Firing your Therapist

I had one where not only did I stop seeing her, I ended up filing a formal complaint for her breaches of the relevant code of ethics.

That was pretty extreme, though...

I guess if you think the relationship isn't working, and can't work for you, it's probably best just to lay out why politely?

I went through several therapists while trying to find a good one. It was always an amicable break-up. I remember one who was always 10 minutes late for my appointment. I asked her if she was always going to be late, and she said yes. I said, "I won't be scheduling another appointment with you, then".

For others I just didn't bother making subsequent appointments. For one I said, "I don't think this is working for me".

You've got to take care of yourself. If your therapy isn't helping, get another therapist. Hopefully you have plenty to choose from where you live.

There was one psychiatrist who just sat there reading a book while the patient spoke. Then after approx. and hour, he would calmly look at his watch and declare the session over without having said a single previous word. Talk about having an easy job! He wasn't fired but only managed to alienate the patient until the partient concluded that he was a total waste of time and stopped seeing him. This same psychiatrist once had a female patient weep hysterically in front of him as he sat quietly and unemotional as a statue. Once the female patient stopped-he robotically offered her some tissue to blow her nose. Then sat there quietly staring at her as she finished telling him why she was weeping. After that he said the session was over. It made me wonder what was the difference between going to him and sitting in front of a brick wall and talking to it. Needless to say she did not go back. The point is that if you are not getting any benefit from the sessions then don't waste your time.

if you don't think that you are a good fit or a good match together, ask for a referral to someone who has the qualities that you feel work best for you. Get several referrals too, then make calls first and make sure they are taking new patients as well as accepting your insurance.
If you can find the courage and the strength and you think they have done something improper please get some friends or family for support and ask around about how to file a formal complaint as well.

As a therapist who knows how many other therapists in my field (MA mental health counseling) as well as in clinical social work act, I can tell you with a bad taste in my mouth that randomly picking a therapist from the Internet is probably a 50/50 shot at finding someone worth keeping, and "worth keeping" isn't a high statement of quality. You're probably 30-40% likely to find someone who can really help you, and 10-20% to find someone who can really dramatically change your life.

Moreso with MA clinicians (clinical social workers and counselors) than PhD ones (psychologists), you're going to have a person who goes through a program that with some exceptions (the top few schools in the person's state for that profession) are going to get an education from a program that gives them just enough to learn how to swim on their own as a therapist. They'll learn how to manage crises, including especially suicide, and how to put into practice basic theory and techniques, given that they're green while in graduate school and only be taught so much with supervision.

Then they have what's mostly up to chance in getting a supervisor who will guide them through their post-graduation internship, where they work anywhere and have to see a supervisor for a certain number of hours. The number of hours (usually half direct, meaning where you see clients, and half indirect, which stands for anything not directly related to seeing a client, mostly paperwork) between states required can vary significantly. I come from Texas, which has one of the highest number of hours (3,000), but I've talked with a person from a Northern state who had requirements that were in the upper hundreds. But there's a lot of chance with a good supervisor, who often is one's favorite professor from graduate school, and a professor's ability to teach well or be likable doesn't always translate into good clinical guidance by far; or the supervisor is someone who is part of your place of work, usually chosen for saving money and/or convenience, and again here this often doesn't bode well with finding a great one.

I was lucky and am incredibly thankful to have had a great one, who has published two textbooks in domestic violence, tens and tens of articles on many different areas (I remember even reading a few textbooks where he was cited), and years and years of experience as a counselor and couples' therapist. Meeting with him weekly was like a one-on-one class, and he had incredible, invaluable things to say each week, and showed me by his behavior (including when he would get frustrated with clients) what it's like to be a great therapist. He also became a sort of fatherly figure, and we keep in touch to this day, and make plans to meet when I'm in his part of town (he transferred a few years ago to another university). I know for a fact that having him as a supervisor compared to other options made a significant difference in my abilities and knowledge as a therapist.

Once you get done with supervision, it's totally up to you as a therapist to swim as you'd like. And, so sadly, most swim according to the basic requirements outlined by their licensing boards, where you have to get a pretty small number of continuing education hours/units (for me it's 12 a year, 24 for license renewal every two years), and you can get a third to maybe even a half by going to a single conference. And where do most people go for conferences? State conferences, which are lukewarm on average in my experience (half are wastes of time, a quarter are good information, another quarter are truly exceptional), or through pamphlets advertising conferences sent to the therapist's mailbox, which are also hit or miss, usually averaging toward the middle.

But if you're a PhD therapist, at least, you know you're getting someone who has had to go through a hairy program that requires high intelligence and interest in learning. Nonetheless, I know too many PhD therapists who don't stay afloat with regard to the literature in the field like MA people do; their advantage is in applying the tools they do know according to the higher intelligence on average they tend to have. Just like most doctors learn the absolute minimum and therefore rely on the outdated information they learned in medical school, so also with even PhD therapists.

So it's sadly a matter of an easily fixable problem: licensing boards should set standards higher. Making people read peer-reviewed articles and books written for therapists (another thing: so many therapists limit their reading to pop psych or self-help that would be read by their clients) would be a step in the right direction. Having higher standards for accepting people who sign up to present at conferences is another (e.g., have them present a video presentation which authorities review beforehand to determine whether they "get in").

But the most important is just finding a therapist who loves to learn, knows where to find the best information to learn, and loves to serve. Find that and it doesn't matter which type of therapist it is. But unfortunately these people are rare.

It makes me sad, really. I love my field, love working for my clients, and love my colleagues, but there's a sort of invisible wall between me and most of them -- a wall of motivation regarding the information I've presented above, e.g., desire to read hard material that can be implemented into good therapy.

And sometimes being a "learner" is implicitly frowned upon. Example: when I worked at a university (currently out of work for medical reasons), I was the young person there by about on average 20 years. I remember one coworker making an entire staff meeting about her and my relationship, because she thought a statement I made about how the group should read a certain book was intended as being condescending, when it was anything but; I just wanted to share my passion for a new area (schema therapy) that had dramatically changed my practice for the better and therefore my clients' lives as well. I proceeded to challenge her by asking her if she had used X or Y theory or technique, and her immediate response was, "I have twenty years' experience," meaning she thought that experience is what counts rather than knowledge and implementing your knowledge through taking risks in the therapy session by trying this new knowledge out.

Sadly for her, she didn't realize that experience is like a beach: you can spend twenty years with your feet grazing the water, or a few years wading in the deep end fighting against the waves, and the latter person is more often going to be better off, even though the former knows the ins and outs about basic ethical situations and how to handle crisis situations.

But hey, good news for me I guess. I'm totally dedicated to learning and growing, love working with my clients, have received lots of positive feedback even compared to my significantly older colleagues, and am male! Hooray! I'll be set for private practice when I get better from this health thing. But I say this with some emptiness and a fair amount of disappointment in my field.

As for firing your therapist, that's your obligation as a client. And yeah, it's hard to fire someone with whom you likely have created a good rapport. That's the most seductive part, and I've received multiple clients from previous therapists whom I've talked with who clearly weren't going in any clearly good direction with the client in question. Many times they were just taking it "week by week," meaning they really didn't know what to do with the client in terms of "fixing" them with tools and techniques suited to their particular concerns. I remember one client who stopped our conversation after half of our first therapy hour was up and said, "I haven't gotten this deep with my last therapist in the year since I started working with her." I say that in sadness, not pride about myself (because I still think I have lots to learn), because this therapist was in private practice and making a living -- by just floating along with clients.

Hope I'm not bumming anyone out, lol. There are great therapists out there, but many times you'll have to try out a fair number and/or wait on waiting lists to find one of them. It's well worth the wait.

You can't seek other opinions, a different perspective .. That seems odd .. Can't you just quit, I don't know much about that stuff but I've quit regular Dr.s

4x4toy said:

You can't seek other opinions, a different perspective .. That seems odd .. Can't you just quit, I don't know much about that stuff but I've quit regular Dr.s

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Yes, you can just quit. That's what I did several times.

dysert said:

Yes, you can just quit. That's what I did several times.

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I know there must be more to it than I imagine, I pray right now the Lord gives you answers dysert ..

One goes to a therapist for specific reasons. presumably. Usually, one has a specific 'issue', like insecurity, smoking, gambling, compulsive lateness for most everything and so on.

The therapist should be dealing with that (or those) issues. Perhaps they may have to take a roundabout approach but for those issues. I personally will not trust a therapist who tells me, "Oh, you think you are self-doubting, but really you need to quit eating red meat".

Also, watch for what I think of as improper approaches. Going to a therapist to end sexual addiction and being told, 'There's nothing wrong with that' is not getting anywhere.

As much as I follow and life Christianity, seeing a counsellor who advertises as a Christian counsellor is iffy. I was going to a marriage counsellor who told me all my problems were due to 'dancing'. Dancing was a sin and all the problems in my marriage were caused by offending God. As it happens, that wife divorced me because the same man told her she could. He was (perhaps still is) a pastor of a church. I really hope he's a better pastor than counsellor.

Know what you want. Do not be afraid to 'shop' for what you want. At the same time, don't mistake 'what you want' with having the therapist simply tell you what you want to hear.

As with everything else, pray about it a lot. Trust God to show you who and how to settle your mind and emotions. God doesn't alway fix your gall bladder or broken arm without the assistance of a doctor. Same for mental or emotional needs.

I've had a couple where I didn't feel the fit and just didn't come back. Actually, with one of them, I just stood up in the middle of the session, and left. The guy was already prescribing me meds without even asking me anything. There's no point in going back when the therapist isn't meeting your specific concerns or needs.

If the person is behaving like a degenerate, just walk out and maybe report them. Or don't come back.

If they behave properly, just say it isn't working for you, thanks, see you.