When is it time to part ways with a therapist?

Anyone who has ever been in therapy has probably considered parting ways with his or her therapist at some point. It’s normal. That said, bad therapy can make people feel worse and “undo” progress. So at what point is it a matter of, “We’re working on issues that are unpleasant” versus “I need this person out of my life, like, yesterday?”

Unsurprisingly, it’s a tough call to make for a lot of reasons. As we all know, the prospect of finding another therapist is an (understandably) daunting task. It’s also hard to walk in and “fire” your therapist. Plus, going to therapy can be expensive and it’s one more thing to include on what is already a packed schedule. Sometimes, a warm bath and a cup of hot tea sound like the most therapeutic comforts around and they’re cheap.

Not to sound like an annoying therapist here, but I can’t tell anyone what the right decision is regarding a therapeutic relationship. It is important and valuable to evaluate your own progress periodically and consider what you are getting out of therapy compared with what you originally wanted to get out of therapy. With that in mind, consider the following:

What were your original goals for therapy? Why did you decide to go in the first place? Have you improved? What is some specific evidence for and against signs of improvement.

The theoretical orientation of your therapist might influence how much say you had in developing goals. In psychoanalysis, for example, the goal is usually to develop insight into your problems and challenges. (I’m not an analyst, so don’t take that as the classic word on it.) In contrast, a Cognitive Behavioral therapist will help you set specific goals and monitor your progress in fairly concrete ways across sessions. Neither approach is inherently superior, but it is important to keep the approach in mind when you consider what you are trying to get out of therapy. If you are looking for concrete things you can do to reduce a certain behavior like procrastination, psychoanalysis may get you there eventually, but probably not in the next few weeks. So, when you consider your goals, also consider: is this the best form of therapy for what I am trying to achieve now?

Talk to your therapist about your concerns.

Based on some unpleasant past experience, calling when you are upset about something else and ranting about something your therapist did that you found annoying and later retracting that complaint when you’re in the office isn’t the most productive way to do this. Therapists are human. We make mistakes. It’s unfortunate, and can cause problems. Most of the time, nobody is damaged irreparably, but we are a lot more likely to get things right if you give us clear and timely feedback. It helps if the feedback is offered in a nice way, but that’s a bonus. It’s okay to be angry, hurt, uncomfortable, etc. and to express that to your therapist. The key is being clear about what you want and what you don’t want and sticking to that yourself. For example, if you don’t want your therapist to text you with appointment updates and would prefer a phone call, express that preference, but if your therapist agrees, don’t text her asking to confirm appointments. I know it may sound obvious, but a lot of people do this kind of thing without realizing it, and it creates headaches for everybody.

Regarding your goals and progress, don’t expect your therapist to bring that up with you automatically. In general, most of us don’t check-in as often as we strictly “should” regarding progress outside of keeping our own records. One reason for this is we may go into the session planning to address that topic, and the client comes in and really wants to process something else that takes up the hour, and that’s fine, but it means the goals and progress discussion gets pushed back. Another reason is we don’t want to seem confrontational. Progress reports bring back memories of grade school. Even when clients are doing well, if they are still under our care, there is usually a reason. If there isn’t a reason, the cup of tea and hot bath are probably a better option than therapy.

Based on what you know now, are you the person in your life who really has the problem?

All of us encounter situations where our normal coping strategies fail. Doing better with therapy and feeling better with it are not signs that something is wrong with you. It’s also possible that you learn in therapy that you are doing pretty well, but you may have a partner, boss, or family member who is a bit “touched” and you have been running ragged trying to avoid setting them off. If that turns out to describe your situation more accurately than determining that the problem is somehow within you, a support group might actually make more sense.

Know your rights.

Any licensed therapist you see is ethically obligated to refer you if necessary. If you request a referral to another practitioner, that counts as necessary. I keep a business card file of other practitioners for that reason. Fortunately, I haven’t had to do that very much, but sometimes, it’s just not meant to be, and that’s okay. Also, among other things, you have a right to a therapist who doesn’t extort money or favors from you, hit you up for sex and all the other obvious unethical stuff.

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