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How To Tell If A Therapist Isn’t A Good Fit For You, According To Experts

Life is a complicated, and the curveballs it launches our way from time to time can be overwhelming. In short, everyone needs a little help sometimes, and a good therapist can make all the difference when we feel like we’re in over our head with life’s challenges. Whether we’re managing mental health conditions, recovering from trauma, or simply navigating a difficult life event or transition, good therapy can be a profound and invaluable resource. But, as with any professional, therapists run along a spectrum of skill, talent, and credentials; basically, there are tons of great therapists out there, and there are other not-so-good ones. And sometimes, even a good therapist might not be a good fit for you, and it’s important to figure that out.

So how do you know if you’re having therapy growing pains — after all, the healing process isn’t always going to be comfortable — or you and your therapist just aren’t meshing? Dr. Darin Bergen, a clinical psychologist in private practice in Portland, Oregon, tells Bustle via email that a good relationship with a therapist “should allow you to feel like you can be yourself completely, and anything that gets in the way of that would be a red flag.” It’s a given, too, that your therapist should be appropriately trained and licensed, with no unresolved complaints with the licensing board.

Here are some key indicators that your therapist isn’t a great fit for you, according to experts, and you might consider seeking help elsewhere.

1. You Don’t Feel Comfortable

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Your comfort level with your therapist is fundamental to your healing process, but it can be easy to overlook at first — especially if we forget to check in with our initial gut reaction. “The most important thing to consider is how comfortable feel with the therapist,” Dr. Bergen notes. Dr. Bergen stresses that the quality of the relationship between a therapist and their client is the greatest indicator of effective therapy, so getting a good fit is key to the entire therapeutic process. Don’t be afraid to vet different therapists, and shop around until you find the right one for you.

2. They Won’t Adjust Their Approach For Your Unique Needs

A sensitive therapist knows that there’s no one-size-fits-all approach for their clients. According to Dr. Bergen, a major indicator that your therapist isn’t a great fit for you would be “if they don’t try to adapt their approach to fit your needs.” If your therapist has one way of doing things and “they try to sell you on it,” that’s a good sign that you may not get what you need out of the relationship.

3. They Don’t Have Boundaries

If you get any inkling that your prospective therapist has poor boundaries — such as, if they flirt with you, discuss their personal problems or disclose personal information not relevant to your therapy, or interact with you outside of sessions for things not related to your care — feel free to bounce, Dr. Bergen says.

4. You Feel Shamed For Your Feelings

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Marriage and family counselor, Tracey Cleantis Dwyer LMFT, author of The Next Happy and An Invitation to Self-Care, tells Bustle via email that being made to feel wrong for your feelings pretty much defeats the purpose of any professional therapeutic relationship. Good therapists create a safe space whereby you can examine your emotions without judgement. Basically, “‘you shouldn’t feel that way’ is not something you want to hear in therapy,” Dwyer states.

5. Your Don’t Feel Heard

Acute active listening skills are a non-negotiable feature of any therapist worth their salt, and feeling heard is a key tenet of effective therapy. “If you don’t feel listened to, and you get the sense that the therapist is tuned out or preoccupied,” says Dwyer, this is a red flag that a therapist’s listening skills aren’t up to par. And without feeling heard in the therapeutic setting, it’s unlikely you’ll garner enough trust with your therapist to effectively navigate your healing process.

6. They Give Too Much Advice

Believe it or not, psychotherapy is not about getting a bunch of advice from your counselor. Good therapists help you self-reflect, examine your life and personal challenges, and glean your own answers in the process. Dwyer notes that “therapy is not a place for advice — it is a place to find your own answers with the help of a therapist.” Your therapist is like a guide in your quest to achieve greater insight and self-knowledge, and pulling the focus from your own innate ability to find your own answers can derail that process.

7. You Feel Judged

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A good therapist will help you feel respected without judgement. This foundation of trust and sound mutual regard is pivotal to effective therapy. If you feel judged for your thoughts, feelings, sexuality, gender identity, personal beliefs, or in any way, really, consider that this is not the best therapist for you.

8. They Don’t Respect Your Personal Goals For Therapy

Good therapy is client/patient-driven — meaning that your goals for therapy should remain front and center, as your therapist collaborates with you to determine an effective treatment plan. A good therapist will not aim to push an agenda on you. Rather, they should check in with you to assess how treatment is serving your goals for your care. If you feel that your therapist is more concerned with their agenda for your therapy than your own, it’s a good indicator that it’s best to look elsewhere for counseling.

Remember that finding a good fit in therapy can take some trial and error — so don’t hesitate to consult with a few prospective therapists, or even try a few sessions first, before committing to one person. Therapy can be a profound tool for healing and self-examination, and choosing a therapist carefully and well gives you the best shot at success.

How do I know if my therapist is a good fit?

It is impossible to say how you will know if your therapist is a good fit, but I can share how I came to feel that mine is a good fit…

I work in a field where I interact with a lot of mental health professionals. My own work requires a lot of the same boundaries and relational approaches as therapy, although less structured since the relationships are not limited to prescribed sessions. I have perceived through the years that some of the more rigid boundaries and expectations around therapeutic relationships can be very limiting (and even damaging) for people who have deep and complex relational trauma to resolve. I think my favorite thing about my therapist is that she shares this perspective, and she has found ways to convey impeccable boundaries while still maintaining a sense of deeply shared coonnection.

Before I began seeing my therapist, I spent months considering what type of person I’d be willing to enter into such a relationship with. I narrowed down some basic (albeit superficial) things — female; my age or older, but not so old that I should worry about their life span; office within 10 miles of my home or work; attractive enough that I won’t be distracted by judgmental thoughts about their looks, but not my type so I also won’t be distracted by personal attraction; stated comfort/expertise in working with the issues I might want to explore.

This last one proved very important, as I narrowed down my choices based on what I could imagine ever wanting to maybe talk about. Things like spirituality and adoption issues (I’m an adoptive parent) were much more unique than things like addressing depression, anxiety or trauma. Eventually, the list of available therapists in my area went from 100+ to one as I added special topics. (I used Psychology Today’s therapist finder online search tool.)

I don’t trust easily, and comfort is not something I ever really expected to feel with a therapist (or anyone else with whom I might share such vulnerable experiences). During our first session, she said all the right things about her approach. I skeptically regarded her and figured we would see if what she said was true. Also during that first session, I learned something new. That was enough to get me to come back a second time. Each subsequent session, some part of the interaction (her honesty, her humbleness, her knowledge) was enough to get me to come back the next week. After about six months, I decided she was genuine and that I could probably stop eyeing her with such intense scrutiny.

It took that long because I had some huge walls around letting someone in. Two years later, I still struggle to let those walls down, to let her in, to let others in. I know she’s a good fit, though — not because I “feel comfortable” or because she challenges me just right or because I can talk about “anything”. I’m still not at that place. I know she’s a good fit because even as I struggle to find my voice and let go of my fears around intimacy, she holds the space with complete integrity. She is open and direct about her intentions and her approach. She is extraordinarily gentle with me, but that doesn’t mean she lets me off easy. And, on the rare occasion we are out of synch with one another, she recognizes it, takes ownership of it, and invites me to move forward with renewed connection.

All in all, I can recognize that my therapist knows who she is as a clinician and knows herself well as a a person. I respect that, and I respect her for it. There’s no way I would keep going back if she hadn’t earned that level of respect and trust through her consistent client-centered actions.

Why Should I Go to Therapy? 8 Signs It’s Time to See a Therapist

Psychotherapy, talk or talking therapy, counseling, or simply therapy—no matter the name it’s known by, mental health counseling can benefit people struggling with emotional difficulties, life challenges, and mental health concerns.

Therapy can help improve symptoms of many mental health conditions. In therapy, people also learn to cope with symptoms that may not respond to treatment right away. Research shows the benefits of therapy last longer than medication alone. Medication can reduce some symptoms of mental health conditions, but therapy teaches people skills to address symptoms on their own. These skills last after therapy ends, and symptoms may continue to improve, making it less likely people will need further treatment.

Mental health issues are common. Recent statistics from the National Alliance on Mental Health show 1 out of every 5 American adults lives with a mental health condition, while 1 in 25 adults lives with a serious mental health condition.

But only about 40% of people with mental health issues get help. Untreated mental health issues often get worse and may have other negative effects. They could also lead to:

  • Inability to work or go to school
  • Difficulty in relationships or taking care of children
  • Increased risk of health issues
  • Hospitalization
  • Suicide

Suicide is the second leading cause of death for people in the United States between the ages of 10 and 34. About 90% of people who die by suicide in the U.S. lived with a mental health condition.

Do I “Need” Therapy?

Telling someone they should go to therapy or that they need therapy can be stigmatizing. It may be difficult to watch a loved one deal with mental health challenges, but it’s important for people to choose to seek help on their own—as long as they aren’t putting themselves or anyone else in danger.

Encouraging someone you care about to look into possible therapy options, even offering to review potential therapists with them, is generally a better way to show support. People who feel forced into therapy may feel resistant and find it harder to put in the work needed to make change.

While therapy can help people work through issues that lead to thoughts of suicide, it’s usually not the best option for people in crisis. If you are in crisis, you can get help right away by reaching out to a suicide helpline through phone, text message, or online chat. You may be encouraged to call or visit the nearest emergency room. A therapist can help support you going forward, once you are no longer in crisis.

When any type of mental health or emotional concern affects daily life and function, therapy may be recommended. Therapy can help you learn about what you’re feeling, why you might be feeling it, and how to cope.

People who feel forced into therapy may feel resistant and find it harder to put in the work needed to make change.

Therapy also offers a safe place to talk through life challenges such as breakups, grief, parenting difficulties, or family struggles. For example, couples counseling can help you and your partner work through relationship troubles and learn new ways of relating to each other. Note that crisis resources, not couples counseling, are typically recommended for abusive relationships.

Should I Go to Therapy?

It may take some consideration before you decide you’re ready for therapy. You might want to wait and see if time, lifestyle changes, or the support of friends and family improves whatever you’re struggling with.

The American Psychological Association suggests considering therapy when something causes distress and interferes with some part of life, particularly when:

  • Thinking about or coping with the issue takes up at least an hour each day
  • The issue causes embarrassment or makes you want to avoid others
  • The issue has caused your quality of life to decrease
  • The issue has negatively affected school, work, or relationships
  • You’ve made changes in your life or developed habits to cope with the issue

If you experience any of the following emotions or feelings to the extent that they interfere with life, therapy may help you reduce their effects. It’s especially important to consider getting help if you feel controlled by symptoms or if they could cause harm to yourself or others.

  1. Overwhelm. You might feel like you have too many things to do or too many issues to cope with. You might feel like you can’t rest or even breathe. Stress and overwhelm can lead to serious physical health concerns.
  2. Fatigue. This physical symptom often results from or accompanies mental health issues. It can indicate depression. Fatigue can cause you to sleep more than usual or have trouble getting out of bed in the morning.
  3. Disproportionate rage, anger, or resentment. Everyone feels angry at times. Even passing rage isn’t necessarily harmful. Seeking support to deal with these feelings may be a good idea when they don’t pass, are extreme compared to the situation, or if they lead you to take violent or potentially harmful actions.
  4. Agoraphobia. People with agoraphobia fear being in places where they might experience panic attacks or become trapped. Some people may become unable to leave their houses.
  5. Anxious or intrusive thoughts. It’s normal to worry about things from time to time, but when worry takes up a significant part of your day or causes physical symptoms, therapy can help you deal with it.
  6. Apathy. Losing interest in usual activities, the world around you, or life in general can indicate mental health issues like depression or anxiety.
  7. Hopelessness. Losing hope or motivation, or feeling as if you have no future, can indicate depression or another mental health condition. Feeling hopeless from time to time, especially after a period of difficulty, isn’t uncommon. But when it persists, it may lead to thoughts of suicide.
  8. Social withdrawal. Many people feel better when they’re able to spend at least some time alone. Introverted people may need even more time alone than others. But if you feel distressed around others or fear being with other people, therapy can help you understand and deal with these feelings.

What If I’ve Already Tried Therapy and It Didn’t Work?

Sometimes therapy doesn’t help right away. Even in an ideal therapy situation, it can take time for symptoms to improve. Going to therapy and seeing no change may cause frustration. It may seem like a waste of time and money. Many people stop going to therapy as a result.

Sometimes therapy doesn’t help right away. Even in an ideal therapy situation, it can take time for symptoms to improve.

Other factors can impact how effective therapy is. There is no single, correct approach that works for everyone. Not every therapist will work for everyone, either. Having a negative experience with a particular therapist or a certain type of treatment can make it hard to try therapy again, even if you want support.

It can help to look for a therapist who treats what you’re experiencing. If you don’t have a diagnosis, you can talk to potential therapists about your symptoms. An ethical therapist will let you know if they’re able to treat your concern. If they can’t, they may be able to recommend someone who can.

Keep in mind different approaches may be better for different issues. Being misdiagnosed can affect how treatment works. If you didn’t feel heard in therapy before, or if you experience different symptoms, a different therapist might be a better fit for you.

Why Should I Go to Therapy?

If you’re considering therapy, you may be thinking about the possible drawbacks. Cost might be a concern for you. You might also be aware that therapy is often difficult. Trauma or other painful events from the past can be frightening to remember, much less discuss with someone else. Even if you aren’t dealing with trauma, working through challenges isn’t easy, and therapy isn’t a quick fix. Therapy also requires honesty, with yourself and with the therapist you work with.

But if you’re willing to do the work, therapy can be rewarding. It’s a safe, judgment-free space where you can share anything, with a trained professional who is there to help.

Here are a few benefits of therapy:

  • You’ll learn more about yourself. Therapists listen to your story and help you make connections. They might offer guidance or recommendations if you feel lost, but they don’t tell you what to do. Therapy can empower you to take action on your own.
  • Therapy can help you achieve your goals. If you aren’t sure of what your goals are, therapy can help you clarify them and set realistic steps to meet them.
  • Therapy can help you have more fulfilling relationships. Whether you’re single or in a relationship, therapy can help you address difficulties with relating to others, such as insecurity in relationships or difficulty trusting your partners.
  • You’re more likely to have better health. Research supports a link between mind and body wellness. Untreated mental health issues can impact physical wellness. On the other hand, people in good emotional health may be more able to deal with physical health issues that arise.
  • Therapy can lead to improvement in all areas of life. If you feel like something is holding you back from living life as you envision it, therapy can help you address this. When you aren’t sure what’s keeping you from making change, therapy can help you discover the answer.

Even if you aren’t sure you want to commit to therapy, many therapists offer a free first session or phone consultation to talk through what you’re dealing with. Based on your symptoms, they might encourage you to get help.

Begin your search for a therapist today!

25 Signs of a Bad Therapist: You Deserve Better

Some signs of a bad therapist are easy to spot. If your therapist insults or shames you, it’s time to find someone new.

Others are more difficult. The therapist might encourage you to blame others or become overly defensive about a criticism. These issues may not hurt your feelings, but they hinder progress in therapy.

This guide will help you spot all the signs of a bad therapist. That way you can avoid bad therapists and find the quality therapy you deserve.

To make the guide comprehensive and inclusive, we included all of the mediums for psychotherapy. This is crucial because some red flags only apply to in-person therapy but not online therapy. Think about how a therapist eating during an in-person or video session would be rude but would not matter for texting therapy.

  • Signs That Apply to All forms of Psychotherapy
  • In-Person Therapy Only
  • Video Chats Only
  • Phone Calls and Audio Messaging
  • Text-Messaging Therapy Only

A Quick Note of Consideration for Your Therapist:

It’s important to catch warning signs, but remember to cut your therapist some slack. They are only human and are bound to make some mistakes.

If you only see one of these signs and it doesn’t bother you too much, consider chatting with your therapist about it. The two of you might be able to work on it. If you like your therapist, it would be a shame to quit over something you could reconcile.

Think about whether the therapist is a good fit for you. Signs a therapist is bad are different than signs he or she isn’t the right match.

Signs That Apply to All Forms of Psychotherapy

1. Not Listening or Responding

This is the most obvious one. Therapists need to listen and respond to what you’re saying. If they are clearly not making enough effort to understand you and provide guidance, it’s time to bounce and find someone better.

2. Judging You

Judging clients in a way that shames them is hurtful and hinders progress in therapy. You should not have to experience this.

3. Telling You What To Do

It’s OK for therapists to share their thoughts and opinions if you ask for advice, but they shouldn’t be ordering you around. Therapy is supposed to empower you and give you the cognitive skills to make great decisions. Telling you what to do defeats that purpose and is an ethical grey area.

4. Imposing Religious, Spiritual, Political or Social Beliefs

Therapists should respect your religious, spiritual, political and social beliefs. That means not imposing their beliefs on you.

If a therapist is opposed to abortion for religious reasons, for example, he or she has no right to raise that during treatment or use it as motivation to advise a client on issues related to an abortion.

Even if you sought a religious counselor so you could discuss religious issues in therapy, your therapist should not impose any belief. A religious counselor is only someone who is more likely to understand a religious perspective.

5. Not Being Sensitive to Your Beliefs or Background

Therapists need to respect differences between themselves and their clients. Their guidance should account for your beliefs.

6. Breaking Confidentiality

A therapist is legally bound to protect your privacy. He or she should only share confidential information if it is necessary to save a life.

7. Encouraging You to Blame Everyone for Your Issues

You want a therapist to be on your side, but they won’t help you if they encourage you to blame all your issues on others. Therapy is supposed to empower you to take responsibility and live a better life.

8. Shaming Mental Illness

If you have a mental illness, your therapist should accept that part of your identity. They shouldn’t treat it like something to be ashamed of. Here’s an example of a therapist doing that by telling a person with bipolar disorder he should not disclose it to anyone:

“In a manic state, promoting bipolar would be like gays promoting gayness at Mardi-Gras. Weeee, which is OK if you are in New Orleans, but real risky anywhere else at other times of the year. That’s not education, that’s in your face.” – Mike Leary, Psychotherapist

He’s also a bigot who hopefully doesn’t work with gay clients.

9. Talking Too Much About Him or Herself

It’s OK for therapists to talk about themselves a little. Sometimes it helps build a strong therapeutic alliance that increases positive results in therapy.

The vast majority of therapy should be about you, though. That’s what you’re paying for!

10. Pushing You to Talk About Something You Don’t Want to Talk About or Aren’t Ready for Yet

You’re paying for therapy, so you should decide where it goes. Therapists need to respect that and be patient with issues. They can guide you, but they shouldn’t push an issue if you tell them to change the subject. If it’s too important to ignore, they should wait and gently, gradually guide you back to it.

11. Rushing a Diagnosis or Overdiagnosing

Not every problem needs a clinical label. Sometimes rushing to diagnose someone can result in a false diagnosis or overdiagnosis.

It can be dehumanizing, too. A therapist should treat you as a person first, then your mental health issues. Unless you ask for a diagnosis immediately, it shouldn’t be the first part of your therapeutic experience.

12. Becoming Overly Defensive About Feedback or Criticism

If you tell your therapist he or she has made a mistake or needs to fix an approach to an issue, he or she should respond calmly and maturely. On the other hand, bad therapists will lose control of their emotions, become overly defensive or criticize you.

13. Pushing Therapeutic Approach Too Much

Therapists shouldn’t put everything you are dealing with in the context of a therapeutic approach. If you pour your heart out about a childhood trauma, your therapist’s first response shouldn’t be, “Let’s see what Freud would have to say about that.”

14. Trying to Be Your Friend

Your therapist should not ask you to hang out as friends. It can interfere with being objective during therapy.

Signs That Only Apply to In-Person Sessions

15. Checking the Clock Too Much

Once is OK, but several times is rude. You shouldn’t feel rushed out the door.

16. The Therapist Is Constantly Buried in Notes

Eye contact and body language are one of the main benefits of face-to-face therapy. You’re missing out on this benefit — one you might have paid a lot of money for — if your therapist spends the vast majority of the session scribbling in a notebook.

17. Eating, Grooming, Primping or Checking Phone

These are rude and there’s no excuse. Lunch breaks exist for a reason.

18. Inappropriate Touching

A therapist should not initiate any form of physical contact other than a handshake or pat on the shoulder. Anything else is a grey area or unethical.

19. Not Giving You the Time You Paid For

If you’re on time to your session, you deserve the amount of minutes the therapist is charging you for. A therapist might need to start late because the client before you was late. That’s OK. But if you start a 30-minute session at 4:35 p.m., it should finish no earlier than 5:05 p.m.

Signs That Only Apply to Live Video Chats and Video Messages

20. Looking or Clicking Around Their Desktop or Phone

During a video chat, you can see a therapist’s eyes wander constantly if they are multitasking while chatting with you. It’s a sign of disrespect.

21. Too Much Background Noise, Not Enough Privacy

If there is a ton of background noise during your scheduled live video chat, it shows the therapist didn’t care or wasn’t organized enough to find a quiet space for the chat. Environments like this risk other people hearing what the therapist is saying. This can violate your privacy.

Signs That Apply to In-Person and Video Chat Therapy

  • Not Giving You the Time You Paid For
  • Checking the Clock Too Much
  • Eating, Grooming, Primping, Etc.
  • Constantly Buried in Notes
  • Checking the Clock Too Much

Signs That Apply to Phone Calls and Audio Messaging

The signs are the same as the video chatting ones: lots of background noise that shows the therapist didn’t try to find a quiet space, eating while talking, etc.

Signs That Only Apply to Asynchronous or Live Text Therapy

22. Taking Forever to Respond

If a therapist consistently takes a more than five days to respond to each one of your messages, they aren’t trying hard enough. Responding that slow defeats the purpose of text therapy.

23. Their Messages Are Too Short

When you send a therapist a huge paragraph with important thoughts, their response should be more than a word or two.

24. Not Trying to Convey Tone

Therapists need to write more during text therapy so they can convey tone. If they don’t put in that effort, the therapy might feel incomplete.

25. Tons of Typos

If messages are riddled with typos to the point where you can’t understand what the therapist is trying to communicate, it means he or she didn’t take the time to edit the message.

Signs You Are Ready for a New Therapist

If you have encountered some of these signs, don’t worry. There are good therapists out there who will fit your needs and preferences. If you still want to improve your mental health, you’re ready for a new therapist.

Can therapy be harmful? What are the signs that you have a terrible therapist?

We asked experts to shed light on these questions.

Table of Contents

Rev. Connie L. Habash, MA, LMFT

Licensed Marriage and Family Therapist, Awakening Self | Yoga Teacher | Interfaith Minister |
Author, Awakening from Anxiety

A bad therapist tells you what to do

A good therapist will listen to you, reflect what they hear, and ideally help you find your own answers within. They may have suggestions or ideas, but ultimately, it’s important to empower you to make your choices in life.

There are exceptions to this, such as preventing a client from harming themselves, but in general, if a therapist is constantly telling you that you have to do what they say, question it.

A bad therapist talks a lot about themselves

Counseling is for the client, not the therapist. Generally, therapists don’t share about their lives, because they don’t want the session to become about them. It should be focused on the client’s needs and experience.

If a therapist is often talking about their own problems or personal life, you’re not receiving everything you should out of your sessions.

A bad therapist pressures you to have a lot of sessions

Sure, it takes a few sessions to get a sense of how well you’ll work together. And change does take time, honestly. But the number and frequency of sessions should be a discussion between you and the therapist that you return to from time to time, not a mandate for a massive long-term investment. It’s always your choice.

A bad therapist judges you

The last thing you need when you’re vulnerable and sharing difficult feelings is the sense that you’re being judged for them. If this is the case, find a different therapist who can accept you and support you as you are, while holding the vision for who you want to be.

A bad therapist is flakey

If your therapist is constantly forgetting about sessions or frequently has to reschedule, there may be something going on in their life, like a family problem or a health issue.

Talk to them about it and work it out together. But if they’re just not making it a priority or putting other things ahead of your sessions, find someone who makes your time a priority.

Dr. Robert London

Psychiatrist | Author, Find Freedom Fast: Short-Term Therapy that Works

A bad therapist may extend the clock for years

Short term therapy is out there for many issues but people are unaware of it and often get trapped in open-ended long term treatment. It may be very costly and not usually focused on specific problems.

Once people do go for help, they may end up spending years in therapy hashing and rehashing the past, but not getting positive solutions or a new perspective on an old set of problems.

As a health care consumer advocate and practicing psychiatrist, let me assure you that it doesn’t have to be this way. Many mental health problems can be substantially helped in a relatively short time period using targeted strategies and short-term therapeutic approaches.

If a therapist wants to keep the patient on the clock for years and doesn’t address the real issues, that may be a warning sign. Whether I’m speaking to an audience of mental health professionals or health care consumers, I always tell them this: For many people, the first line of treatment should be short-term, straightforward problem-solving techniques that have specific goals in mind.

As with other health conditions, one can proceed to long-term care if it’s needed. The work I do as a psychiatrist, educator, and public speaker is to help spread a positive message that many mental health problems can be treated quickly, effectively, and completely, which is not popular oftentimes.

G. Scott Graham, MS, LADC

Licensed Substance Abuse Counselor | Psychotherapist | Business Coach, True Azimuth, LLC |
Author, Ten Things You Need to Know About Coaching Before You Get a Coach

A bad therapist can’t talk about the model they are using with you in therapy

The first thing you should do is ask your therapist what model they use

Most people don’t ask this question when they see a therapist. Most likely because they are not aware that there are different models about how people change. They might have heard of psycho-analysis and maybe even behavior therapy but probably not much more.

There are many models of therapy from reality therapy to Adlerian therapy to rational emotive behavior therapy to motivational interviewing to interpersonal psychotherapy — just to name a few.

Don’t accept “I am eclectic” as an answer — “eclectic” means “I don’t know.” And don’t accept an activity as a model. Play therapy is an activity. Art therapy is an activity.

Second, ask for proof of competency

Your therapist should not only be able to tell you what model they use but show you a document/certificate that shows they have been trained in that model. You don’t want someone who read about some model (and it’s accompanying technique) over the weekend and experimenting with it on you.

Finally, ask your therapist if the model they are planning to use in your therapy is proven effective

For example, interpersonal psychotherapy (or IPT) has been proven more effective than Rational Emotive Behavior therapy in treating depression.

If you are considering therapy, then these three questions will help you sort out the good therapists from the bad therapists. If you are currently in therapy, ask these questions at your next session.

It is noteworthy that people ask these types of questions all the time in other aspects of their health care — from cholesterol to cancer to high blood pressure therapies.

People seek to make informed decisions about their physical health but somehow don’t bring the same critical thinking when making decisions about their mental health.

Traci W. Pirri, MSW, LCSW-S

Owner & Director, Hope of the Journey

Therapists come in all shapes and sizes. What makes a good therapist for one person might make them a bad fit for another. But, like with everything, there are skilled, ethical clinicians and those who miss the mark. Knowing how to spot the bad ones can save you lots of time, money, and emotional turmoil.

Luckily, there are a few easy things to watch for that can really help weed out the bad apples.

A bad therapist shows lack of attention

Therapists are human, and we all have moments when we’re tired or lose focus. However, if your therapist seems consistently off focus–asking you to repeat things, responding with unrelated or unhelpful statements, or (yikes!) even falling asleep–this is a huge warning sign that the therapist might be burned out.

A bad therapist can’t connect with the client

You can have the best skills as a therapist around, but if you can’t connect with your client, you will not be effective. The strength of the relationship between a client and a therapist is one of the most predictive elements of a good outcome.

It’s kind of like dating. If you don’t feel that connection pretty quickly, move on. While they might not be a bad therapist overall, they are not a good fit for you.

A bad therapist gives too much advice

Most people think that therapists are constantly giving advice and helping people make better decisions. While many people do find they improve their decision-making as a result of therapy, a good therapist helps their clients decide for themselves instead of just giving a solution.

A bad therapist feels like the expert in everything

Beware the therapist who works with all populations and all specialties! Part of all clinical licensure ethical standards requires counselors to practice within their scope.

If we are inexperienced with something, we need to fully disclose that and be actively seeking supervision and/or training in these areas. If we are untrained, we are required to refer out.

Sometimes, counselors get so caught up in their desire to help others that they forget to stay within their scope. This is one of the most common ways a therapist can get into an ethically bad situation.

A bad therapist has poor boundaries

Every therapist has a different way of working. These systems and policies should be clearly communicated to you both in person and through documents such as the Consent for Treatment. If the therapist isn’t following their own policies or doesn’t seem to have any, it is confusing at best and dangerous at worst.

Poor boundaries can look like anything from not having a clear policy regarding canceling appointments to making sexual advances towards clients.

While poor boundaries about things like scheduling don’t always lead to severe boundary-crossing like a sexual advance, there are usually other smaller boundaries that have been crossed first. So, it’s a good rule of thumb to look for a therapist who does have good boundaries from the start.

Suzanne Jessee

Clinical Therapist | Founder & CEO, Anew Era TMS

When it is time to enlist the help of a psychotherapist, the process of finding one may feel like a daunting chore. Most people are comfortable asking friends for referrals to other providers, be it a dentist or a medical doctor. But some may shy away from asking others for a referral to a therapist.

So, the list of possible providers streams down the computer screen, one name after another. Some may select a therapist based on their location, others by their gender. However, much care should be taken when deciding which therapist you will be welcoming into your mind and your life.

To help eliminate the substandard therapist options, note any of these red flags when meeting with a prospective psychotherapist:

  • A bad therapist does not look you in the eye. Any therapist who does not make eye contact may lack empathy or will not forge a bond with you.
  • A bad therapist appears bored. The therapist should be tuned in to your story and not be distracted, nodding off, or constantly looking at their phone.
  • A bad therapist lacks expertise. Some therapists agree to take you on when in reality they have no practical experience treating your particular mental health condition.
  • A bad therapist makes you feel uncomfortable. If while in their presence you are fidgety, anxious, or just plain uncomfortable, this is not a right fit.
  • A bad therapist is not a good listener. A good therapist will respond appropriately to the feelings, thoughts, or experiences you share.
  • A bad therapist does not elicit confidence. If the therapist does not inspire feelings that he or she can help you with your problem, they probably can’t.

Margery D.E. Boucher, MA, MS, LPC-S

Licensed Professional Counselor, North Texas Counseling

If your therapist is telling you what to do, instead of helping you on a path of self-discovery, that is no good! Therapists are not advice-givers! We are supposed to help our clients learn to think, act and problem solve on their own.

A bad therapist gives too much self-disclosure

A little self-disclosure can be appropriate, especially when trying to connect and build trust with clients. However, if you notice that you seem to know as much about your therapist as they know about you… that is a problem! And of course, having an intimate relationship with clients!

Brandi Lewis, M.Ed, LPC

Licensed Professional Counselor | Owner, Reach Counseling Solutions, PLLC

A bad therapist makes you feel that you can’t speak freely without feeling judged

I have found that clients who don’t feel that they can speak freely don’t have the same results because they may not be forthcoming with information or openly tell the truth about what they may be feeling or going through.

There are therapists who specialize in many different areas. A therapist may not be right for you if you are seeing a therapist who doesn’t specialize in your concern. For example, if you struggle with anxiety or depression, it may not be helpful to see someone who specializes in solely addictions.

A bad therapist uses too much self-disclosure that it overshadows your needs

For example, you’ve come in because you’ve had a bad break-up with your partner. Your therapist begins to talk about one of her breakups as a means to relate to you and says, “Oh, yes. Breakups are tough. I’ve had a bad breakup. You’ll get through it. This is not as bad as you think.”

Adina Mahalli

Certified Mental Health Consultant, Enlightened Reality | Relationship Expert, Maple Holistics

A bad therapist makes you feel that you are being judged in your sessions

If you find yourself nervous to open up about certain things because you expect that this specific therapist will sneer, snicker or respond in other inappropriate ways, it means that you should not be seeing them.

A bad therapist blurs the boundaries of the therapist-client relationship

If your therapist opens up to you too much about their personal life, takes out their phone to show you pictures of their kids, or suggests meeting up outside of the office, it’s a clear indication of a lack of professionalism.

Laurie Bankston, LPC

Licensed Professional Counselor, Journey To New Beginnings

A bad therapist does not respect your time

I have heard of clients having to wait 30-45 minutes for a 45-minute session! Unless your therapist is handling an emergency, this is unacceptable.

In the past, I worked for an agency that encouraged therapists to double-book sessions. This meant that if both clients showed up for your 11:00 session, you saw one client from 11-11:30 and one from 11:30 to 12.

In this scenario, one client had to wait 30 minutes and both had shorter sessions (standard was 45-minute sessions). If you notice that your therapist is consistently late and your sessions are shorter than expected, your session time may have been double booked.

Your time, just like your therapist’s time is valuable. In the same vein, good clients are not consistently late and do not miss appointments without calling first.

Jacqueline Getchius, MA, LPCC

Licensed Professional Clinical Counselor | Owner, Wellspring Women’s Counseling

It’s important to advocate for yourself when entering mental health therapy. Always trust your gut if you get a bad feeling that the therapist you’re seeing may not be a good fit or, even worse, may actually be a bad therapist overall.

A bad therapist engages in unethical behaviors

If you notice your therapist engaging in unethical behavior, such as talking about other clients with you, overly sharing about their own personal life, or leaving other clients information around the office where it could easily be seen by other clients.

More signs of a bad therapist would be not starting or ending sessions on time, taking phone calls during your session, or clearly becoming inattentive during your sessions, such as dozing off or staring out the window.

Even on a more basic level, a bad therapist is also one who doesn’t give you feedback about your mental health diagnosis, has no clear treatment plan for your sessions together and doesn’t share information about other treatment options available to you.

Alena Gerst, LCSW, RYT

Psychotherapist

A bad therapist tries to make the session about themselves

A therapist may disclose a personal anecdote from time to time if they deem it to be in the interest of the client. It is not uncommon for therapists to use themselves as tools to illustrate a point to the client or to relate to them in order to build engagement.

But if a client becomes concerned about the therapist’s feelings, whether or not the therapist is accepting of them, or feels afraid to disclose information for fear it would upset the therapist, that is a sign the therapist is not maintaining necessary and appropriate boundaries in the therapeutic relationship.

Ted Chan

Founder & CEO, CareDash

As CEO of CareDash, a health provider rating site, I can tell you about several of the most common reasons people give when negatively reviewing therapists.

  • First of all, insufficient empathy is an issue — this is often apparent when the therapist talks about themselves rather than asking questions to the patient.
  • Another common complaint is about therapists who appear to be distracted, for example by talking on the phone or never looking up from their notepad.
  • Violation of privacy or confidentiality is another serious issue often mentioned in negative reviews of therapists.
  • An excessive focus on billing and payment on the therapist’s part at the beginning and throughout the therapy relationship is a turnoff for many counseling clients.
  • Additionally, we hear from unhappy reviewers who complain of therapists cutting appointments short or showing up late — a red flag to watch out for early in therapy relationships.

5 Signs You Have the Wrong Therapist

Source: Adam Gregor/

The Roots of Disappointment

Remember, every profession has its share of crackpots; psychotherapists are no different. Very few employers hire people on the spot. And since you are the employer, treat hiring a therapist with the same caution and consideration.

Most people who express dissatisfaction with their therapist have many common experiences. The top three are:

  • They rushed into therapy without interviewing different therapists.
  • They didn’t get a referral from a reliable source, such as a friend or colleague.
  • They hired the cheapest therapist (and got what they paid for).

The attunement between a therapist and a patient is key to success, so taking your time to find the right person is crucial. If you can pay out-of-pocket, you have lots of options; there’s really no need to rush. Take your time and interview at least three before choosing one.

If you’re lucky enough to have good insurance, work through that long list of providers. Yes, it’s frustrating, but well worth it. Be patient, find a therapist you can trust and open up to.

If you’re broke and have no insurance benefits for therapy, search for local mental health clinics, hospitals or training institutes. Whenever I provide clinical training seminars in such places, I’m always impressed quality of care that they provide. Even with a low fee, you still have the selection process on your side.

5 Signs Your Therapy is Going Nowhere

If you’re in therapy and discouraged with the results, here’s some warning signs that you’re probably working with the wrong therapist.

1. You don’t look forward to your sessions.

When therapy is working best, your session is a high point in your week. You leave your therapist’s office feeling invigorated by insights, motivated for change. Naturally, sometimes sessions can be sluggish or dull. But if this is the majority of the time, there’s a problem. Therapy is a growth experiences. Even when it is painful, it should be empowering. If you find yourself chronically bored, confront your therapist, tell him that you want to get more out of your sessions. If nothing changes, pack-up and spend your money elsewhere.

2. You don’t feel challenged by your therapist.

Many patients complain to me that their former therapists were too passive and never said anything. Naturally, every good therapist needs to be a good listener—but there’s more to therapy than listening. A good therapist confronts, challenges and inspires you to make new choices. Therapy should embolden you. If your therapist is too passive and unresponsive, move on. Therapy should never be a snoozefest. If you’re bored, chances are your therapist is too.

3. You don’t quarrel with your therapist.

A therapist who always agrees with you may feel good, but you won’t see much progress. Bottom line: therapists are not paid friends. You don’t hire them to enable you or passively listen to you vent. For therapy to work well, you and your therapist should clash now and then. The patient/therapist relationship works best when you express a full range of feelings toward your therapist: affection, irritation, admiration, even hate. Such a dynamic, active relationship is the hallmark of good therapy.

4. You don’t see any growth in your life.

Why keep going to therapy if you don’t see the payoff in your daily life? There has to be some kind of positive motion, such as better relationships, more confidence, less depression or anxiety. If you see absolutely no change or growth from therapy, something’s seriously out of whack that needs to be addressed with your therapist.

Speaking with therapists at WSI, New York City Source: Sean Grover

5. Your therapist isn’t a good role model

Is your therapist expressive, engaging or dull and passive? Therapists need to be good role models for their patients. Even if your therapist reveals nothing, you can sense if he practices what he preaches. Truth be told, a lot of therapists suffer from depression. If they can’t cure themselves, how could they possible cure you?

For information about workshops and seminars, visit www.seangrover.com

10 Ways to Spot a Good Therapist

Source: Olimpik/

Many approaches to therapy have been developed in the decades since Freud first began his experimentation with the talking cure. Psychotherapy today comes in many varieties: The psychoanalyst will probe your unconscious; the behaviorist will rearrange your reinforcement contingencies; the cognitive therapist will challenge your irrational thoughts; the humanist will provide a safe space within which you may activate your self actualization tendency; the existentialist will encourage your find meaning in the desert of existence; the reality therapist will guide you toward choosing behaviors that facilitate your connection to others; the feminist therapist may show you how your personal problems could be manifestations of patriarchal oppression, and so forth, on and on.

In this rich ecology, no single therapy theory or technique holds a monopoly on healing. Depending on the particular context—when, where, how, and with whom they are used—multiple approaches, explanations, and interventions may prove effective and helpful, or, alternately, ineffective and harmful. Given this, and the endless array of choices, how can potential clients tell good therapy from bad?

Well, just as all wines—despite their great diversity in taste, price, and presentation—share the same active ingredient (grapes), so it is with therapy: Underneath the surface diversity all good therapies share several underlying principles. These common factors are in fact responsible for most of the healing that takes place in therapy.

Here’s a list (based on my own reading of the research, and my clinical experience) of 10 basic, common ingredients of good therapy:

1. Good therapy is not friendship.

There are several differences between friendship and therapy. First, you may have multiple relationships with your friends. You can go into business with them, borrow money from them, have sex with them. With your therapist, you can only do therapy. Your therapist may be friendly, but she is not your friend. If your therapist is your friend, then she is not your therapist.

Second, friendship doesn’t need to have a plan, goal, or purpose beyond its own existence. You can hang out with your friends for no good reason other than that you enjoy it, are used to it, or have nothing better to do. You don’t hang with your therapist. Therapy is purposeful and pragmatic, moving deliberately toward one or more mutually negotiated goals. Therapy is not an end in itself.

Third, you and your friends have a mutual, equal claim on your encounter. Your interests, needs, and concerns are as important as your friends’ concerns and issues. Therapy is not like that. By design it is one sided; it is about the client. Every action of the therapist can legitimately be directed only toward one goal—helping the client. The therapist cannot use therapy time, or the therapeutic relations, to take care of their own needs. If your therapist uses therapy time for any purpose other than to help you, then what they’re doing is not good therapy.

2. Good therapy is evidence-based.

Good therapy involves keeping good records, connecting anecdotes into patterns, generating hypotheses and testing them. Good therapy is responsive to new knowledge. It admits and corrects its mistakes. While good therapy seeks to foster hope and nourish the expectation of change, its promises are tethered to facts. If your therapist guarantees success or promises to change your personality, walk away.

There is art to good therapy, since it is an intentional human encounter, and as such is inherently dynamic, creative, and unique. But the art of good therapy must align with science in the way that the art of architectural design must align with the principles of sound engineering. What the therapist suggests to the client—the course of action, the explanations and interventions—should be based on scientific research, to the extent that such research exists. Good therapy does not contradict or ignore sound scientific data, knowledge, or evidence. Good therapy recognizes the simple truth—simple, yet not easy—that the evidence wins out in the end.

3. Good therapy affirms the client’s basic human dignity and worth.

Good therapy looks to facilitate sound mental health. Mental health, however, is not a destination, not an end in itself, not a place you arrive at, pearly-gates style, to be ushered into bliss. Rather, mental health is a process you adopt and use in the pursuit of your chosen goals. In other words, mental health is your driving skill, not the destination of your trip. The therapist, therefore, is not a chauffeur but a driving instructor.

Good therapy concerns itself with judgments, but it is not about judging people, in the same way that a church must concern itself with finances, but should not be about money. Most people who come to therapy have been judged harshly enough for their troubles—by themselves, their peers, spouses, employers, neighbors, and, often, society at large. They have also been given plenty of advice. Therefore, unlike media therapists, good therapists go light on both judgment and advice. And by and large, that’s not what people come to therapy to find. They come for an experience—a healing, corrective experience. What they require is understanding, empathy, attention, acceptance, and encouragement.

Just as a surgeon has a duty to operate regardless of the patient’s ideology, moral character, wealth, or ethnicity, so must a therapist accept, listen, and seek to understand, respond appropriately to, and honor the humanity of every client, regardless of how much the therapist “likes” or approves of the individual. And needless to say, good therapy does not condescend, patronize, abuse, abandon, manipulate, lie, or cheat.

4. Good therapy encourages and models accurate, honest, and timely feedback and communication.

Video games are hugely popular. One reason is because people who play a lot can improve a lot. They improve because the video game environment provides timely, consistent, unflinching, and accurate feedback: You kill the bad guy, you move to level 2; the bad guy kills you, you repeat level 1. Likewise, clients improve when they receive timely, accurate feedback in therapy.

Many of our encounters with people outside the therapy room are mannered, circumspect, or shallow. Many are touched by deceit, or plagued by inattention. Our communications in the world often seek to obscure rather than reveal our true intents, to avoid the truth rather than confront it. We are often afraid to say what we truly feel and think; afraid to hurt and be hurt; afraid that our secrets will leak out and be used against us. Truth may set us free. But more than we want to be free, we want to belong and get along, because that’s how we survive and keep safe. What is the right to privacy, if not the right to withhold truth, to maintain a distance between how we present ourselves and who we are, to keep our truths to ourselves? Out there in the social world, truth can be dangerous.

Truth is safe in good therapy. Therapy creates a space that invites, expects, and is quite purposely designed for frank, probing, and revealing dialogue. It’s a safe space for clients to express themselves honestly, get to understand their true feelings, and work with the therapist to figure out how to use that information in their journey toward healing.

5. Good therapy = a good therapeutic alliance.

Generally, the best predictor of success in therapy is rapport—feelings of trust and respect between the participants; a therapeutic alliance. When there’s no rapport, there’s no therapy. Thus, while a therapist may look good on paper—experienced, well trained, etc.—if upon meeting them (within the first few sessions) you feel no chemistry, no trust, no warmth, then it’s probably best (for both of you) if you move on.

6. Good therapy encourages the client’s independence and competence.

If the therapy process is not moving in the direction of improving client resilience, independence, decision-making, and life competence, then therapy is not taking place. If your admiration for the therapist rises in tandem with your self-doubt, then you’re probably not in good therapy. A good sign of therapy at the brink of failure, or of therapy that’s not legitimate, is when your dependence on the therapist increases over time. Therapy is not about handing out solutions to problems; it’s about teaching the client to problem solve.

7. Good therapy considers the client’s history and biography.

Some therapy approaches focus mostly on the here and now, or on the future, while others focus mainly on re-envisioning past experiences. Either way, good therapy makes room for biography. The past is not the only key, but is often one key to the present. We may not focus on it, but acknowledge it we must. We all come from somewhere. And where we come from has implications for where we are and who we are. A person’s biography provides a map of their experiential field; it’s a context within which their behavior can be usefully understood. The past may not determine the present, but it certainly informs it. And it informs good therapy.

8. Good therapy takes into account the client’s subjective experience and inner world.

People experience life through their senses. Our individual sensory experiences—while rooted in the common soil of our evolutionary heritage—are shaped by our genetic makeup and life experiences, both of which are unique. Thus, while on some level we are all in this together, on another, to paraphrase Lilly Tomlin, we are all in this alone. Which is to say, how you represent and process the phenomena of the world may be quite different from how I do so. Good therapists know that to understand the client, they must understand her subjective experience. Not just her circumstances, but what the circumstances mean to her. Good therapy is curious about the client’s inner grammar. Good therapy honors, maps, and works within the client’s subjective experience. In other words, good therapy accepts that while, for example, your mother is in all likelihood an average person by objective measurements, she is special to you, because of how she is represented in your subjective world.

9. Good therapy happens when the client does the work.

Like parents do with their children, therapists tend to take too much credit for their clients’ success (and too much blame for failure). In fact, both parents and therapists are less powerful than they (and the world) believe they are. Client factors such as hope, motivation, resources, social support, and grit account for far more than the therapist’s ability and characteristics in determining the therapy’s outcome. The client’s experience of the therapy also matters more than the objective measurement of therapy ingredients. All therapy, in a fundamental sense, is self-therapy. If therapy is to work for the client, the client has to work for the therapy. As the old joke goes: How many therapists does it take to change a light bulb? Answer: Two or three, but the light bulb has to want to change. (And yes, humor belongs in good therapy).

10. Good therapy offers support, requires learning, and facilitates action.

Good therapy engages clients on multiple levels. It involves clients’ emotions, cognition, and behavior. Often, the effort in therapy will focus first on emphatic understanding of the client, establishing alliance and becoming aware of the client’s inner architecture, life circumstances, and personal narrative. Then, good therapy will also facilitate learning—new insights, new ways of thinking, of communicating with others, and managing emotion. Finally, good therapy includes a focus on the clients’ action in the world—practicing new skills, adopting new habits, and new ways of moving in the world.

If you are in therapy feeling alone and unsupported, if you haven’t learned anything new, and if your behavior has not changed at all, then you’re not in therapy, at least not in therapy that’s any good.

Check Psychology Today’s directory of therapists for a professional near you.

LinkedIn Image Credit: February_Love/

Does My Therapist Care About Me? Is That What I Pay Them For?

It is a reasonable question. “Does my therapist like me”? In the bizarre, boundaried, prescribed therapist/client relationship, where clients can come to have such potent feelings about their therapists, it is fair for the client to wonder where they stand.

Such a Prescribed Relationship

For some of our clients, having to pay us throws into question whether or not our relationship is authentic. There are many aspects of this quite intimate relationship that can trouble clients. Basically, all the elements that define the boundaries of the relationship, otherwise referred to as the frame. Examples include but are not limited to the following:

  • There is a fee to meet with us, even years after the relationship is well established.
  • Meetings occur in our professional office and no where else.
  • We meet for a defined period of time that we schedule.
  • The session start time does not shift to accommodate lateness.
  • The session ends regardless of where we are in the conversation.
  • There are defined limits on the contact they can have with us outside the session.
  • The sharing of personal information is primarily one way.
  • They might be charged for cancelled sessions.

Because this is a relationship with specific boundaries and pre-defined structures determining many aspects of the relationships, clients can fear that everything about the relationship is contrived, including any care or tenderness we might show in our work with them.

The Tools Of The Trade

The false premise is that “caring” is one of our tools, or mechanisms for change. They are imagining that our care for them is what heals them, but that they have to pay for that. We all know money doesn’t buy feelings of concern, care or love, so surely if that is what they were paying for, they would be receiving an empty exchange. The thing is, it isn’t our job to care about them. That isn’t one of the tools of our trade. That isn’t the thing we set out to offer that is potentially healing or transforming.

This can even be confusing for some entry level clinicians, who might have been drawn to the field because of a general caring of others and wish to take good care of people that are suffering. There is nothing wrong with that impulse, but is not what we operationalize to help clients. In fact, “caring” about some of our clients would only serve to injury and further distance the client, for instance with clients who had emotionally inauthentic care-takers, or emotionally impinging care-takers. While there are many different approaches to therapy, I would challenge any discipline that argued that caring or love was a tool of the trade as lying outside of the theoretical stances of the discipline of psychotherapy.

In my own discipline, which is analytically oriented psychotherapy, our primary pursuit is knowledge. My approach focuses on helping the client in developing a clearer channel of communication between their conscious and unconscious minds. I work towards this goal through noting associative thinking, pointing out conflicts between words and affects, highlighting links between current and past relational dynamics, and reflecting on the client’s and my own relational dynamics, among other things. None of these tasks ask me to have emotionally positive or caring thoughts or feelings about my clients.

Some Things Look An Awful Lot Like Caring

Some of what we offer in sessions gets mistaking experienced as care because of elements shared in common with a caring stance. Firstly, we listen. And we are good at listening. We don’t interrupt. We don’t re-direct the conversation to talk about ourselves. We ask good follow-up questions to hear more. We offer up language that further elucidates their feelings. Folks rarely in life have an opportunity to sit down for 50 minutes with the focus exclusively on us and our struggles. Clients can experience this as a kindness, even though in actuality, that is a by product, not the goal or intention.

Another example of what gets experienced as caring is that in our pursuit of the details that make up the client’s suffering, we are disinclined to judge, as judgement interferes with our curiosity. When a client reveals something that they expect to be judged or reprimanded for, we are likely to respond with questions, or to point out elements that give the the detail context, or some other such move that does not embody shame. For the client, they get to have an experience of not being judged, even though we are leveraging that mental stance for other purposes.

Does My Therapist Care About Me?

I am not arguing is that we don’t care about our clients. Most of us do care about, and sometimes even have loving feelings towards our clients. In fact when we don’t, we are often aware that it means something clinically important, worth thinking through in supervision. Not because it is our job to care about our clients, but because when we want to truly understand another person, we must take into consideration the whole context. When we understand the source of someone’s suffering we know the cause of their negative attributes as well. Compassion is a natural response to knowing the big picture of someone’s life.

Clients don’t pay us to care about them. Nor are we their friends. They pay us for our professional skills and knowledge. They pay us to use the tools of our trade to help them. They pay us to think with them, to notice links and discrepancies, to help them sit with certain feelings or truths.

It is true, we often care about them. But they get that for free.

Smith is an analytically oriented psychotherapist with 25 years in practice. She is additionally the Founder/Director of Full Living: A Psychotherapy Practice, which specializes in matching clients with seasoned clinicians in the Greater Philadelphia Area.

If you are interested in therapy and live in Philadelphia or the Greater Philadelphia Area, please let Full Living: A Psychotherapy Practice match you with a skilled, experienced psychotherapist based on needs and issues as well as personality and style. Request an Appointment Today.

For posts on similar topic, follow the links below:

How Does Psychotherapy Help?

Listen to Your Unconscious (a video blog)

What Should I Talk about in Therapy Today?

AuthorKaren L. Smith MSS LCSW Karen is the founder and director of Full Living: A Psychotherapy Practice, which provides thoughtful matches for clients seeking therapists in the Philadelphia Area. She provides analytically oriented psychotherapy, and offers education for other therapists seeking to deepen and enriching their work with object relation concepts.

9 Signs You Have A Toxic Relationship With Your Therapist

It’s often pretty helpful to see a therapist to work through personal issues, but sadly sometimes that relationship can become too intense or inappropriate. If you notice any signs of a toxic relationship with your therapist, it’s important to cease sessions or have a firm dialogue to figure out next steps (and the ways you might be able to keep working together, in a professional manner). Of course, any relationship that’s toxic isn’t good, but especially one that is supposedly intended to help the rest of them.

As a certified health coach, I work with clients on having positive relationships and limiting any stress or discomfort. You might have a friend or parent that drives you crazy, where he or she is either a bad influence, or is manipulative (making you feel out of control and insecure); either way, it’s bad news. The same goes for a therapist, and it’s even worse in a way because that therapist is there to give support, unconditional acceptance, and motivation to make some serious changes and evaluate your other relationships. Inappropriate behavior could be along the lines of manipulation, sexual advances, or hostile language, for instance. If you see any of these nine behaviors popping up in sessions, it’s time to call it quits.

1. They Judge Your Spouse

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According to relationship expert and Rabbi Shlomo Slatkin, over email with Bustle, if your therapist judges your spouse without ever meeting him or her, it can sabotage your marriage. Instead, your therapist is supposed to be there to listen and help you on your journey, rather than offering criticism and direct opinions.

2. They Are Combative In Dialogue

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According to Weena Cullins, Licensed Marriage and Family Therapist (LCMFT) and Relationship Expert, over email with Bustle, “if you find yourself disagreeing with almost every suggestion your therapist makes, then it will be difficult to benefit from your time together.” Instead, your therapist should listen to your thoughts and help you reflect.

3. Your Therapist Doesn’t Care About Your Feelings

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Seems odd, as that’s the purpose of therapy, but it really can happen, explains Cullins. “If your therapist appears to be disinterested or disconnected from your concerns,” it’s a toxic relationship. “Feeling invalidated by your therapist can make your initial concerns even worse. If this happens consistently then it’s time to address it or move on,” Cullins advises.

4. You Constantly Need To Defend Yourself

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You shouldn’t have to defend yourself for your actions, as your therapist should be compassionate and nonjudgmental, explains Cullins. “If you feel judged or compelled to defend yourself on a regular basis,” this relationship isn’t working the way it should. “When therapy no longer feels like a safe space to gain acceptance and be transparent, then the relationship might be toxic,” explains Cullins.

5. They Don’t Accept Boundaries

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If you tell your therapist that something’s off limits, that conversation topic should actually be. Unfortunately, sometimes you’ll still be pressed for information against your will, and this can make a session really uncomfortable. And, if “the therapist feels more like a friend than a person who is an impartial helper who puts you and your best interests first, this relationship might feel nice on some level, but it is not serving you well,” tells Rhonda Milrad, LCSW, Relationship Therapist to Bustle. It can also make you feel less trusting of your therapist, as their behavior is disrespectful and pushy.

6. You Find Yourself Lying

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If you find yourself lying to your therapist to avoid having an argument or feeling ashamed (two things which should never happen during a session), then it could mean that you’re in a toxic relationship, says Milrad. Instead, you should feel free and safe to be yourself, and your therapist can’t really help you unless he or she knows the truth anyway.

7. You Feel On Edge

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If you feel stressed around your therapist, or even in danger (perhaps you feel sexual advances or flirty behavior), it should be a clear warning sign of a toxic relationship. You should never feel threatened, anxious, or uncomfortable in your own skin around your therapist.

8. They Ask You For Favors

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“Therapy should be a one-sided relationship. The therapist is there for you and the relationship should not be reciprocal,” says Milrad. If the therapist asks for a favor, by reading their story (and you are an editor), help them out by looking at their plan for their garden (and you are a landscaper) or ask you for legal advice because you are a lawyer, for examples, it’s inappropriate behavior, says Milrad.

9. They Make You Feel Hopeless After Session

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This can be simply from making you feel uncared for, or it can be from a harsh criticism, that puts you in an anxious, depressed state, says Meredith Sagan, MD, MPH, APC, over email with Bustle. Also, if your therapist looks more anxious, worn out and stressed than you are or keeps checking the clock for the time to be up, it’s a toxic indicator, says Sagan.

If you notice any of these behaviors, it’s time to discuss it with your therapist to see if there’s a way to keep the relationship positive moving forward. If there’s no saving it, it’s best to move on and find a someone else to lend support.

What If You Don’t Like Your Therapist?

You’re not always going to like your psychotherapist. In fact, most people go through phases during the psychotherapy process where their admiration and liking for their therapist will wax and wane. This can be based upon a number of factors, such as the type or difficulty of the material being addressed in therapy, the amount of stress you or the therapist may be experiencing, or something else altogether. These changing feelings toward one’s therapist are a normal part of the therapeutic process.

Some people, however, realize that either they’ve gotten as far as possible with their current therapist, or find out shortly after they’ve begun therapy that the therapist they’ve chosen isn’t right for them. Individuals often become anxious when they realize this, and many will stay with their therapist long after they should simply because it does take some effort and courage to end the professional relationship you have with them. Some therapists also don’t always make this as easy as they could, suggesting that you “work on” your dislike of them in future sessions. Some will even suggest that it could be therapeutic and beneficial for you to do so.

The fact is, some anxiety and stress is a normal part of therapy and you will find that you will not always agree with your therapist. Some therapists will push you and challenge your existing beliefs, and encourage you to work toward change in your life. The key is to recognize the difference between a short-term level of stress due to a specific issue you’re working on, or a minor disagreement, and a longer-term, more serious issue that is interfering with your treatment moving forward. This difference isn’t always easy to spot.

Starting with a new therapist, you generally should determine whether you want to work with the professional within the first three sessions. If, after the first three sessions, you feel you have issues with the therapist that haven’t been resolved, it may be time to cut your losses. It is unrealistic to believe that every therapist can work with every client, and vice versa. Simply let the professional know that you’d like a referral to a colleague (if you need a referral), and that you will not be returning. Most therapists will respond in a professional manner, and ensure that if you need a referral, they help with that. Some therapists may ask why you’re leaving, and you’re welcomed to answer them honestly or say you prefer not to say. It is up to you — it is your therapy and your choice in how much of that reason you want to share.

If you’ve been with the therapist for a longer period of time, but find that you’re just spinning your wheels week after week, that may also be an indication it’s time to move on. If, after discussing this concern with your current therapist and not finding any acceptable resolution, it may be advisable to consider changing therapists. Again, the best way to approach the issue is directly, in session, and ask for a referral if you need one.

Finding a therapist who will work with you, and not against you, is an important part of successful psychotherapy. A good therapist will act as a guide, a support, and a person who will challenge you when they know you’re ready to be challenged. Don’t settle for a therapist or professional where you feel you are butting heads more than getting work accomplished.

What If You Don’t Like Your Therapist?

Pooja Parikh Traveled Across The World For The HS Diagnosis That Changed Her Life Forever

20. They won’t admit whether they can help you or not.

I once had a therapist who sighed whenever I asked her if she thinks she can truly help me navigate my anxiety. This gave me the creeps in the beginning, then it made me feel much more nervous and insecure. I started to wonder what was I doing, whether she was refusing to answer on purpose or because this was a therapy technique, and why do I keep paying her. Ultimately, I gathered the courage to ask her upfront why she avoids answering. She replied she has yet to determine that. We were on our 7th session when this happened and back then I didn’t know so much about how therapy should happen or what a therapist is required to do. Now I know: they are supposed to discuss this with you in the first session, and if they determine they can’t assist you along the way, they should tell you so. Not all therapists might specialize in your situation, but you have the right to the best service and assistance, and a therapist who just keeps you in limbo to cash in more money from you or says they’re undecided is briefly playing with your time and health. Stay informed, and don’t shy away from asking anything you’d like to know. It’s your right.

Photo: Tatyana Ignatenkova/EyeEm/Getty Images

Here’s what the relationship between a therapist and a patient should be: compassionate. Accepting. Challenging — to the point of painful, sometimes. It should be a space where you can air your flaws, where you feel free to talk about yourself practically nonstop without worrying about the person on the other end of the conversation.

Here’s what it shouldn’t be: infinite. As I’ve reminded patients, my job isn’t to make them dependent on me. It’s to help them reach a place where they don’t need me anymore.

But quitting your therapist isn’t as easy as quitting, say, your accountant or dentist — cutting ties with someone who’s repeatedly listened to you spill your guts can be an uncomfortable prospect, or even a frightening one. And many people seek out therapy in the first place to deal with issues related to attachment and loss, which can make it that much harder to excise someone from your life. Still, like therapy itself, ending things can be a huge opportunity for healing and growth. The trick is to know when to do it, whether it’s because things aren’t working out or because it’s just time to move on.

* * *

Sometimes, the signs are obvious, like when your therapist clearly isn’t the right fit for you. Research has shown that a positive “therapeutic alliance” is crucial for treatment success. This doesn’t mean that you need to have a ton in common with your therapist — you don’t necessarily have to laugh at the same jokes or understand the same cultural references — but it does mean that they need to understand you and your thought processes. After the first couple of sessions, you shouldn’t have to keep laboriously explaining yourself or rehashing the same details. When it’s a good match, your therapist remembers things that are important, and never insists you do something that doesn’t fit your values.

That was the red flag for one of my patients, who explained at our first session that she’d left her previous therapist after they kept insisting that she go on a diet. She was comfortable with her size, but the therapist seemed convinced that she wouldn’t be happy unless she lost weight. “When I found myself editing some of my stories because they involved eating meals I knew she wouldn’t approve of,” she recalled to me, “I knew I had to leave.”

There’s also such a thing as meshing too well, and it can be equally problematic. No matter how well you feel like your therapist gets you, you shouldn’t leave an appointment feeling like you’ve had a great time venting about your co-worker’s latest misstep, or like the biggest takeaway was that you learned about a great new Peruvian restaurant. Being comfortable with your therapist is great, but it should always be a different kind of comfort than what you feel with a friend. If you are my patient, I will not be your Facebook friend, take a phone call during a session, or share personal details unless it’s something that can help you cope with a trauma (i.e., yes, I know what it’s like to have a parent with Alzheimer’s).

It’s no big deal if sessions occasionally veer off into unproductive chattiness. But if you’re no longer being challenged to delve deeper into the issues that brought you to therapy in the first place, it’s time to assess why: Are the two of you treading water because you need more time to build enough trust in your therapist to drop to a new level of sharing? Or have you already milked this relationship for everything it can offer you? There’s no shame in realizing that perhaps you need someone with a different perspective, or that you might benefit from switching to a new therapeutic orientation (like going from psychoanalysis to cognitive behavioral therapy, a short-term treatment that teaches skills to deal with a mood or anxiety disorder).

But even the therapist-client relationships with no red flags — even the healthiest, most productive ones — likely should eventually come to an end. In the first session or two, you and your therapist hopefully discussed treatment goals. Perhaps you sought help to become more assertive, or finally understand why you keep getting into disastrous love affairs, or to grieve the loss of a loved one. These treatment goals are just that: goals to be achieved.

Some people benefit from open-ended, long-term therapy — especially people battling chronic issues like depression or grappling with early abuse or trauma — but for the most part, there will be an end point defined by the progress you’ve made. Maybe you’ve reached it when you notice a decrease in symptoms, or when you find yourself able to use new coping skills in triggering situations (both of which, research has shown, are commonly cited reasons for ending treatment).

That’s not to say that an ending has to be forever. Sometimes, patients of mine who have met their initial goals stay in or return to treatment to work on new ones. And graduates know that my door is always open for check-ins. But being able to openly discuss why you want to leave is a mark of progress in itself — it’s a transition to a healthier way of communicating that you can carry over into your real life.

At a closure session, my patients and I will discuss what was learned in our months or years together, and how to make sure that the patient has the tools and confidence to keep their progress going on their own. Sometimes, I’ll try to suss out if the reason they want to end treatment is an unwillingness to discuss certain topics; if that’s the case, I might recommend continuing, rather than quitting as a way to avoid addressing something painful.

For the most part, though, I just feel a sense of bittersweet pride: It’s always sad to lose someone I have come to know and care for, but I’m also deeply touched to have had a positive impact on someone’s life. The best piece of advice I have to ease your mind: If we’ve done our jobs right, we want to see you go.

Sherry Amatenstein, LCSW, is a New York–based therapist and editor of the anthology How Does That Make You Feel? True Confessions From Both Sides of the Therapy Couch.

7 Tips for Changing Therapists

Psychotherapy is a great treatment option for virtually any mental disorder or mental health concern, as well as life and relationship issues. Decades’ worth of research have proven its effectiveness, at least when you’re working with an experienced therapist who knows their stuff and uses empirically-backed techniques.

But what happens when you need to change therapists? We all need to change therapists from time to time, so how do you start over with a new therapist? Where do you begin? What do you do? And what do you look for in your new therapist?

Changing therapists can be a daunting, anxiety-inducing process. There is no “right” time to change therapists. You do it when you feel like you’re treading water with your current therapist, or you’re just not seeing the progress you’d like in therapy. With that in mind, here are 7 tips for changing therapists I recommend.

1. Tell your current therapist. Now.

This may seem obvious, but many put the obvious off until the last minute. If you haven’t already, you need to tell your current therapist that it’s time for a change. This should start near the beginning of your next session (don’t wait until the end, even though it may provoke some anxiety in you). While therapists are professionals, they are people too and can have a natural, human reaction to being dumped. While most therapists won’t take your decision personally, there may be some who do. Be prepared to answer some basic questions about your decision — Why are you changing therapists? Is there anything specific about your therapy that you found particularly rewarding? Unrewarding? Helpful? Not helpful?

Remember, this is your decision and technically it’s not up for “review” by anyone, unless you choose to share your reasoning behind it. There’s nothing that says you have to, but in most cases, it’s probably easiest to do so. And who knows? It may help your old therapist better help others in the future, especially if you’re leaving them because of a specific personality or interpersonal issue of the therapist.

2. You are legally entitled to a copy of your record — so get one.

Many therapists act as though your mental health record is their exclusive property. Nothing could be further from the truth. In the U.S., you are legally entitled not only to review your mental health record that your therapist keeps on you, but also to a copy of it. You may have to pay for photocopying costs, but the mental health record is actually yours.

You may want to review and have a copy of your mental health record before moving on. Your new therapist may also want to review your old mental health record and may ask you to sign a release form in order to expedite the process. Not all therapists will do this though, as sometimes these records have very little helpful information in them. I’ve seen progress notes that were no longer than 2 sentences long: “Patient showed up for session on time. We discussed patient’s current issues and therapist recommended following through on homework assignments.” This isn’t going to be particularly helpful to a new therapist to read through pages of similar material.

What does having a copy of your record do? It helps you understand the progress you’ve made to date, what goals you’re accomplished, and what areas may be of greater difficulty for you. Ideally, your treatment record will help you and your next therapist figure out where to pick up, and what sorts of things might be helpful to watch out for as stumbling blocks in the future.

3. If you still need a new therapist, ask for a recommendation.

Surprisingly, therapists who work within the same town or community tend to know one another, at least by reputation. Good therapists usually stand out, and even bad therapists will usually know who might be a good therapist who’s also a good fit for their patients who are looking for a change. If you’re leaving your current therapist because you question their ethics or judgment, then this may be a step you can safely skip.

Also, check out online directories, such as our psychotherapist directory here at Psych Central. They can help give you the basic background information about a therapist without having to lift a finger (other than to type your ZIP code in!).

4. Put your fear aside — this is a part of the therapist’s professional work.

Some people stick with the wrong therapist for them for far too long for one reason — fear. They are fearful to speak up for themselves, or to suggest something as seemingly drastic as leaving their current therapy.

Therapy doesn’t always work with a therapist you’ve chosen for a multitude of reasons, however. If you’ve tried your best, were open to change, and actively worked on changing your thoughts and behaviors associated with the problem that brought you into therapy in the first place, then it’s not your fault. Sometimes it just takes the right combination of therapist + patient = change.

As mentioned in #1, your therapist is a professional who should be trained and experienced in people leaving their practice from time to time. Expect to be treated in a respectful and professional manner when you’ve announced your decision. (And if you’re not, that’s just another sign it was the right time to move on!)

5. Consider taking a therapy break.

I’ve known people who’ve been in therapy for 3, 5, even 10 years at a time, sometimes even with the same therapist. We all need breaks from things — even helpful or beneficial things like psychotherapy. Consider taking a therapy break if you’ve been at it for years at a time, a vacation from therapy if you will. It doesn’t have to be long — a few weeks or months. It may give you a fresh perspective on what you most need and want out of your next therapist.

6. Prepare yourself for re-telling your story all over again.

Even if your new therapist has a copy of your old mental health records, they’re still going to want to hear it from the “horse’s mouth,” so to speak. So prepare to share your family history and life story up to the present, in your own words, to your new therapist.

This is probably one of the most frustrating parts of starting with a new therapist — picking up the pieces and getting the new therapist up to speed. I can’t tell you how many times I’ve heard people upset about this prospect. And why wouldn’t you be? You’ve spent months or years cultivating the relationship and knowledge with your current therapist. Starting over seems like such a backward step.

Sometimes, however, taking a step backwards allows us to gain new perspective, or stop ourselves from falling over an edge that is closer than we thought.

7. Approach your new therapist from a fresh perspective.

Just as taking a break from psychotherapy might be helpful, and preparing to re-tell your life story might give you some new perspective, your entire approach to your new therapist is a chance to change things up as well.

In fact, consider the new therapist you choose from this fresh perspective, too. If you had a woman, maybe a male therapist might be more helpful this time around. The main qualities I look for in a therapist is someone who’s well-experienced, has prior experience working with my specific kinds of issues, and is someone I can connect with almost immediately from the first session. It’s kind of like a first date — you know there’s a connection there or not almost immediately. Give it up to 3 sessions to figure out whether your new therapist is right for you or not. If not, move on again. It’s much easier to do so sooner rather than later.

Changing therapists is not the easiest thing to do, but it’s sometimes necessary to move on for your own benefit. Don’t be afraid to take the plunge if you feel the time is right.

These are just 7 tips I’ve come up with for changing therapists. Do you have more (I bet you do!). If so, please add your tips below.7 Tips for Changing Therapists

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.

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

6 Signs You Might Need a New Therapist

Disclaimer: the points I make are based on personal experience. I don’t mean to judge or scrutinize therapists because I know there are many who take their job seriously and do a great job providing a service that can help people progress in their everyday lives.

People pursue therapy for many different reasons and in my experience, there are some therapists you instantly connect with and others you don’t. A recent experience with counseling left me feeling very uncomfortable, so I wanted to write this article with tips for spotting red flags with the general message of the importance of making sure you are comfortable in your therapy sessions.

Here are signs you may need to find a new therapist:

1. They are always late.

Let’s face it, things happen. People run behind schedule and we are all human. Whether we are professionals or not, it is expected that sometimes people will be late. However, the dynamic between therapist and client is one that differs from most relationships. Your therapist is meant to provide emotional support and part of this depends on the amount of trust and communication you have built with one another. If a therapist is continuously or consecutively arriving late to sessions, it may be time to consider finding a new one. It can be hurtful when a therapist doesn’t acknowledge the lateness or continually gives excuses without compensating for the lateness by adding time to the end of a session. It can seem like your therapist is unconcerned with respecting your time and building trust with you.

It is disrespectful to turn up late to something and your therapist knows this. If they do not address the situation right away, it’s probably a strong indicator they are not going to address situation without you bringing it up.

2. They don’t know how to end sessions appropriately.

I’ve had an experience when I’ve been mid sentence and been told I need to stop talking. If this has happened to you, you probably know how baffling it feels. It’s not as if somebody told you to stop reading something during a presentation or to stop gossiping about something. I was mid sentence speaking to somebody about things that concern me in my life. It’s a huge red flag if your therapist does not know how to end sessions properly.

Sometimes, therapists will give you a 10 minute warning before the end of the session so you can prepare yourself and be mindful about what topics you want to discuss before leaving. If a therapist does not sensitively or effectively end a session, it can feel like they are more concerned about timing than about you.

3. They want talk about anything except the problem at hand.

I’ve been in counseling sessions when the therapist did not seem to want to speak about anything regarding my issues. She extended small talk to the majority of the session. If she asked me about what I was doing in the supermarket, I notice she would further probe into that topic and seem to have no desire to change or redirect the topic or transition into the counseling session. If you notice your therapist would rather chat about recent political developments, what color you dyed your hair or what you think about the new public library, it may be a sign you need to change therapists. Of course nothing is wrong with small talk, but if there is no attempt to transition to therapy, you would probably benefit from seeing a different therapist.

4. They take things personally.

Therapists are human beings and they have feelings, too. Sometimes patients make comments that can be emotionally triggering and therapists can respond in the wrong way. For example, my therapist responded poorly when I discussed my feelings of concern about my employment prospects as a minority ethnic person with a physical and long term psychological disability. My therapist and I share the same racial and cultural background, which made me feel comfortable enough to share this. But discussing this topic made my therapist change her body language and start speaking in a raised tone about experiences of her family member and his success, implying I assumed he would not succeed in life. At this point, I felt the need to interject and clear up the misunderstanding, to which I was shut down and told to listen, as she continued to rant about personal experiences. I remained quiet because I respected that this topic had very deep and personal meaning to her. But after this encounter, my therapist struggled to maintain eye contact and was clearly upset with me. Her anger put me in an uncomfortable position.

How your therapist deals with their emotions is a sign of their professionalism and competency as a counselor. If your therapist addresses the situation and apologizes for their reaction and for making you uncomfortable, this is a good sign and shows they take your feelings into account. If the therapist seems unaware or doesn’t acknowledge their inappropriate emotional reaction, it may be a sign your therapist doesn’t communicate in the way you need them to. While therapists are human beings with feelings, they should not take offense at things you say or take things too personally.

5. They seem to have no clear direction in sessions.

This one might be obvious, but for a lot of people in counseling, just speaking to someone is therapeutic. That being said, it is your therapist’s job to make sure the sessions are beneficial to you in the long run. If you find your therapist does not seem to have any established goals or a direction they want to lead you in by the end of your sessions, it may be a good idea to question their intentions. It’s possible some therapists aren’t really looking at you as the primary focus of the session, which is a huge red flag. While it can be helpful to a patient for a therapist talk about herself occasionally, it’s a problem if you find your therapist is talking about herself too often, possibly indicating a lack of direction in sessions. If your therapist seems a bit scattered in their approach to sessions, I think it might be wise to consider whether it is useful for you to continue with this particular therapist.

6. They disregard important information.

This is something I find really awful, because it’s often takes a few sessions to build up the courage to talk about something that has been bothering you or something from your past that is hard to talk about. Sometimes with or without meaning to, a therapist will discuss if briefly and never bring it up again or discard it completely.

Drawing on an example from my own experience, during a time of crisis, I sent an email to my therapist. It was quite a detailed email with many thoughts, feelings, emotions and risks mentioned. I received a reply of a couple of lines asking for me to make an appointment with her and my local general practitioner. In our next therapy sessions, these events were never mentioned and nothing I disclosed in my email was brought up in any way to explore further. When this happened, it was really hurtful. Therapy is to heal and if you cannot introduce new topics without being ignored or made to feel uncomfortable, it might be time to find a new therapist.

I hope people find the right therapist for them, because the wrong one can bring a patient down a lot and can make them feel mistreated and taken advantage of. But please don’t be discouraged. Just as not everybody in life is compatible, the same is true for finding a therapist. You just need to find the right person who is compatible with you to work on things together effectively.

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Thinkstock photo via Ljupco.

How to know if a therapist is right for you?

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