Complex Trauma | Neurodivergence | Finding a Therapist | Understanding our Mental Health

Important Qualities of Effective Therapists

The Most Important Qualities of Effective Therapists

To read all about my therapy journey and experiences, please visit this page.

What are the most important qualities of effective therapists? In my experience, this has ultimately boiled down to cues of safety. Just because someone is a licensed mental health practitioner does not mean they are an effective therapist. Like most things in life, therapists exist on a spectrum, and there’s a lot of gray area. Therapists are human. No matter who you choose, there will be areas of strength and areas for growth. That applies to all of us–that’s life.

If you have four minutes, I recently heard some pretty insightful commentary from experienced clinical psychologist and bestselling author Dr. Rick Hanson. He says that while all of the therapists he knows are well-intentioned, they aren’t all effective and/or competent. Listen to minutes 28-31 of So You Want to be a Therapist? on the Being Well podcast.

With that being said, I want to share some of the most important things I have learned on my own personal therapy journey. I had so many questions and so much confusion. I’m hypervigilant. I also have sensory sensitivities and disorganized attachment patterns. I had a difficult time distinguishing red flags from my own trauma responses. This has not been easy for me. Based on my experience with six therapists, here are the most important qualities of effective therapists for anxious clients:

Consistency

I can thank Charlotte for this. She not only shared with me that consistency is important in relationships, she has demonstrated this for a year. I felt like I had been tossed around by two of my therapists, not to mention many unstable past relationships. I desperately needed reliability and stability. This has slowly helped heal some wounds for me. Charlotte has specifically done this by attuning to my schedule. She hasn’t been flaky–she has kept our appointments as scheduled. I felt like I could count on her, and I really needed that. For hypervigilant clients, reliability paves the way to trust.

Authenticity

I struggled with this so much with Donna. It often felt like I was just seeing a superficial facade. I wanted real connection, but I honestly don’t think she had done enough of her own work to be self-actualized and know her own authentic self. It perpetuated my own masking, in fact. Once again, Charlotte shared that authenticity is a crucial element in relationships. For me personally, I desperately craved authenticity, and I think it’s because I have “masked” for so long as a neurodivergent woman. I also realized that I don’t want a therapist to agree with me “just because” in an attempt to demonstrate empathy or resonance. I want real and imperfect. Be honest with me. Tell me the truth.

Niche

When scrolling through directories and profiles of mental health providers, it is inevitable that you will find therapists with long laundry lists of specialties, therapy modalities, or issues that they claim to be able to help you with. I encountered some of these myself. In my experience, these individuals might be a good place to start to help you narrow it down a little bit. I sometimes refer to these types of therapists as generalists, or maybe a jack-of-all-trades. Once you narrow it down, you can find a professional who specializes in your specific area(s) of need. As I am currently two years into my own therapy journey, I have really begun to appreciate therapists who offer therapy within a more specialized niche. They have specific knowledge, skills, passion, and experience to offer help in a deeper, more targeted, and more effective manner. They will be able to relate to you and stay a step ahead of you. Most therapists will tell you that their education was very general and that it takes initiative to begin mastering an area of specialty.

Office Space

This might be a bit of a surprise, but this has actually been a huge factor in my experience. Yes, I’m hypervigilant. I also have neurodivergent sensory sensitivities. The more simple, streamlined, and cohesive a space, the better. So much contributes to my comfort or discomfort in a waiting room or office. I am easily distractible. I am easily overstimulated. Relaxing is difficult for me, so please provide a peaceful environment to make it easier. Charlotte, my current therapist, has a very neutral office space. With Teresa, her overwhelmingly cluttered office space immediately activated my stress response and made it nearly impossible to engage in any work. Donna and Jessica both had such comforting offices that just being there felt therapeutic. Donna’s office had a great view and the most comfortable seating. Jessica’s office was like a spa, complete with meditation music, cohesive furnishings, and a subtle, relaxing fragrance. I also love the art over the couch in Charlotte’s office. The office space is significant and can be an easy way to help regulate your clients.

Rupture, Repair, and the Therapeutic Relationship

Out of everything, the therapeutic relationship–complete with rupture and repair–is by far the most important factor for effective therapy. Like I mention in my story, therapy with Donna had been one unresolved rupture after another. Childhood emotional neglect is also one unresolved rupture after another. In the face of potential conflict, I naturally resort to my survival responses–especially flight and freeze. This has come up for me repeatedly over the past year in my therapy with Charlotte. It can potentially be extremely dysregulating. It has taken me so much courage to bring things up with her. When she receives me in a healthy way and communicates and collaborates with me on the path forward, it slowly helps form new, healthier neural pathways in my brain. Research suggests that here-and-now therapy with a therapist who demonstrates empathy is the most important factor on the path to healing. Please read more about the therapeutic relationship in this post. Read more about childhood emotional neglect in this post. Building a foundation of safety and comfort is essential.

Doing Their Own Work

It’s honestly almost triggering for me to even write this. I don’t want a complacent therapist. While I want to collaborate with my therapist, I want to be confident that my therapist can lead me and contain me. I don’t want to trigger my therapist. I want her to be a step ahead of me. Therapists are vulnerable to what’s known as “vicarious trauma.” Knowing that my therapist attends regular, consistent therapy gives me a sense of confidence and trust. Otherwise, I can easily fall into the role of hypervigilant trauma survivor and begin observing her for any signs of trouble. My recent post Does my therapist need therapy? mentions the concept of “wounded healers” and reiterates that “therapists can only take you as far as they have gotten themselves.” Therapists need to have the ability to co-regulate with their clients. This Therapy Chat podcast episode is a must-listen for all therapists.

While there are so many important qualities of effective therapists, these are the things that really stood out in my own personal experience. Please be sure to check out some of the resources listed below to dive deeper into this topic!

Recommended Books About Therapy

Podcasts About Therapy

  • Being Well: So You Want to be a Therapist? with Forrest Hanson, Dr. Rick Hanson, Lori Gottlieb, Terry Real, and more; 1 hr 45 min (2023) key traits of good therapists, complacent therapists, mistakes in therapy, emotional intimacy, self-regulation, heal yourself first, messiness, modalities, boundaries, what therapy is actually like, being yourself, human connection, vulnerability, first sessions, career paths
  • Therapy Chat: Complex Trauma, The Freeze Response + Somatic Therapy with Dr. Arielle Schwartz; 47 minutes (2021) dissociation, resilience, childhood trauma, parts work, window of tolerance, “high functioning,” unexpressed distress, authenticity, emotion
  • Therapy Chat: Wisdom + “Witchcraft” in Trauma Treatment with Susan Pease Banitt, LCSW; 51 minutes (2023) creating a healing relationship with trauma clients is more important than evidence-based therapies; attachment, emotions, and relationally-focused therapy especially among younger generation; developing trust; the need for connection in therapy
  • Therapy Chat: Trauma + Opening Up in Therapy with Dr. Robert Muller; 60 minutes (2023) vulnerability, control, childhood trauma
  • Therapy Chat: Understanding Childhood Emotional Neglect with Dr. Jonice Webb; 30 minutes (2019) depression, anxiety, empty feelings, loneliness, growing up when emotional needs are not met, feeling defective and invalid; getting in touch with emotions; how emotions affect relationships and connections
  • EMDR Chat: EMDR Therapy with Neurodivergent Clients 21 minutes (2023) support and accommodations, sensory processing, stuckness, stimming, shutdown vs. dissociation vs. overstimulation
  • Notice That: Introduction to EMDR Case Conceptualization 54 minutes (2021) targets vs. getting lost in details, resource installation, anxious energy, the unique biology of mammals and need for relationship, polyvagal theory, loneliness, safety, early relational trauma, shame, invalidation, expressing needs, risk of disconnection or rejection, repressing emotions, unresolved generational trauma, interpersonal neurobiology
  • The Whole Therapist: Nonverbal Communication 31 minutes (2023) somatic work, regulation with the therapist, early attachment wounds, grief work, sensory information in therapy, moving slowly, attuning to nonverbals, eye contact, embodiment
  • Science of Psychotherapy: EMDR, Polyvagal Theory, Therapeutic Relationship, & Trauma with Rebecca Kase; 40 min (2023)

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