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How do you know when to switch therapists/if a therapist is good for you? - March 2nd 2020, 04:05 AM

Hey all,

I'm wondering how to tell if a therapist is good for you and when to switch therapists.

I've had some pretty bad therapists over the years, and some pretty decent ones, but I don't know if I've ever made "progress" per se. The first one I had in middle school kept canceling appointments. The second one was good but retired. The third one was kind of "meh" and focused on weird stuff like why I didn't care that I didn't know my mom's family. My insurance stopped covering the practice. The fourth one was good but was limited in what she could do since I was a minor and it was through our school health center. The fifth one was an intern at college that I only had a semester. The sixth was okay but I don't think I made any real progress... And now I'm on my seventh? Jeez.

I have had one now for maybe a year give or take? She's pretty nice and actually listens and takes notes and stuff, but weirdly I don't know how to tell if I'm making progress with her and if she's actually helping. But I've also always been kind of resistant to therapy in a way? Like I know I need it and I go, but then I don't always take everything into practice. Like we've spent at least two sessions talking about driving but I haven't done any driving yet, LOL. I also didn't speak up and tell her that I didn't actually WANT to talk about driving last time, but that's on me and not her. It's an anxiety thing, even though it's MY session. Or she'll tell me to do thought challenging and such and I'll kind of fudge it. But I have with prior therapists too so I don't know what I actually NEED from therapy.

Her appointment before mine ran over too last session and I CANNOT stay later than my designated time because I am on a medical ride system. I'm planning on starting to schedule my rides 15 minutes after my appointment is supposed to end, because that's not the first time this has happened. There was also a time where she was half an hour late to my appointment, but I guess her kid was sick and she had to go to his school or something, and sometimes that can't be helped. I can't say she's a bad person because she's late sometimes though!

So yeah, in general how do you know if a therapist is good for you or if you should try someone new?


   
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Re: How do you know when to switch therapists/if a therapist is good for you? - March 2nd 2020, 02:40 PM

I've only had a few and one was really bad which made deciding to change easy. These sessions are yours and if coverage/time allows it you could always 'shop around'. It can't hurt to seek out consultations with other therapists while you're seeing your current one. Sometimes you'll know right away if they aren't for you and sometimes it takes a few sessions.

You could also talk with your current therapist to figure out what you want/need not only in therapy itself but also in a therapist. Just as an example, I need someone who is very involved in my therapy as opposed to someone who smiles and nods. I also need humor. Sometimes identifying what you'd look for in a therapist is easier than assessing therapy as a whole. You could talk to her about progress and see what her thoughts are. Maybe you could write a list of your needs and wants, and see if it helps?

It can be hard but if things bother you (even the occasional lateness) you could tell her about that and explain you can't stay too long. If a therapist is right for you, generally discussing feelings about them or things they do (no matter how large or small) work in your benefit and strengthen the relationship. After a while those things like 'I don't want to talk about this' or 'I felt upset when you' get easier to say. This type of conversation helps especially because a lot of people don't have a person outside of therapy they can talk to in that way.

If your current one is kind and listens, it might be worth staying with her longer and trying to take more things into practice and then evaluate again.

I hope things work out with her. Good luck with driving, by the way. I know it's nerve wracking.


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Re: How do you know when to switch therapists/if a therapist is good for you? - March 3rd 2020, 10:35 PM

When you mentioned that you know you need therapy, and you go but you don't always put things into practice, I was going to ask why you feel you need therapy...but then I also realised you later say that you don't know what you need from therapy either. I'm wondering if it's worth starting from there? What made you feel like you needed therapy? Has that changed over the years?

I ask because I was in a similar (kind of) situation myself. I've struggled over the years with various things and as a result have struggled with low mood and anxiety. I thought I needed therapy to help 'fix' myself- if I could just have therapy to help me recover from low mood, gain more confidence/self-esteem, lower anxiety, then I would be 'fixed' and life would be 'normal'. So I started with my university counselling (I opted for email counselling as I was uncomfortable with face to face) but that was time limited and I realised that I had talked a lot about things and hadn't actually done anything. When I graduated, I was on the search for a new counsellor- someone specialising in trauma, as I assumed all my problems were rooted in trauma. Again, online, but it was the same thing- me talking about stuff, trying to put some things into practice, not speaking up when things weren't working for me, and overall not feeling like I'm getting anywhere (although this counsellor was quite good) After I had a breakdown, I mentioned to my counsellor that I was being referred for CBT and face to face counselling, but I was nervous. So we talked about that, and I discovered...I didn't know why I wanted counselling? Or what I wanted from it? What started out as finding something to help me be 'normal' (not awkward, anxious, feeling lost in life) ended up with me realising, I didn't want or need that, but I did want acceptance for me being the way that I am. I feel I spent so much time over the years, not just in therapy, but trying to fix myself, I realised I kind of lost myself, and just really wanted acceptance. While that might not be your situation, I think it does highlight the importance of thinking about what we want from therapy, and the difference between expectations and reality (since my idea of being 'fixed' was unrealistic).

So my first suggestion is to really think about why you are in therapy, what you want from it, and how to make it work for you.

Did your current therapist do an intake session with you? Such as looking at why you wanted therapy, what you want help for, how she can help etc. It might be worthwhile looking over these things and seeing where you are now and whether things have changed. Maybe you could talk about this with your therapist? You could then try reviewing/updating these things to suit your needs now.

I understand the anxiety of not wanting to step in and re-direct the attention of therapist to something that you do want to talk about. What I've noticed that helps me sometimes, is writing things that I'd like to talk about and bringing notes in and making sure those notes are visible/letting the other person read them. It can help to keep things on track.

I agree that it might be worth sticking with your current therapist and trying to put things into practice, and then re-evaluating. But if not, don't forget that though the personality and match between therapist and client is important, there are also loads of different types of therapies too, so it might also be that some approaches might be better/worse for you, depending on what you want out of therapy.


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Re: How do you know when to switch therapists/if a therapist is good for you? - March 4th 2020, 12:01 AM

Those are great ideas from both of you!

As for the "why," I have depression and anxiety and know I need something to cope, and also because I am on medications so I know I shouldn't rely on meds alone. And also also because my med person probably won't let me rely on meds alone.


   
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Re: How do you know when to switch therapists/if a therapist is good for you? - March 5th 2020, 06:02 AM

Hi Dez,

That must be frustrating for you that you go to a therapists for help and it feels like you're not making progress.

I've only really ever had 1 psychologist and 1 mental health nurse which I was at the same time due to my OCD and depression. At the time I was 16 and my mental health nurse couldn't prescribe me with medication. I was seeing more of my mental health nurse to discuss what I was going through and I was only seeing my psychologist about maybe once a month? But both were very good and I'm glad I was assigned them.


   
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Re: How do you know when to switch therapists/if a therapist is good for you? - March 7th 2020, 02:22 PM

Maybe you could start with the "why". You have anxiety and depression and are looking for additional coping skills. That's something you could talk to your therapist about and then if you try some new skills you could assess how it's going.


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Re: How do you know when to switch therapists/if a therapist is good for you? - April 7th 2020, 03:06 AM

Lately therapy has been more of a chore to me than anything and I still can't figure out if it's her or me. I mean before all this quarantine started I was dreading going to appointments and was happy she had to cancel the last one. Then with everything going on it's been a few weeks since I've had any therapy. Now I have a Telehealth meeting Wednesday with her and it's like "ugh, do I have to?" It feels tedious and I still can't tell if I'm making progress.


   
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Re: How do you know when to switch therapists/if a therapist is good for you? - April 8th 2020, 09:10 PM

How did the meeting go?

It seems like overall you are feeling quite negative towards therapy and your therapist. There's nothing necessarily wrong with that per say, but it may impact on your progress. Although, it could be argued that you could still be making progress. There is no 'right' way to do therapy but if you are feeling that therapy is tedious and you are happy when your therapist has to cancel then that may give an indication as to whether this therapist or this therapy is right for you. Of course, you may be going through a rough patch and may prefer to stick it out and see if things improve. Does your therapist know you feel this way? What does she say about it?

Also, you mentioned that you hadn't had therapy in a few weeks. Were you coping okay during this time? Did you notice whether you felt better or worse during this time without therapy?


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Re: How do you know when to switch therapists/if a therapist is good for you? - April 9th 2020, 04:24 AM

I'll start with your last paragraph just because it's the easier one to answer. I've been okay during this time, but it's also been really uneventful. Everything that's going on in the world is concerning but I'm not like worked up about it or depressed about it or anything. When it first started happening I was a bit stressed because of how fast they kicked us out of the dorm, moved to online classes, and then expected us to come back randomly to get our stuff all without much notice. But then that settled. Now I'm just doing my online classes as far as major things go, and the only thing I'm really concerned with is my thesis (but I've made progress on even that, honestly). There are some things that may be a little chaotic when the isolation period is over and a few things that haven't hit me just yet (ie I'm graduating and leaving campus for good, I am in the "real world", etc) but besides that... I'm doing okay. I can't say I don't have SOME depression symptoms right now, but these symptoms could also be from boredom. I'm eating and sleeping all day, haha.

Today's session was really uneventful. Since I had nothing to really talk about, I didn't know what to say. I know eventually some things will hit me like I mentioned above, but they haven't yet.

My therapist doesn't know how I feel and for some reason I don't have the courage to say it in person. I'm thinking maybe I should text her before we have our FaceTime session next week. Maybe I could text her and start out by saying

1. I'm worried I'll have nothing to really talk about for a while as long as I'm isolated, until the major life events actually happen and it hits me. I'm USED to isolation due to depression and a constant state of anxiety, and now I'm forced to isolate. So in that sense it's just another day.
2. I've been feeling really unmotivated in therapy lately and haven't been wanting to go, even before all of the Coronavirus stuff happened, and I'm not sure why it is, and that I'm not sure what I'm getting out of therapy right now.
3. I may need to refocus my goals.

But I'm really afraid of wording it poorly and it sounding rude.


   
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Re: How do you know when to switch therapists/if a therapist is good for you? - April 19th 2020, 06:53 AM

Thank you for you know when to switch therapists
   
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Re: How do you know when to switch therapists/if a therapist is good for you? - May 23rd 2020, 06:31 AM

I'm still thinking about switching therapists, or if possible ending my sessions at this specific office altogether, not just because of this therapist but because I realized how inaccessible the office will be. I don't drive, and even if I did drive I wouldn't want to drive 20-30 minutes away once a week, twice if I have a medication management appointment that week. The reason I was able to access them before was because I was living on campus and was able to get a ride service to appointments by using my dorm address. Now I am at home and the website says they only will take you to the closest local person. That's fine for actual therapy but there aren't a lot of people in my area that take Medicaid. I looked one time and couldn't find any at all in my city or the next city over, for example. The office I am in now I think requires you to see one of their therapists to get medication services.

I was thinking of asking my PCP to take over my medication management. She's done it in the past, although I am not sure if she will now because I am on more medications than I was then. She was prescribing me Effexor and Propranolol (that one for tachycardia) before, but now I am on FOUR medications including those two. I don't see my PCP until August and right now I think they're still doing telehealth but I'm not sure. So, I am thinking about writing a message to my PCP in preparation so everything isn't last minute. Of course this message can only be 1000 characters. I drafted a message to her. I know some parts may sound a little weird but it's because I had to finagle things to get within the character limit. Here's what I am thinking of saying, if anyone can give me their thoughts:

I hope you are doing well! I’m wondering if you’d be willing to prescribe my mental health medication again. I was on Effexor and Propranolol when you last prescribed it. I am still on those medications but also am on Buspar and Lamictal for a total of 4 medications and am stable/doing well. I’m asking bc I realized my prescriber’s office is inaccessible to me now that I’m back home. At school I used a ride program but I don’t think they’ll take me from (MY HOMETOWN) to (THE OFFICE). This office is also where I get my therapy and I’m going to have to look for a new therapist for the same reason, and I think the office has a policy where you have to see one of their therapists to get medication. The problem is the last time my old therapist and I looked we couldn’t find a prescriber in the (MY HOMETOWN)/(NEXT TOWN OVER) area so I may not be able to access my medication without your help. I thought I had time to get something in place, but then Corona came. Can you please share your thoughts/suggestions? Thx!

Please share your thoughts!


   
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Re: How do you know when to switch therapists/if a therapist is good for you? - May 24th 2020, 09:45 PM

I think the message is fine. It gets the point across that you are looking for help with prescribing your medications and that you will have difficulty accessing therapy and medications, now that you are at home and not in school, as you used to be when accessing these services.

Hope your PCP can help you!


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Re: How do you know when to switch therapists/if a therapist is good for you? - May 26th 2020, 11:31 PM

I didn’t hit it lucky, my PCP said if I submit another transit request they might take me from my hometown to the office. :nosweat; So I guess I have no choice but to tell my therapist I want to switch to another one in the office but when and how? It’s so awkward over telehealth, or I could text it but then she still probably would want to call, aaa. Or I could text the person that owns the office but then I would still have to tell my therapist I’m sure.
How and when do I tell her (or the owner if that’s a better option)? It’s not like she did anything wrong. I just have a weird feeling and don’t feel the connection anymore. Should I just tell whichever one y’all think is better that I need a change? Aaaa.


   
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Re: How do you know when to switch therapists/if a therapist is good for you? - May 29th 2020, 09:57 PM

Sorry to hear that!

It is awkward approaching therapists about changing. It's up to you when to broach the subject. You could text her and then let her follow up with a call or discuss it in session. I'm not sure how she may approach the subject...it may be that she wonders what your reasons for wanting to change are, whether there is anything that she could change to help you further, or to start preparing for ending your current sessions. I'm sure therapists have dealt with clients changing or ending therapy 'prematurely' many times so even if it feels awkward, your therapist should be understanding. You could text the person who owns the office, but yeah, you'll still need to follow up with your therapist.

I can't remember if you said or not, but did you bring it up with your therapist that you felt unmotivated with therapy? If not, you could start with saying that you've felt this way for a while and feel that you just don't 'connect' anymore and how that might be affecting your motivation to engage in therapy and that you'd like to explore other therapists. While it's often not recommended to have more than one therapist at a time, equally, you are allowed to 'shop' around so don't feel bad about wanting to switch and finding a new therapist instead.


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Re: How do you know when to switch therapists/if a therapist is good for you? - May 30th 2020, 05:18 AM

True, I haven't told her but I've just been so scared to tell her anything for some reason. Lately I've just been (virtually) going and barely putting much in. But I was having a hard time before too and still haven't said anything. Which is why I was thinking of telling the owner or maybe the person that prescribes my medication instead..


   
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Re: How do you know when to switch therapists/if a therapist is good for you? - May 30th 2020, 03:52 PM

Hmm, I'm wonder if your therapist has noticed a change in how you've been approaching therapy recently...it's a shame if she hasn't as that would provide an opening for you to say what's on your mind. I guess you could approach the owner or someone else first, if you feel it might be easier to get the ball rolling and potentially have them to back you up when it comes to talking with your therapist. That might be a bit more abrupt if your therapist didn't see this coming but she should still respect your wishes and understand that sometimes these things just don't work out...nothings necessarily gone wrong.


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