Porn/Sex Addiction: CHARACTERISTICS OF A GREAT THERAPIST
Therapist Empathy, Warmth, and Genuineness
CHARACTERISTICS OF A GREAT THERAPIST! Therapist Empathy, Warmth, and Genuineness Humanistic therapists in particular have stressed the role of therapist empathy, warmth, and personal genuineness in facilitating the therapeutic relationship and, presumably, in increasing the likelihood of a positive outcome.
Empathy describes the "ability of the therapist accurately and sensitively to understand experiences and feelings and their meaning to the client during the moment-to-moment encounter of psychotherapy" (Rogers and Truax, 1967, p. 104).
Warmth is manifest in the therapeutic relationship when "the therapist communicates to his client a deep and genuine caring for him as a person with human potentialities, a caring uncontaminated by evaluations of his thoughts, feelings, or behaviors" (Rogers and Truax, p.102).
Therapist genuineness means precisely that: the therapist avoids communicating in a phony, "professional," or defensive manner. He is "freely and deeply himself" (Truax and Carkhuff, 1967). Obviously, a therapist can neither be empathic nor warm if he or she is not being genuine. Obviously, too, when shopping for a therapist, genuineness may be one of the first things to look for.
It is generally believed that warmth, empathy, and genuineness are necessary preconditions for successful therapy, though they do not guarantee it (Gurman, 1977; Mitchell, Bozarth, and Krauft, 1977). These characteristics would seem to apply to all kinds of therapists, regardless of their orientation. For example, with regard to behavior therapy (which concentrates on changing immediate behavior rather than the exploration of feelings), Marks and Gelder (1966) have argued that the single most important ingredient in determining outcome is the relationship between client and therapist.
Moreover, Morris and Suckerman (l974a, 1974b) have shown that "warm" therapists are far more effective than "cold" ones in utilizing the behavioral techniques of desensitization for snake phobias. Therapist Experience Beyond warmth, empathy, and genuineness, are there other therapist characteristics that facilitate treatment? There probably are, but their meaning is not entirely clear. Consider the matter of experience. Some studies find that experienced therapists promote greater improvement among their clients than do inexperienced ones (Myers and Auld, 1955; Katz, Lorr, and Rubinstein, 1958; Cartwright and Vogel, 1960; Barrett-Lennard, 1962; Strupp, Wallach, and Wogan, 1964; Scher, 1975). To the extent that empathy and genuineness are requisites for therapeutic progress, they are likely to be found in greater quantity among experienced therapists, if only because experience makes one more comfortable and competent in that role. Nonetheless, other studies have found no relationship between therapist experience and client outcome (Fiske, Cartwright, and Kirtner, 1964; Fiske and Goodman, 1965; Strupp, Fox, and Lessler, 1969; Auerbach and Johnson, 1977).
Relatively inexperienced therapists may bring enormous enthusiasm to treatment, thereby compensating for the fact that they are relatively "green." Conversely, experienced therapists may become tired and less empathic with time. Experience, then, is no uniform guarantor of excellence in therapy, although there are no studies in which inexperienced therapists were more successful than experienced ones.
Other Concerns: Other factors that might possibly influence therapeutic outcome, such as gender, race, social class, sexual preference, religious involvement, and marital status, have not been fully investigated yet. Some studies have found that opposite-sex dyads communicate more effectively with each other (Cartwright and Lerner, 1963; Brooks, 1974), others (e.g., Mendelsohn and Geller, 1963) have suggested that this is not the case. These are matters where good sense is more important than research findings. A woman whose problems touch on matters of feminism, for example, may want to see a female therapist. But because all female therapists are not feminists nor even sympathetic to feminist concerns, a sensitive male therapist may be as effective (Rawlings and Carter, 1977). Gender alone is no certain guide to insight and understanding.
During the first sessions, clients will do well to explore the concerns that lead them to prefer a particular type (i.e., female, religious) of therapist. A good therapist may well be sensitive to, and understanding of, a wide variety of concerns and issues that reach beyond the therapist's own gender, sexual orientation, religious preference, and the like. But the sad fact is that in therapy, as in other matters, one does not always get what one desires. Consider: about seven out often therapists are male, but the majority of clients are female.
Therapists come mainly from the upper middle class, clients from all classes. Nearly all therapists are white, but clients come in all colors. In a very large city, a black woman who wants to consult a black feminist therapist may be lucky enough to find one. But people in small cities and towns, where few qualified therapists practice, are not likely to be lucky enough to find therapists with all the desired characteristics, as the following case demonstrates:
She is the intelligent, well-educated mother of two small children, wife of a popular internist in a small, remote town. Increasingly, she finds herself depressed. Worse, she finds herself jealous of her husband, who gets all of the community rewards ("Oh, Dr. Barker-isn't he just wonderful ... ") while she gets the diapers. The very intensity of her feelings troubles her. With the passage of time, she hurts more and more and understands less and less. She tries to talk to her husband really, her best friend-but he reacts guiltily and defensively. He really does love his work and finds it hard to understand that his pleasure and success should cause her such pain.
What to do? Somehow, she feels this is a "woman's problem" and would prefer to see a woman. In fact, she would prefer to see a woman who is a feminist, one who understands something of the social and political aspects of womanhood, in addition to the psychological ones. Most of all, she wants someone to reassure her that though she is quite upset, she is not crazy, and that her feelings have some basis in reality. There are two therapists in her town, both men, both colleagues of her husband. One of them is "fresh out" of his residency. She finds him too young. The other is well into his seventies. He seems too old. She has other concerns about these therapists as well, but already her dilemma is clear. There are no nonprofessional alternatives in town: no women's groups in which these matters could be discussed, no sympathetic clergy. What should she do?
Perhaps you can find a solution to her dilemma. We cannot. Some problems simply do not lend themselves to easy solutions, and this is one of them. She might try one of the psychiatrists in town, and begin by discussing her reservations and discomforts about working with him. He might be able to get her over these hurdles, but then again he might not. Psychotherapists, like the rest of us, are merely human. Alternately, she might wait until spring thawed the mountain snow, and travel some three hours to a larger city. Even then, there is no guarantee that the help she wants would be found. For some problems there are no easy solutions.
Avoiding the "Psych-noxious" Therapist Most therapists are professionals in whom one can trust. A few, however, are not. Whether from defects of training, character, or personality, they are unlikely to help and more likely to harm. In addition, there are therapists who, while useful to some, are harmful to others. Below follow some ways in which to detect such therapists (Haley, 1969; Segal, 1968).