David Baxter PhD
Late Founder
Advice: When to Fire Your Therapist
By Nando Pelusi, Ph.D., Psychology Today
Is your relationship with your therapist the right fit? Or do you pull the plug?
Q: I've been seeing a therapist for the last five months. We've been working through my issues but I don't feel the sessions and insight are productive. When and how can I tell that I have a bad therapist-patient relationship?
A: Your gut can tell you, better than anyone, whether someone is helping you. What stops you from trusting your gut? Perhaps you believe you must be totally sure about the situation?a need for certainty that just sets you up for constant questioning. Or perhaps you're telling yourself you need your therapist's love, and thus disconnecting from your own intuition. Clients know a lot about themselves, and it is up to the professional to respect this fact. You do not need to seek the approval of your therapist to terminate therapy.
Five months is more than enough time to figure out whether your therapist is a good fit. Good therapeutic results are often seen after about a dozen sessions, and greater results still after two dozen.
That said there are a few criteria for you to consider. Your goals probably include feeling better?but that is accomplished by truly getting better and thinking better?seeing more options and feeling understood by your therapist.
A sense that your therapist understands you is a prerequisite for improvement. You want a therapist who intuits your feelings and thoughts, one who demonstrates his or hers by using specific examples, such as proposing what you might be telling yourself to get upset. Such a therapist functions as a collaborator in your life, a person with whom you can assess your ideas, feelings, and goals. More important, a good therapist helps you learn to make these assessments on your own. You can become a better therapist to yourself?if you have a method, a theory of self, and you feel confident in your ability, you are growing and getting better.
Clients who like their therapists, and in turn, are liked by their therapists, tend to improve more quickly than those who do not have a so-called "therapeutic alliance." If you identify with someone, feel understood, and have help processing your experiences, you will take the behavioral steps that can improve your life.
Does your therapist help you to get better, or merely to feel relieved for the hour? It's easy to feel good by getting distracted. On the other hand, getting better means that you are increasing your general confidence, your openness to new experiences and people, and that you have overcome your disturbances, such as anxiety and depression, to a noticeable degree.
If you are upset about your relationship with your boyfriend, you can feel better temporarily by cataloguing his deficiencies and having your therapist sympathetically agree that yes, that man is in the wrong. However, you get better by accepting that your boyfriend is imperfect, refusing to despair about being with him, and creating productive platforms such as giving the relationship a timeline for growth.
Research into various types of therapy (psychoanalysis, psychodynamic, cognitive-behavioral therapy, etc.) has found that it may not be the approach itself but the relationship you have with the therapist that most accounts for improvement. The cognitive behavioral approach, for example, has much to recommend it, but it can be executed poorly, too rigidly, or not rigorously enough.
Sometimes the fit is just not there. Like any relationship, you know when it clicks, and if you look deep down, you also know when it does not.
What to Look For in a Therapist:
By Nando Pelusi, Ph.D., Psychology Today
Is your relationship with your therapist the right fit? Or do you pull the plug?
Q: I've been seeing a therapist for the last five months. We've been working through my issues but I don't feel the sessions and insight are productive. When and how can I tell that I have a bad therapist-patient relationship?
A: Your gut can tell you, better than anyone, whether someone is helping you. What stops you from trusting your gut? Perhaps you believe you must be totally sure about the situation?a need for certainty that just sets you up for constant questioning. Or perhaps you're telling yourself you need your therapist's love, and thus disconnecting from your own intuition. Clients know a lot about themselves, and it is up to the professional to respect this fact. You do not need to seek the approval of your therapist to terminate therapy.
Five months is more than enough time to figure out whether your therapist is a good fit. Good therapeutic results are often seen after about a dozen sessions, and greater results still after two dozen.
That said there are a few criteria for you to consider. Your goals probably include feeling better?but that is accomplished by truly getting better and thinking better?seeing more options and feeling understood by your therapist.
A sense that your therapist understands you is a prerequisite for improvement. You want a therapist who intuits your feelings and thoughts, one who demonstrates his or hers by using specific examples, such as proposing what you might be telling yourself to get upset. Such a therapist functions as a collaborator in your life, a person with whom you can assess your ideas, feelings, and goals. More important, a good therapist helps you learn to make these assessments on your own. You can become a better therapist to yourself?if you have a method, a theory of self, and you feel confident in your ability, you are growing and getting better.
Clients who like their therapists, and in turn, are liked by their therapists, tend to improve more quickly than those who do not have a so-called "therapeutic alliance." If you identify with someone, feel understood, and have help processing your experiences, you will take the behavioral steps that can improve your life.
Does your therapist help you to get better, or merely to feel relieved for the hour? It's easy to feel good by getting distracted. On the other hand, getting better means that you are increasing your general confidence, your openness to new experiences and people, and that you have overcome your disturbances, such as anxiety and depression, to a noticeable degree.
If you are upset about your relationship with your boyfriend, you can feel better temporarily by cataloguing his deficiencies and having your therapist sympathetically agree that yes, that man is in the wrong. However, you get better by accepting that your boyfriend is imperfect, refusing to despair about being with him, and creating productive platforms such as giving the relationship a timeline for growth.
Research into various types of therapy (psychoanalysis, psychodynamic, cognitive-behavioral therapy, etc.) has found that it may not be the approach itself but the relationship you have with the therapist that most accounts for improvement. The cognitive behavioral approach, for example, has much to recommend it, but it can be executed poorly, too rigidly, or not rigorously enough.
Sometimes the fit is just not there. Like any relationship, you know when it clicks, and if you look deep down, you also know when it does not.
What to Look For in a Therapist:
- Keep shopping until you feel comfortable with someone. You should believe that they understand you and that they are helpful.
- Trust your own sense of whether someone is helpful.
- Give your therapist a chance, such as a handful of sessions. Then assess the connection and usefulness of the approach.
- Set specific goals at the outset; assess your progress after a dozen sessions.
- To review profiles of more than 10,000 professionals, consult the Psychology Today Therapists Directory
