Today I want to share with you all a problematic style of interaction that I've experienced numerous times while attempting to search for basic psychotherapy one-on-one counseling services.
Especially of use to any mental health service providers reading this, I've added very simple ways to restate the reply in ways I'd find much less triggering. I cannot express how large of a positive difference these proposed simple alterations in language used would have for me. Clients take a huge risk in reaching for help, as well as overcoming a myriad of possible social anxieties to write anything at all. That effort deserves to be met with respect, care, and understanding.
This article contains an analysis of what was problematic and how to fix it.
Below is the transcript of my initial outreach note to a Portland-based depth counseling group, sent through Psychology Today. As well as their initial reply back. I have three points to go over in explaining how and why the reply made me feel extremely uncomfortable.
My outreach note...
"Hello,
I am interested in finding a therapist competent at critical psychology approaches and challenging modern therapy culture, even the more holistic approaches. Common items like CBT, DBT, etc. have all failed me. Somatic and mindfulness approaches failed me. I am on my eighth year of being failed by your field. If you have recommendations of someone up for that sort of task, open to referral ideas.
Sincerely, [me]"
The initial reply from the director of the counseling group...
"Hi. I have a long waiting list at this time. However I run a clinic in Portland with lots of therapists.
Based on what you wrote I think you might benefit from working with one of the staff that is training with me and Process oriented psychology. It’s a method that you haven’t used and it can be quite powerful there’s never any guarantees but it’s probably worth a try. Let me know if you want to try and I’ll have [admin staff] our office manager give you a call.
Thanks, [director]"
My Feedback About This Interaction
1) They made an erroneous claim about my past counseling history
I said nothing one way or the other about a background with process oriented counseling (a style of "depth counseling"). I have, in fact, already seen two depth psychology counselors in my past. I know it seems like a maybe harmless error, but assuming something about me without asking, and then giving advice based on a false assumption?
That's the sort of behavior used by my past abusers, and this reply is directly repeating that style of interaction.
What to Do Instead
A very easy adjustment is saying something like "I didn't see you mention process oriented counseling in your list of past items, and if you haven't tried it yet it's an approach I've seen some success with".
2) Why to be careful with the phrasing "it's probably worth a try"
This person has read exactly three sentences about my life. And they hold the status of an "expert". A phrase like this, while sometimes meant to just be a quick off-hand remark, can also very much sound like an actual professional opinion. A claim that yes, they can probably help.
A claim like that is impossible to make to a near-total stranger. Especially given the highly individualized need nature of psychotherapy services.
A person of authority is making a clear claim of likely potential help. It's a promise they're not in a position to actually make. It's generating false hope. It makes me, as a client, feel like I'm the problem if a service doesn't work out well. If the service works, then the implicit conclusion is that I'm the problem component.
It's asking me to trust them. Without any effort real effort to earn my trust, except through the social power dynamic of them being given the position of "expert".
And to be clear, I highly doubt that the way I saw their reply is a view actually held by them. But I'm not seeing that in the words they wrote. It casts doubt. It makes me have to trust them, instead of them showing in clear terms through more careful language that they understand the concerns in all I've written out above.
What to Do Instead
An example of a much more respectful reply is something like "What we offer is process-based services. I'm not sure if that relates to your ask for critical psychology approaches and am open to having you chat more about that with me or one of my clinicians".
3) They barely referencing my initial note and very clear and direct asks
Taken in total, what does the director's reply most look like? Answer: A sales pitch.
There was no empathy toward my eight years of failed attempts at help. They didn't explain how process psychology relates to my direct and clear ask for service preference - critical psychology. They say "given what you wrote" but that's not showing me you actually understood what I wrote.
All that's really being said here is "even though we don't know you at all, we think our approach is awesome. I'm going to pressure you into calling by saying we can probably help (but don't hold us to that - no guarantees!)" And also, it's your choice. You are totally free to walk away from our pressure-driven sales pitch.
What to Do Instead
Many therapists I've talked to have expressed feelings of hesitancy or inadequacy. They so badly want to help that they start to sugar-coat their offerings. They might also feel confident in their methods, and that's not always a problem as long as it's accompanied with some humility.
There was no humility here. Be honest with clients. If you feel like you weren't trained to help them, say so. Share in their frustrations finding help. Be an ally speaking out against a broken system, and maybe even consider doing some advocacy on that front. Many of you even are! We still, sadly, need even more of that.
Above all - be honest. Show your own fears. It's one of the most trust-building actions a person can take when interacting with a service user. We don't need a false savior. We need an imperfect, respectful human to be real with us.
Final Thoughts
Sales tactics and disrespectful language should have no place in the world of professional therapy. This is, quite simply, unacceptable and unprofessional behavior. Car lot salesman aren't held to professional ethics. This field is.
Services users deserve better than this, and the fixes are incredibly simple to implement.
