r/ClinicalPsychology • u/Regular_Bee_5605 • 1d ago
Certain therapist subreddits have regular posts where all commenters agree that one MUST do their own therapy to be an effective clinician; it made me wonder if any research supports that?
Because I've never seen or heard of any such research. It makes me think that such an assertion, particularly if it's in the form of a rigid universal rule for potential therapists, is simply a dogmatic assertion based on nothing other than one's feelings and intuition. Except our emotions and intuition often do NOT align with reality at all, hence the need for research.
I have done plenty of my own personal therapy, and I don't think its been a factor in my skills as a therapist whatsoever, frankly speaking.
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u/summer323 1d ago
Based on this systematic review the existing studies aren’t great, but it looks like you might be right.
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u/rebek97 20h ago
Sounds like something that we should be researching more in the field. Interesting.
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u/Terrible_Detective45 19h ago
Yes, it is an empirical question that should be answered by gathering and analyzing data, not a polic that is continued by tradition.
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u/wrissin 1d ago
I went through a psychodynamic program and learned about this in the context of transference and counter-transference. I learned that being aware of how you come across and insightful to your own automatic responses. Therapy is a better place for it than the classroom. I think that's why my professors all said it.
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u/MattersOfInterest Ph.D. Student (M.A.) - Clinical Science - U.S. 1d ago
This does not answer the question of whether the convention comes from any solid evidence or just exists due to tradition and appeals to intuition.
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u/themiracy 1d ago
I don’t think it does come from a well-developed evidence base, but I do think its origin is in the tradition of psychodynamic training programs. There I think it was a tradition that went all the way back to the old days of psychodynamic/psychoanalytic therapy, and like everything else in early psychodynamic/psychoanalytic practice, it was about theory and tradition and not about empirical validation.
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u/beckk_uh 1d ago
This!!!
Also, I think being in therapy provides the important perspective of the intimate experience of admitting the need to help, seeking a therapist, participating in therapy, doing the hard work in therapy, and implementing insight and changes discovered in therapy throughout different areas in one’s life. Without any experience one’s own vulnerable journey, it may be difficult to understand client’s bravery in seeking help.
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u/Forsaken_Dragonfly66 1d ago
I've noticed that a lot of therapists elevate therapy to some kind of pseudo-religious spiritual journey that EVERYONE benefits from.
Some people need therapy, and some people don't. Good therapy can do wonders for some people. But a lot of people actually don't benefit much at all, which is something our profession likes to ignore. Franky, we can be holier than thou sometimes.
There is no evidence to support that clinicians need to be in ongoing therapy.
I do think that therapists being in the occasional course of therapy can help us to gain insight into our own transference and also help us to understand how the experience may be for clients though.
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u/Crafty-Ad4230 1d ago
I’m genuinely interested, what types of people do you see not benefiting much from therapy? I used to feel therapy was unnecessary for most people but find myself sliding more to that idea that everyone could benefit.
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u/Specialist-Quote2066 22h ago
Just like everyone could probably benefit from a personal trainer at the gym but not everyone needs one.
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u/Crafty-Ad4230 22h ago
The person I was replying to went further than that analogy stating some people don’t benefit much at all.
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u/Forsaken_Dragonfly66 21h ago
There are some personality disorders that don't tend to respond very well to therapy.
People with A LOT of psychosocial stressors also often don't benefit much until the stressors calm down (if they do). For example, if you're in poverty, CBT is very unlikely to help. They tend to do better with classic social work and case management support.
People with extremely poor insight often don't benefit.
There is also a pretty huge number of people who see therapy as someone to "vent" to once a week without any problem solving or self-reflection. Sometimes these people can shift gradually over time (and with a very skilled therapist), but it's tough.
The list goes on and on.
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u/Crafty-Ad4230 16h ago
It’s interesting that therapists with personality disorders, extreme psychosocial stressors or low insight are exactly the ones that the field would most want to require to do therapy
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u/Substantial-Eye-8846 15h ago
I think they might be referring only to narcissistic or AS- because you’re right about all the others
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u/Jezikkah 23h ago
Bingo. Could therapists become better clinicians by receiving good therapy that identifies and targets issues that affect their clinical skills? Sure; I bet a lot would. But as you said, “good therapy,” and especially therapy that’s targeted in these ways, is actually not all that easy to find. And yes. There are arguably other benefits like being able to relate more to the unique position of a client, but I imagine that has a negligibly small effect on the client’s therapeutic progress. It strikes me that supervision is far better poised to address the factors that make a clinician good/bad and everything in between.
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u/Forsaken_Dragonfly66 22h ago
Exactly. Skilled therapists in general are fairly difficult to find. Skilled therapists with experience + training in specific issues are harder to find. Skilled therapists with specific expertise who are also a good personality fit are even harder still to find.
Depending on how complicated your issues are, it can take years to find the right therapist. Many people don't appreciate this reality.
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u/MattersOfInterest Ph.D. Student (M.A.) - Clinical Science - U.S. 1d ago edited 1d ago
I've seen absolutely no evidence to support this idea. I can see value in knowing what it's like to be a client, but anyone claiming it's a necessity for being a good or effective therapist is, in my opinion, wrong. Many therapists have a view of therapy that frames it as this sort of semi-spiritual thing that transforms the soul and can only be delivered by one who has been through that transformation. I think it's frankly weird and culty, and largely a holdover from the (thankfully) bygone era of most psychotherapists having been trained psychoanalytically (which explains the "culty" vibes).
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u/AcronymAllergy Ph.D., Clinical Psychology; Board-Certified Neuropsychologist 1d ago
This is more a program preference, and a matter of, "I did it, so you need to do it, too" than it is something with any strong empirical support. If it were strongly supported by extant evidence, I imagine more science-heavy clinical programs (e.g., clinical science, academia-oriented scientist-practitioner) would require it than currently seems to be the case.
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u/WPMO 19h ago
I think I fall mostly into the camp that it should be highly advised, but again, I have to admit I'm not very familiar with research about this. I would however say that I think this is very difficult to research, as we obviously can't do a within-subjects design where the same person gets therapy but doesn't get therapy, and even between-subjects I don't know if any training programs would spit their cohort in two to see if there is a difference in therapist efficacy. Then there is the whole difficulty of measuring therapist efficacy...
I'd say that leaves us with anecdotes and trying to reason our way to an answer, which admittedly is not ideal. I can at least say that my experiences as a client helped guide my theoretical orientation by helping me understand what is really important from a client's point of view. It also helped me be less anxious early in my training because I realized that clients are typically very focused on their own experiences and wouldn't really even notice minor errors in things like reflecting emotions. I also learned some basic rules of thumb, like explaining that a therapy "hour" is more like 53 minutes, so as to avoid having clients drop a bomb shell 50 minutes in because they think you'll have 10 more minutes to talk instead of three. Undergoing psychological testing myself also helped me understand how important it is to set expectations about what the testing does and does not look at.
I do also think that we can say through research that most people improve their own mental health if they go to therapy, and therapy may not be used only as a way of addressing problems, but also for personal growth. I have a disorder, but some benefits of therapy have been unrelated to it. I believe there is good research showing that self-care and better therapist mental health leads to fewer unethical actions, and presumably better outcomes for clients. Results may of course vary from student to student, which is another challenge. I know one student with Borderline Personality Disorder who had SI addressed through therapy, which I can guarantee made her a better therapist because, you know...she's alive.
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u/fluffysiopaoyum 1d ago
A therapist can judge you from the outside. Some things you do or say you don’t even notice
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u/Deedeethecat2 1d ago
Such an interesting question, I'm not aware of any research and I would love to see what people find, if any.
I know that there's research about psychologist boundary violations and lack of self care/balance, and for some people this self-care might be therapy but it certainly doesn't need to be.
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u/Substantial-Eye-8846 15h ago
Do you have a good study? Just curious. Seems like that’s something important they should teach us
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u/vienibenmio PhD - Clinical Psych - USA 1d ago
I not only think it isn't necessary, i think it's inappropriate and a waste of resources to require it
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u/Substantial-Eye-8846 15h ago
. Especially in PsyD with heavy tuition, low income students, and 20hr a week prac
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u/et_irrumabo 1d ago edited 1d ago
All I’ll say is that I would be very wary of seeing a therapist who has not undergone therapy themselves. Not because “you need to experience what it’s like to be a client” (no one would say this of doctors, e.g.) but because I think everyone sees people with a certain amount of personal distortion, and being aware of the way in which this distortion manifests for you can make you more sensitive to what a patient is actually saying/the clinical material they’re bringing. Even aside from an analytic tradition, I don’t see how that’s that controversial. And the idea that one absolutely does see free of any personal distortions seems the height of arrogance—which would also make me wary of a therapist! Again, not because the practice is personal or spiritual, but because I think it will make you miss or misrepresent actual clinical material. The variegations and discrepancies inherent across subjective experience will alway persist, of course—no one is finally cured of the fact that we’re always in our own heads. But I think being treated can allow you to at least work consciously with that fact.
(Edit: I mean, even thinking about the many studies on how unconscious racial biases affect how people see or interpret the same behavior from different racial groups differently seems useful here. That’s a very certain kind of distortion, a social one that manifests personally, but ultimately not entirely unrelated I think.)
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u/AcronymAllergy Ph.D., Clinical Psychology; Board-Certified Neuropsychologist 20h ago
The concept of implicit bias is itself not without criticism. I think if therapy helps a person to know themselves better, and it's something they believe they need and/or can benefit from, right on. But if it were something that consistently resulted in significantly better therapeutic outcomes, that'd probably be borne out by research. It's possible that it could be beneficial to most therapists; it's also possible it could not. And it's possible that there's a grey area in-between--maybe it benefits most therapists, but not in a significant enough way to result in improvements in the therapy they provide. And maybe some of the benefits therapists could obtain from therapy are also obtainable via other means (e.g., ongoing peer-to-peer consultation).
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u/et_irrumabo 17h ago
"And maybe some of the benefits therapists could obtain from therapy are also obtainable via other means (e.g., ongoing peer-to-peer consultation)." Totally! The point is that there should be a sort of 'third' in a clinical relationship because human beings are notoriously subjective creatures!
I'm just saying that in any interaction, the words of others do not reach us in an unmediated way. This doesn't even assume the "unconscious"--it just assumes the natural variability of human subjectivity. I'm so shocked this is so controversial, lol.
I'm actually very curious: are you and the other ppl who disagree with me suggesting that one /can/ have complete, unmediated access to what someone feels or thinks through language? And you believe that one's personal experience or the random vicissitudes of one's affect will in no way color how you are hearing things from clients? And that ideas to the contrary only makes sense in a psychoanalytic frame? I find that all very interesting.
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u/AcronymAllergy Ph.D., Clinical Psychology; Board-Certified Neuropsychologist 3h ago
No, I'm not saying that our perceptions of others aren't impacted by our on trait- and state-like factors. Nor am I saying that what a person says to us is a 100% accurate and full description of what they're feeling. I don't think anyone arguing against the idea that receiving personal therapy is necessary for providing adequate therapy to others is saying either of these things. I also don't think paying attention to how we receive others, and how we're received by others, is at all unique to a psychodynamic approach.
What I am saying is that these are factors all therapists should address in their training and ongoing professional development, and that participation in personal therapy isn't a requisite to gain insight into these things.
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u/Terrible_Detective45 19h ago
Exactly. It's an empirical question that should be researched and not something that should be required out of tradition. It's likely that the answer is nuanced and complex.
Also, I'm not sure how a therapist going to therapy would reveal or treat unconscious bias, unless you're a psychodynamic therapist who believes that eventually this would reveal itself.
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u/New_Tangerine_2589 23h ago
Common Factors is legit research showing the actual variables that affect client outcomes. Empathy is one of them. The fact that your response has been down voted is data here in itself. If therapy allows clinicians to have better perspective-taking (empathy) then they probably are better therapists.
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u/Crafty-Ad4230 16h ago
I wonder if the way to look at (and research this) is more as a failsafe. Maybe many therapists don’t improve as a result of therapy, but there is a class of therapists that does improve and they wouldn’t seek it on their own. The same way most of us would never have sex with a client but all the pamphlets and education around that is meant to stop a select few from doing something very unethical.
For example, if most therapists don’t really need therapy, but therapists who qualify for a certain diagnosis do and they don’t tend to seek therapy on their own, is requiring therapy for every therapist a necessary measure?
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u/Lassinportland 1d ago
I believe it's something you have to experience to understand what it's like to be a client. For example, can you expect a client to talk about their deepest vulnerabilities if you cannot in a similar setting? Would you understand a client's resistance without being in their shoes? It's similar to how some clients have a preference for therapists who look like them so they feel they will be understood on a deeper level. Yes, you could eventually get there, but there are some bad therapists who don't seem to really understand their clientele.
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u/Terrible_Detective45 19h ago
This is begging the question that (1) therapy would confer these things to a provider and (2) that's the only way to obtain these things.
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u/Lassinportland 19h ago
It's not the only way to obtain those skills. Some people generally have the social and emotional intelligence to be a great therapist. Some people have the lived experience without the therapy part to understand how to be a great therapist. But if one doesn't have the emotional intelligence or the lived experience, being a client yourself can help to understand what the process is like from the clientele side. There is no amount roleplaying or studying that will prepare you for real people with mental health problems.
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u/TheBitchenRav 1d ago
I think this is a great question. I bet you can use the Stanford AI research tool to ask the question and see what results it can pull up.
This would be a great topic for a lit review.
I think the question comes more interesting when you define a good therapists.
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u/Crafty-Ad4230 1d ago
I had no idea about that tool, thank you. I’m sorry you are getting so downvoted
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u/TheBitchenRav 23h ago
I don't get why I am getting downvoted. I think some people just have biases against STORM, but I have no idea why.
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u/boraxo808 23h ago
Lots of people with psychological issues go into therapy to control the narrative surrounding their issues and don’t go to therapy for fear of having their idealized self penetrated.
Metaanalysis of therapeutic action across modalities points to the therapeutic relationship being the cause of change as opposed to any specific theory or intervention. This makes studies like the ones quoted above suspect.
Do therapists need therapy to be good therapists? Maybe not. But a therapist who doesn’t get therapy is a red flag for narcissism.
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u/MattersOfInterest Ph.D. Student (M.A.) - Clinical Science - U.S. 17h ago
This is a misrepresentation of the common factors evidence, which does not conclude that therapeutic relationship is the reason people change.
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u/Terrible_Detective45 19h ago
Metaanalysis of therapeutic action across modalities points to the therapeutic relationship being the cause of change as opposed to any specific theory or intervention. This makes studies like the ones quoted above suspect.
How does it make them "suspect?"
Do therapists need therapy to be good therapists? Maybe not. But a therapist who doesn’t get therapy is a red flag for narcissism.
How is it a "red flag for narcissism?"
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u/maxthexplorer Counseling Psych PhD Student 17h ago
The comment on narcissism makes me wonder if that Redditor has doctoral training in psychology since they’re using that word seemingly with the pop psych/lay definition.
Also I’m a big fan of common factors as the foundation of treatment modalities but there’s a reason we have EBPs/ESTs
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u/InMyExperiences 21h ago
It's not a requirement but it is helpful to do check ups like one would with a doctor
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1d ago
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u/Terrible_Detective45 1d ago
Should someone need to receive chemotherapy before they are allowed to practice as an oncologist?
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1d ago
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u/Terrible_Detective45 1d ago
Huh?
No, I provided a better analogy than your driving one, which doesn't make any sense in this context.
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u/Present-Village-7941 1d ago
I've seen that in classes but the full context was that if you are treating someone with similar trauma to your own, you need to have done your own work so your trauma response isn't triggered and you can stay in the present with the client.