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  (#1 (permalink)) Old
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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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