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When to fire a therapist. (Trust your instincts)



 

This is a tough topic to address. Counseling and therapy doesn't always feel "good". So how do we know when the "not feeling good" is part of the process versus a poor fit with the therapist, versus plain bad therapy? It's not an easy determination to make, but there are some things to consider.

But first, if you are one of many who have continued with a therapist who has in some way harmed you, or just not been helpful, I want to say it is absolutely not your fault. We are taught to respect and defer to people who are supposed to have more expertise than we do. If the "expert" isn't pointing out that the therapy isn't working for you, then who are you to point it out? My answer to this question is YOU. YOU are the expert. You are the expert on your life and your experiences, and a good therapist will be open to your feedback. This brings me to my first indicator that you should fire your therapist.

He or she becomes defensive when their point of view is challenged, or you provide negative feedback in a session.

Therapists are trained to be open to feedback from clients. It's important for therapists and counselors to be open to feedback and be able to reflect on how we can change or improve our practices to ensure a helpful therapeutic experience. Therapy sessions are your own and your experience of them is important. If you are telling your therapist that your experience has been negative and he/she is not open to hearing and discussing this, find a new therapist.

You learn your therapist has broken confidentiality.

Confidentiality is the cornerstone of therapy. If we do not trust our therapist will keep what we say confidential, we are unlikely to be open and honest with him/her about our struggles. If your therapist does or says something that makes you believe confidentiality has been broken, say something immediately. There are specific cases in which your therapist or counselor can legally and ethically break confidentiality. Those cases are typically:

1. If there is reason to believe you are a threat to yourself or someone else.

2. You have disclosed the abuse of a child or elderly/disabled adult.

3. A judge has subpoenaed your records.

In each of these cases, you should be informed that confidentiality has been broken and why. One other reason for breaking confidentiality might be if the therapist/counselor needed to consult with another therapist/counselor about a specific issue you may have presented. In this case, you may not be informed (Some therapists will let you know. I always do.) but the consult and reasons for the consult should be documented in your records.

Some therapists/counselors will post information about clients on social media platforms. This is NOT OKAY. Some may justify this as "consulting" and think it's okay because your name has not been used. I disagree. If you read something on social media that your therapist/counselor has posted and you can identify that he/she is talking about you, this is a breach in confidentiality.

Another example might be if you were receiving couples counseling with your partner from one therapist in a clinic and individual counseling from another counselor in the same clinic. It is reasonable that you expect these two counselors/therapists will NOT discuss you or your partner unless you have given express permission for them to do so. This permission would take the form of a Release of Information signed by BOTH you and your partner. Additionally a separate Release of Information form (sometimes referred to as an ROI) would need to be signed with each provider.

If you notice comments made by either provider that lead you to believe the two are communicating with each other about your case, bring this to their attention immediately. Trust your instincts. Most of the time we are very aware of what we have told each provider, so if something you have only told your individual counselor comes up in a couples session, you know there has been inappropriate communication between the two. This is a huge red flag and should be addressed. Just as in the previous example, if the therapist/counselor becomes defensive, or worse, outright gaslights you with denials, fire them and find another therapist. Even if they believe they have done nothing wrong, this is a conversation a therapist should be willing to have with you.

Breaches in confidentiality are seen as damaging enough that a complaint can (and probably should) be reported to their licensing board. I will write another post explaining this process later.

You feel like it's just not working.

This one is a little less tangible than the others. Every counselor/therapist has their unique way of working with clients. Sometimes there is just not a good fit between therapist and client and this is okay. There are some therapists/counselor who may notice and bring this up in session while others may not. It is absolutely okay for you to bring it up. Just as in the previous two examples, the therapist/counselor should be open to discussion about this. We know we will not be able to meet the needs of every client who walks through our doors. We are always (or should be) willing to provide referrals to other providers who may be better equipped to meet your needs.

There are likely many more reasons to fire a therapist or counselor. These are just the three that are at the forefront of my mind at this time.

The bottom line is that therapy sessions are for you and they need to work for you. You know yourself better than anyone and deserve to have a voice in your mental health treatment decisions. It can be hard to speak up. Especially for those of us who may struggle with people pleasing and fear of confrontation, however it is important. This is your life. You get to be in the driver's seat.



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