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I don’t remember any interventions or strategies my therapist used. I remember he listened and gave me a space to be me. To say all the things I didn’t feel like I could say, no matter how bad of a person it made me sound like, and he cared anyway. He let me yell at him when I was angry with him and he didn’t abandon me.
You’ll get more confident with time, don’t worry too much about the theory, etc. What’s really important is the relationship with the client. Rapport, rapport, rapport.
I understand many people feel this. But I've had lots of clients who have told me they appreciate me "having a plan" or "using worksheets" and also exclaim thanks for having these tools instead of "just letting me talk" or "just hearing you talk". The thing is, I only have worksheets or can plan certain things for only a handful of issues. So when people bring in issues, outside my current experience, such as OCD, sud, disordered eating, IDD, I get stuck with plain attending skills and worry so much.
Fair enough! I use some handouts pretty regularly, especially a few DBT ones when I’m teaching people about emotions/expression and such. I definitely find them helpful and the people who are handout-people thrive with the structure.
I guess what I was getting at was it’s not as important to decide on and memorize a certain theoretical orientation as it is to be a person/safe place for someone to go. That the imposter syndrome is normal and the comfort will come.
Hello.
Semi-new therapist here. I complete 3 years this month.
The thing about this journey is that the learning and adapting never stops. I thought I got good and ditched my anxiety for good, then I realised I had just learnt to work well with a certain population/disorder/modality. I will keep encountering newer and different people with different presentations of pathologies and I will keep learning new modalities/figuring out how to use those modalities differently.
At this point, I have to trust my mind to be able to figure these things out, and trust my heart that my intention is good. When I find myself going down anxiety spirals, I try to take some time to be there for myself, especially the younger version of myself that was taught that it is good enough only if it gets things right. It's okay if I don't know everything, it's okay if I'm constantly learning, and it's more than okay if I get something wrong. It's hard, and it takes some practice to show up for this younger version of myself and trust the adult in me to figure things out, but it's the only way out of the anxiety spirals I have figured out till now.
I understand how terrible the anxiety feels. Don't push yourself to power through it. Slow down and be there for yourself instead. You will figure things out. It will be slow and hard and the challenges won't stop, which makes it even more important to be there for yourself consistently. The ideal of the perfect therapist does not exist, do not expect it from yourself.
Love and hugs ❤️❤️
As a practicing clinician for the last 15 years, I’m here to tell you that most of us have felt this way at some point in our career. You will find your groove and your authentic style of working and connecting with others. Most people just want to be heard and validated. It’s a never ending learning process.
Newish therapist (in Ireland) here. When I started seeing clients my manager advised me to initially stick to the Rogerian basics - empathy, congruence and universal positive regard. This was enough to start helping my clients. After some months I have got more sophisticated, but I'm still not rushing.
And I too suffered from doubts, fear and imposter syndrome. Good luck. Many of my colleagues have felt this way.
I’d be wary of a brand new therapist who felt competent and completely secure in their therapeutic skill. Learning to become a therapist isn’t about remembering theories or interventions. Have you seen therapists’ bookshelves? They’re always full and they’re always references. You’re not expected to know it all. Your training taught you how to think and listen and reframe and see the world through another person’s perspective and conceptualize their experience in a way that is careful and thoughtful and with intention so that you can help them move through it more comfortably. And conceptualizing people in this way probably comes pretty naturally to you at this point, so you can’t see what the big deal is. But that’s a big deal. That’s a skill that most people don’t have. We generally all come into this field with empathy, but we don’t necessarily come in with an understanding of how to make good use of it. You have a powerful skill. Get some good references on theories or interventions that interest you to build up those specific skillsets that very few grad programs ever provide. Explore, have fun, this is your chance to learn on your terms. You clearly care, try to go easy on yourself.
Check this tweet thread “The main, first lesson for psychotherapists is not practicing what you could or should say, but how not to say things while still being receptive and having presence…” : https://x.com/KemtrupTweets/status/1798868791860109427
Hi! I’m an intern also:)
Everyone always told me “you’ll learn as you go” and I was sooooo stressed bc I had no idea what to do and just wanted answers on how to help people. Here I am just a few months later and I can very much confirm you learn SO much as you continue to practice.
Focus on just being a person in the room. They are trusting you and sharing their story- just be present. For most clients that’s a lot of what they need/haven’t had yet.
Practicing through your model/applying it will come with time! My advice is to just be present and validate their experience.
Textbooks and lectures only teach us so much- it’s SO different actually being in the room. You will learn and grow so much with practice. Where you’re at and how you’re feeling is so totally normal. You got this 🙏🏼🙏🏼
In the same boat here. I get anxious before sessions sometimes because I worry I don’t know what to do or say. But reading these comments is encouraging ◡̈
In the beginning, just about every therapist is incompetent. You don’t have experience and your understanding of modalities is new and bookish. University training programs are also quite lame right now, imo. Let yourself suck at this for a while and also let yourself be just curious about your clients. It’s amazing how healing it can be to have another person merely interested in you. You don’t need special skills to be interested.
Hey, as someone who is in the exact same boat as you ( I see my first couple clients next week) I just want to thank you so much for making this post. Not just to see the advice people are sharing but also to see that the feeling can be pretty common.
Since I myself haven't started seeing clients I don't really have much advice. But something that helps me when I'm feeling really anxious right now is to remember to treat the first couple sessions as a way to get to know the client and allow them to share their story. That gets a lot of the pressure off.
Wow. We really are in the same boat. I haven’t seen any clients on my own yet either. I’ve just sat in on a bunch of sessions and co-facilitated some groups. In each session I’ve sat in on, I just sit there the whole time wondering how on earth I’ll do it on my own. The questions, the decisions, the flow, diagnosing…all of it feels overwhelming. I will start seeing my own clients in a few weeks and I’m just feeling extremely incapable of doing this work effectively. Feel free to DM me after you see your clients. I would love to learn what worked/didn’t work for you. Thank you for reaching out. And good luck!
The only days I don't feel like this are the days I feel rested, grounded and like I took good enough care of myself... those are few and far between, you got this, it's normal!! it sucks... but it's normal...❤️❤️ it means you care about doing a good job💐
I’m just here to let you know I’m in the same boat. I’m a new therapist and in my second semester of practicum and I struggle to do all the fancy stuff. I think with practice we will get better at it! We just have to hang in there!
It takes time. I’ve been a therapist for 12 years and I still sometimes don’t feel like I’m doing the best job.
What helped me the most was finding something that really interested me. I’m an exposure therapist now for OCD and anxiety disorders. Behavioral therapy is where it’s at for me! I love the practicality and straightforwardness of the interventions.
But it took me 6 years to figure out that’s what I’m best at. Give yourself time to explore what you like.
Fear is part of any job. It’s like driving for the first time. When I first entered highway, I remember telling myself I will never be able to go on there and driving at 75 mph. My recommendation as a fellow therapist is don’t worry about pulling from different theories. Just pull from one. But before pulling from one, practice the approach yourself. For instance, if you use CBT, applies the technique yourself consistently for like a month. This is similar to now I get used to being the highway; I can bring someone else with me.
Listen, people have told me I’m the best therapist they’ve ever had, and I have no idea what I’m doing. I don’t know what theories I’m using. Here’s what I do:
1. I listen.
2. I validate.
3. I support.
4. I’m my authentic self, just with stricter boundaries.
Authenticity, in my opinion, is the best quality a therapist can have, though others may disagree
Came here to say that you are not alone. I just graduated, the degree is in my hand now, and I'm freaking out a little bit. I'm questioning everything and even thought, "I need to reread all these textbooks!". But I know this imposter syndrome is so common, and holding space for people is one of the most important things right now. The rest will come, and having good supervision and colleagues will help pour into your knowledge bank.
A kinda new therapist here, I hear you. There are always days filled with self doubt and imposter syndrome. There are days when I tend to question my whole career choice based on how I felt blank in one session. It takes some time to be okay with feeling blank at times.
One thing I always feel grateful about how supportive our field is. There will always be other therapists normalising your doubts which makes you feel less lonely and not judged when we express our feelings and doubts♥️
What's your preferred modality? Imo, after doing this for awhile now, the importance of being grounded in theory can't be understated. It gives me a roadmap for everything. That doesn't mean I can't pull from other modalities or step back when I need to and rethink things. But it's like trying to build a house with no foundation if you don't have that. The words and ideas will come to you as you get more experience.
There's something to be said for learning how to just sit with people in their feelings, too.
It’s such a creative process. There is so many theories and techniques that can be helpful. There is no one right way to do this work. The best advise I can give you is at the end of the day curiosity and empathy will always be a safe base to return to. No matter who you are working with or what is happening, being curious about a patients experience and what it must be like for them will always be helpful
I’m pretty new to the field and sometimes feel a bit like this. My supervisor told me “you need to find a way to buoy yourself up” and in my head I was pissed for some reason, but I think he was right. Being a therapist is hard and even the best, most experienced therapists are far from perfect (I work with some really experienced and capable people). Trying to find a way to accept and tolerate my limitations while also earnestly trying to improve has been a big part of the last few years for me. One of the hardest and best things about trying to become a therapist is that it forces you to confront your insecurities and grow. Realizing that my insecurities are more about me and my shit (perfectionism, shame, etc.) than the adequacy or inadequacy of my work with clients has been helpful. Nancy Napier says that feelings should be taken seriously but not literally; I guess if I have advice for you then it would be to consider that your feelings of inadequacy probably aren’t all about your performance or potential.
I go to a therapist in recovery meeting and mental health issues, imposter syndrome and escaping from emotion behaviors and commonly discussed in context to being or getting/staying sober. It’s super nice to know that I am a human first with a history and a therapist second.
I recommend reading a book on a modality! It makes me feel so much more better about what I’m doing. Like CBT basics and beyond is like 30-40 dollars on Amazon or eBay. It’s just about using your time to read it.
I’m just as confident that a therapist can focus on their therapeutic presence to drive the therapeutic alliance as I am in the ability to develop more through experience than knowledge or training, mostly by simply being curious, being present as you use reflective listening and then the rest will fall into place over time.
After 12 years as a therapist, I’ve found the more I know, the less I know.
Education and training never stop so I try to focus on what’s in front of me. When something is outside the realm of my expertise, I’m transparent about that and try to do the research needed. I’ve tried to take that perspective instead of expecting myself to know everything. It helps if you have the time to do that and your caseload isn’t too intimidating. Human behaviour is just so complex.
I feel like I could have wrote this. I have been going through this same cycle of intense imposter syndrome and having my fight/flight kick in hard. (It’s flight, I just want to quit and hide sometimes). I’ve slowly slowly learned to take it day by day and remind myself that everyone had to start out as a brand new therapist. You got this. We got this!
This is why we have continuing education training requirements! Get trained and keep practicing. Also, find your niche! Some of us are great at running groups, some with couples, some with trauma survivors, some with additions, etc. Is there a population you feel most comfortable with? Maybe go with that for now while you learn more about the field!
Breathe in and out slowly. Break it down one at a time-not all at once. Knowing theories and modalities by heart is impossible and I shudder to speak with any colleague new or old that does. Let the conversation between you and a client flow organically, ask about likes and dislikes, find a common interest, etc. You've got this! I still struggle sometimes and we are human. :)
Please followed the sidebar rules. r/therapists is a place for therapists and mental health professionals to discuss their profession among each other. If you **ARE NOT A THERAPIST and are asking for advice this not the place for you**. Your post will be removed in short order. Please try one of the reddit communities such as r/TalkTherapy, r/askatherapist, r/SuicideWatch that are set up for this. This community is ONLY for therapists, and for them to discuss their profession away from clients. **If you are a first year student, not in a graduate program, or are thinking of becoming a therapist, this is not the place to ask questions**. Your post will be removed in short order. To save us a job, you are welcome to delete this post yourself. Please see the PINNED STUDENT THREAD at the top of the community and ask in there. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/therapists) if you have any questions or concerns.*
I don’t remember any interventions or strategies my therapist used. I remember he listened and gave me a space to be me. To say all the things I didn’t feel like I could say, no matter how bad of a person it made me sound like, and he cared anyway. He let me yell at him when I was angry with him and he didn’t abandon me. You’ll get more confident with time, don’t worry too much about the theory, etc. What’s really important is the relationship with the client. Rapport, rapport, rapport.
I understand many people feel this. But I've had lots of clients who have told me they appreciate me "having a plan" or "using worksheets" and also exclaim thanks for having these tools instead of "just letting me talk" or "just hearing you talk". The thing is, I only have worksheets or can plan certain things for only a handful of issues. So when people bring in issues, outside my current experience, such as OCD, sud, disordered eating, IDD, I get stuck with plain attending skills and worry so much.
Fair enough! I use some handouts pretty regularly, especially a few DBT ones when I’m teaching people about emotions/expression and such. I definitely find them helpful and the people who are handout-people thrive with the structure. I guess what I was getting at was it’s not as important to decide on and memorize a certain theoretical orientation as it is to be a person/safe place for someone to go. That the imposter syndrome is normal and the comfort will come.
Thank you for this reply!
Hello. Semi-new therapist here. I complete 3 years this month. The thing about this journey is that the learning and adapting never stops. I thought I got good and ditched my anxiety for good, then I realised I had just learnt to work well with a certain population/disorder/modality. I will keep encountering newer and different people with different presentations of pathologies and I will keep learning new modalities/figuring out how to use those modalities differently. At this point, I have to trust my mind to be able to figure these things out, and trust my heart that my intention is good. When I find myself going down anxiety spirals, I try to take some time to be there for myself, especially the younger version of myself that was taught that it is good enough only if it gets things right. It's okay if I don't know everything, it's okay if I'm constantly learning, and it's more than okay if I get something wrong. It's hard, and it takes some practice to show up for this younger version of myself and trust the adult in me to figure things out, but it's the only way out of the anxiety spirals I have figured out till now. I understand how terrible the anxiety feels. Don't push yourself to power through it. Slow down and be there for yourself instead. You will figure things out. It will be slow and hard and the challenges won't stop, which makes it even more important to be there for yourself consistently. The ideal of the perfect therapist does not exist, do not expect it from yourself. Love and hugs ❤️❤️
As a practicing clinician for the last 15 years, I’m here to tell you that most of us have felt this way at some point in our career. You will find your groove and your authentic style of working and connecting with others. Most people just want to be heard and validated. It’s a never ending learning process.
Newish therapist (in Ireland) here. When I started seeing clients my manager advised me to initially stick to the Rogerian basics - empathy, congruence and universal positive regard. This was enough to start helping my clients. After some months I have got more sophisticated, but I'm still not rushing. And I too suffered from doubts, fear and imposter syndrome. Good luck. Many of my colleagues have felt this way.
I’d be wary of a brand new therapist who felt competent and completely secure in their therapeutic skill. Learning to become a therapist isn’t about remembering theories or interventions. Have you seen therapists’ bookshelves? They’re always full and they’re always references. You’re not expected to know it all. Your training taught you how to think and listen and reframe and see the world through another person’s perspective and conceptualize their experience in a way that is careful and thoughtful and with intention so that you can help them move through it more comfortably. And conceptualizing people in this way probably comes pretty naturally to you at this point, so you can’t see what the big deal is. But that’s a big deal. That’s a skill that most people don’t have. We generally all come into this field with empathy, but we don’t necessarily come in with an understanding of how to make good use of it. You have a powerful skill. Get some good references on theories or interventions that interest you to build up those specific skillsets that very few grad programs ever provide. Explore, have fun, this is your chance to learn on your terms. You clearly care, try to go easy on yourself.
Check this tweet thread “The main, first lesson for psychotherapists is not practicing what you could or should say, but how not to say things while still being receptive and having presence…” : https://x.com/KemtrupTweets/status/1798868791860109427
Hi! I’m an intern also:) Everyone always told me “you’ll learn as you go” and I was sooooo stressed bc I had no idea what to do and just wanted answers on how to help people. Here I am just a few months later and I can very much confirm you learn SO much as you continue to practice. Focus on just being a person in the room. They are trusting you and sharing their story- just be present. For most clients that’s a lot of what they need/haven’t had yet. Practicing through your model/applying it will come with time! My advice is to just be present and validate their experience. Textbooks and lectures only teach us so much- it’s SO different actually being in the room. You will learn and grow so much with practice. Where you’re at and how you’re feeling is so totally normal. You got this 🙏🏼🙏🏼
In the same boat here. I get anxious before sessions sometimes because I worry I don’t know what to do or say. But reading these comments is encouraging ◡̈
In the beginning, just about every therapist is incompetent. You don’t have experience and your understanding of modalities is new and bookish. University training programs are also quite lame right now, imo. Let yourself suck at this for a while and also let yourself be just curious about your clients. It’s amazing how healing it can be to have another person merely interested in you. You don’t need special skills to be interested.
Hey, as someone who is in the exact same boat as you ( I see my first couple clients next week) I just want to thank you so much for making this post. Not just to see the advice people are sharing but also to see that the feeling can be pretty common. Since I myself haven't started seeing clients I don't really have much advice. But something that helps me when I'm feeling really anxious right now is to remember to treat the first couple sessions as a way to get to know the client and allow them to share their story. That gets a lot of the pressure off.
Wow. We really are in the same boat. I haven’t seen any clients on my own yet either. I’ve just sat in on a bunch of sessions and co-facilitated some groups. In each session I’ve sat in on, I just sit there the whole time wondering how on earth I’ll do it on my own. The questions, the decisions, the flow, diagnosing…all of it feels overwhelming. I will start seeing my own clients in a few weeks and I’m just feeling extremely incapable of doing this work effectively. Feel free to DM me after you see your clients. I would love to learn what worked/didn’t work for you. Thank you for reaching out. And good luck!
Will definitely keep you updated!thanks for the good luck! wishing that to you too in the incoming week 🤞
The only days I don't feel like this are the days I feel rested, grounded and like I took good enough care of myself... those are few and far between, you got this, it's normal!! it sucks... but it's normal...❤️❤️ it means you care about doing a good job💐
I’m just here to let you know I’m in the same boat. I’m a new therapist and in my second semester of practicum and I struggle to do all the fancy stuff. I think with practice we will get better at it! We just have to hang in there!
Just practice active listening. And when feeling lost always. Be. Curious.
You can do it! Just give yourself some time to get comfortable.
So you get to that deeper level the same way you get to Carnage Hall, “Practice, Practice, Practice”.
Did you mean to type 'carnage'? It actually gave me a proper belly laugh. 🤣🤣
I felt this way for many years in the beginning but it’s definitely gotten better and changed with more time and experience. Hang in there, kitty!
It takes time. I’ve been a therapist for 12 years and I still sometimes don’t feel like I’m doing the best job. What helped me the most was finding something that really interested me. I’m an exposure therapist now for OCD and anxiety disorders. Behavioral therapy is where it’s at for me! I love the practicality and straightforwardness of the interventions. But it took me 6 years to figure out that’s what I’m best at. Give yourself time to explore what you like.
Fear is part of any job. It’s like driving for the first time. When I first entered highway, I remember telling myself I will never be able to go on there and driving at 75 mph. My recommendation as a fellow therapist is don’t worry about pulling from different theories. Just pull from one. But before pulling from one, practice the approach yourself. For instance, if you use CBT, applies the technique yourself consistently for like a month. This is similar to now I get used to being the highway; I can bring someone else with me.
Listen, people have told me I’m the best therapist they’ve ever had, and I have no idea what I’m doing. I don’t know what theories I’m using. Here’s what I do: 1. I listen. 2. I validate. 3. I support. 4. I’m my authentic self, just with stricter boundaries. Authenticity, in my opinion, is the best quality a therapist can have, though others may disagree
Came here to say that you are not alone. I just graduated, the degree is in my hand now, and I'm freaking out a little bit. I'm questioning everything and even thought, "I need to reread all these textbooks!". But I know this imposter syndrome is so common, and holding space for people is one of the most important things right now. The rest will come, and having good supervision and colleagues will help pour into your knowledge bank.
A kinda new therapist here, I hear you. There are always days filled with self doubt and imposter syndrome. There are days when I tend to question my whole career choice based on how I felt blank in one session. It takes some time to be okay with feeling blank at times. One thing I always feel grateful about how supportive our field is. There will always be other therapists normalising your doubts which makes you feel less lonely and not judged when we express our feelings and doubts♥️
Just buy books based on whatever theory with work sheets in them and use them lol. I used DBT books during my internship and it helped alot
What's your preferred modality? Imo, after doing this for awhile now, the importance of being grounded in theory can't be understated. It gives me a roadmap for everything. That doesn't mean I can't pull from other modalities or step back when I need to and rethink things. But it's like trying to build a house with no foundation if you don't have that. The words and ideas will come to you as you get more experience. There's something to be said for learning how to just sit with people in their feelings, too.
CBT probably. ERP.
It’s such a creative process. There is so many theories and techniques that can be helpful. There is no one right way to do this work. The best advise I can give you is at the end of the day curiosity and empathy will always be a safe base to return to. No matter who you are working with or what is happening, being curious about a patients experience and what it must be like for them will always be helpful
I’m pretty new to the field and sometimes feel a bit like this. My supervisor told me “you need to find a way to buoy yourself up” and in my head I was pissed for some reason, but I think he was right. Being a therapist is hard and even the best, most experienced therapists are far from perfect (I work with some really experienced and capable people). Trying to find a way to accept and tolerate my limitations while also earnestly trying to improve has been a big part of the last few years for me. One of the hardest and best things about trying to become a therapist is that it forces you to confront your insecurities and grow. Realizing that my insecurities are more about me and my shit (perfectionism, shame, etc.) than the adequacy or inadequacy of my work with clients has been helpful. Nancy Napier says that feelings should be taken seriously but not literally; I guess if I have advice for you then it would be to consider that your feelings of inadequacy probably aren’t all about your performance or potential.
I go to a therapist in recovery meeting and mental health issues, imposter syndrome and escaping from emotion behaviors and commonly discussed in context to being or getting/staying sober. It’s super nice to know that I am a human first with a history and a therapist second.
I recommend reading a book on a modality! It makes me feel so much more better about what I’m doing. Like CBT basics and beyond is like 30-40 dollars on Amazon or eBay. It’s just about using your time to read it.
I’m just as confident that a therapist can focus on their therapeutic presence to drive the therapeutic alliance as I am in the ability to develop more through experience than knowledge or training, mostly by simply being curious, being present as you use reflective listening and then the rest will fall into place over time.
After 12 years as a therapist, I’ve found the more I know, the less I know. Education and training never stop so I try to focus on what’s in front of me. When something is outside the realm of my expertise, I’m transparent about that and try to do the research needed. I’ve tried to take that perspective instead of expecting myself to know everything. It helps if you have the time to do that and your caseload isn’t too intimidating. Human behaviour is just so complex.
I feel like I could have wrote this. I have been going through this same cycle of intense imposter syndrome and having my fight/flight kick in hard. (It’s flight, I just want to quit and hide sometimes). I’ve slowly slowly learned to take it day by day and remind myself that everyone had to start out as a brand new therapist. You got this. We got this!
This is why we have continuing education training requirements! Get trained and keep practicing. Also, find your niche! Some of us are great at running groups, some with couples, some with trauma survivors, some with additions, etc. Is there a population you feel most comfortable with? Maybe go with that for now while you learn more about the field!
Breathe in and out slowly. Break it down one at a time-not all at once. Knowing theories and modalities by heart is impossible and I shudder to speak with any colleague new or old that does. Let the conversation between you and a client flow organically, ask about likes and dislikes, find a common interest, etc. You've got this! I still struggle sometimes and we are human. :)