Reading Reviews for Therapy in Utah

De-bunking Common Criticisms of Therapists

It's not uncommon to check reviews of businesses online before you buy anything from them. It can be hard to find a good therapist, one that "gets" you, one that is affordable, and one who can help you.

Unfortunately, many therapists in Utah (and elsewhere) have negative reviews on places like Google and Yelp, so I thought I'd clear things up to bring perspective to those who might be looking for a therapist.

Just so you know: At the time of this writing, I don't have any reviews on any websites that I know of for my work as a therapist. I'm not writing this to justify any wrongdoings, and I'm not anticipating that anyone will review me negatively. I'm only writing this because I've noticed an unfair review dynamic for most therapists, and the record needs to be set straight!

So imagine that you see a therapist for the first time. Maybe they make a good impression on you, or maybe they don't, and you decide to keep seeing them anyway to see if they can help. You go through a few sessions with them. They charge you $150 per session. They assign homework. They might sometimes get off-topic with you if you entertain such a trajectory. You notice that you still don't feel better. You start to feel dissatisfied with your therapy experience.

What's the natural inclination? Stop going to therapy. But those who take the time to go out of their way to leave a review are in one of two categories: (1) they are really happy with their experience and want to shout it from the rooftops ("10 out of 5 stars"), or (2) they are really unhappy and want to make life hard for that therapist, out of retaliation ("I wish I could leave zero stars..."). Nobody goes out of their way if they are merely satisfied (3 stars). If they got what they wanted out of therapy, but it wasn't above-and-beyond, they aren't going to leave a review of any kind. Notice that this is true in other contexts as well, like Amazon.

While the above point is an important one, there's another, glaring side of the reality of reviews for therapy that you won't find on Amazon. As therapists, we work with the mentally ill. It's considered unethical for us to ask for reviews of our therapy clients, so that creates another unfair dynamic for us; it means the reviews that show up are written on one's own accord and are, most likely, emotionally biased and pessimistic.

In the above example, if you go to therapy for a few sessions and the therapist assigns homework, but you aren't really following through with it, is that your therapist's fault? Perhaps your therapist goes off-topic a little bit with something you said, but you keep going down that rabbit hole with them. Is that entirely on your therapist?

Unfortunately, this happens a lot. Many therapists assign homework and patients don't follow through with it. But even if you are one of the stellar clients who does follow-through, it takes time to make progress in therapy.

In the Western medical (allopathic) model of health treatment, we are conditioned to think that healthcare is more or less instant. We tend to treat the body as if it's a car with a broken part. Much like hiring a mechanic, doctors prescribe medication or recommend surgery as if it's as simple as changing a faulty sensor to solve all your problems without any work on your part. But therapy doesn't work that way. To get the most out of it, you have to put work into it, and be patient with the process.

Most likely, if someone comes for only two or three sessions and then quits therapy, they are still mentally ill because their issues haven't been resolved in such a short time. These are the ones who are most likely to go out of their way to leave negative reviews on Google. They are feeling emotionally unwell, so they are naturally inclined to think more pessimistically and project that on others.

Attention Deficit and Off-Topic Sessions

It seems increasingly common for people, therapists included, to be distracted. You might say that ADHD is on the rise, especially since the pandemic, for some reason (I might say that's caused by epigenetics). A hallmark of ADHD is to talk a lot and go off-topic in conversations. I see this with most of my patients. Attention deficit is also a symptom of depression and anxiety. Regardless of the diagnosis, it's an increasingly common problem. Most likely, your therapist is struggling to keep you on-topic in your sessions, even though you might get frustrated that they sometimes seem to encourage it.

But to be fair, there are some counseling approaches that encourage following those tangents (like EMDR). In most cases, the therapist won't tell you which counseling theory they are operating from. So is your therapist a bad therapist if the session goes off-topic? Maybe sometimes, but you never really know.

Cost of Therapy

Another thing people tend to complain about is the cost of therapy. Once, I had a patient who thought I was rich because I was charging him $100 per session. He assumed that that was my hourly take-home pay. But to clarify, our hourly fee is not our take-home pay. 

In my area, the average cost of therapy is $120-$200 per session. I even know of a therapist who charges close to $300. Usually, you will pay less for less-experienced therapists (like interns and associates) and more for clinicians who have more training and expertise. I know of a local clinic that charges $135 to see an intern! But again, this isn't how much money they are taking home. 

In a private practice setting, which is where most therapists work, there are business costs. The rent for the office they are seeing you in, the cost of supplies, utilities, taxes, training, marketing, maintaining their website, and other expenses take a large chunk out of that session fee you are paying. Many of us get less than half of the session fee as our pay, and that's before personal income taxes. 

Another thing to consider is that we don't always have back-to-back sessions all day, every day. So if we make $50 from one session (after the above expenses), it might spread out to pay us for the next two hours that we don't have any appointments and we're sitting in the office until that next client comes. We only get paid when we have appointments. So if we make an average of $50 per session, it might spread out to being more like $20 per hour, depending on how full our schedule is. That's a minuscule compensation considering our level of education and the secondary trauma we subject ourselves to.

The Kind-Heartedness of Therapists

Now let's shift to a more positive topic. No therapist goes into this profession, knowing that we don't make very much money, with ill intent. It takes many years to become independently licensed. We have to deal with our own trauma as well as the trauma of several other people in a day. It's a lot of work, and emotionally taxing.

I'm confident when I say that most (or all) therapists go into this profession because we've had personal experience with, or watched a loved one go through, mental illness. We know how horrible it is, and we selflessly want to help others who are going through that.

WE WANT TO HELP YOU! Perhaps we aren't perfect at it (because we're human). Perhaps we are strapped for cash and have to charge what seems like a lot of money so we can provide for our families. But we are therapists because we want to help those who suffer find peace in their hearts.

Mistakes are Made

I don't want to give the impression that therapists are perfect people who are never at fault. Like doctors, teachers, grocery store shelf stockers, and everyone in between, we make mistakes, too. Sometimes, we misdiagnose you (but really, that's mostly just for billing purposes, anyway). Sometimes, our sick child keeps us awake the night before your session so we're not totally attentive with you. Maybe we should have rescheduled, but didn't. Sometimes, we might even forget important details about you because we are having a hard time keeping everyone's stories straight. But please remember that we are human and we make mistakes, just like you. We are trying our best to help, even when our "best" doesn't always appear to be superb every single session. So try not to label a therapist as altogether "bad" if they just made an honest mistake (or a few).

Conclusion

If, after reading this, you are thinking, "but there ARE bad therapists..." You are right. There are certainly some therapists who are abusive and inappropriate in the way they provide treatment. That's an unfortunate reality, and we see this in every profession, not just therapy. No amount of regulation (education requirements, supervision, background checks, clinical exams, etc.) can guarantee that every professional is going to act ethically and appropriately.

Maybe I'm biased as I see these situations with a therapist's compassion, but my speculation is that professionals who end up being unethical are probably struggling to deal with their own trauma. Trauma brings out the worst in people. It makes us selfish, unkind, impatient, angry, and even physically unhealthy. Therapists are one of few professionals that deal with secondary trauma (others might be first responders, nurses, and sometimes teachers).

Secondary trauma comes from hearing about, or witnessing, the trauma of others. Secondary trauma can cause depression, anxiety, PTSD, and more, just like primary trauma.

While I'm not justifying the wrongs of evil therapists, having a sense of compassion can help soften the blow and make us want to help them rather than hurt them. Maybe that means just not leaving that scathing review, or being more optimistic about it if you do write one.

And hopefully this never happens to you, but if you do encounter a very bad, downright evil situation with a therapist, definitely report it.

While it's tempting to see negative reviews and believe them at face value, try to see them objectively. Those who write negative words are still struggling with their own demons. Those who get better from therapy don't typically write reviews. 

So how do you find a good therapist? Word-of-mouth (real-life reviews) can be really helpful. Also, read the therapist's profile and see what their values and training are like. While it's not our job as therapists to manipulate people or push our values on anyone, finding a therapist who understands your culture or your passions can make a real difference for building a relationship of trust and therapeutic rapport.