When you should consider changing therapists and what steps to take

In this article, I discuss factors which may lead you to consider changing therapists and steps you should follow if these factors are present.

To stay or not to stay (with your therapist)—that is the question

Choosing the right therapist is an important factor in your being successful in addressing your issues whether the focus is depression counseling, anxiety counseling, anger management counseling, stress management counseling, couples counseling, self-esteem counseling, sports psychology counseling, or eating disorders counseling among other issues. An equally important factor is being alert to signs that the therapist you’ve chosen may not be the right therapist for you. Once you’ve identified that one or more of these signs is present, there are helpful steps you can follow which will either lead you to stay with that therapist or switch to another one. I will discuss these steps later in this article. First, let’s consider some of those key signs to watch for which will make it reasonable for you to consider switching therapists.

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Factors to watch for which may lead you to consider changing therapists

Some of the key factors are:

(1) You don’t think you’re making enough progress in addressing your issues. The main reason you’re in therapy is to address your issues. If you don’t see progress, considering switching therapists to another therapist with whom you have a better chance of making progress is reasonable;

(2) You don’t think your therapist’s approach is a good fit for you. It is difficult to make progress in counseling if you’re not on the ‘same page’ with your therapist regarding the ‘game plan’ to address your issues along with the skills, tasks and techniques to use in this endeavour. For example, this factor would be present if it appears that your therapist has focused on having you express your feelings to address your concerns when you think that concrete action is more in order. You might also have these concerns if your therapist thinks that talking about events in your past are important and you want to focus instead on your present-day concerns;

(3) You don’t think you have a good relationship with your therapist. Having a good relationship with your therapist is predictive of success in therapy. So if you don’t think you have this kind of relationship, you might reasonably consider changing therapists. ‘Red flags’ which suggest that a negative relationship is present include your not feeling heard, understood or respected. A negative relationship with your therapist may be present even if it does not result from their behaviour toward you. For example, you may not like aspects of their personality or the way they talk or dress. It’s also possible that you don’t like them because they remind you of someone from your past or present who you don’t like. You may also have a negative reaction to your therapist without being able to identify the reason for it.

If one or more of these factors is present, it is reasonable for you to consider switching therapists. In the following section, I will discuss steps you can take which may ultimately lead you to find a new therapist.

Options you can pursue when one or more of these factors is present

That you’ve identified concerns regarding your therapy makes it reasonable for you to consider changing therapists. However, as in other relationships it may be possible to address your concerns and stay in the relationship—in this case the relationship with your therapist. The following are possible options you can pursue when you’re considering leaving your therapist:

(1) Stick with your therapist without raising your concerns. Sometimes your concerns will resolve themselves without your having to raise them with your therapist and you can go on to have a successful therapy experience. For example, your concerns about not making progress may be alleviated once you’ve tried and benefitted from some skills and techniques your therapist has suggested. Your initial concerns about your relationship with your therapist may also recede after you’ve had a few sessions with him or her and have become more comfortable with them as a result. As these examples suggest, I am more likely to recommend the ‘wait and see’ approach to your concerns when these concerns are present early on in therapy. If you’ve had several sessions and the concerns are still present, then it would be worth your considering one of these additional options;

(2) Change therapists without raising your concerns. If you’ve had several sessions and your concerns have not resolved themselves on their own, it would be reasonable for you to seriously consider changing therapists. The question to ask at this point is, ‘Should I raise my concerns with my therapist to see if they will address them or should I change therapists without raising my concerns?’ There are pros and cons to each course of action which you can use to decide which route to take. For example, if the evidence you have strongly suggests that raising your concerns with your therapist is unlikely to lead to them being addressed while sticking with your current therapist, it may make sense to start fresh with a different therapist and avoid what could be a stressful conversation in which you bring your concerns to the attention of your current therapist. The downside of this option is that you’ve already invested some time and (probably) money in your experience with your current therapist and you now must start anew with a different therapist. But if the circumstances warrant a change without raising your concerns, it may be smart to ‘cut your losses’ and move on to a different therapist as soon as possible. In other instances, circumstances may lead you to choose the next option;

(3) Raise your concerns with your therapist and see how they respond. Unless you’re certain that bringing your concerns to your therapist’s attention will prove futile, it may make sense to do so. Such a conversation can result in your getting on track without having to change therapists. For example, expressing your concerns about lack of progress may result in your therapist pointing to evidence indicating that you are actually making progress. Expressing your reservations about the goals you are focusing on and/or the tasks used to accomplish your goals may result in your therapist taking steps to get in sync with you on your goals and the means to achieve them. Whatever the concerns you raise with your therapist, note how they respond in deciding on your next steps. If your therapist is receptive to hearing your concerns and responds in a manner which helps you to get on the road to progress, you would likely choose to stick with them. On the other hand, if your therapist does not respond well when you raise your concerns or if the changes they make in response do not lead you to get on track in addressing your issues, then changing therapists at that point would make sense. If you do make the switch after expressing your concerns, you can do so with the knowledge that you did everything you could to make things work before giving up on your first therapist.

Raising your concerns need not involve a ‘root canal’ conversation

Clients sometimes avoid raising their concerns with their therapist because they fear having a conversation which will involve the level of pleasure associated with a root canal. Although such conversations can sometimes be unpleasant, they can in many instances be relatively easy to have and may even be enjoyable. With rare exceptions, your therapist wants you to make progress and will likely be relieved to have a ‘state of the therapy’ conversation in which the two of you discuss ways to get you on the track to improvement. Also note that in many cases your therapist will take steps to make it easy for you to express any concerns that you have. For example, when working as a Calgary psychologist I ask my clients to complete a brief ‘session rating scale’ at the end of each meeting. On this one-page questionnaire,  clients can report in a quick checklist form how they think the session went in terms of the therapeutic relationship, whether we worked on and talked about what they wanted to work on and talk about, and whether my approach is a good fit for them. If I notice that that they have expressed in writing any concerns, I discuss with them changes I or the two of us can make so that the sessions and the therapy in general will go better for them. Many other therapists follow this routine with their clients.

Changing therapists is sometimes necessary to find the right fit

Even the best therapists will acknowledge that they cannot help every client they encounter despite pulling out all the stops in attempt to do so. This occurs because success in therapy requires a good therapist-client relationship and sometimes the ‘fit’ conducive to a good relationship is just not there. That is, just as there are some people outside of therapy with whom you ‘click’ and others with whom you don’t click, the same will be true of your experiences with particular therapists. You can use this knowledge to determine as soon as possible whether you have a good enough fit with your current therapist to make progress. If the fit with your therapist is insufficient, keep trying until you find a therapist with whom you have a good fit. In the same way that you may need to encounter several potential friends or dating partners before you find ones that are the right fit for you, persistence will eventually pay off for you in your efforts to find the right therapist for you. However you decide to proceed when you have concerns about your therapy experience, don’t give up on therapy as a way to address your issues. There is a therapist out there who can help you. You just need to keep trying until you find one.

May you find the right therapist a.s.a.p.,

-Dr. Pat

About the Author:

Feeling Challenged? Work with a psychologist who knows how to overcome challenges… Depression, anxiety, stress & other psychological issues may seem as daunting as completing a marathon. My approach to “Plan, Take Action & Track Progress”, has helped 100s of clients and is the same approach I used to succeed in the Boston Marathon & Ironman Canada.

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