When Should You Fire Your Therapist?
The therapeutic process can be enormously helpful to someone with depression, but its success is largely dependent on a positive relationship with the therapist. If you are not happy with the progress you’re making, or uncomfortable with your therapist in general, it might be time to find someone else.
Here are three significant reasons to fire your therapist:
- Your therapist does not respect therapeutic boundaries.
- Your therapy isn’t going anywhere.
- The chemistry just isn’t right.
Your therapist doesn’t respect the therapeutic boundaries
Boundaries are probably the most crucial element of the therapist/patient relationship. In therapy, boundaries exist to protect the therapeutic experience.
The big no-no of therapeutic boundary violation is any type of exploitation of the patient by the mental health professional - sexual, financial or emotional. Your therapist should not interact with you sexually in any way. He/she should not ask to borrow money or items or ask you to invest money in a venture.
However, there are other boundaries that, when violated in the therapeutic relationship, could hamper your progress, and they are less obvious than exploitation. Here are a few examples:
- A therapist not respecting the client’s session - being late, canceling frequently, taking non-essential phone calls.
- A therapist who talks about him or herself too much. It’s appropriate for a therapist to occasionally use an example from his/her life to illustrate a therapeutic point, but any disclosures beyond that should be minimal or nonexistent.
- A therapist who sees you outside of the office setting in any capacity. Your therapist should strive to prevent any type of outside contact, even something as innocuous as a book club or attending the same church.
Your Therapy Isn’t Going Anywhere
First, you need to ask yourself a few questions:
- Have I done all the work I can in my therapy, or did I expect my therapist to wave a magic wand and make everything better? Therapy is a collaborative effort, and some, if not most, of the work is on the patient’s side.
- Did my therapist and I agree on a goal together? A therapist should discuss what your goals are when you first start seeing him or her and occasionally revisit your goals to determine how far you’ve progressed toward completing them.
- Did I express my concern about the lack of progress toward my goal(s) to my therapist?
If you’ve participated fully in the therapy and expressed your concerns to your therapist without a satisfactory response, it might be time to move on, especially as most health insurance companies require documentation of progress for continued authorization of treatment.
The Chemistry Just Isn’t Right
Chemistry or rapport between you and your therapist is very important. Are you comfortable talking to him/her? Do you feel that he/she understands you? Do you feel that the therapist’s suggestions and techniques are helpful? If the answer to these questions is “no” the lack of rapport could significantly impair the progress of your therapy.
One last point. During the therapeutic process, you may come to at least one crisis point (my term) where you are about to uncover something painful. This is a danger zone in that I have known people who have abandoned therapy at this point. Make sure that you are not considering firing your therapist because you’re fooling yourself about being afraid of continuing.
Deborah Gray wrote about depression as a Patient Expert for HealthCentral. She lived with undiagnosed clinical depression, both major episodes and dysthymia, from childhood through young adulthood. She was finally diagnosed at age 27, and since that time, her depression has been successfully managed with medication and psychotherapy.