Counselling and other therapies are techniques in which a trained professional — the counsellor or therapist — helps individuals explore and manage personal issues, ranging from mental health concerns to everyday life challenges.
It is a shared journey in which the therapist empowers the client to find a way forward.
Approved therapies have their roots in valid psychological theories. Such interventions, in layman’s terms, are often referred to as talk therapies.
A simple Google search will reveal the adverse effects of medications prescribed for mental health issues. However, only a few are aware of the potential harm that can be caused by an unqualified or unsuitable talk therapist.
Google may explain the theory behind an intervention, but not the competence or ethics of the person administering it.
The training and knowledge of the therapist are vital in providing effective therapy. Unlike medication, where the response is largely based on chemical composition, the effectiveness of talk therapy depends greatly on the therapist’s approach. Their personality, values, and attitudes can either facilitate or hinder the therapeutic process.
Who is a good talk therapist?
Identifying a good talk therapist is important. They should have recognised training and follow evidence-based techniques. It is equally important to avoid quacks, who are rampant in this field.
A good therapist possesses certain personality traits that help build trust, empathy, and healing relationships with clients.
Here are some of the key qualities:
Empathy and compassion — A therapist should create a supportive and empathetic space for clients to express themselves, making them feel heard and understood.
Listening skills — Attentive and focused listening is crucial, including both verbal and non-verbal communication. Talk therapy works best when grounded in good listening skills. Constant advice-giving may be a sign of weakness.
Confidentiality — Ensuring confidentiality builds trust and encourages openness.
Non-judgemental and accepting — Therapists should avoid criticism or judgement, creating a safe space for introspection.
Calm and balanced — A calm approach helps clients feel comfortable. For instance, crying alongside a depressed client is not a good sign.
Watching out for dependence — Therapists must recognise and manage unhealthy dependencies, maintaining professional boundaries.
Reflective and self-aware — Recognising one’s own biases, emotions, and limitations is essential to avoid interference in therapy.
Creative and flexible — Within a scientific framework, therapists should adapt approaches to meet each client’s unique needs.
Effective communicator — Clear communication and working at the client’s pace foster a positive therapeutic relationship.
Staying updated — Good therapists keep themselves informed of best practices and apply their expertise to support client growth.
Clients can usually sense these qualities as therapy progresses. They establish trust, strengthen the therapeutic bond, and help clients achieve their goals. A lack of such traits can be a warning sign of potential adverse effects.
Adverse Effects?
While psychotherapy is often highly effective, it is not without risks. Adverse effects may occur due to the following factors:
Therapist-related factors — Defective approaches, lack of essential qualities, errors in technique, or unethical behaviour.
Client-related factors — Rigid personality traits, unrealistic expectations, lack of cooperation, or negative psychosocial backgrounds.
Therapeutic relationship — Unhealthy dependence or intrusion of the therapist’s personal attitudes can weaken outcomes and create new issues.
Issues that can crop up:
Deterioration of symptoms — Existing symptoms may worsen, or new ones may emerge.
False memories — Excessive focus on certain themes, especially past trauma, may induce false memories in vulnerable clients.
Therapy dependence — Unhealthy clinging to the therapist can itself become a psychological problem.
Breaches of confidentiality — This can cause serious crises and undermine the therapeutic relationship.
Addressing adverse effects
Share your concerns with your therapist so that approaches can be revised. Even therapists may sometimes require guidance from more experienced colleagues.
Consult another qualified therapist if your concerns remain unaddressed.
In cases of serious misconduct, report the matter to the relevant authorities.
Being aware of potential risks, and taking proactive steps when necessary, helps clients work collaboratively with their therapist towards a positive outcome.
The writer is a consultant psychiatrist at Medical Trust Hospital, Kochi.