, there do seem to be a number of contradictory examples, or examples that seem too vague. Therapists ought to have both the experience and the practical knowledge that allows them to move towards painful issues at a pace suitable to each individual. But for us to judge a therapist without the same experience and training seems like it would be too easy to prevent useful therapy from occurring. I think that is somewhat true. However, it is important that as a patient, I click with the therapist.

When we are pushed too far, and the therapist refuses to back down, there is a problem. The therapist who promotes their own agenda misses the cues. This could happen to any professional, but to not claim or own it is untherapeutic. All of this causes the therapy to not be effective, or AS effective, as both should want it to be. SO both the therapist and the client should reiterate often during the course of therapy, what they understand the goal of therapy to be.

The therapist should teach this to the client from the start. Therapy should help the client, know how to do therapy on themself…and eventually not need the therapist. Now, there are a group of clients whose main goal in therapy is to hear themselves validated. This, they feel, gives them the courage to continue. The energy, the esteem to face life. BUT, a therapist can not get a client to work on something, IF they do not want to do this. A good therapist, will be aware of when this is happening to them.

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Which tends to make me suggest that a good therapist will NOT have eight hours back to back sessions during the day. Very few people can do their maximum best work, for eight hours straight. If the therapist trys to confront the client on areas the client has not agreed are areas they want to improve…this may feel like an ambush. It makes you feel a little better for the moment; BUT it does not do the prime task of therapy, which is to make you your own therapist, someone who eventually will not need another person as a crutch to cope with the world.

They are looking for a home; a surrogate parent, family or friend. A place to dock their boat when life feels stormy, and is out of control. They want a place to feel soothed, valued, and accepted. No more than you would marry the first person you dated as all dates would be equal would the first therapist you saw, have the likely hood of meeting your particular needs and style.

Also, sadly, sometimes after you have been married for a while, you may have grown beyond your mate, and wish to move on. The fault here would be with the therapist, because the minute that the therapist starts feeling frustrated, the therapist should re-check to see they are going in the direction the client wants. The therapist should help the client see what is happening in their relationship, not just leave the client wondering what IS going on.

If the therapist realizes that they are not capable of helping the client grow to the level the client wants; the good therapist should offer to help the client find the person who can. Sometimes this means confronting the client, but with the VERY things the client says they want. The goals may need to be re-thought, or new goals added after this is done. BUT, know this happens in many, many cases.

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It is the conflict between the conscience and the ID, and is normal. It is up to a good therapist to make this understandable and workable in therapy. One part of us believes in our changing, wants it. The other part finds it embarrassing, overwhelming, and impossible. If the therapist is relying on trust alone, and there is not enough trust established, the client may leave therapy. Everything should be with a purpose in mind, and an anticipated result.

If the therapist confronted the client; the therapist should anticipate the result, AND be ready to deal with the result, they intended to create. Before the therapist confronts, the therapist should know the client well enough to be able to anticipate the result. An exception to this would be, if the therapist has not been able to find a way into a resistant client, who may not be there voluntarily, and may use confronting as a tool to try to uncover some insight into what makes the client tick. This means, therapy is like doing a load of clothes.

You have to know how much time you have not only to wash them, but to dry them. The same is true for therapy, if you leave the client holding a bag full of bad feelings at the end of the session, the client may quit therapy. Just so, a good therapist, needs to plan the session so that if painful feelings will be experienced, the good therapist needs to make sure they will have enough time to help the client make sense of all of this and see the achievement they have made by working on the painful areas.

Same is true in therapy. You break the muscles down to a degree, in order to rebuild them. AND just like exercise there is a warm up, and a cool down period. This said, IF you have been having a GOOD and productive relationship with your therapist in general, and you have ONE or a few sessions here and there where you leave feeling not much better or even upset; the therapist may have had an off day…like us all. You will need to confront the therapist, each time this happens, and see what THEY say, then act from there if you are satisfied…or not, with their explanation.

When a therapist gets angry…or has any emotional reaction to something in therapy…a good therapist always explores what is causing this. A bad therapist will say, the client MADE me feel this way. So to have good results, you will not only need a good therapist, but a good client. When YOU have an emotional reaction to something that happened in therapy, take a look at it. Discuss it with your therapist. See how they react.

Do they help you come to terms with it, or leave you hanging. Geuss which one is a sign of a good therapist. Am I angry because someone is telling me this? Lots of people go to therapy, expecting the therapist to do the work. You face things you would rather not, you experience and re-experience hurt, shame, awful heartbreak.

You have to readdress those miserable painful issues that damaged you in the first place. Some of which you did not even realize at the time were happening to you.

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Generally, pain comes before change. A baby coming throught the birth cannal is not just slipping happily through. It is an exhausting, painful for both sides difficult path. You have to decide what you want, what you are willing to work for. You have to decide how much you can take, at what time. So make sure you are clear on what you are telling your therapist you want from them. Realize each therapist has different tallents, or lack of tallents.

One might be intelligence. If you happen to be a gifted person, probably only another gifted person will be able to lift you beyond yourself. It is said, that one can only truly teach to the level they have themselves reached. Consider this, all you need to get that degree is a passing grade. Some schools may pass on D students, many pass on C students..

There are only a few A students in any bunch. They show their diploma, not their grades. If you were an A student, you may need a therapist that was too. Every body learns best in different ways. Processes information in different ways. We tend to feel best understood, and understand others that function in the manner we do. I do agree with much of what you are saying. Although grades in graduate school are not the same as in undergrad. Here is a sample of grade requirements for grad school: The unit curriculum of the MSW degree program provides the mix of academic, experiential, and research experiences essential for MSW degree students.

Students must maintain a program grade point average of 3. The minimum acceptable grade for required core courses is a B- 2. Grades in selective courses must be a minimum of a C 2. Courses with grades falling below the standards set for required and selective courses must be repeated. Students are financially responsible for the cost of repeating courses where grades obtained do not meet the minimum standards. The minimum grade in regular classes is a B-. Selective courses are courses apart from the regular curriculum of your choice.

Some professionals believe Medicare will not cover phone therapy, but they do. I just need the Medicare papers to sign. Anyone here willing? Or know of someone? Main issues: 1. Previously learned coping skills wear out fast when in this kind of life situation; would like to find some new skills to last at least few years more before having to develop another new set. Not sure how to connect to someone here if anyone is willing ; possibly the Admin could give my email address to a professional interested in working with me? She denigrates other psychologists, although not to their face. She thinks she is the best.

She is extremely convincing. Given she works with people with BPD and personality disorders her own problems should be well addressed. She never bothered getting professional supervision. Hopefully she is now. She has serious boundary issues and had a serious occurence that happened with a psychiatrist at VGH Out-Patient Psychiatry where action needed to be taken. They should. Be careful and if you think you are doing therapy with this woman, run.

I feel that my therapist has judged me on my weight, being a stay at home mom, and not driving. I always feel worse about myself after every session. She canceled three sessions in about 4 months last year; I had to wait another month after my scheduled appointment to see her again. If I wanted someone to tell me what a loser I am, I would call my mother in law. I have experienced 2 incidents that I feel hindered my therapy. I confronted him when I realized it, but it kept surfacing during therapy and I feel contributed to the problem I had with transference because I felt violated by my therapist and kept seeing him as the person who violated me during childhood.

That statement made me feel more worthless than I felt before I started therapy, and was the reason I left therapy with him, and the reason I will never have therapy again with a male therapist. Therapist falls asleep. Therapist throws a tissue box at you, instead of offering one. Therapist laughs at what you wrote in a journal.

Therapist repeatedly insists on a specific diagnosis, even when client has proof otherwise. When I was young, I was served liver and onions. It was absolutely horrible. I gagged and gagged while trying to eat it; tears even came to my eyes. Closes: Sat 28 Sep, pm 5 days, 1 hours, 14 minutes.

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