Therapist Quest 2019 is well underway for me, and so far, I’ve been far more successful at finding people who definitely aren’t a fit. It feels like a sick-joke, real-world version of Are You My Mother? That’s because I want to find someone who comes highly recommended, yet being recommended often comes with a hearty helping of conflict of interest. This whole thing feels harder finding a promising date.
Furthermore, being proactive by taking your query to Google as a first stop can lead to results so abundant and varied that the overwhelming effect may be paralyzing. This may lead you to stop the hunt completely, meaning your emotional baggage becomes that piece of luggage you inexplicably can’t bring yourself to unpack four months after the vacation ended. Obviously, this cannot happen.
To save you some time and sweet, sweet mental energy, below is a list of four people who really shouldn’t treat you for one reason or another. Because knowing who’s not a great fit (and why) is super helpful for identifying that perfect healthy match once you encounter it.
1. Someone who is treating another family member
Unless it’s in the context of family therapy, seeing a professional who’s already treating a close relative is an enormous conflict of interest. So though my parents mean well by offering to send me to my sibling’s psychologist, in practice, allowing that guy to be my guy would be an awful idea, because while he may well be renowned and wonderful, he already has a decade’s worth of intel on me, and no doubt has some preconceived notions about who I am derived from my sibling’s narrative. (And TBH, putting myself on a mandatory NJ Transit trip once a week surely wouldn’t help my mental health, either.)
“You need to be with someone who knows where you are today, who you get to tell your history,” —counselor Virginia A. Simpson PhD
Not being able to share my own story to someone with totally fresh ears is indeed problematic in terms of therapy. “You need to be with someone who knows where you are today, who you get to tell your history,” says counselor Virginia A. Simpson, PhD.
While the American Psychiatric Association doesn’t technically mark the practice as unethical, it’s still decidedly complicated—and isn’t a goal of therapy to uncomplicate things? The 2019 Opinions of the Ethics Committee on the Principles of Medical Ethics addresses what could possibly go wrong. “Seeing multiple members from the same family may blur boundaries of the doctor-patient relationship,” it reads. “Depending on the dynamics in the family, there is the possibility of causing complicated feelings of guilt, resentment, or shame if one family member responds well to treatment but the other does not.” So yeah, just don’t do it.
2. Your friend
It’s really not a great idea to offer fauxfessional expertise—even if you actually are a real, accredited, professional, mental-health expert. Therapy is meant to be a practice between you and your dedicated mental-health professional, not your friend. Blurring this line can be confusing for all parties, and the situation is likely to change the dynamics of your relationship—in every sphere.
The ethics committee even warns pros against platonic friendships with a friend or sibling of a former patient for fear of violating numerous ethical issues. Because, for instance, that friendship might exploit the third party or unintentionally tamper with doctor-patient confidentiality.
Tl;dr: Friends and therapists simply shouldn’t be one and the same.
3. Someone you’re sleeping with
Being treated by someone with whom you’re romantically and/or sexually involved is a major ethical issue. It’s a huge abuse of power on the counselor’s part, and is strictly forbidden by the Ethical Principles of Psychologists and Code of Conduct.
I don’t care if this person is a finely aged John Stamos—don’t do it.
4. Probably not someone who also treats your friend
Though there’s no official ruling that this is a no-no, Dr. Simpson says sharing a therapist with a buddy opens up the potential for a conflict-of-interest issue. Asking your friend for a therapist rec may seem like a smart idea—especially if she’s always raving about how great Dr. so-and-so is—but based on Dr. Simpson’s experience, sharing a therapist can lead patients to reevaluate the advice they receive. For instance, let’s say the doc told your friend that the key to happiness is to relax but told you that it’s it’s to work hard. How can you not read into that discrepancy?
If you do go this route, Dr. Simpson says to set some ground rules with your friend so as to preserve the friendship—namely, what happens in therapy stays in therapy. “If you’re going go to a friend’s therapist…set the boundaries ahead of time.”
So, um, who can be my therapist—and how do I find them?
To start, find someone who works in the general focus area for which you’re seeking help, and see if they have recommendations. “Let’s say you wanted somebody who deals in the field of grief, then talk to your local hospice or people who deal with grief, they’re going to know the local grief counselors in the area,” says Dr. Simpson.
And if that sounds too ambitious, know that you can lean on your friends, albeit indirectly. Dr. Simpson doesn’t underestimate the value of a “good referral from somebody,” be it an acquaintance or by asking your friend if their therapist has any available rock-star colleagues. Or, ask the friend’s therapist directly for recs. (This is the step I’m currently on in Therapist Quest 2019, BTW).
“You need to be with somebody independent who can have that professional eye when they see you,” Dr. Simpson says. Bonus points if they’re in-network for your insurance plan.
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