When should I find a new therapist?

brightcouch-insideThis is a great quote:

Carl Rogers, she said, would have been laughing (happily, that is) had he read the findings we cited documented the lack of differential efficacy of competing treatment approaches.  We had, in essence, proved him right!

“It turns out,” OHara wrote, “that Miller, Hubble, and Duncan come to similar conclusions.  Carl Rogers was right.  After all our forays into the dizzying arcana of paradoxical interventions, inner children, narrative therapy, EMDR, behaviorism, psychopharmacology, bioenergetics, TA, Jungian analysis, psychodrama, Gestalt, and so on down the entire list of hundred brand named therapies, what actually creates change is the … creation of a relationship between client and therapist…”.

from Why is this man laughing? by Scott D. Miller PhD

See, that’s what I was talking about before.

You know, I think we do a lousy job helping people be good consumers of therapy.

Melanie asked for “some insight into estimating the effectiveness/fit of one’s therapist” and I’m going to tackle that here a bit.

I’d say if you’re wondering whether or not you’ve found a good fit with your counselor you can ask yourself these questions:

  • Do you feel heard and believed?
  • Do you feel safe? Do you trust your counselor?
  • Do you feel like you’re on the same wavelength? Do you feel like she understands your worldview or is willing to learn about it?
  • Do you feel permanently stuck in your sessions?

Anonymous said that after six weeks meeting with her counselor she ended up feeling worse so she quit. She brings up a good point. If you’re feeling worse because you’re pushing yourself and doing the work and not getting anywhere, that certainly might be a sign it’s not a great fit.

Unfortunately, feeling lousy in therapy is sometimes a hazard of the work because confronting hard truths and making change can be painful. Sometimes feeling worse after a session is normal but if it’s happening, you can talk to your therapist for some help making room in your life for more self-care or to make a support plan.

Being stuck can also be a sign that you’re ready to go deeper or that you’re ready to graduate from therapy. Again, it’s something you can talk to your therapist about.

But I don’t think that’s what Anonymous is talking about here; I think she’s illustrating that not-a-great-fit feeling. So how can you tell the difference between the regular challenges of good therapy and the not-a-great-fit? I think it comes down to forward motion. Do you feel like you’re getting somewhere? Do you feel like your therapist is appropriately pushing you? Do you feel like your relationship can withstand some confrontation on your end? If you don’t feel like you can come to your therapist with your concerns, that’s a good sign that she’s not the the right therapist for you.

I’d love to hear from other counselors who might have other insights into assessing a good fit.


Comments 8

  1. I agree with your suggested assessment questions and would even go so far as you should ask yourself them in that order. You typically cannot find out if you are stuck until you determine the first few. I have a wonderful therapist – after spending 20 years with stinkers. Even when he may not understand at times i see he is willing to try and research and educate himself. That shows his commitment to me.

    1. Yeah, you don’t need to be paying someone to do all of her learning from you. That’s what colleagues, books and continuing education credits are for!!

  2. I’m the same Anonymous you quoted above and you definitely hit the nail on the head with my situation. I gave my therapist that six weeks because I didn’t want to quit because it was hard (’cause change and growth are hard sometimes).

    At the time, I knew it was the right choice for me, but I also DID feel like a quitter. Over time, I realized that I’d never felt that way with my previous therapist (that I had to leave due to insurance circumstances) and that I felt a lot better after I quit. Reading those “ask yourself” questions definitely helps me in articulating the reasons I needed to move on.

    1. You should be proud of yourself for knowing that it wasn’t a good fit. That really speaks to your self-awareness and willingness to work for what you need!

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  4. I agree that being a good fit is important. I try my best to be a good therapist and I believe I am open to clients sharing anything with me. I believe in creating a non-judgmental environment. I even like when clients say they are mad at me or didn’t like something I said. It tells me we have that open relationship to talk about those things and sometimes those discussions lead to a greater understand of the situation. Yet, I sometimes get clients who don’t seem to connect with me, or maybe I don’t connect with them. These are the clients who don’t stay long. I’d love any suggestions on how to improve this (if it can be improved). I wonder if sometimes you just have to find the right therapist for you. I have an example without giving any specifics, I had a client recently who called asking for help with a certain issue. Whenever I brought the issue up, the client deflected. I tried working on other issues because I didn’t want to push too hard but the client kept going to “safe” topics. Needless to say, the client quit coming. Do you have any suggestions for this situation? Does it mean it isn’t a good fit or the client isn’t ready? Any suggestions are welcome. Thank you for writing a great post that made me think.

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