Hiring and Firing a Therapist
Terence Campbell, Ph.D.
Reprinted with permission of author and publisher
Excerpt from Beware the Talking Cure, pages 247-251
Boca Raton, FL: SIRS, Inc. 1994.
Choosing a therapist is a mind-boggling endeavor. Neither a therapist's
degree, nor his professional identity, predict his competence.
Moreover, one cannot assume that an older, experienced therapist
possesses greater competence than a younger, inexperienced therapist.
Experienced therapists are more inclined to cling tenaciously to an
Above all else, training-supervisory experiences determine a
therapist's competence. Though they are relatively few in number, there
are therapists who have undertaken training organized around live,
moment-to-moment supervision. These training-supervisory experiences
enhance their ability to develop well-defined courses of therapeutic
Since live supervision usually involves a group of supervisees, they
also learn from observing each other. Because they enjoy greater
objectivity as a result of their training, these therapists respond
more effectively to their clients' needs.
In contrast, a therapist who has never been observed by a supervisor or
a colleague is a therapist who can conceal his incompetence behind
closed doors. He understands very little about his weaknesses--and his
strengths--as a therapist. Consequently, he does not know what he needs
to do to increase his therapeutic competence. Training that emphasizes
live supervision is the best standard for evaluating a therapist.
Prospective clients should not hesitate to ask a therapist about his
training. Such questions are altogether necessary and appropriate. Any
therapist who refuses to answer, or responds evasively, is a therapist
There may be readers who are presently involved in psychotherapeutic
treatment. Such a reader may confront the problem of evaluating the
effectiveness of ongoing therapy. This is especially troublesome
because firing a therapist is a more difficult decision than hiring
Any client who wonders whether his therapist is effectively aiding him
contends with substantial frustrations and self-doubt as he weighs what
to do next. If a client terminates treatment with a therapist he
regards as ineffective and/or incompetent, he is faced with the
question of who he will find now to aid him.
The following forty questions are designed to help clients evaluate and
make decisions about their ongoing therapy. Prospective clients can
also use these questions to interview a potential therapist, and bring
greater objectivity to their impressions of that therapist.
Additionally, any client who has found it necessary to terminate an
incompetent therapist, can use these questions to assess a potential
- Has your therapy limited itself to giving you a better understanding of
the difficult situations in your life?
- Do you feel more worried and discouraged since you began
- Is your therapist so preoccupied with your insight that he neglects
to outline specific courses of action for you to
Is your therapist intensely interested in the minutiae of your
fantasies, feelings, and/or thoughts?
Does a great deal of your therapy seem to focus on issues that are
trivial or obscure?
- Is your therapist more curious about you than he seems committed to
helping you (do you feel reduced to an object of study by your
- Despite a situation where you have felt ready to terminate therapy, has
your therapist repeatedly advised you not to?
- Does your therapist focus primarily on the events of your childhood and
overlook the present-day issues of your life?
- Does your therapist overemphasize your deficits and shortcomings while
ignoring your strengths and resources?
- Does your therapist frequently tell you things about yourself which
seem wildly speculative?
- Does your therapist spend a good deal of time explaining how you
supposedly feel about him?
- When differences of opinion exist between you and your therapist, does
he almost always insist that you are mistaken?
- Does your therapist seem to see himself as intellectually superior?
- Does your therapist appear to distrust you; is he quick to assume that
you are merely victimizing yourself and sabotaging your
- Does your therapist insist that he is a much more important figure in
your life than he really is?
- Does your therapist frequently talk about other people in your life,
but refuse to include them in your therapy despite their
- Does your therapist attribute malevolent motivations to other people in
your life, and indict them as a result?
- Does your therapist insist that you postpone important decisions in
your life (marriage, job change, educational plans), pending his
permission for you to make those decisions?
- Has your therapy created a situation where you feel pulled in one
direction by your therapist, and pulled in another direction by someone
else in your life?
- Is your therapist a remote, aloof individual who exhibits all the human
warmth of a computer?
- Has your therapist insisted that you cannot discuss you therapy with
anyone else in your family?
- Has your therapist become a good friend with whom you spend most of
your sessions chatting amiably?
- Have you assumed that your therapist is competent merely because he
seems to be a pleasant, personable individual?
- Does your therapist act as if he provides you with a uniquely important
relationship that is unavailable to you in other sectors of your life?
- Does your therapist seem to assume that he is a charismatic figure?
- Is your therapist committed to pursuing ill-defined goals such as
'growth' and 'existential quests?'
- Does your therapist seem so bound and determined to be your friend
that he disregards the resolution of your
- Is your therapist preoccupied with telling you about his own feelings?
- Does your therapist seek to determine where some feeling or emotion is
located in your body?
- Is your therapist more concerned about how you experience your
feelings, compared to what (or who) influences those
- Does your therapist seem more interested by what transpires in a
session, than by what transpires in your life outside of
- Does your therapist expect that you should imitate him and adopt his
- Does your therapist assume that his relationship with you will suffice
to resolve your problems?
- Does your therapist often seem as bewildered and confused by your
problems as you are?
- Does your therapist rely on sympathetic platitudes advising you to
'trust yourself' and/or 'be kind to yourself?'
- Has your therapist subjected you to any kind of physical
- Instead of planning a therapy session, does your therapist merely react
to whatever direction a session spontaneously takes?
- Is your therapist unaware of who is included in your family and how
they influence you?
- Instead of planning how to influence the behavior of someone else in
your life, does your therapist merely hope that those changes will
transpire by themselves?
- Is your therapist unresponsive to the idea of including other people in
If you answered "Yes" to only one or two questions, the chances are
better than fifty-fifty that your therapist is competent. You and the
therapist will probably be able to resolve whatever doubts you have
about your therapy.
If you answered "Yes" to between three and five questions, it is
imperative that you and your therapist resolve your concerns.
Otherwise, therapy may deteriorate into a waste of your time, money,
If you answered "Yes" to between six and nine questions, you need to
seriously discuss the direction of your treatment with this therapist.
Nevertheless, do not feel too optimistic about the outcome of such a
dialogue. A therapist who provokes this many "Yes" answers is likely
very entrenched in antiquated methods and approaches. You may find it
necessary to fire this therapist.
If you answered "Yes" to ten or more questions, you need to carefully
question your therapist about the relevance of your therapy. If the
outcome of this discussion fails to reassure you, decisive action is
warranted. Rather than walk away from this therapist, or even trot,
consider sprinting from therapy as rapidly as you can. Any therapist
who elicits this many "Yes" responses is likely incompetent. He or she
is probably doing you much more harm than good.