Updated: Mar 25
We get a lot of calls from people who are seeking to find a therapist for their struggling loved one. Desperate to help, they spend a whole afternoon looking online for the perfect person to be their psychologist. The intentions behind the search are beautiful and I am so glad there are people out there who care so deeply for one another. However, hear me on a couple of things before reaching out to make the first appointment on your spouse or friends behalf.
First, for therapy to work they have to want to get better or at least want change even if ill defined. They have to want things to be different than they are and feel a bit of hope that someone can help them get there. Therapy is already a very emotional and sometimes challenging journey, even for the supremely motivated. The desire to see a therapist is a necessary precursor. There is some evidence to this, about 1 in every 7-10 calls of this sort result in an actual first session. More often than not the person no-shows or never make it past the first session. Second, your loved one has to feel ownership over their own therapy. Therapy starts at the very first call. The psychologist can’t be any psychologist, it has to be their chosen person. Putting together a few options for them to look at isn’t a bad idea but picking the person, calling them, and setting up the first appointment for them is. It has to feel like someone separate from the rest of the world they are in, not an extension of it. This creates the basic sense of safety, trust, and security necessary for therapy to begin. If you call, instead of them, they may have trouble getting past the idea that the therapist may be working for your agenda. Give your loved one the opportunity to feel this empowerment themselves. Consider the possibility that the way in which you are finding the psychologist may co-sign their already negative/destructive self-concept or narrative (broken, inadequate, ineffective, lost). Allow them to drive themselves to their first appointment, and if you are going to take them, its best to wait outside or drop them off and come back at the end of the hour. Again, it’s all in the spirit of letting therapy be their own (and hence the responsibility and change process to be too). Obviously there is some exception in parents calling for their teen, however, presenting some therapists and allowing them to choose the person before setting up the first appointment is a great idea.
Lastly, its often important to get help in giving help. When it comes to mental health, our intuitions are not always the best guide. Our love gets in the way of being an effective friend/partner. Groups like ALANON are vital to providing the skillful combination of love and boundaries necessary to support another’s change. Here is a quick link to a video that highlights some ideas about what to consider when helping someone else (in this example, one who is depressed) https://www.youtube.com/watch?v=SneoysrYjTw
For Parents of Teens and Young Adults. I include this burp in my consent form and thought I would add it to this post as it seems relevant. Please consider some of the ideas here when you have an adult child in therapy.
“It is common that parents will want to give many updates about their child from week to week (emails, calls, texts, etc.) with what appears to be the motivation to optimize their adult son/daughter’s therapy. This is not a helpful idea. Teens and young adults often feel unsafe when their parent is directly involved in their therapy without their consent. In-person sessions with a parent on the other hand can be incredibly helpful, and we can work towards having those while maintaining the therapeutic relationship. I often make the comparison for parents - if you were in therapy, imagine what it might be like to have your own parent or perhaps a boss (which you have many and complex feelings about) send an email before your session each week with major events in your life, his or her sense of your general behavior, attitude, opinions of your marriage and parenting, and ideas of what medications or supplements they think you should be on, etc. Just as it would to you, it feels invasive to your adult child and it precludes me from having a genuine and authentic response to their self-revelations and the major events in their lives. My vision is skewed from the beginning and it damages the rapport I have with them. Literature shows 80% of treatment success is due to the quality of the therapeutic relationship. I have never received a bit of information that transformed therapy and expedited a cure. However, I have watched many parents overstep into their kids treatment and sabotage it with poor boundaries and frequent contact. If you are in need of support or parenting support/guidance I have some excellent referrals and would be glad to provide them. I also provide co-parenting therapy alone, but I would never simultaneously see you and your child, they would need a referral to another psychologist. On occasion, however, I will reach out with some general ideas in the spirit of helping co-sign changes the patient (your child) is trying to make in a positive direction. If, however, there appears to be any dangerous behaviors (e.g. drug use, suicidality, homicidality, extreme risky behaviors) I will absolutely notify the parent(s) if your kid is under 18. I will also reach out if therapy is at a stand-still. In that sense, no news is good news and therapy is moving along. What works best is if you drop them off at the front door downstairs and come back 50 minutes later, it lets them feel that the therapy is theirs. The importance of this cant be overstated.”
Keil Psych Group