
This blog is authored by Kayo Curra, MA, LCPC, NCC, CCMHC, a member of the IntraSpectrum Counseling clinical team.
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Different theoretical orientations might have different things to say about it, but I believe that the relationship between the client and the therapist is pretty crucial to the therapeutic process working. If you’re looking for a new therapist, it might be worth checking out the “Choosing a Therapist” information on our website, or visiting our previous articles about “Finding An LGBTQ+ Affirming Therapist” and “The Benefits Of Working With A Provisionally-Licensed Mental Health Therapist.” Hopefully those resources will have some useful tips to help you find a therapist who is going to be a good fit for you and the work that you want to be doing.
But, if you’ve been working with a therapist for a while, sometimes the question can become “when is it time to try someone new?” Keep in mind, therapy isn’t going to work overnight. Particularly since the first few sessions are usually spent just getting background information and getting to know each other, the therapeutic work isn’t going to start right away. And, even once it does, therapeutic skills and strategies take time and practice to start working. So give the process, and your therapist, some time before you switch to someone new. And, if you have a concern about how therapy is going, talk to your therapist about it. Hopefully they’ll be understanding and open to having a conversation about what’s going on. If they aren’t, or they seem to be taking it personally, that might be a good sign that your current therapist isn’t a good fit.
In addition to challenges with progress, there might be other reasons that someone would need or want to switch therapists. Some might seem pretty obvious, but some might be things you hadn’t considered. There are people who stay with their same therapists for years. But there are also times when our relationship with our therapist might be unexpectedly cut short. So what are some of the reasons that a person might find themselves switching therapists?
~ Your therapist behaved in a way that made you feel uncomfortable. Therapists are humans, and sometimes humans really do just make mistakes. I once met with a therapist who seemed to misinterpret my saying that I don’t like feeling like the therapist is pitying me to mean that he should make a joke out of everything I said. Suffice to say, I did not return. In that case, I probably could have gone back and had a talk with him about how I didn’t appreciate his behavior. And maybe I should have said something to him or his supervisor, in order to try to prevent the behavior from repeating with other clients. Check in with yourself about what feels safe and what you have the bandwidth for. If the behavior needs to be addressed, but it doesn’t feel safe or comfortable to report it on your own, seek the support of friends or loved ones to help make a report to the therapist’s practice/agency.
~ Your therapist said that they will not/cannot work on the issue you want to address. There are some therapists who won’t address certain topics due to firmly held beliefs. There are some employers that won’t allow their staff to address certain topics that conflict with the values of the organization. Sometimes therapists just don’t have experience in a certain area. Either way, if your therapist says that they cannot or will not work with you on an issue you want to address, and they aren’t willing or able to have a conversation about it, this probably isn’t the therapist for you.
~ Your therapist told you they’re going on a short-term leave. It’s tough when a therapist you’ve developed a good rapport with needs to take a leave of absence. If they work for a group practice, like IntraSpectrum, the practice should be able to offer you the option of transferring to a new provider. Then you should have the option of either returning to your original provider when they return or continuing with the new therapist if you’re feeling comfortable. If you feel safe and like you have the necessary tools to do so, you can also take a break from therapy, and check back in after your therapist’s scheduled return. You don’t need to feel like you’re going to hurt anyone’s feelings if you don’t want to work with a new therapist temporarily, or even if you work with them for a while, but then decide it’s not a good fit. You also don’t need to feel bad if you decide that you’ve been working well with the new therapist and don’t want to switch back to your original therapist when they return. Your therapy is about you and what you need.
~ Your therapist told you they’re leaving the practice. This is going to play out similarly to a therapist going on leave. Except, in some cases, you might be able to follow your therapist to their new job. If this is an option, your therapist will let you know. Unfortunately, some places don’t allow therapists to retain clients when they leave. This is most common with community mental health centers. Also, unfortunately, there’s a chance that the new practice your therapist moves to might not work with the same insurance providers as the current practice.
~ Your insurance changed. Health insurance is an important resource for accessing care, but can also sometimes be a barrier as well. Unfortunately, not all practices work with the same insurance providers. There are a number of factors that go into which insurance providers a practice does/does not work with. And, even within a practice, sometimes some therapists will be approved to accept insurance that other therapists can’t. So, if your insurance provider changes, there’s a chance that you’ll need to switch therapists as well. However, if you can afford to pay out of pocket for your sessions, some insurance providers do offer reduced coverage for out-of-network providers. So, be sure to check in with your insurance provider and your therapist about coverage and payment options if you have an insurance change. And, if you do have to change to a new therapist, you can ask your current therapist if they know any in network providers that they might recommend.
~ You’re moving out of state. In order to practice therapy in Illinois, a therapist has to have a license from the state of Illinois and the client has to be in Illinois during the session. So, while it might seem like a simple solution, your therapist probably isn’t going to be able to do telehealth services with you if you move out of state. But sometimes there can be exceptions, if the therapist is also licensed in the state you’re moving to. So, it’s worth asking if continuing over telehealth will be an option. But be prepared for the likelihood that you’ll need to switch to someone new.
~ You want to work with someone with a shared cultural background/worldview that your therapist doesn’t match. There’s a reason that so many therapists will say that the client is the expert of their own life. Because lived experience is important. And, while learning about the lived experiences of others can expand someone’s understanding, it’s never going to fully replace actual lived experience. So, even if you’ve been working with a therapist for a while, and even if it’s been a good relationship, it’s okay to ask for referrals in order to explore an area of your life with someone who can understand it in a deeper way. That said, even if they don’t share your cultural background/worldview, your therapist should be able to work with you around issues they haven’t personally experienced. If they can’t, that might be a sign that therapist isn’t a great match for you anyway.
~ You’ve been feeling stuck for a while, and trying different strategies hasn’t helped. Even with a great therapist, it might take a couple rounds of feeling stuck and trying something different before things feel like they’re progressing. Be sure to check in with your therapist when you’re feeling stuck, so you can work together to try to resolve the issue. It’s also important to check in with yourself about the work you’re doing in between your therapy sessions, to be sure that you’re practicing your skills and giving yourself credit for progress that you might actually be making but not seeing. But, at a certain point, it’s totally fair to say that “maybe this therapist just isn’t the right fit.” Maybe you need someone with a worldview more similar to your own. Maybe the theoretical orientation your therapist is working from just doesn’t align with how you work as a person. So, assuming you’ve given the therapist and the process a genuine chance, it’s okay to say, “hey, this just isn’t working for me…I think it’s time to try someone new.”
~ You’ve been with the same therapist for 2+ years. Different therapists have different takes on duration of treatment. My personal philosophy is that I’m trying to get clients to a place where they have the tools and interpersonal resources that they don’t need to rely on therapy, and can take a break. But, especially with a therapist that you get along well with, it can be easy to get comfortable in therapy or with a therapist, and have the therapeutic work end up becoming less about the work and more about the routine. If you’re finding yourself running out of things to talk about in session, or thinking about your therapist more as a friend than a care provider, it’s probably worth checking in with yourself about whether it’s time to take a break or maybe try someone new. And check in with your therapist to see what they’re thinking about your progress and whether it might be time for a change. Sometimes, even if you’ve been working with a great therapist, it can be worth trying to work with someone who is going to have a new perspective on you and the therapeutic work that you’re doing. This is especially true if your main reason for not wanting to switch is anxiety about having to build a new interpersonal relationship. In that case, building that new relationship might be the exact work you need to be doing. Of course, if you have a good relationship with your therapist, and you feel like you’re still getting something from the work, by all means, keep doing what’s working.
It’s not uncommon for clients to feel self-conscious or even guilty when they decide that they want to try switching to a new therapist. Some people might worry about hurting their therapist’s feelings, or feel like they’ve wasted the therapist’s time by deciding to switch to someone new. But, if you’re wondering if it might be time to change therapists, it doesn’t need to be a scary conversation. Your therapist shouldn’t take the decision personally. We know that we just aren’t going to be the perfect match for all clients. And we understand the financial factors that can contribute to client’s needing to make a change. But, if you’re feeling that you want to make a change, and are anxious about talking to your therapist about it, here are two strategies that you can use to help express your needs and advocate for yourself (in this or any situation):
DEAR
Describe – Describe the situation, stick to the facts
Express – Express your feelings and opinions about the situation
Assert – Ask clearly for what you want/need
Reinforce – Explain the positive outcomes of getting what you want/need
FAST
Fair – Be fair to yourself and the other person, remember to validate your feelings
(No) Apologies – Don’t over-apologize, don’t apologize for having opinions and needs
Stick to values – Be clear on what you believe you need and what you believe is right
Truthful – Be honest and direct, don’t exaggerate or make excuses
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This blog is authored by Kayo Curra, MA, LCPC, NCC, CCMHC, a member of the IntraSpectrum Counseling clinical team. IntraSpectrum Counseling is Chicago’s leading psychotherapy practice dedicated to the LGBTQ+ community, and we strive to provide the highest quality mental health care for multicultural, identity, kink, polyamorous, and intersectional issues. For anyone needing affirming and validating support, please click here or contact us at help@intraspectrum-chicago.com.