When should I find a new therapist?

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This is a great quote:

Carl Rogers, she said, would have been laughing (happily, that is) had he read the findings we cited documented the lack of differential efficacy of competing treatment approaches.  We had, in essence, proved him right!

“It turns out,” OHara wrote, “that Miller, Hubble, and Duncan come to similar conclusions.  Carl Rogers was right.  After all our forays into the dizzying arcana of paradoxical interventions, inner children, narrative therapy, EMDR, behaviorism, psychopharmacology, bioenergetics, TA, Jungian analysis, psychodrama, Gestalt, and so on down the entire list of hundred brand named therapies, what actually creates change is the … creation of a relationship between client and therapist…”.

from Why is this man laughing? by Scott D. Miller PhD

You know, I think we do a lousy job helping people be good consumers of therapy.

A reader asked for “some insight into estimating the effectiveness/fit of one’s therapist” and I’m going to tackle that here a bit.

I’d say if you’re wondering whether or not you’ve found a good fit with your counselor you can ask yourself these questions:

  • Do you feel heard and believed?
  • Do you feel safe? Do you trust your counselor?
  • Do you feel like you’re on the same wavelength? Do you feel like she understands your worldview or is willing to learn about it?
  • Do you feel permanently stuck in your sessions?

Another reader said that after six weeks meeting with her counselor she ended up feeling worse so she quit. She brings up a good point. If you’re feeling worse because you’re pushing yourself and doing the work and not getting anywhere, that certainly might be a sign it’s not a great fit.

Unfortunately, feeling lousy in therapy is sometimes a hazard of the work because confronting hard truths and making change can be painful. Sometimes feeling worse after a session is normal but if it’s happening, you can talk to your therapist for some help making room in your life for more self-care or to make a support plan.

Being stuck can also be a sign that you’re ready to go deeper or that you’re ready to graduate from therapy. Again, it’s something you can talk to your therapist about.

But I don’t think that’s what Anonymous is talking about here; I think she’s illustrating that not-a-great-fit feeling. So how can you tell the difference between the regular challenges of good therapy and the not-a-great-fit? I think it comes down to forward motion. Do you feel like you’re getting somewhere? Do you feel like your therapist is appropriately pushing you? Do you feel like your relationship can withstand some confrontation on your end? If you don’t feel like you can come to your therapist with your concerns, that’s a good sign that she’s not the the right therapist for you.

I’d love to hear from other counselors who might have other insights into assessing a good fit.

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