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On being a ‘successful’ therapist

By Thomas Winterman April 15, 2014

The other day I was asked to speak with the members of the board at the agency I work for about what it is like to be a child therapist, what my day is like and things like that.

“Just tell one of your success stories,” I was advised.

“No problem,” I thought to myself. “This will be easy.”

So I began thinking … thinking … thinking. After about 10 minutes, I was feeling pretty down because I could not think of a single “success” story. All kinds of questions were running through my mind at once, and I was having some difficulty sorting them all out: Do I suck at my job? What’s wrong with me? Am I too hard on myself?

measuringsuccessSo I started thinking again (which is what got me in trouble in the first place). Instead of racking my mind for some miracle story about how I was the psychological Sherpa for a poor orphaned soul to navigate the treacherous journey to wellness, I began to think about the general conceptualization of the term “success.”

Success is an abstract concept that is easy to define in an area such as business. It’s about numbers, and numbers don’t lie. The ratio between money coming in and money going out is the definition of success in business.

Counseling is not constructed that way. The whole concept of success in counseling is subjective. Granted, insurance companies try to make it less subjective by creating treatments plan with measurable objectives, such as the frequency and intensity of client symptoms (crying spells, anger outbursts, depressive thoughts, etc.).

This bugs me though, and here is why. If you measure your success as a therapist by whether or not a client “gets better,” you will think you are the worst person in the world — the absolute worst. Why is that? After all, shouldn’t therapists be skilled enough to help people get better? Yes, they should, but that data set alone is not reliable.

The problem is that there are an insane amount of variables when it comes to client symptoms — the most important and telling variable being whether the client is committed to getting “better.” The greatest therapist in the world cannot help a person who is not committed to improvement. Likewise, the worst therapist in the world will be able to help a highly committed client. Oh, and here is another variable: Most client symptoms get worse before they get better. That’s just part of the process.

Do you understand how maddening this is? If you measure your success by whether a client gets “better,” you will burn out in a glorious explosion of expletives and resignation letters. So what are we to do? How do we measure success? The answer is to challenge the very definition of the word.

I came across a quote the day before I was scheduled to present before the members of the board. (Sidenote: I always feel really smart when I say “I came across a quote” as if I spend my spare time reading poetry and examining great speeches. The truth is, just between you and me, I came across this quote because someone on ESPN Radio said it … but no one else has to know that.) Winston Churchill famously said, “Success consists of moving from failure to failure without loss of enthusiasm.”

That’s it! I knew when I heard it that this was what I was looking for … this is success as a therapist. “Success consists of moving from failure to failure without loss of enthusiasm.” (Disclaimer: This does not mean that if you happily suck at your job, then you are successful. Sorry, Charlie. You still need the skills.)

A successful therapist is one who comes into each session confident, competent and present. Be confident in your training and abilities, be competent with the symptomology you are treating, and be present in body, mind and spirit. Dive in completely, give yourself to your client for that hour (enthusiastically), incorporate the skills, and you will never fail.

Counseling is a profession that is far more difficult than I ever thought it could be. The paperwork, the bureaucracy, the insurance companies, the co-workers, the clients, their parents, the “system,” the courts, the schools, the supervisors and the politics are all factors that make this job hard. But my greatest enemy? Myself. All of that other crap can be soul sucking, and it certainly contributes to the high burnout rate in the profession. But I am the greatest enemy of success. My self-doubt, my constant questioning, my never-ending quest for “magical” counseling skills that will completely heal all of my clients — all of it contributes to a feeling of professional hopelessness and helplessness.

When I was in graduate school, Carl Rogers never resonated with me much. I always (being really analytical) thought that his person-centered theory of counseling was a little simplistic and, well, naive. Rogers famously stated that there are three conditions (brought to the session by the therapist) that are necessary for client change. The more I practice, the more I realize that his core three predictors for change are true: empathy, unconditional positive regard and congruence (congruence signifies realness or genuineness). All the counseling “skills” in the world are absolutely useless if you do not bring these three traits into every single session.

Are other counseling skills necessary? YES, YES and YES. Again, this is not an excuse to suck at your job and be happy about it. This is, however, a wake-up call and a challenge to change your perception of success. Let go of your self-doubt and preconceived notions about how to “fix” people. Fix yourself first and your clients will follow. Be of good cheer. You may just be more successful than you give yourself credit for.

 

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Thomas Winterman is a father, husband, therapist, author and blogger who lives in Panama City, Fla. He has worked in the mental health field for a number of years, mostly serving underprivileged children at a nonprofit agency as both a social worker and clinical counselor. You can find his blog at www.thethrivelife.org or email him at thethrivelife@yahoo.com. His first book, The Thrive Life, will be available in April.

10 Comments

  1. Shavavian

    1. You are hilarious. 2. This article was on point, concise and well written. While I am not currently a professional counselor, it is something that I have experience in and am considering pursuing. I’ve struggled with being confused and non-empathetic when clients don’t/won’t get better because they won’t help themselves. I think I may bookmark this article for a reference point when trying to correlate my success with client wellness.

    Reply
    1. Thomas Winterman

      Thank you so much for your comment Shavavian. Yes, the struggle is real. Every counselor has to find ways to define success for themselves, and I think I have found my own definition. I wish you the very best!

  2. Akua Oladunjoye

    Hello and thank you Thomas . Words from an experienced therapist. I totally understand and relate. I am not a clinical psychologist, I do In-home therapy. At times the questions occur…and I doing enough and is there success at the end of the journey.

    Thank you again.
    Akua

    Reply
    1. Thomas Winterman

      Thank you Akua. Yes, the questions come constantly and never seem to end. Sometimes we get too focused on results and can lose sight of the fact that the journey itself is pretty great and full of “little” successes here and there.

  3. Irene

    Hi! As a graduate student starting my internship and very anxiously anticipating my very first counseling sessions, this post helps to put me at ease. I have spent the last 2 weeks preparing myself and identifying, acknowledging and understanding my fear and anxiety in starting this new chapter as a natural process. As I’m getting closer to having my first client, I’m having self-doubt and a ridiculous amount of questions. However, I am very aware that this is my negative self talk and fear trying to get my attention. Thank you for this post. It’s a reminder that instead of having this mindset that i am going to fix every one’s problems, it is more important and more comforting for me to know that I am there as support, as a listening ear and as a safe haven for those that come and share their stories.

    Reply
    1. Thomas Winterman

      Hey Irene! Thank you very much for your comment. I was in your shoes not too long ago so I can completely understand. The fear and anxiety never completely goes away (I think that’s a good thing), but you will feel at ease once that first session starts and you get in your groove. Best of luck!

  4. Olivia H.

    Hello,
    I just want to let you know that I thoroughly enjoyed reading your article. You really opened my eyes on how differently success can be measured. My current class assignment is to conduct an informal job analysis on a job I am interested in and your article really helps. Thank you for sharing.

    Reply
  5. John

    A very disturbing article. If psychotherapists were genuinely helping people, they would not write articles like this one. Nor would they pretend to take such articles seriously.

    Reply

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