When New Clients Interview Therapists

The old model of the therapist as the expert parental figure taking care of the client has been evolving for some time toward a more egalitarian view of the relationship. More clients have begun viewing themselves as informed consumers who wish to interview their potential therapist. But as a recent discussion on a therapists' listserv indicates, authority is sometimes a difficult thing to give up.

A therapist on the listserv asked for collegial advice about dealing with an increasingly common occurrence: clients who want to meet with her and several other therapists before choosing one. She reported that virtually none of these clients ended up choosing her, and she wondered whether her discomfort about being interviewed had something to do with it.

Therapists on the listserv who reported the highest success rate in the group-interview process used a technique long familiar to anyone who's looking for a date: don't act too hungry. San Diego therapist Lew Mills compliments the other therapists who are on the list if he knows and respects them. When Chicago therapist Lauren Miller finds that a client isn't a good fit for her, she often unexpectedly ends up seeing them. "The harder I try to refer out, the more persistent clients tend to be," she says. New Jersey therapist Michael Gindi informs such clients that his first session is always a brief, free consult because he himself retains the right to choose whether to work with someone, and that he takes on only one in four new clients.

Although many therapists routinely give three referrals, some are uncomfortable when they find that they themselves are one of three candidates. Although San Francisco therapist William Henkin thinks this kind of shopping is a good idea for clients, he has reservations about going through the selection process himself. "I never like to be part of this experiment because I invest myself in the first meeting and want to feel it's likely to continue." Some psychodynamically-inclined therapists refer to it as a job interview or running a gauntlet, and believe that potential clients who let the therapist know they're interviewing candidates are probably anxious, hostile, or ambivalent. But therapist Alice Graubart of Chicago takes a different view. Although such clients may be trying to gain mastery over an inherently insecure situation, she tries to understand what the client feels he needs and whether the client feels that she understands him.

Graubart's approach illustrates an important point. Therapists who feel uncomfortable about selling themselves might remember that an important technique of successful selling is also one of the basic techniques of therapy: first find out from clients what they want or need.

Resources

Energy Therapy: Psychotherapy Theory, Research, Practice, Training 45, no. 2 (June 2008): 199-213, and 46, no. 2 (June 2009): 262-69. Brain Cells: Psychotherapy and Psychosomatics 78, no. 3 (April 2009): 187-92. Web Therapy: episodes may be purchased at www.lstudio.com. Some older episodes are available for free at www.hulu.com. Feedback: Journal of Consulting & Clinical Psychology 77, no. 4 (August 2009): 693-704.

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PsychotherapyBrownBag  - Earning Respect   |Registered |2009-11-10 11:24:20 Very interesting stuff! I was directly to this site today and am very glad to have found a new resource for discussions of empirical research. I recently wrote on Psychotherapy Brown Bag about TFT and Monica Pignotti's excellent work to dispel misleading claims of efficacy. When I see situations like this, I understand why somebody passionate about a particular idea would be frustrated by a lack of acceptance by the psychological community. After all, this is their livelihood and they no doubt have come to believe that the approach offers substantial benefits. That being said, it is entirely unclear to me how somebody can look at the research on TFT and somehow conclude that it is empirically supported for any diagnosis. The very nature of science is captured by the direct competition between opposing hypotheses, the objective evaluation of subsequent data, and the development of newer, more precise follow-up hypothese...

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