ISSUES IN FORENSIC PSYCHOLOGY
40 Questions for Evaluating a Psychotherapist

Are you, or someone close to you, currently seeing a psychotherapist? Clients undergoing psychotherapeutic treatment need to evaluate the effectiveness of their therapy. Clients who wonder whether their therapist is effectively aiding them contend with substantial frustration and self-doubt. When clients terminate treatment with a therapist they regard as ineffective and/or incompetent, they worry about how and where to find a new therapist.

The following forty questions are designed to help clients evaluate and make decisions about their ongoing therapy. Prospective clients can also use these questions to interview a potential therapist, and bring greater objectivity to their impressions of that therapist. Additionally, any client who has found it necessary to terminate an incompetent therapist, can use these questions to assess a potential replacement.

Directions: In taking this inventory, merely respond "Yes" or "No," and count how many questions you answer "Yes."

1. Has your therapy limited itself to giving you a better understanding of the difficult situations in your life?
   
   
2. Do you feel more worried and discouraged since you began therapy?
   
   
3. Is your therapist so preoccupied with your insight that he or she neglects to outline specific courses of action for you to undertake?
   
   
4. Is your therapist intensely interested in the minutiae of your fantasies, feelings, and/or thoughts?
   
   
5. Does a great deal of your therapy seem to focus on issues that are trivial or obscure?
   
   
6. Is your therapist more curious about you than he or she seems committed to helping you (do you feel reduced to an object of study by your therapist)?
   
   
7. Despite a situation where you have felt ready to terminate therapy, has your therapist repeatedly advised you not to?
   
   
8. Does your therapist focus primarliy on the events of your childhood and overlook the present-day issues of your life?
   
   
9. Does your therapist overemphasize your deficits and shortcomings while ignoring your strengths and resources?
   
   
10. Does your therapist frequently tell you things about yourself which seem wildly speculative?
    
    
11. Does your therapist spend a good deal of time explaining how you supposedly feel about him or her?
    
    
    
12. When differences of opinion exist between you and your therapist, does he or she almost always insist you are mistaken?
    
    
13. Does your therapist seem to see himself or herself as intellectually superior?
    
    
14. Does your therapist appear to distrust you; is he or she quick to assume you are merely victimizing yourself and sabotaging your therapy?
    
    
15. Does your therapist insist that he or she is a much more important figure in your life than she or he really is?
    
    
16. Does your therapist frequently talk about other people in your life, but refuse to include them in your therapy despite their availability?
    
    
17. Does your therapist attribute malevolent motivations to other people in your life, and indict them as a result?
    
    
18. Does your therapist insist that you postpone important decisions in your life (marriage, job change, educational plans), pending his or her permission for you to make those decisions?
    
    
19. Has your therapy created a situation where you feel pulled in one direction by your therapist, and pulled in another direction by someone else in your life?
    
    
20. Is your therapist a remote, aloof individual who exhibits all the human warmth of a computer?
    
    
21. Has your therapist insisted that you cannot discuss your therapy with anyone else in your family?
    
    
22. Has your therapist become a good friend with whom you spend most of your sessions chatting amiably?
    
    
23. Have you assumed that your therapist is competent merely because he or she seems to be a pleasant, personable individual?
    
    
24. Does your therapist act as if he provides you with a uniquely important relationship that is unavailable to you in other sectors of your life?
    
    
25. Does your therapist seem to assume that he or she is a charismatic figure?
    
    
26. Is your therapist committed to pursuing ill-defined goals such as "growth" and "existential quests?"
    
    
27. Does your therapist seem so bound and determined to be your friend that he or she neglects the resolution of your problems?
    
    
28. Is your therapist preoccupied with telling you about his or her own feelings?
    
    
29. Does your therapist seek to determine where some feeling or emotion is located in your body?
    
    
30. Is your therapist more concerned about how you experience your feelings, compared to what (or who) influences those feelings?
    
    
31. Does your therapist seem more interested by what transpires in a session, than by what transpires in your life outside of therapy?
    
    
32. Does your therapist expect that you should imitate and adopt his or her values?
    
    
33. Does your therapist assume that his or her relationship with you will suffice to resolve your problems?
    
    
34. Does your therapist often seem as bewildered and confused by your problems as you are?
    
    
35. Does your therapist rely on sympathetic platitudes advising you to "trust yourself" and/or "be kind to yourself?"
    
    
36. Has your therapist subjected you to any kind of physical ordeal?
    
    
37. Instead of planning a therapy session, does your therapist merely react to whatever direction a session spontaneously takes?
    
    
38. Is your therapist unaware of who is included in your family and how they influence you?
    
    
39. Instead of planning how to influence the behavior of someone else in your life, does your therapist merely hope that those changes will transpire by themselves?
    
    
40. Is your therapist unresponsive to the idea of including other people in your therapy?

If you answered "Yes" to only one or two questions, the chances are better than fifty-fifty that your therapist is competent. You and the therapist will probably be able to resolve whatever doubts you have about your therapy.

If you answered "Yes" to between three and five questions, it is imperative that you and your therapist resolve your concerns. Otherwise, therapy may deteriorate into a waste of your time, money, and energy.

If you answered "Yes" to between six and nine questions, you need to seriously discuss the direction of your treatment with this therapist. Nevertheless, do not feel too optimistic about the outcome of such a dialogue. A therapist who provokes this many "Yes" answers is likely very entrenched in antiquated methods and approaches. You may find it necessary to fire this therapist.

If you answered "Yes" to ten or more questions, you need to carefully question your therapist about the relevance of your therapy. If the outcome of this discussion fails to reassure you, decisive action is warranted. Rather than walk away from this therapist, or even trot, consider sprinting from therapy as rapidly as you can. Any therapist who elicits this many "Yes" responses is likely incompetent. He or she is probably doing you much more harm than good.

If you are interested in learning more about psychotherapy, you may want to order any, or all, of the following publicatons authored by Dr. Campbell.

Psychotherapy and malpractice exposure. American Journal of Forensic Psychology, 1994, 12 (1), 5-41. (Order article #9, cost $10.00)

Systemic therapies and basic research. Journal of Systemic Therapies, 1996, 15 (3), 15-39. (Order article #12, cost $12.00)

Beware The Talking Cure: Psychotherapy May Be Hazardous to Your Mental Health. Social Issues Resource Series (SIRS), Upton Books, Boca Raton, FL, 1994. (Order directly from Amazon.com).

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©2005 Dr. Terence W. Campbell, Ph.D.