How did you find a good therapist?

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I'm struggling to find a good online therapist. Also I'm not sure what's the definition of "good" and maybe I was unlucky in my previous experiences. As of today, these things triggered me to fire the two previous therapists:

- looking at the phone while I'm talking, if only for 2 seconds
- saying something along the lines of "philosophy is not important for my job"
- focusing on "searching deeper" in a Jungian way as opposed to actually trying to understand what I was talking about
- not taking notes
- not having a plan for what we were going to do and how, just wanting to talk and talk and talk (and getting paid)

I should say that I worked with both therapists before I knew about ASD, and in fact they were not taking me seriously when I was telling them all the things that now make perfect sense. They didn't even think about that possibility. That surely shows how hard they were trying.

Any suggestions??

Could this help?

I found that I had to just try a few out. Many Therapists offer a free 20-30 min session to see if things work before going further.

Maybe, if you have a friend that is attending therapy you could ask him/her who they visit. You could ask your friend to ask their mental health professional for a referral to another counselor/therapist ect.

I was referred to my current counselor by a family member who had a good experience with their services.

One last point, if you are looking for a male therapist it may take longer since mental health is a female dominated industry. So that's just something to keep in mind when looking.

Best of luck with your search

Cheers,

CFL

Hey.

I've been seeing my current therapist pretty continuously for over 12 years or so. (To be fair, I stopped seeing her for perhaps 6 months because I couldn't afford it at the time.) I am aware that for a therapeutic relationship of this kind to go on for this long is a little rare. (And yes, it has always been very professional.)

After having been around the block a few times with different therapists, I think what it comes down to is the 'chemistry' between the two of you. Can you trust your therapist enough to be vulnerable? (they have to show they deserve this trust, imo). Do you think she/he understands where you're coming from? Do you think they may have the skills to help you? And these answers may depend on the individual client.

Yes, I think it is harder for autists to find a therapist they can 'gel' with, but don't give up looking if you see glimmers of light. My therapist has been a source of clarity and sometimes healing for me. One downside: I do wish she wasn't as expensive, but 1) my government sponsors me and 2) she IS very experienced and skilled. Also, a few of the sessions can be downright illuminating, but some can be a bit more mundane. I think that's OK - that's probably as good as it gets.

So overall, one happy customer here.

Good luck.

P.S. my counsellor was recommended by my GP (doctor).

In my experience, finding a good therapist is just getting lucky that you found someone with integrity and effectiveness. Here's an actual published study on poor therapy: https://www.tandfonline.com/doi/full/10 ... 3#abstract

To me, the system is just too messed up to trust a therapist. There is no one holding them accountable in a relationship that has highly unbalanced power dynamics. With a few little comments in therapy, they can manipulate their clients into abdicating their own perceptions and decision-making capacity to the therapist. For example, they can simply say something like, "You seem happier lately, but I don't want you to develop a false sense of security. We need to work on [whatever] so that you don't fall into that trap again. Also, considering your history with hurtful people, do you think that [actually supportive person] is good for you right now?" Or they can straight up manipulate an assessment to straight up misdiagnose you. If a client were to start complaining, they would get attacked as a psychologically unwell and possible malicious person. The laws that protect client confidentiality also protect therapist ineffectiveness since no one can track it in any meaningful way. And, they get paid for their time, not the outcome. So, the incentives and system are perfect for abuse, making it an attractive profession for people that get their needs met by hurting others.

Being autistic, we're at an even greater disadvantage. I've had some very poor experiences that have severely damaged my life due to attending therapy. I've also personally known several therapists that I thought were al around just pathetically terrible people. I will never see another therapist ever again. I loosely estimate that therapists have much higher prevalence of narcissists, psychopaths, and general abusive characters than many other professions because they are in a place where they get to speak for and control a vulnerable population. They can also use their psychological training to prevent getting caught by hiding their abusive behaviors, gaslighting their victims, and making their victims seem like the abusers. But don't take my word for it. Check this sight out: https://therapyabuse.org/topics.htm

In my opinion, the best way to find a good therapist is by word of mouth of someone you trust that was their client. Even with that, be cautious, know exactly what outcomes you want, and leave if you are not having your needs met or have any reason to mistrust them. Find an supportive online forum...maybe you can make a second throwaway account on here...and stay anonymous. Post your experience with your sessions every week and have others review it. Be honest. Let others that are not emotionally involved or personally vested analyze the experiences for anything that might be off.

I think it was something like 3rd or 4th time lucky for me

I'm in the UK so you get what you're given on the NHS

Now that I'm thinking about it, the worst psychologist I had at this clinic even passively pointed out that I was autistic before I knew it. When doing a trauma therapy with her (gross), she specifically pointed out that I would show up to our virtual sessions (COVID and I didn't like being alone with her in person nor going to her office because she seemed a bit too emotional, offended, judgmental, and like to blame) with guava candy in my mouth. She said that there are some people that like to distract themselves or release anxiety by grounding themselves through movement and other sensory experiences. At the time, I was like, "Yeah, duh," but really acted like it was a revelation to not upset her again. "Oh wow, really?" I didn't realize she was saying I was autistic. Yet, she never talked to me about autism or that I might be autistic. However, she did gaslight me to my face when I told her that I didn't know what was real, and she said, with a big smile, that, "We will talk about that at our next session," during out explicitly agreed upon final session. In retrospect, I realize that several other employees at the clinic definitely knew I was autistic, but no one ever told me anything. They also outright declined to even discuss ADHD with me when a medical doctor told me to bring it up with mental health. I don't know how people like that exist. I can't place myself in their shoes no matter how hard I try.

This is why I can't trust therapists. If I tried, it would take me years to undo the damage just to be able to trust them enough to do some real work. It's not my choice. My body just wont let me. It's like my mind goes blank, I don't feel anything, and I can't even express that itself. What is the trap? And, I don't have the money to spend on years of therapy, would be making me even more upset knowing that I'm paying to undo the damage they did, nor do I want to be sitting there wondering if the money and pain I would be spending were even helping or making things even worse like before. There was one therapist that was actually effective and taught me what I needed to know to recognize that my previous experiences with therapy were abuse and that I was autistic, but that therapist died, so that's no longer a possibility. That was such a loss for humanity.

I think I'm a lost cause when it comes to therapy. I don't see a way around it. Sorry for being a downer. If anything, I hope that anyone else that has been through something similar and sees this knows they're not alone. You're not crazy. It happens. There are horrible people out there posing as therapists, and they will continue to get away with it because that's the way it is.

Thank you very much for your very useful comments, although it's a bit sad that you had such terrible experiences. I'm sorry.
My experiences were not that bad, but I definitely felt manipulated. I hate when someone uses Junghian tricks to keep you hooked.

One time I had a major issue with my brother. He wanted something from me and it was a really weird situation: he was asking because he knows that I cannot say "no". So after a couple of weeks of reflections and I was able to say "no" (first time!!) and I was pretty happy about it. I shared all of this with my therapist, and she was like "yes that's great, but we must dig deeper, in a place that you don't know and I don't know".

Makes sense! Who decides how much is enough, if we don't know anything about that place? Seems like an unfalsifiable claim to keep me paying indefinitely.

Personally, I think licensed clinical social workers make the best counselors because they usually care about people. Social workers understand because they are humble individuals who can identify with the population authentically. They aren’t doing the job for great pay or to climb the social status ladder.

Also, remember that you are your own best advocate. That means that you can counsel yourself by reading self-help books, listening to self-help podcasts and enrolling in mental health education classes. This is a great strategy because it can teach you how to create the best ‘toolbox’ for your own emotional and mental health wellbeing.

You're welcome, and thank you too! You understand the power imbalance and lack of accountability. They can easily manipulate the situation. I've often thought about how to reduce that, but I can't think of much. Maybe having a client complete some education on what is appropriate behaviors and experiences in therapy. For example, your therapist can't tell you to change your answers on a scale. Or if there were an independent watch dog agency that clients could contact if they feel odd about therapy, but that could be misused by clients as well. What about an independent agency that clients have to report to after session but is confidential from the therapist. They can review reports and notice when things aren't working like they should. That's a lot of work though. And we'd have to guard for corruption. I don't know. I just don't trust therapists or the system.



I had this experience with a social worker therapist once. They actually seemed to believe in their overall purpose rather than going through the day checking off boxes on a template. I also knew a social worker what was awesome, but he wasn't my therapist. More of a guiding role model. Now that I'm thinking about it, there were a few that were pretty decent people, but they had other things in common aside from being social workers. I don't know. Best to keep an eye out.

Red flags
- They get personally offended
- They argue/deny your feelings
- They look at you judgmentally
- You see them get angry about something irrelevant or trivial
- They smile at pain/seem to enjoy failure <-- biggest red flag for me. there's a specific smile. it shows up before you even finish. it's a smile of delight. they are delighted by other's pain.
- They tell you what your goals are, even if you explicitly said otherwise
- You have to repeat yourself three times
- They decline to conduct any assessments you request
- They look like you're bothering them
- They end sessions 30 mins early because they have something else to get ready for
- They argue with you
- They promise something if you do something for them first, especially when the don't deliver it later
- The relationship feels antagonized
- They are asking irrelevant questions
- They have personal and emotional opinions about people in your life
- They say something, then hide their smile
- They insist that you cannot talk about certain things that affect you
- You say something, and their response is to just look at you
- They say things that cannot be true
- They introduce you to their family in session
- They make you feel gross
- They refer you to other people for your concerns, but then never follow up or when you report that those people weren't helpful, they ignore it

Green flags
- Meet you where you are at
- Intervene when you say “I should’ve...”
- Feels stable/they’re the same person every session
- You feel comfortable saying anything
- They laugh with you (this is important!)
- They show individuality/preferences/opinions as valid but not universal
- You’re included as you are
- Their practice is internally consistent. For example, their practice’s name matches their fundamental values. This is an important one because it shows that this is all a cohesive and thought out purpose that they are personally vested in and expressed through. This communicates education, cohesiveness, direction, and personal integration that matches their practice.
- - Name: Emerging Empowered. You feel you are becoming empowered throughout sessions.
- - Name: ADHD Advantage: Their interventions show they see neurodivergence as a strength.
- - Name: ASD as*hole: You spend all session talking s**t. (this one is a joke)
- They respectfully tell you when you are heading in the wrong direction or said something unhelpful. This shows that they are paying attention, helping you, and not keeping it in to judge you on it along with a collection of other judgments they have been making.
- They teach rather than control. They explain why and work with you instead of insisting. For example, if you tell them you’re not hungry, but they insist you eat. This is a power struggle. If you tell them you’re not hungry, but instead listen to you and validate that helping you make sense of your lack of hunger. Then, give you information on why they think eating will help you and then if you agree, work with you to help figure out a way you will eat. In other words, you want to do what they recommend because it makes sense, not because you have to in order to appease them.
- Each session seems to grow on the previous one in the direction you guys agreed on
- You can ask them questions and their responses feel sincere! It’s not a pre-scripted corporate response.
- A fluid dynamic emerges after a few sessions in which you understand each other and exchanges build on previous statements.
- They have a minor silly thing/gesture they do they may not be aware of, but you notice it and find it refreshing. This is because they are not hiding who they are since they don’t feel the need to. You’re not see a complete show, rather their professional persona that is a legitimate expression of their true-self.
- In my case, they seem to have a tendency to follow their own hearts and not the generally prescribed standard model of doing things. With my best experiences, they didn’t seem to believe or at least mention diagnosing. It’s like it didn’t make sense to them or something. They just didn’t like it for whatever personal reasons. Maybe they don't like defining an entire person with labels.
- They think being ND has advantages! Wow, I just realized this one as I was typing.
- Issues and events are used to assess and learn how to address. You tell them an experience or situation, you analyze it together, then develop a plan that you use in order to address it. This is opposed to someone just telling you what to do. In the latter case, you are not learning and becoming independent. You are being babysat.

Bonus: The practice name has two words and the first two letters of the two words are the same. That summons the autistic mythological god of consistency called St. Ephen Stephen. He gets it because he also has two letters that are the same in both of his names, making it ephen. This might be a spurious relationship that is based on coincidental anecdotal evidence. Further studies are needed to establish sufficiently valid and reliable confidence.