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Excerpts from the book: "Crazy" Therapies:
What are They? Do They Work? for AFF News, Vol. 3, No. 1. Excerpted with permission from "Crazy" Therapies: What Are
They? Do They Work? By Dr. Margaret Thaler Singer and Janja Lalich,
copyright 1996 by Dr.
Margaret Thaler Singer, Ph.D. and
Janja Lalich, Ph.D., by Jossey-Bass Inc., Publishers, 350 Sansome Street,
San Francisco, California 94104 (800-956-7739). Available through AFF’s
Bookstore.
"Crazy" Therapies: What Are They? Do They Work?
The Therapeutic Relationship
Margaret Thaler Singer, Ph.D.
Janja Lalich, Ph.D.
The relationship between patient and therapist is unique in
important ways when compared to relationships between clients and other
professionals such as physicians, dentists, attorneys, and accountants. The key
difference is present from first contact: it is not clearly understood
exactly what will transpire. There is no other professional relationship in
which consumers are more in the dark than when they first go to see a
therapist.
In other fields, the public is fairly well informed about what
the professional does. Tradition, the media, and general experience have
provided consumers with a baseline by which to judge what transpires. If you
break your arm, the orthopedist explains she will take an X ray and set the
bone; she tells you something about how long the healing will take if all goes
well and gives you an estimate of the cost. When you go to a dentist, you
expect him to look at your teeth, take a history, explain what was noted, and
recommend a course of treatment with an estimate of time and cost. Your
accountant will focus on bookkeeping, tax reports, and finances, and help you
deal with regulatory agencies.
Consumers enter these relationships expecting that the
training, expertise, and ethical obligations of the professional will keep the
client's best interests foremost. Both the consumer and the professional are
aware of each person's role, and it is generally expected that the professional
will stick to doing what he or she is trained to do. The consumer does not
expect his accountant to lure him into accepting a new cosmology of how the
world works or to "channel" financial information from "entities" who lived
thousands of years ago; or for his dentist to induce him to believe that the
status of his teeth was affected by an extraterrestrial experimenting on him.
Nor does the patient expect the orthopedist to lead him to think the reason he
fell and broke his arm was because he was under the influence of a secret
satanic cult.
But seeing a therapist is a far different situation for the
consumer. In the field of psychotherapy there is no relatively agreed upon body
of knowledge, no standard procedures that a client can expect. There are no
national regulatory bodies, and not every state has governing boards or
licensing agencies. There are many types and levels of practitioners. Often
the client knows little or nothing at all about what type of therapy a
particular therapist "believes in" or what the therapist is really going to be
doing in the relationship with the client.
In meeting a therapist for the first time, most consumers are
almost as blind as a bat about what will transpire between the two of them. At
most, they might think they will probably talk to the therapist and perhaps get
some feedback or suggestions for treatment. What clients might not be aware of
is the gamut of training, the idiosyncratic notions, and the odd practices that
they may be exposed to by certain practitioners.
Consumers are a vulnerable and trusting lot. And because of
the special, unpredictable nature of the therapeutic relationship, it is easy
for them to be taken advantage of. This makes it all the more incumbent on
therapists to be especially ethical and aware of the power their role carries in
our society. The misuse and abuse of power is one of the central factors in
what goes wrong.
Questions to Ask Your Prospective Therapist
Ultimately, a therapist is a service provider who sells a
service. A prospective client should feel free to ask enough questions to be
able to make an informed decision about whether to hire a particular therapist.
We have provided a general list of questions to ask a
prospective therapist, but feel free to ask whatever you need to know in order
to make a proper evaluation. Consider interviewing several therapists before
settling on one, just as you might in purchasing any product.
Draw up your list of questions before phoning or going in for
your first appointment. We recommend that you ask these questions in a phone
interview first, so that you can weed out unlikely candidates and save yourself
the time and expense of initial visits that don't go anywhere.
If during the process a therapist continues to ask you, "Why
do you ask?" or acts as though your questioning reflects some defect in you,
think carefully before signing up. Those types of responses will tell you a lot
about the entire attitude this person will express toward you - that is, that
you are one down and he is one up, and that furthermore you are quaint to even
ask the "great one" to explain himself.
If you are treated with disdain for asking about what you are
buying, think ahead: how could this person lead you to feel better, plan
better, or have more self-esteem if he begins by putting you down for being an
alert consumer? Remember, you may be feeling bad and even desperate, but there
are thousands of mental health professionals, so if this one is not right, keep
on phoning and searching.
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How long is the therapy session?
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How often should I see you?
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How much do you charge? Do you have a sliding scale?
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Do you accept insurance?
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If I have to miss an appointment, will I be billed?
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If I am late, or if you are late, what happens?
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Tell me something about your educational background, your degrees. Are you
licensed?
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Tell me about your experience, and your theoretical orientation. What type
of clients have you seen? Are there areas you specialize in?
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Do you use hypnosis or other types of trance-inducing techniques?
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Do you have a strong belief in the supernatural? Do you believe in UFOs,
past lives, or paranormal events? Do you have any kind of personal
philosophy that guides your work with all your clients?
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Do you value scientific research? How do you keep up with research and
developments in your field?
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Do you believe that it's okay to touch your clients or be intimate with
them?
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Do you usually set treatment goals with a client? How are those
determined? How long do you think I will need therapy?
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Will you see my partner, spouse, or child with me if necessary in the
future?
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Are you reachable in a crisis? How are such consultations billed?
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