Clues on finding a therapist for a gifted client

This is another topic I get asked about a lot… “My kid is really struggling to adjust, to make sense of himself in a world that doesn’t quite understand him. I think therapy would help, but how do I find someone who really “gets” the whole gifted thing?”

This is a huge problem.   A recent publication from my esteemed mentor, Jean Peterson, showed that most accredited counselor training programs offer zero training in understanding giftedness, and those that do have only very tiny amounts of time spent on the topic.  And I worry, frankly, about what is actually being taught when anything’s being taught… whether they are just continuing to promulgate the same typical myths about how gifted kids “will be just fine on their own.”  There aren’t any studies yet looking at training programs for psychologists, but my sense of it is that, if anything, the situation is worse, since “gifted education” exists as a distinct field, while “gifted psychology” kinda basically doesn’t.  Basically, giftedness is not considered a relevant dimension of human difference or cultural experience.  Gifted folks are just like everyone else except that we got As in school and we’re all just fine.  Aren’t we?  <cough, cough…>

And it’s not just a problem for kids, either.  Gifted adults also struggle to make sense of ourselves in a world that often isn’t even remotely a good fit.  Giftedness isn’t just a school-bound phenomenon, and it doesn’t expire upon graduation — we are who we are across domains and throughout the lifespan.

I wish I had some easy answers.  My dissertation research, on the therapeutic working alliance between gifted clients and their therapists, was useful in that it showed where some of the major pitfalls were.  But it didn’t help with the basic problem that most therapists think they do get it (an example of the Dunning-Kruger effect, where the lack of knowledge and metacognitive skills in a domain interferes with accurate self-assessment of skill in a domain — basically, if you don’t know what you don’t know, you don’t know that you don’t know it).  So it’s like in education: if you ask someone if they understand giftedness, they’ll all tell you they do, but that doesn’t mean a whole heck of a lot.

Plus, a lot of providers seem to think that “gifted” means “fiscally gifted,” and they see us as high-functioning clients who are likely to provide a nice revenue stream (as Tom Lehrer said, they think they’re specializing in “diseases of the rich“), so they advertise claiming this as a specialty area.  We know that gifted folk are found in every social, ethnic, racial, and economic group, but, well, like I said, a lot of folks don’t know what they don’t know.

So what we need is a way to interview prospective providers to find out what they actually know, rather than what they’ll tell you they know.

I know, we’re all afraid to talk about it (I should really put up a rant about gifties as a closeted minority), but we have to.  If we don’t, they won’t either — remember, they think it’s not relevant.

So, I would advise specifically bringing up the topic of giftedness and multiple exceptionality with any prospective therapist in a nonthreatening but clear way, one which focuses on observable behavior — “What experience do you have working with folks who are highly intelligent?  What do you see as the major risk and resilience factors in this population?   Have you found it necessary to adapt your approach in working with gifted folks?  If so, how, and what is your rationale for that?”

Pay attention not just to the content of the responses, but also to the nonverbal signals and your gut feeling about how they’re responding to the notion. If you feel like you’re getting a dismissive or hostile reaction, go somewhere else and don’t feel bad about it.  Really.  You’re not crazy (okay, you might be, but I’m not going to diagnose you via a blog).  You might be a bit hypersensitive, sure (I see that a lot, especially from adult GT folks who had educationally or socially traumatic experiences in childhood), but in the shrink biz, they teach us to pay attention to those feelings.

Ideally, I would want to hear someone spontaneously identify issues of social isolation, intense imaginations and emotions, and asynchrony between cognitive and emotional development, as all being relevant things to think about when working with gifted folks.  Look up one of the many lists of myths and realities about giftedness (try this one, or this one, or this one), and if they start spouting any of these, try disagreeing gently.  If you get push-back instead of thoughtful dialogue, just thank them nicely and walk.

Second choice would be someone who can at least spontaneously admit that they are not knowledgeable in the area but would be interested in self-educating.  If they want to self-educate, the (btw, I would recommend the Models of Counseling Gifted Children, Adolescents, and Young Adults book, edited by Jean Peterson and Sal Medaglio, for a professional to self-educate on the topic).  There are some very good materials available on the SENG (Supporting the Emotional Needs of the Gifted) website, too.  Or they could call me for a short-term professional consultation — I’m thrilled to be able to spread the knowledge here.

Anyone who frames giftedness as being part of the problem, anyone who defines the intensity and drive and perceptiveness and differentness and postformal reasoning as “the thing that’s wrong with you,” leave and don’t look back.  The goal is not to get our kids (or us!) to act like everyone else.  The goal is to help us figure out who we are and how to act like ourselves, just in an adaptive way.

I hate to have to say it, but I really do think that therapists who work with smart folks probably should be at least reasonably smart themselves, if for no other reason than so they can follow the logic and metaphor, quick thinking, intuitive leaps, and so on.   Also, I would want someone who in your initial interview seems to have some level of personal empathy with those experiences — they don’t necessarily have to have had them themselves, but it helps if they’re close enough that they didn’t experience their own intelligence as always a positive thing.  Both of these showed up in my research as a very common theme in terms of what distinguished successful from unsuccessful alliances.  Someone who is at least moderately bright and who is a good listener is okay for a client who is looking mainly for symptom relief, but for a client who needs a long-term mentor relationship, the respondents in my study were pretty clear on the topic… they need to be pretty smart.  When you’re trying to figure out who you are and how you’re going to exist in the world, you don’t want to have to wait around for the therapist to catch up, or to feel like you’re doing all the work yourself.

Note, however, that the therapist who happens to be gifted needs to have done their own work and come to some level of acceptance and understanding of their own intelligence. If they’ve got unmetabolized “stuff,” it’s going to play out in the relationship.  Some of the nastiest and most invalidating responses I’ve personally experienced or heard about in my research came from professionals who were themselves very likely to be highly intelligent. I’m not saying “contrary,” I’m saying “downright nasty.” (in the biz, we’d call those countertransference reactions).

Another reason why it helps to have someone reasonably smart so that the kid will have a harder time snowing them if they try.  The research on client honesty is pretty solid across the board — therapists tend not to know what clients hide from them.   I’ve heard consistent reports from GT clients that if they weren’t able to leave therapy (many child or adolescent clients don’t feel they have much choice in the matter), they were highly successful not just in stonewalling, but in outright snowing therapists who they felt didn’t empathize with them effectively (my favorite was the tweenaged client who structured her play so as to make her therapist come to certain interpretations).

In general, gifted folk don’t do as well in rigidly manualized treatments (which are, sadly, becoming extremely popular).  Cognitive-behavioral techniques can be really useful as tools, but a flexible and collaborative approach is going to be key. Don’t believe the press about “evidence-based treatments.” All forms of therapy have evidence to support them, and some forms are better than others for some clients for some kinds of situations — it’s all very individual. And what the main body of evidence shows is that, as James Carville might have said, it’s the relationship, stupid.

Before you ask, no, I don’t have a giant network of people I can recommend.  You can try asking me privately if I know anyone in your geographical area, and I’ll try, but no guarantees.